bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathology of Hand–Foot–Mouth Disease in Adults and Criteria for Differentiation From Erythema Multiforme
Authors: Böer-Auer Almut , Metze Dieter 
Published: September 2018

Background:
Hand–foot–mouth disease (HFMD) is a common contagious viral infection usually affecting infants and children. Recently, literature on HFMD in adults is increasing. It has been reported that adults often present with unusual exanthems with similarities to erythema multiforme (EM). No study has so far compared the histologic features of HFMD with those of EM.

Methods:
Histopathologic features in 7 biopsies of 6 adult patients with HFMD are compared with biopsies from 9 patients with EM to identify the best criteria for differentiation.

Results:
HFMD and EM both have a perivascular lymphocytic infiltrate together with epidermal necrosis, spongiosis, ballooning, and reticular alteration. However, large numbers of neutrophils in parakeratosis (P < 0.05), in the viable epidermis (P < 001), or neutrophils forming intraepidermal collections (P < 0.05) are significantly more common in HFMD. In HFMD, necrotic keratinocytes are emphasized in the upper third of the epidermis (P < 0.05), whereas the lower third is typically involved more in EM. Neutrophils are significantly more common and more numerous in the dermal infiltrate of HFMD compared with EM (P < 0.01) Extravasated erythrocytes in the epidermis are more common and more numerous in HFMD (P < 0.05).

Conclusions:
Lesions of EM and HFMD can be differentiated based on the amount of neutrophils in the epidermis and in the dermal infiltrate, which are significantly more numerous in HFMD. In addition, necrosis is emphasized in the upper part of the epidermis in HFMD and in the lower part of it in EM.
Follicle and Sebaceous Gland Multinucleated Cells in Measles
Authors: Magdaleno-Tapial Jorge , Valenzuela-Oñate Cristian , Giacaman-von der Weth Macarena , Ferrer-Guillén Blanca , García-Legaz Martínez Marta , Martínez-Domenech Álvaro , Hernández-Bel Pablo , Alegre-de Miquel Víctor 
Published: September 2018

Abstract:
We report the case of a 32-year-old man with measles in which skin biopsy helped to establish a definitive diagnosis. Follicular involvement is a common histopathologic feature of measles. Multinucleated epidermal and follicular cells are distinctive findings.
Mixing of Injectable Fillers: A National Survey
Authors: Libby Tiffany J. , Williams Ramone F. , El Habr Constantin , Tinklepaugh Adam , Ciocon David 
Published: September 2018

BACKGROUND
The mixing of hyaluronic acid or calcium hydroxylapatite fillers with normal saline, plain lidocaine, or lidocaine with epinephrine before injection is a familiar practice among dermatologists. However, the frequency of this practice and rationale behind it has not been well studied.

OBJECTIVE
To better elucidate the clinical practice of mixing fillers with other solutions before injecting among dermatologists.

METHODS
A survey was electronically distributed to members of the American Society for Dermatologic Surgery.

RESULTS
Four hundred seventy-five dermatologists responded to the survey. Thirty-five percent of respondents mix fillers before injection. Solutions used were as follows: plain lidocaine (44%), lidocaine with epinephrine (36%), normal saline (30%), and sterile water (7%). Respondents mix filler for the following reasons: to decrease viscosity (40%), increase anesthesia (30%), decrease swelling (17%), and increase volume (13%).

CONCLUSION
Despite the lack of evidence, more than one-third of dermatologists surveyed mix fillers with other solutions before injection. Plain lidocaine is most commonly used. The top reason for mixing fillers is to decrease viscosity and facilitate ease of injection. More scientific data are needed to support this practice and better understand the biophysical changes that occur when mixing fillers with other solutions.
Hidradenitis Suppurativa After Radical Surgery—Long-Term Follow-up for Recurrences and Associated Factors
Authors: Walter Anne-Christine , Meissner Markus , Kaufmann Roland , Valesky Eva , Pinter Andreas 
Published: September 2018

BACKGROUND
Hidradenitis suppurativa (HS) is a chronic debilitating skin disease in inverse body areas. Wide excision is recommended in Hurley Stages II to III, but the rate and symptoms of recurrences in long-term follow-up remain unclear.

OBJECTIVE
To analyze the allocation of recurrences regarding the operative field, the onset and quality of HS symptoms as well as factors associated with recurrences in long-term follow-up.

