bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal and Scleral Problems Caused by Skin-Lightening Creams
Authors: Hollick Emma J. , Igwe Chinedu , Papamichael Esther , Gore Daniel M. , Angunawela Romesh I. , Philippidou Marianne , Jones Sophie M. 
Published: June 2019

Purpose:
To present a case series of patients with corneal and scleral changes associated with the use of skin-lightening creams. This is the first report of corneal changes with these widely available creams.

Methods:
Three patients of West African origin presented with strikingly similar skin, corneal, and scleral changes and were found to have all been using skin-lightening creams containing hydroquinone. Histopathology was obtained for 1 patient.

Results:
Three patients were referred to the corneal clinics of 2 hospitals with corneal changes and a history of blurred vision for 1 to 3 years. There was a 60-year-old woman from Nigeria and a 68-year-old woman and a 73-year-old man both from Ghana. All 3 had been using skin-lightening lotions containing hydroquinone on their faces for between 3 and 15 years and had black-blue facial pigmentation of exogenous ochronosis, a recognized complication of these creams. Their corneas all had horizontal striae radiating across the posterior corneas with scleral thinning and plaques. Linear brown epithelial pigmentation was observed within the lower third of the corneas. Biopsy of the sclera in 1 patient showed ochronosis.

Conclusions:
We present previously unreported eye changes associated with the use of skin-lightening creams containing hydroquinone, with a triad of signs: posterior corneal striae radiating from 3 o'clock to 9 o'clock, thinning and plaques in the sclera, and a normal endothelial cell count. Similar pathological changes are seen in exogenous ochronosis, a recognized skin complication of hydroquinone, are seen in the sclera.
Sensory Adaptation to Silicone Hydrogel Contact Lens Wear Is Not Associated With Alterations in the Corneal Subbasal Nerve Plexus
Authors: Kocabeyoglu Sibel , Colak Dilan , Mocan Mehmet C. , Irkec Murat 
Published: June 2019

Purpose:
To evaluate corneal subbasal nerve alterations in contact lens (CL)-naive silicone hydrogel CL wearers and to investigate the relationship between structural subbasal nerve changes with corneal sensitivity.

Methods:
Twenty eyes of 20 neophyte daily silicone hydrogel CL wearers and 20 eyes of age-matched control subjects were recruited for this prospective longitudinal study. Corneal subbasal nerve densities were evaluated using in vivo confocal microscopy. Central corneal tactile sensitivity was measured using Cochet–Bonnet esthesiometers. In vivo confocal microscopy and Cochet–Bonnet esthesiometry were performed before and at the 6-month time point after the initiation of CL wear. Two-way repeated measures analysis of variance, χ2, and Wilcoxon signed-rank tests were used for statistical analyses.

Results:
The mean ages of CL users and control subjects were 21.8 ± 1.8 years (range = 19–24 years) and 21.5 ± 2.3 years (range = 20–24 years), respectively (P = 0.579). Compared with their baseline values, there were no significant changes at the 6-month follow-up period in the mean total subbasal nerve fiber length (2266.6 ± 414.6 vs. 2277.9 ± 405.0 μm/frame; P = 0.432), mean total subbasal nerve branch density (10.4 ± 1.5 vs. 10.5 ± 1.3 nerves/frame; P = 0.655), or the mean long nerve fiber density (4.7 ± 0.7 vs. 4.8 ± 0.7 nerves/frame; P = 0.564) of CL users. Mechanical corneal sensitivity remained unaltered during the 6-month period in CL users (11.2 ± 0.5 vs. 11.2 ± 0.5; P = 1.000). No significant changes were observed in the subbasal nerve plexus or corneal tactile sensitivity of the control subjects during the study interval.

Conclusions:
Sensory adaptation to CL wear is not mediated through attenuation of the subbasal nerve or reduction of corneal tactile sensitivity in CL-naive users.
Evaluating Immunopathogenic Biomarkers During Severe Malaria Illness as Modifiers of the Neuropsychologic Benefits of Computer Cognitive Games Rehabilitation in Ugandan Children
Authors: Boivin Michael J. , Sikorskii Alla , Nakasujja Noeline , Ruiseñor-Escudero Horacio , Familiar-Lopez Itziar , Opoka Robert O. , Giordani Bruno 
Published: June 2019

Background:
We explored 3 immunopathogenic biomarkers collected during acute malaria illness as potential moderators of gains from a computerized cognitive rehabilitation training (CCRT) intervention.

