bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Peer Support on Colorectal Cancer Patients’ Adherence to Guideline-Concordant Multidisciplinary Care
Authors: Kanters Arielle E. , Morris Arden M. , Abrahamse Paul H. , Mody Lona , Suwanabol Pasithorn A. 
Published: May 2018

BACKGROUND:
Multidisciplinary care is critical for the successful treatment of stage III colorectal cancer, yet receipt of adjuvant chemotherapy remains unacceptably low. Peer support, or exposure to others treated for colorectal cancer, has been proposed as a means to improve patient acceptance of cancer care.

OBJECTIVE:
The purpose of our study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it.

DESIGN:
We conducted a population-based survey of patients with sage III colorectal cancer and compared demographics and adjuvant chemotherapy adherence after patient-reported exposure to peer support.

SETTINGS:
Patients were identified by using Surveillance, Epidemiology, and End Results Program cancer registries and were recruited 3 to 12 months after cancer resection.

PATIENTS:
All patients with stage III colorectal cancer who underwent colorectal resection between 2011 and 2013 and were located in the Detroit and Georgia regions were included.

MAIN OUTCOME MEASURES:
The main outcome measure was adjuvant chemotherapy adherence. Exposure to peer support was an intermediate outcome.

RESULTS:
Among 1301 patient respondents (68% response rate), 48% reported exposure to peer support. Exposure to peer support was associated with younger age, higher income, and having a spouse or domestic partner. Exposure to peer support was significantly associated with receipt of adjuvant chemotherapy (OR, 2.94; 95% CI, 1.89–4.55). Those exposed to peer support reported positive effects on attitudes toward chemotherapy.

LIMITATIONS:
This study has limitations inherent to survey research including the potential lack of generalizability and responses that are subject to recall bias. Additionally, the survey results do not allow for determination of the temporal relationship between peer support exposure and receipt of chemotherapy.

CONCLUSION:
Our study demonstrates that exposure to peer support is associated with higher adjuvant chemotherapy adherence. These data suggest that facilitated peer support programs could positively influence patient expectations and coping with diagnosis and treatment, thereby affecting the uptake of postoperative chemotherapy. See Video Abstract at http://links.lww.com/DCR/A587.
A Population-Based Cohort Analysis of Chemoradiation Versus Radiation Alone for Definitive Treatment of Stage I Anal Cancer in Older Patients
Authors: Buckstein Michael , Arens Yotam , Wisnivesky Juan , Gaisa Michael , Goldstone Stephen , Sigel Keith 
Published: May 2018

BACKGROUND:
Although the benefit of chemoradiation over radiation therapy alone has been shown in randomized trials for stage II to III squamous cell of the anus, this benefit is not clear for patients with stage I cancer. Nevertheless, most societal recommendations endorse chemoradiation for patients with stage I squamous cell carcinoma of the anus despite the lack of proven benefit and potential increase in toxicity.

OBJECTIVE:
The purpose of this study was to determine whether outcomes are improved with the addition of chemotherapy versus radiation alone for stage I squamous cell carcinoma of the anus.

DESIGN:
This was a cohort analysis using Surveillance, Epidemiology and End Results registry linked to Medicare from 1996 to 2011. Propensity-score methods were used to control for potential confounding.

SETTINGS:
This was a population-based study.

PATIENTS:
Medicare eligible patients (age >65 y or with an eligible disability) with stage I squamous cell carcinoma of the anus treated with either definitive radiation alone or chemoradiation were included.

INTERVENTIONS:
Radiation or chemoradiation was the intervention.

MAIN OUTCOME MEASURES:
Overall survival, disease-free survival, cause-specific survival, colostomy-free survival, and acute or late toxicities were measured.

RESULTS:
A total of 200 patients with squamous cell carcinoma of the anus were identified who received chemoradiation versus 99 treated with lone radiotherapy. Median age was 72 years and did not differ by treatment (p = 0.6). Patients receiving chemoradiation had improved unadjusted overall survival compared with lone radiotherapy, but after adjustment using propensity-score methods there was no difference in overall survival (HR = 0.7 (95% CI, 0.4–1.0)), cause-specific survival (HR = 0.7 (95% CI, 0.3–1.6)), colostomy-free survival (HR = 1.1 (95% CI, 0.5–2.5)), or disease-free survival (HR = 0.9 (95% CI, 0.6–1.4)). Chemoradiation was associated with an increased risk of select early and late toxicities.