MATERIAL AND METHODS
Forty-eight patients with Hurley Stage III disease who had undergone 91 wide excisions from 2010 to 2015 were clinically examined regarding postoperative complications and allocation and quality of recurrences. To determine the risk of recurrence, possible surgery, and lifestyle-related associated factors were investigated.

RESULTS
Postoperative recurrences of HS were seen in 54.2%. Most recurrences (inflamed nodules) were detected in a <1-cm margin around the operative field (18.7%). Surgery under tumescence local anesthesia showed symptoms in 40.6% compared with 28.6% under general anesthesia. Increased alcohol consumption (p = .027) but not body mass index (p = .11) or smoking behavior (p = .45) had significant effect on relapse of HS.

CONCLUSION
Caution must be given especially in surgery with local anesthesia only. Half of patients with HS showed long-term follow-up signs of recurrence after wide excision, most frequently nearby the operation field.
Effect of Vitamin D Deficiency on Hypertrophic Scarring
Authors: Ince Bilsev , Uyar Ilker , Dadaci Mehmet 
Published: September 2018

BACKGROUND
Although many different diseases have been reported with vitamin D deficiency, the authors failed to find any studies on the association of hypertrophic scarring (HS) in the literature.

OBJECTIVE
The authors aimed to determine the relationship between vitamin D deficiency and HS and investigate the effect of replacement therapy on HS development in patients with vitamin D deficiency.

PATIENTS AND METHODS
Patients who presented to the authors' outpatient clinic with HS between 2013 and 2016 were included in the study. In the first stage, all the patients with HS complaints were assessed for vitamin D levels. In the second stage, 50 patients with a vitamin D level less than 25 ng/mL and a linear scar after at least 1 year of trauma were randomly divided into 3 groups. Group 1: patients who did not accept any medical or surgical treatment; Group 2: patients who were subjected to vitamin D replacement only; Group 3: patients who underwent surgical excision and suturation after vitamin D replacement.

RESULTS
A statistically significant correlation was found between HS and vitamin D levels (p < .05). A statistically significant decrease in scar width was observed in Group 3 (p < .05).

CONCLUSION
Increasing vitamin D levels to above 25 ng/mL before scar revision and vitamin D deficiency in patients with HS may help reduce scar width.
Copaiba Oil Attenuates Right Ventricular Remodeling by Decreasing Myocardial Apoptotic Signaling in Monocrotaline-Induced Rats
Authors: Campos-Carraro Cristina , Turck Patrick , de Lima-Seolin Bruna Gazzi , Tavares Angela Maria Vicente , dos Santos Lacerda Denise , Corssac Giana Blume , Teixeira Rayane Brinck , Hickmann Alexandre , Llesuy Susana , da Rosa Araujo Alex Sander , Belló-Klein Adriane 
Published: September 2018

Abstract:
There is an increase in oxidative stress and apoptosis signaling during the transition from hypertrophy to right ventricular (RV) failure caused by pulmonary arterial hypertension (PAH) induced by monocrotaline (MCT). In this study, it was evaluated the action of copaiba oil on the modulation of proteins involved in RV apoptosis signaling in rats with PAH. Male Wistar rats (±170 g, n = 7/group) were divided into 4 groups: control, MCT, copaiba oil, and MCT + copaiba oil. PAH was induced by MCT (60 mg/kg intraperitoneally) and, 7 days later, treatment with copaiba oil (400 mg/kg by gavage) was given for 14 days. Echocardiographic and hemodynamic measurements were performed, and the RV was collected for morphometric evaluations, oxidative stress, apoptosis, and cell survival signaling, and eNOS protein expression. Copaiba oil reduced RV hypertrophy (24%), improved RV systolic function, and reduced RV end-diastolic pressure, increased total sulfhydryl levels and eNOS protein expression, reduced lipid and protein oxidation, and the expression of proteins involved in apoptosis signaling in the RV of MCT + copaiba oil as compared to MCT group. In conclusion, copaiba oil reduced oxidative stress, and apoptosis signaling in RV of rats with PAH, which may be associated with an improvement in cardiac function caused by this compound.
A Brief Review—EPR Dosimetry and the Use of Animal Teeth as Dosimeters
Authors: Harshman Amber , Johnson Thomas 
Published: September 2018