Method:
Von Willebrand Factor (vWF), tumor necrosis factor (TNF) and Regulated on Activation, Normal T Expressed and Secreted (RANTES) were assayed from plasma and cerebral spinal fluid (CSF) of children during acute severe malaria anemia or cerebral malaria. Two years after acute malaria illness, 150 surviving children and 150 nonmalaria community controls (CCs) from their households 6–12 years old entered a 3-arm randomized controlled trial of titrating and nontitrating CCRT against no CCRT. Tests of cognition [Kaufman Assessment Battery for Children (KABC)], Tests of Variables of Attention and Achenbach Child Behavior Checklist (CBCL) were administered before and after 24 CCRT sessions over a 3-month period, and at 1-year follow-up. Differences in outcomes by trial arms and biomarker levels were evaluated using linear mixed effects models.

Results:
Severe malaria survivors with lower levels of vWF, lower CSF levels of TNF and higher levels of plasma and CSF RANTES had better KABC cognitive performance after both titrating and nontitrating CCRT compared with no CCRT. For the CBCL, high plasma RANTES was associated with no benefit from either the titrating and nontitrating CCRT, whereas high TNF plasma was predictive of the benefit for both interventions. These biomarker moderating effects were not evident for CC children.

Conclusions:
Severe malaria immunopathogenic biomarkers may be related to poorer long-term brain/behavior function as evidenced by diminished benefit from a computerized cognitive rehabilitation intervention.
Vancomycin-associated Nephrotoxicity and Risk Factors in Critically Ill Children Without Preexisting Renal Injury
Authors: Feiten Helen dos Santos , Okumura Lucas Miyake , Martinbiancho Jacqueline Kohut , Andreolio Cinara , da Rocha Taís Sica , Antonacci Carvalho Paulo Roberto , Pedro Piva Jefferson 
Published: June 2019

Background:
A recent systematic review concluded that critically ill pediatric patients have higher odds of vancomycin-related nephrotoxicity [odds ratio (OR): 3.61, 95% CI: 1.21–10.74]. We aimed to assess the incidence and risk factors for vancomycin-associated nephrotoxicity in critically ill children without preexisting renal injury.

Methods:
A cohort of children admitted to a pediatric intensive care unit, from 2011 to 2016 treated with vancomycin without preexisting renal injury. The main diagnosis, therapeutic interventions and medications administered in this period were evaluated. Generalized estimating equation models were used to assess the association between clinical covariates and the dependent variable pediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE).

Results:
Hundred ten patients, representing 1177 vancomycin days, were analyzed. Vancomycin-associated nephrotoxicity was seen in 11.8%. In a multivariate model, higher vancomycin doses were not associated with poorer renal function (P = 0.08). Higher serum vancomycin levels were weakly associated with pRIFLE classification (OR: 1.05, 95% CI: 1.02–1.07). Furosemide or amphotericin B in addition to the vancomycin treatment was associated with impaired renal function (OR: 2.56, 95% CI: 1.38–4.8 and OR: 7.7 95% CI: 2.55–23, respectively).

Conclusions:
Vancomycin-associated nephrotoxicity in acute ill children without preexisting renal injury, measured with pRIFLE, is close to 11.8%. Furosemide and amphotericin B in addition to the vancomycin treatment are strong predictors of worse pRIFLE scores. The influence of acute kidney injury status at pediatric intensive care unit admission and the method used for renal function assessment might influence the incidence of vancomycin-associated nephrotoxicity and its associated risk factors.
Altered microbiome composition in individuals with fibromyalgia
Authors: Minerbi Amir , Gonzalez Emmanuel , Brereton Nicholas J.B. , Anjarkouchian Abraham , Dewar Ken , Fitzcharles Mary-Ann , Chevalier Stéphanie , Shir Yoram 
Published: June 2019

AbstractFibromyalgia (FM) is a prevalent syndrome, characterised by chronic widespread pain, fatigue, and impaired sleep, that is challenging to diagnose and difficult to treat. The microbiomes of 77 women with FM and that of 79 control participants were compared using 16S rRNA gene amplification and whole-genome sequencing. When comparing FM patients with unrelated controls using differential abundance analysis, significant differences were revealed in several bacterial taxa. Variance in the composition of the microbiomes was explained by FM-related variables more than by any other innate or environmental variable and correlated with clinical indices of FM. In line with observed alteration in butyrate-metabolising species, targeted serum metabolite analysis verified differences in the serum levels of butyrate and propionate in FM patients. Using machine-learning algorithms, the microbiome composition alone allowed for the classification of patients and controls (receiver operating characteristic area under the curve 87.8%). To the best of our knowledge, this is the first demonstration of gut microbiome alteration in nonvisceral pain. This observation paves the way for further studies, elucidating the pathophysiology of FM, developing diagnostic aids and possibly allowing for new treatment modalities to be explored.
Preservation of Vestibular Function and Residual Hearing After Round Window Cochlear Implantation
Authors: Stuermer Konrad Johannes , Kluenter Heinz Dieter , Lang-Roth Ruth , Schwarz David , Hüttenbrink Karl-Bernd , Anagiotos Andreas 
Published: June 2019