LIMITATIONS:
This is a retrospective series from an anonymous database. The data might not be relevant for younger, healthier patients.

CONCLUSIONS:
Lone radiation may be associated with adequate oncologic outcomes when used to treat older and sicker patients with stage I anal cancer. Physicians should discuss the potential benefits and harms of adding chemotherapy for the treatment of these patients. See Video Abstract at http://links.lww.com/DCR/A628.
Endovenous Thermal Ablation of Recurrent Varicose Veins due to Residual Great Saphenous Venous Insufficiency After Saphenous Venous Surgery: A Comparative Study
Authors: Hwang Jin Ho , Park Sang Woo , Chang Il Soo , Kim Ki Hyun , Kang Ji Hun 
Published: May 2018

BACKGROUND
Redo surgery for recurrent varicose veins of the great saphenous vein (GSV) is technically more challenging than the initial surgery.

OBJECTIVE
To compare 980 and 1,470-nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) for the treatment of residual GSV insufficiency after saphenofemoral ligation ± stripping.

MATERIALS AND METHODS
Thirty-seven limbs in 29 patients with recurrent varicose veins were retrospectively evaluated. Patients were divided into 3 groups: 980-nm EVLA (group A), 1,470-nm EVLA (group B), and RFA (group C). Duplex ultrasonography, Venous Clinical Severity Score (VCSS), and adverse events were examined at intervals of 1 week, 1, 3, 6, and 12 months.

RESULTS
Complete closure was achieved in 35 (94.6%) limbs at 12 months. Venous Clinical Severity Score decrease in group C (3.6 ± 0.5) was significantly (p < .017) greater compared with that of group A (2.6 ± 0.9). Ecchymosis grade was significantly (p < .017) lower in group C (0.1 ± 0.3) than that in group A (1.6 ± 1.5).

CONCLUSION
Endovenous thermal ablation using EVLA or RFA is safe and effective for treatment of recurrent varicose veins resulting from residual GSV insufficiency after saphenous venous surgery. The RFA is superior to 980-nm EVLA in terms of postprocedural ecchymosis and improvement in VCSS.
A Review of Objective Measurement of Flap Volume in Reconstructive Surgery
Authors: Azzi Alain Joe , Hilzenrat Roy , Viezel-Mathieu Alex , Hemmerling Thomas , Gilardino Mirko 
Published: May 2018

Background:
The utility and efficacy of 3-dimensional representation have been proven in bony reconstruction; however, its role in soft-tissue reconstruction remains limited. There is currently no reliable gold standard to objectively measure flap volume. This systematic review aims to summarize the available techniques used to objectively measure flap volume in reconstructive surgery.

Methods:
A systematic literature search was performed to identify all relevant articles describing objective techniques to quantify flap volume. The search included published articles in 3 electronic databases—Ovid MEDLINE, EMBASE, and PubMed.

Results:
A total of 16 studies were included. Flap volume was calculated using the following techniques: magnetic resonance imaging, computed tomography, 3-dimensional imaging and modeling, material templates, ultrasound, and weighing scales. Techniques and results of the included studies are summarized.

Conclusions:
This systematic review provides a summary of various published techniques for objective pre- or intraoperative quantification of flap volume in reconstructive surgery. The preliminary results from this review are promising, and we believe that 3-dimensional representation and objective quantification is the future of reconstructive flap surgery. More studies are needed to study the clinical relevancy and impact of the various imaging modalities reviewed and to develop automated volumetric measurement technology with improved accuracy, efficacy, and reproducibility.
Closed Posterior Levator Advancement in Severe Ptosis
Authors: Oh Lawrence J. , Wong Eugene , Bae Sol , Tsirbas Angelo 
Published: May 2018

Background:
Repair of blepharoptosis from the posterior eyelid approach has usually been done utilizing a Müller’s muscle-conjuctival resection (MMCR) or an “open sky” technique. We present a new technique to advance the levator muscle from the posterior-approach in a closed fashion that can be used in patients with severe involutional ptosis.