Abstract
The technique of electron paramagnetic resonance dosimetry using tooth enamel was established in the late 1960s, and considerable research has been conducted to learn more about the benefits of using human teeth as dosimeters for the purpose of retrospective dose reconstruction. Comparatively few studies have been done which have investigated animal teeth for the same purpose. The potential exists for utilizing animal teeth as dosimeters to reconstruct doses received by a species, as well as by humans. Animals investigated in electron paramagnetic resonance studies included cows, rats, mice, dogs, pigs, rhesus monkeys, goats, reindeer, walruses, bison, polar foxes, moose, and polar bears. Much has been determined regarding the characteristics of animal teeth, and overall the use of animal teeth for electron paramagnetic resonance dosimetry appears to be a viable means of estimating external dose. Although much has been learned from animal studies, there remain unanswered questions related to electron paramagnetic resonance dosimetry and the use of animal teeth as electron paramagnetic resonance dosimeters. This article summarizes the findings of animal electron paramagnetic resonance studies and outlines what is still unknown.
Reflections on Basic Science Studies Involving Low Doses of Ionizing Radiation
Authors: Paunesku Tatjana , Woloschak Gayle 
Published: September 2018

Abstract
Investigation of health effects of low doses of radiation as a field of study has been riddled with difficulties since its inception. In this document we will use 100 mGy as the cutoff upper limit for low-dose radiation, borrowing this definition from the U.S. Department of Energy, although other agencies and researchers sometimes include up to five‐fold higher doses under the same title. Difficulties in this area of research are most often ascribed to the fact that effects of low doses of radiation are subtle and difficult to distinguish from the plethora of other low-grade stresses. Thus, for example, most epidemiological studies include hundreds of thousands of samples and generate risk estimates that are statistically meaningful only when they are considered on a scale of hundreds or thousands of people. A logical approach to remedy the situation for low-dose research was to conduct well-controlled animal studies with hundreds of animals; nevertheless, even after many such studies were completed, our understanding of the biological basis for risk from low-dose radiation exposure is still not conclusive. In this paper we argue that the problem lies in the fact that our approach to animal studies is not comprehensive but conceptually binary. While some researchers apply epidemiological models to animal data, others look into molecular and cellular biology only. Very few studies are conducted to bridge this gap and consider how a realistic model of DNA damage could be integrated into a realistic model of radiation carcinogenesis.
The Evolving Role of the Medical Radiation Safety Officer
Authors: Berry Kendall , Elder Deirdre , Kroger Linda 
Published: September 2018

Abstract
The field of medicine has been rapidly changing recently for providers and patients. This article considers how such changes have impacted the roles and responsibilities of the medical facility radiation safety officer. To supplement the personal experiences of the authors, a questionnaire soliciting voluntary feedback was submitted to a group of medical radiation safety officers. Several common themes emerged in the responses received, confirming that the role of the medical radiation safety officer has indeed changed concurrent with the changes occurring in medicine, frequently due to changing regulations and accreditation requirements in response to new and novel imaging and treatment modalities. Today’s medical radiation safety officer faces some daunting challenges, including limited staffing, incorporation of numerous accreditation standards, and maintenance of effective communication with administrators and other personnel. Nonetheless, respondents indicate that they have tremendous job satisfaction and embrace the changing landscape. Shared challenges and changes are discussed herein to provide readers with a perspective on the life of a medical center radiation safety officer.
A Radiation Weather Station: Development of a Continuous Monitoring System for the Collection, Analysis, and Display of Environmental Radiation Data
Authors: Lynch Rebecca A. , Smith Travis , Jacobs Mitchell C. , Frank Samuel J. , Kearfott Kimberlee J. 
Published: September 2018

Abstract
Due to heightened fear surrounding the possibility of future terrorism involving nuclear weapons and radiological dispersive devices, compounded by nonroutine nuclear power plant releases such as from emergencies or accidents, interest in contamination levels of environmental radiation has spiked. This project sought to develop a continuously operational radiation-monitoring system, with graphically visualized data easily accessible to the public. Because this continuing project is housed at a university facility, it bears no connection to perceived political or commercial interests, generally increasing the credibility of the endeavor. Outdoor weather and radiation parameters were gathered by sensors installed on the rooftop of a two-story building. A display and cloud service website was used to project the live data in an understandable format. A correlation was observed between weather and visibly heightened levels of gamma radiation. The goal of this paper is to share and highlight the overall hardware selection and the unique software challenges encountered when developing a robust collection and analysis system, along with the challenges of displaying meteorological and radiological data in a clear and concise fashion.
A 15-Year Review of Corneal Transplant in Brazil
Authors: Almeida Hirlana Gomes , Kara-José Newton , Hida Richard Yudi , Kara-Junior Newton 
Published: September 2018

Purpose:
To analyze 15-year of corneal transplant in Brazil.