Objective:
To examine the possible correlation between the loss of short-term residual hearing and vestibular function after cochlear implantation (CI).

Study Design:
Retrospective patient review.

Setting:
Academic tertiary referral center.

Patients:
One hundred twenty patients with normal vestibular function (VF) in the caloric testing and residual hearing (RH) at the frequencies 250, 500, and 1000 Hz on the surgery side between 2008 and 2016 were included in the study.

Intervention:
Primary CI on the first side via round window with a conventional full-length electrode.

Main Outcome Measures:
Changes of RH and VF 7 weeks after surgery were analyzed. Preservation of RH was defined as measurable postoperative thresholds at the frequencies 250, 500, and 1000 Hz in the pure-tone audiogram. Preservation of the VF after CI was assessed both by an absolute and relative threshold in the caloric testing.

Results:
Seven weeks after implantation, the preservation of RH was achieved in 52 (43.3 %) patients and the preservation of VF in 95 (79.2 %) patients on the operated side. There was no significant statistical correlation between these two parameters.

Conclusion:
The loss of RH was more than twice as frequent as the loss of VF. However, no statistical correlation between the failure of the two inner ear functions was found. The exact causes are still unknown, but our data could give an indication that there may be different underlying pathomechanisms.
Bilateral Cochlear Implantation in Vogt-Koyanagi-Harada Syndrome: A Case Report
Authors: AlHelali Nora , Hajr Eman , Almuhawas Fida , Hagr Abdulrahman 
Published: June 2019

Objective:
To evaluate cochlear implantation in Vogt-Koyanagi-Harada syndrome with regard to surgical difficulties and hearing outcomes.

Patients:
Single case report.

Intervention(s):
Therapeutic complete electrode insertion during surgery despite evident intra-cochlear fibrosis.

Main Outcome Measure(s):
Postoperative speech audiometry, categories of auditory performance, and speech intelligibility rating.

Results:
Vogt-Koyanagi-Harada syndrome is a multisystem autoimmune disease that affects tissues containing melanin. It is characterized by bilateral uveitis with auditory, vestibular, and dermatologic manifestations. Standard treatment comprises aggressive administration of systemic corticosteroids.
This report describes the use of bilateral cochlear implants in a 30-year-old Saudi woman who presented with uveitis and was diagnosed with Vogt-Koyanagi-Harada syndrome. She had progressive hearing loss in both ears and experienced minimal improvement with hearing aids. The patient underwent sequential cochlear implantation, which was challenging because it was difficult to insert the electrode in the right ear due to intra-cochlear fibrosis. After more than 5 years of follow-up, she has good hearing in both ears, despite the advancement of ocular disease and recurring visual complaints.

Conclusion:
This study suggests that patients with Vogt-Koyanagi-Harada syndrome could develop intra-cochlear fibrosis during cochlear implantation due to the autoimmune nature of disease. Moreover, cochlear implantation becomes more difficult with disease advancement. Therefore, it is essential that healthcare professionals consider early detection and prompt treatment of hearing loss in patients with this syndrome.
Negative Predictive Value of Non-Echo-Planar Diffusion Weighted MR Imaging for the Detection of Residual Cholesteatoma Done at 9 Months After Primary Surgery Is not High Enough to Omit Second Look Surgery
Authors: Horn Roelof J. , Gratama Jan Willem C. , van der Zaag-Loonen Hester J. , Droogh-de Greve Kitty E. , van Benthem Peter-Paul G. 
Published: June 2019

Objectives:
To evaluate non echo-planar diffusion weighted magnetic resonance imaging (non-EP DW MRI) at 9 months after primary surgery to rule out residual cholesteatoma in patients scheduled before second-look-surgical exploration.

Study Design:
Prospective observational study.

Setting:
Secondary teaching hospital.

Patients/Interventions:
Patients who were scheduled for second-look-surgery after primary canal wall up repair of cholesteatoma underwent 1.5 T MRI including non-EP DWI and high-resolution coronal T1 and T2-FS SE sequences.