Methods:
A retrospective chart review was performed for consecutive patients with severe involutional blepharoptosis during a 6-year period treated by a single surgeon with a Closed Posterior Levator Advancement. The inclusion criteria were good levator function (≥ 10 mm), graded response to phenylephrine (change in lid height, 0–5 mm), and no concomitant procedures. Severe involutional blepharoptosis was defined as a margin-to-reflex-distance-1 (MRD1) of ≤ 1.5 mm. Follow-up for all patients was a minimum of 9 months. The main outcome variables were MRD1, upper eyelid contour, intereye symmetry, and reoperation rates.

Results:
Three hundred three eyes from 192 patients, with severe ptosis were identified. The average age was 65 years, and the mean preoperative MRD1 was 0.3 mm. Postoperatively, mean MRD1 was 3.5 mm with a median improvement of 3.2 mm. The upper eyelid contour was deemed to be satisfactory by patient and surgeon in 98.3% of eyes. Intereye symmetry was excellent in 96% of our cohort. An overall revision rate of 1.8% was found.

Conclusions:
We present a new technique that involves an advancement of the levator muscle in a closed posterior eyelid approach. The technique has produced satisfactory outcomes in our cohort of patients with severe ptosis with a low revision rate.
A New Dual-purpose Quality Control Dosimetry Protocol for Diagnostic Reference-level Determination in Computed Tomography
Authors: Sohrabi Mehdi , Parsi Masoumeh , Sina Sedigheh 
Published: May 2018

Abstract
A diagnostic reference level is an advisory dose level set by a regulatory authority in a country as an efficient criterion for protection of patients from unwanted medical exposure. In computed tomography, the direct dose measurement and data collection methods are commonly applied for determination of diagnostic reference levels. Recently, a new quality-control-based dose survey method was proposed by the authors to simplify the diagnostic reference-level determination using a retrospective quality control database usually available at a regulatory authority in a country. In line with such a development, a prospective dual-purpose quality control dosimetry protocol is proposed for determination of diagnostic reference levels in a country, which can be simply applied by quality control service providers. This new proposed method was applied to five computed tomography scanners in Shiraz, Iran, and diagnostic reference levels for head, abdomen/pelvis, sinus, chest, and lumbar spine examinations were determined. The results were compared to those obtained by the data collection and quality-control-based dose survey methods, carried out in parallel in this study, and were found to agree well within approximately 6%. This is highly acceptable for quality-control-based methods according to International Atomic Energy Agency tolerance levels (±20%).
POSTERIOR SCLERAL CONTRACTION TO TREAT RECURRENT OR PERSISTENT MACULAR DETACHMENT AFTER PREVIOUS VITRECTOMY IN HIGHLY MYOPIC EYES
Authors: Zheng Linyan , Pan Anpeng , Zhu Shuangqian , Wu Yue , Dong Liang , Xue Anquan 
Published: May 2018

Purpose:
To determine the efficacy of posterior scleral contraction (PSC) to treat recurrent or persistent macular detachment after previous vitrectomy in highly myopic eyes.

Methods:
We reviewed the medical records of patients with high myopia and recurrent or persistent macular detachment after previous vitrectomy treated with PSC at our hospital between April 2013 and March 2017. Fourteen eyes (14 patients; mean age, 58.93 ± 11.08 years) were included. Sclera cross-linked with genipin was used for PSC. The desired axial length decrease was 0.1-fold. The reattachment rate, best-corrected visual acuity, and axial length changes were evaluated.

Results:
The macular reattachment rate was 100%. In seven eyes with a silicone oil tamponade, the oil was successfully removed 2 weeks to 4 months after surgery. The best-corrected visual acuity improved significantly postoperatively (Snellen acuity improved from 20/1,000–20/400) (1.75 ± 0.90 vs. 1.34 ± 0.58 logarithm of the minimal angle of resolution; P < 0.05). Eight eyes (57.14%) improved; six eyes (43.86%) remained stable. The axial length decreased significantly postoperatively (31.32 ± 3.04 vs. 29.08 ± 3.05 mm; P < 0.05).