Methods:
Cross-sectional, retrospective, observational, and analytical study, between available data from the Brazilian Transplant Registry (January 2002–December 2016), collected by the Brazilian Association of Organ Transplantation was performed. The variables analyzed per year were number of corneal transplants, corneal transplants per million people (pmp), corneal transplant teams, and individuals on the waiting list for corneal transplants. Quantitative variables were expressed by their respective values. To verify the relationship of time with the variables, the Spearman correlation test was applied, adopting P<0.05 for rejection of the null hypothesis.

Results:
Evaluation of the data from 2002 to 2016 revealed an increase in number of (1) corneal transplants (4,976–14,534—approximately 292% in 15 years; P<0.0001); (2) corneal transplants pmp (29.4–71.1 pmp; P<0.0001); (3) productivity of corneal transplants teams (40.1–79 transplants by each team per year; P=0.067); (4) effectiveness in meeting the Brazilian population demand for corneal transplants per year (18.2%–57.0%; P<0.0001); (5) potential donors (P<0.0001), effective donors (P<0.0001), and nondonors (P<0.0001). There was a reduction in the number of patients on the waiting list (19,189–10,923; P=0.056).

Conclusion:
Despite the progress in the last decade, the number of corneal transplants in Brazil cannot meet the growing population demand. Thus, this study suggests the implementation of more effective public policies of corneal transplants in Brazil, to minimize disparities in national territory, adequately meet the population demand, and reduce the time in waiting lists for corneal transplants.
Diurnal Variation of Choroidal Thickness in Primary Open-angle Glaucoma
Authors: Baek Sung Uk , Kim Jin-Soo , Kim Young Kook , Jeoung Jin Wook , Park Ki Ho 
Published: September 2018

Purpose:
To investigate, in primary open-angle glaucoma (POAG) and healthy subjects, the pattern and magnitude of diurnal variation in macular choroidal thickness (mCT).

Methods:
A prospective study was conducted on Koreans comprising 21 patients with POAG and 17 healthy subjects. All underwent mCT, systemic blood pressure (BP), and intraocular pressure measurements during the daytime at 5 time points (8 am, 11 am, 2 pm, 5 pm, and 8 pm). The mCT was determined at 5 sites using swept-source optical coherence tomography.

Results:
In the healthy subjects, the mean mCT was 233.63±50.98 μm at 8 am, which then decreased gradually to 2 pm (206.02±45.91, P=0.015) and increased again in the evening (8 pm; 228.12±51.69, P=0.030). The mean mCT in the POAG patients at 8 am, 246.50±48.94 μm, also decreased to 226.77±51.48 at 2 pm (P=0.027) but did not increase in the evening (229.07±50.87; P=0.566). However, the overall diurnal variation of mean mCT was not statistically significant in either group (P=0.179 and 0.164, respectively). The systolic BP, diastolic BP, and mean ocular perfusion pressure of the POAG had the peak value at 8 am and the trough value at 8 pm (P=0.001, 0.002, and <0.001).

Conclusions:
The mCT in the POAG patients did not increase in the evening relative to the healthy subjects’ pattern. However, the diurnal mCT values measured in the healthy subjects and POAG patients were not statistically significant.
Choroidal Detachment and Increased Intraocular Pressure in a Case of Secondary Pulmonary Hypertension
Authors: Lei Xunwen , Zhang Jinzhi , Li Qiang , Liu Yang , Pu Donghui , Jin Xin , Yang Kehu 
Published: September 2018

Purpose:
To report a case of secondary pulmonary hypertension, choroidal detachment, and increased intraocular pressure (IOP) in a patient with a congenital ventricular septal defect.

Methods:
This is a case report.

