bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-Reported Vision-Related Quality of Life After Boston Type I Keratoprosthesis
Authors: Bostan Cristina , Elfekhfakh Marwan , Harissi-Dagher Mona 
Published: September 2019

Purpose:
To determine patient-reported vision-related quality of life (VR-QoL) after Boston type I keratoprosthesis (BKPro) and its determinants.

Methods:
A cross-sectional study including consecutive consenting BKPro patients was conducted. The French National Eye Institute Visual Function Questionnaire-25 measured postoperative VR-QoL. Medical charts were retrospectively reviewed for demographics, ocular comorbidities, indication for surgery, postoperative visual acuity (VA), and complications. Univariate analyses were used to identify VR-QoL determinants. Multivariate linear regression was additionally performed for patients operated unilaterally, using VR-QoL as the dependent variable and age, sex, and postoperative VA as covariates. P < 0.05 indicated statistical significance.

Results:
Sixty-three patients, aged 63 ± 13 years, with a mean follow-up of 54 ± 19 months, were included. VR-QoL was measured 53 ± 18 months postoperatively. “Composite” VR-QoL scores in patients with unilateral (n = 51) and bilateral (n = 12) BKPro were 65 ± 23 and 63 ± 19, respectively, and did not significantly differ between the 2 groups (P = 0.71). In patients with unilateral BKPro, VR-QoL was determined by postoperative VA in the better eye, which was the contralateral nonoperated eye in most cases. Achieved vision in the operated eye contributed to VR-QoL when vision in the contralateral nonoperated eye was poorer. In the bilateral BKPro group, VR-QoL was determined by postoperative VA in the better eye and the number of ongoing complications.

Conclusions:
Five-year VR-QoL scores were lower in BKPro patients compared with healthy cohorts reported in the literature and were similar after unilateral and bilateral BKPro surgery. The main determinant of postoperative VR-QoL was postoperative vision in the better eye.
Clinical Results of Repeated Corneal Collagen Cross-linking in Progressive Keratoconus
Authors: Akkaya Turhan Semra , Aydın Fahri Onur , Toker Ebru 
Published: September 2019

Purpose:
To evaluate the effectiveness of repeated corneal collagen cross-linking (CXL) in eyes with progressive keratoconus after primary CXL.

Methods:
Twelve eyes of 10 patients who underwent repeated CXL were included in this study. All cases were treated with a second CXL when disease progression was noted. Uncorrected visual acuity, best-corrected distance visual acuity, and corneal tomography were performed before and after repeated CXL. Common risk factors for progression were recorded.

Results:
The mean age of the patients was 23.4 ± 6.2 (14–34) years. Eye rubbing was detected in 6 patients. The preoperative maximum keratometry (Kmax) value was >58.0 diopters (D) in 11 eyes (62.2 ± 4.9 D). Repeated CXL was performed with a mean interval of 19.3 months after the first CXL procedure when a disease progression of 2.3 D on average in Kmax was determined. With a mean follow-up of 36 months, Kmax regressed in 8 eyes, remained stable in 2 eyes, and progressed in 2 eyes after repeated CXL. Uncorrected and corrected visual acuity remained unchanged. No complications were observed.

Conclusions:
Repeated CXL seems to be effective in stabilizing keratoconus progression after failure of primary CXL. Patients should be followed up at least for 2 years after primary CXL.
Stepwise Combination of Femtosecond Astigmatic Keratotomy With Phacoemulsification and Toric Intraocular Lens Implantation in Treatment of Very High Postkeratoplasty Astigmatism
Authors: Sorkin Nir , Kreimei Mohammad , Einan-Lifshitz Adi , Mednick Zale , Telli Alexandre , Trinh Tanya , Santaella Gisella , Chan Clara C. , Rootman David S. 
Published: September 2019

Purpose:
To report the outcomes of stepwise combined femtosecond astigmatic keratotomy (FSAK) and phacoemulsification with toric intraocular lens (IOL) implantation in the treatment of very high astigmatism after either penetrating keratoplasty or deep anterior lamellar keratoplasty.