Conclusion:
Posterior scleral contraction is safe and effective for recurrent and persistent macular detachment after previous vitrectomy in highly myopic eyes. The silicone oil is removed after PSC, and vision can be preserved in these refractory cases.
ACCELERATED ONSET OF RETINAL TOXICITY FROM HYDROXYCHLOROQUINE USE WITH CONCOMITANT BREAST CANCER THERAPY
Authors: Sharma Aman , Maiz Alejandra M. , Tucker William R. , Cukras Catherine 
Published: May 2018

Purpose:
To report a case of accelerated retinal toxicity due to hydroxychloroquine (HCQ) use for treatment of Sjögren syndrome in a patient treated with concomitant chemotherapy for breast cancer.

Methods:
Observational case report.

Results:
A 56-year-old white woman using 400 mg HCQ (7.1 mg/kg real body weight) daily for a total of 2 years and 10 months for treatment of Sjögren syndrome with concomitant use of docetaxel and cyclophosphamide therapy (21-day cycle, 4 cycles) followed by anastrozole for breast cancer, presented with visual complaints and findings of severe HCQ toxicity.

Conclusion:
Concomitant breast cancer therapy may have a synergistic effect with HCQ leading to accelerated retinal toxicity. As such potential acceleration is poorly understood, patients on HCQ who are treated with concomitant chemotherapy should be considered for more frequent retinal screenings to maximize safety and preservation of vision.
A Case of Corneal Neovascularization Misdiagnosed as Total Limbal Stem Cell Deficiency
Authors: Le Qihua , Samson C. Michael , Deng Sophie X. 
Published: May 2018

Purpose:
To report a case of corneal neovascularization misdiagnosed as total limbal stem cell deficiency (LSCD).

Methods:
This is a case report of a 61-year-old woman who has a history of bilateral idiopathic scleritis, keratitis, and uveitis for more than 20 years. She was diagnosed with total LSCD in her left eye based on clinical presentation alone and was confirmed as a candidate for limbal transplantation at several major tertiary eye care centers in the United States. After referral to the Stein Eye Institute, in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) were performed to clarify the diagnosis.

Results:
Slit-lamp examination of the left eye revealed 360-degree severe thinning at the limbus and peripheral corneal pannus and neovascularization that spared the central cornea, a smooth epithelium without fluorescein staining at the central cornea, an uneven surface, and pooling of fluorescein at the peripheral cornea accompanied by minimal fluorescein staining of the sectoral peripheral epithelium. IVCM showed that epithelial cells in the central cornea exhibited a corneal phenotype and that the morphology of the epithelium in all limbal regions except the nasal limbus was normal. Epithelial cellular density and thickness were within the normal range. AS-OCT showed severe thinning in the limbus and a normal epithelial layer in the cornea and limbus. Based on the findings of IVCM and AS-OCT, we concluded that the patient had minimal LSCD, and limbal stem cell transplantation was not recommended.

Conclusions:
Clinical presentation alone is insufficient to correctly diagnose LSCD in complex cases. Additional diagnostic tests, such as IVCM, are necessary to confirm the diagnosis before any surgical intervention.
Interface Fungal Keratitis After Descemet Stripping Automated Endothelial Keratoplasty: A Review of the Literature With a Focus on Outcomes
Authors: McElnea Elizabeth , Power Billy , Murphy Conor 
Published: May 2018

Purpose:
To examine the management and associated outcomes of reported cases of interface fungal infection after Descemet stripping automated endothelial keratoplasty (EK).

Methods:
A literature review identified reports of interface fungal infection after Descemet stripping automated EK. Data retrieved from the same included patient demographics, surgical procedure undertaken, donor rim culture result, clinical course, and outcome. A review of the relevant literature was also conducted.

Results:
Twenty-four cases of interface fungal infection after Descemet stripping automated EK were analyzed. Mean age of those affected was 66 years with range 52 to 85 years. Interface fungal infection after Descemet stripping automated EK was noted at a mean of 49.2 days postoperatively. Candida species were the causative infection in 79% cases. Penetrating keratoplasty was eventually performed in 79% of cases. The mean posttreatment best-corrected visual acuity was 0.44 logMAR.

Conclusions:
Penetrating keratoplasty is frequently required to eliminate interface fungal infection after Descemet stripping automated EK. A satisfactory visual outcome is usually achieved.
Radiotherapy for Active Thyroid Eye Disease
Authors: Godfrey Kyle J. , Kazim Michael 
Published: May 2018

Purpose:
To critically review the published literature on orbital radiotherapy as a treatment modality for thyroid eye disease (TED).