Main Outcome Measures:
Imaging studies were evaluated for the presence of cholesteatoma by three independent observers. Intraoperative observations were regarded the standard of reference. Ear, nose, throat (ENT) surgeons were blinded for imaging findings. The primary outcome was the negative predictive value (NPV) of MR imaging, secondary outcomes were sensitivity, specificity, and positive predictive value.

Results:
Thirty-three patients underwent both MRI and surgery, among whom 22 had a cholesteatoma. Mean time between primary surgery and MRI was 259 days (standard deviation [SD] 108). NPV of non-EP DW MRI in detecting recurrent cholesteatoma was 53% (95% CI: 32–73%). Sensitivity and specificity were 59% (39–77%) and 91% (62–98%), respectively. The positive predictive value was 93% (69–99%). In five out of nine false-negative cases, recurrent cholesteatoma measured 3 mm or less. Using a 3 mm detection threshold, NPV increased to 79%.

Conclusion:
Non-EP DW MRI cannot replace second look surgery in ruling-out residual cholesteatoma at 9 months after primary surgery. It could be used in a follow-up strategy in low risk patients. Further research is needed which types of residual cholesteatoma are not revealed by MRI.
A Validated Questionnaire to Assess the Severity of Persistent Postural-Perceptual Dizziness (PPPD): The Niigata PPPD Questionnaire (NPQ)
Authors: Yagi Chihiro , Morita Yuka , Kitazawa Meiko , Nonomura Yoriko , Yamagishi Tatsuya , Ohshima Shinsuke , Izumi Shuji , Takahashi Kuniyuki , Horii Arata 
Published: June 2019

Objective:
To establish a questionnaire to diagnose and assess the severity of persistent postural-perceptual dizziness (PPPD).

Study Design:
Retrospective chart review.

Setting:
Tertiary referral center.

Patients:
Fifty PPPD patients and 50 consecutive control patients with other vestibular disorders.

Interventions:
Patients answered questions on three exacerbating factors of PPPD (upright posture/walking, movement, and visual stimulation), and each factor was evaluated using four questions scoring the severity from 0 (none) to 6 (unbearable). Somatic and psychological distress was evaluated by the Visual Analog Scale (VAS) and the Hospital Anxiety and Depression Scale (HADS), respectively.

Main Outcome Measures:
The questionnaire's reliability was tested by Cronbach's alpha, and it was validated by examining the differences in the questionnaire's scores between PPPD patients and controls. The area under the curve (AUC) of the receiver operating characteristic curve for each factor was calculated.

Results:
Cronbach's alpha coefficient was >0.8 for all factors, except the movement factor. There were no significant differences in the VAS and HADS scores between the two groups. However, the combined and individual questionnaire scores for each factor were higher in PPPD patients than in controls, indicating the questionnaire's high validity. The AUC was widest for the visual stimulation factor (0.830), and a score of 9 (full score 24) had the best sensitivity (82%) and specificity (74%) for discriminating PPPD patients from controls.

Conclusions:
We developed a questionnaire that exhibited high reliability and validity in evaluating PPPD severity. The visual stimulation factor may be the most characteristic among the three exacerbating factors.
Endre Hőgyes (1847–1906), Forgotten Father of the Vestibulo-Ocular Reflex
Authors: Tamás László T. , Mudry Albert 
Published: June 2019

Objective:
Throughout the history of vestibular research, the discovery of the vestibulo-ocular reflex in 1881 by Endre Hőgyes (1847–1906) is rarely mentioned. The aim of this study is to review Hőgyes’ vestibular research articles, all originally written in Hungarian and emphasize their epoch-making content.

Main Data Sources:
Hőgyes’ vestibular publications, originally written in Hungarian, which describe various eye movements of the rabbit in response to vestibular stimulation by rotation about three axes.

Results:
Hőgyes was the first to use a three-axis turntable on an experimental animal, in this case a rabbit. He found that depending on the plane of rotation, different types of binocular eye movements were produced. He then demonstrated by destructive and excitatory experiments, the anatomical pathways and the physiological function producing this phenomenon. Ultimately, he explained the exact connections between the inner ear labyrinth and certain muscle contractions during eye movements. He identified this pathway as the “associating center of the ocular movements,” later defined as the vestibulo-ocular reflex. Hőgyes’ discovery was only superficially noted during his lifetime and ignored after his death.