Patient:
A 36-year-old man with congenital ventricular septal defect developed dilated and congested conjunctival and episcleral veins, high IOP, and choroidal detachment.

Results:
The right eye had secondary glaucoma, myopia, and choroidal detachment. He had severe pulmonary hypertension and decreased heart function. After successful treatment for heart failure, IOP was reduced, the refractive state returned to normal, choroidal detachment was reversed, and visual acuity improved.

Conclusions:
Secondary pulmonary hypertension resulting from a congenital ventricular septal defect caused serious optic abnormalities that resolved substantially with appropriate treatment of the pulmonary hypertension.
Acute Secondary Optic Neuropathy as a Complication of a Single Episode of Acutely Raised Intraocular Pressure: A Case Series
Authors: Garala Pavitra , Bansal Atul 
Published: September 2018

Purpose:
The purpose of this case series is to report development of acute secondary optic neuropathy due to optic nerve injury associated with single episode of acutely raised intraocular pressure (IOP) of varying etiologies.

Patients and Methods:
Retrospective review of a series of 3 consecutive cases diagnosed at University hospitals of Coventry and Warwickshire and review of published literature.

Results:
Three cases, respectively, with Posner Schlossman syndrome, acute idiopathic hypertensive anterior uveitis, and primary acute angle-closure initially presented with raised IOPs of 38 to 68 mm Hg. All cases were treated initially with medical management and the primary acute angle-closure case had subsequent Nd:YAG laser peripheral iridotomy. All 3 cases developed acute optic nerve injury with reduced vision, an afferent pupillary defect and optic disc swelling which subsequently persisted as optic neuropathy with sectoral optic atrophy and disc pallor.

Conclusions:
This rare cases series highlights the importance of increased awareness of the possibility of developing acute secondary optic neuropathy in patients with acutely raised IOP. On the basis of the acute clinical features, including disc edema with disc hemorrhages and an afferent pupillary defect the most likely pathophysiology of the resultant optic nerve injury is the acute impact of high IOP on optic nerve head perfusion. This appears similar to nonarteritic anterior oschemic optic neuropathy. Other systemic and local risk factors may also contribute. Appropriate timely management to reduce the acutely raised IOP are essential but may not be sufficient in preventing optic neuropathy due to changes at presentation.
Delayed Seroreversion in HIV-exposed Uninfected Infants
Authors: Chatpornvorarux Sunsanee , Maleesatharn Alan , Rungmaitree Supattra , Wittawatmongkol Orasri , Phongsamart Wanatpreeya , Lapphra Keswadee , Kongstan Nantaka , Khumcha Benjawan , Chokephaibulkit Kulkanya 
Published: September 2018

Background:
Recent studies report delayed anti-HIV antibody clearance (seroreversion) among HIV-exposed uninfected infants that may affect diagnostic practices. We evaluated the age-specific seroreversion rates in Thailand.

Methods:
The medical records of HIV-exposed uninfected infants born in January 2000–December 2014 were reviewed. Anti-HIV seroreversion rates at 12, 18 and 24 months were analyzed in 3 periods according to the Thai National Guidelines of prevention of mother-to-child transmission of HIV: zidovudine with or without single dose nevirapine to all women (2000–2006), adding lamivudine plus nevirapine to zidovudine in women with CD4 count <200 cells/mm3 (2007–2009) and zidovudine plus lamivudine plus boosted lopinavir to all women (2010–2014). In 2013, the serologic test kit was changed from third- to fourth-generation (4G) assay. All the infants were formula fed.

Results:
Among 736 infants, the overall seroreversion rates at 12, 18 and 24 months of age were 59.38%, 94.57% and 100%, respectively. The seroreversion rates at 12 months of age declined from 68% in 2000–2006 and 65.9% in 2007–2009, to 42.9% in 2010–2014 (P = 0.001). Seroreversion rates at 18 months of age were more than 96.5% before 2013 and decreased to 79.1% in 2013–2014 (P = 0.001) with use of 4G. Multivariate analysis identified antepartum protease inhibitors treatment and the use of 4G testing as independent factors associated with delayed seroreversion.

Conclusions:
Anti-HIV seroreversion delay in HIV-exposed uninfected infants was associated with use of protease inhibitors and 4G HIV testing, complicating the interpretation to exclude perinatal HIV infection.