Methods:
A systematic review and analysis of the relevant published literature was performed.

Results:
Thyroid eye disease is an autoimmune condition that is amenable to treatments that modulate the immune response, including orbital radiotherapy (ORT). Ideal candidates for ORT are patients in the early, active phase of TED with moderate to severe, or rapidly progressive, disease, including patients with significant motility deficits and compressive optic neuropathy. Patients with progressive strabismus may also benefit. Patients with mild or inactive disease will not benefit from ORT when compared with the natural history of the disease. Orbital radiotherapy should generally be used in conjunction with corticosteroid therapy, with response to corticosteroids demonstrating the immunomodulatory therapeutic potential of ORT. When treating TED-compressive optic neuropathy, ORT may help obviate the need for urgent surgical decompression, or postpone it until the stable, inactive phase of the disease. Orbital radiotherapy treatment doses should approach 20 Gy in most cases, but lower doses may be considered in younger patients without significant dysmotility. The safety profile of ORT is well established, and side effects are minimal in appropriately selected patients.

Conclusions:
Radiotherapy is a safe and effective treatment for active TED in appropriately selected patients.
Anatomic Variations of the Infraorbital Foramen in Caucasian Versus African American Skulls
Authors: Zhang Kevin R. , Blandford Alexander D. , Hwang Catherine J. , Perry Julian D. 
Published: May 2018

Purpose:
The infraorbital foramen (IOF) represents a highly conserved structure but demonstrates morphologic variability. The purpose of this study is to describe the IOF location, size, and supernumerary foramina in an African American population and compare it with a Caucasian population.

Methods:
Sixty African American and 60 Caucasian skulls from the Hamann-Todd collection of the Cleveland Museum of Natural History were studied. The primary outcome was the number of accessory IOF and measurements of the location, size, shape, and direction of each foramen. Pearson chi-square, t tests, Fisher exact test, and Wilcoxon rank sum tests were used to analyze the data.

Results:
The African American population had a smaller vertical IOF diameter (mean = 2.81 mm) compared with the Caucasian population (mean = 3.08 mm) on the right side (p < 0.01). The distance from the IOF to the anterior nasal spine on the left side was greater in the African American population (mean = 33.93 mm) compared with the Caucasian population (Caucasian mean = 32.84 mm, p = 0.03). The distance from the IOF to the zygomaticomaxillary suture was significantly shorter in the African American population (mean = 11.85 mm) compared with the Caucasian population (mean = 13.21 mm) on the left side (p = 0.01). Accessory foramina were found in 13 Caucasian skulls (21.7%) and 6 African American skulls (10%; p = 0.08). Two distinct types of IOF existed in each population, one close to the main foramen and one within the sutura notha.

Conclusions:
The IOF is smaller and exits more laterally, with a lower proportion of accessory foramina in an African American population compared with a Caucasian population. Both groups exhibit 2 distinct types of IOF. These morphologic differences should be noted during surgeries and anesthetic planning to avoid neurovascular complications.
Health Outcomes of Youth in the United States Exposed to Parental Incarceration: An Integrative Review
Authors: Boch Samantha J. , Ford Jodi L. 
Published: May 2018

ABSTRACT
In the United States, parental incarceration (PI) has been increasingly recognized as an understudied adverse childhood experience. In response, a rapidly expanding body of research has begun to investigate the effects of PI on youth mental and physical health outcomes.

Objective:
The purpose of this integrative review was to synthesize recent quantitative evidence investigating the effects of PI on youths' mental and physical health outcomes.

Design and Measures:
Electronic strategies were used to find relevant quantitative articles published between September 2006 and 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Equity guidelines. Articles in the review (N = 17) varied in study design and methodologic rigor, complicating the analysis.

Results:
In general, U.S. youth exposed to PI are more likely than their unexposed peers to exhibit internalizing and externalizing behavioral difficulties. There is substantially less evidence on the associations between PI and the physical health of youth, in addition to the proposed linkages between exposure to PI and poor health. Overall, there is limited inclusion of contextual specifics of PI (e.g., type and duration of incarceration, relationship quality), which hampers generalizability.

Conclusion:
Future research could investigate the biological and social linkages between PI and health outcomes. Forensic nurses could help build supportive environments and meaningful behavioral health interventions to assist the health of those youth with a parent incarcerated.