Conclusion:
Hőgyes was the first to demonstrate the vestibulo-ocular reflex. He was forgotten during the ensuing 140 years probably because his articles were appeared only in Hungarian and because a short time later, Róbert Bárány's award of the Nobel Prize overshadowed many of Bárány's predecessors and contemporaries, including Hőgyes and relegated them to the background.
Efficacy and safety of treatment of chronic hepatitis C with sofosbuvir and ribavirin with or without peginterferon: a French prospective real-life cohort study of unselected 211 patients
Authors: Garioud Armand , Heng Ratmony , Amiot Xavier , Rémy André-Jean , Ollivier-Hourmand Isabelle , Mokhtari Camelia , Medmoun Mourad , Renou Christophe , Zougmoré Honoré , Pulwermacher Philippe , Lucidarme Damien , Rosa-Hézode Isabelle , Causse Xavier , Arotcarena Ramuntcho , Zanditenas David , Halfon Philippe , Pariente Alexandre , Cadranel Jean-François ,   Association Nationale des Hépato-gastroentérologues des Hôpitaux Généraux (ANGH), France
Published: June 2019

Introduction
Sofosbuvir is the first directly-acting antiviral for the treatment of hepatitis C virus. First, the regimens were combinations with sofosbuvir+ribavirin (SR) or with sofosbuvir+ribavirin and pegylated-interferon α-2a (SPR) with cure rates around 90%. The aim of this study was to report the results of these combinations in ‘real-life’ in France.

Materials and methods
Main features of patients treated with SR or SPR in 24 hospitals were collected. Undetectable hepatitis C virus week 12 viral load after treatment defined sustained virological response (SVR12). Statistics were performed using StatView software for descriptive analysis and χ
2 for the sub-groups comparisons.

Results
Two hundred and eleven patients were analyzed. The average age was 56.1. One hundred and seventy-one (89%) patients had a fibrosis score of at least 3. Seventy-nine patients were infected by a genotype 1 (G1). One hundred and thirteen patients were treated with SR and 95 with SPR. In naive patients: with SPR for 12 weeks, SVR12 was 93% in G1, 100% in G3 and 83% in G4. With SR for 12 weeks, SVR12 was 100% in G2 patients (6/6). The safety of these regimens was satisfactory with only two patients who had to stop P due to severe side effects. Multivariate analysis shows a higher SVR in SPR versus SR (odds ratio = 1.28; P = 0.05) and in G2 or G3 versus others (odds ratio = 1.56; P = 0.04). Moreover, Child–Pugh score B or C (P = 0.02), platelets count under 100G/l (P = 0.05) or a past event of ascites (P = 0.04) was independently associated with less SVR.

Conclusion
This multicenter large study confirms the good results of SR for 12 weeks in G2 naive patients. Finally, a decompensated cirrhosis, a past event of ascites and a baseline low platelet count were strongly associated with poor response.
Contemporary management of orbital blowout fractures
Authors: Homer Natalie , Huggins Alison , Durairaj Vikram D. 
Published: June 2019

Purpose of review
Orbital floor blowout fractures may lead to significant morbidity, including debilitating double vision and globe malposition. Thorough evaluation and timely surgical intervention may prevent long-term sequelae.

Recent findings
New studies have demonstrated certain patients with orbital floor fractures to do well when managed conservatively. In those necessitating operative repair, precise surgical dissection and adequate fracture reduction are essential to restoring orbital anatomy and function. Novel surgical techniques and orbital floor reconstruction materials, described in this review, will further optimize patient outcomes.

Summary
A knowledgeable evaluation, thoughtful management strategy and modernized surgical technique can prevent long-term disability in patients with orbital floor blowout fractures.
The Work-Role Transition of Part-time Clinical Faculty
Authors: Wenner Teresa A. , Hakim Amy Cooper , Schoening Anne M. 
Published: June 2019

Background
Part-time clinical nurse educators who simultaneously work in both a clinical and an academic setting experience a unique work-role transition. Identifying and addressing their needs during this time may assist in new faculty retention.

Purpose
As part of a larger study examining the work-role transition of part-time clinical nurse faculty, a specific research question was developed to determine how these individuals experience the phases of the Nurse Educator Transition (NET) model.

Methods
This qualitative phenomenological study used both purposive and snowball sampling to recruit 14 RNs who were part-time clinical educators.

Results
Study findings validated all 4 phases of the NET model. In addition, several participants indicated a sense of returning to the first 2 phases of transition at the beginning of new semesters and courses.

Conclusion
The NET model is applicable to the part-time clinical nurse educator population. This theory can be used as a framework to design orientation and mentorship programs that specifically target part-time clinical nurse educators.