Methods:
This is a retrospective, interventional case series including 8 eyes of 6 patients with very high astigmatism [≥8.00 diopter (D)] after either penetrating keratoplasty or deep anterior lamellar keratoplasty who underwent FSAK, followed by phacoemulsification and toric IOL implantation. Outcome measures were corneal and manifest astigmatism and uncorrected and best spectacle-corrected visual acuity (UCVA, BSCVA).

Results:
The average age was 58.9 ± 5.1 years. The average follow-up time was 40.9 ± 43.8 months. Outcome measure changes after both FSAK and toric IOL implantation were: corneal astigmatism improved from 13.56 ± 4.81 D to 4.48 ± 2.83 D (P < 0.001), manifest astigmatism improved from 9.15 ± 3.86 to 1.46 ± 0.88 D (P = 0.011), UCVA improved from 1.69 ± 0.45 LogMAR (Snellen equivalent ∼20/980) to 0.23 ± 0.11 LogMAR (Snellen equivalent ∼20/33, P < 0.001), and BSCVA improved from 1.01 ± 0.71 LogMAR (Snellen equivalent ∼20/200) to 0.19 ± 0.11 LogMAR (Snellen equivalent ∼20/30, P = 0.015). BSCVA and UCVA at the last follow-up were 20/40 or better in all patients. All procedures were uneventful. Two eyes underwent photorefractive keratectomy after FSAK to regularize and further reduce astigmatism before toric IOL implantation. One patient underwent temporary compression suturing because of FSAK overcorrection.

Conclusions:
Combined stepwise use of FSAK and phacoemulsification with toric IOL implantation was an effective and apparently safe approach in patients with very high postkeratoplasty astigmatism. Additional treatment using photorefractive keratectomy may be beneficial in some cases.
Outcomes of Flap Lift Laser In Situ Keratomileusis Enhancements in a Large Patient Population: Does Application of a Bandage Contact Lens Affect Incidence of Epithelial Ingrowth?
Authors: Ortega-Usobiaga Julio , Baviera-Sabater Julio , Llovet-Osuna Fernando , González-López Félix , Bilbao-Calabuig Rafael , Llovet-Rausell Andrea , Beltrán-Sanz Jaime 
Published: September 2019

Purpose:
To compare the incidence of corneal epithelial ingrowth (EIG) and the visual outcomes of enhancement with laser in situ keratomileusis (LASIK) by flap lift when a bandage soft contact lens (CL) was fitted after the procedure and when it was not.

Methods:
This is a multicenter, retrospective, interventional case series in which all patients who underwent LASIK enhancement from January 2005 to January 2015 were included consecutively. Patients were grouped depending on whether a bandage CL was fitted after re-treatment by flap lift (group 1) or not (group 2).

Results:
A total of 16,702 eyes from 12,485 patients were included. There were statistically significant differences between the groups regarding corrected distance visual acuity (better in group 1) and safety index (better in group 2) although these were not clinically relevant. The incidence of EIG was 0.58% in group 1 and 0.55% in group 2 although, again, the difference was not statistically different.

Conclusions:
We found no relevant differences in LASIK enhancement between patients who received a bandage CL and those who did not regarding the incidence of EIG and visual outcomes.
Analysis of the Optic Disc and Peripapillary Structures in Monozygotic Twins
Authors: Park Do Young , Han Jong Chul , Lee Eun Jung , Kee Changwon 
Published: September 2019

Purpose:
We assessed the structural similarity of the optic disc and peripapillary region between monozygotic (MZ) twin pairs. Through these analyses, we sought to determine whether these structures are more likely to be affected by genetic or environmental factors.

Methods:
Using fundus photographs of 362 MZ twins, cup-to-disc ratio, tilt ratio of the optic disc, and the angle between the major temporal retinal vessels were measured. We also checked for the presence of peripapillary atrophy (PPA) and, if present, recorded its size and direction. We compared the level of consistency of these parameters and axial length (AL) between the right and left eyes within each individual and also between the corresponding paired eyes of the twins. Subgroup analysis was performed according to age and the difference in the AL between the twin pairs.

Results:
The mean (SD) age of the twins included in this study was 38.6 years (8.1). The size of the PPA was significantly correlated with the AL, but not with the intraocular pressure. For PPA-related factors, the level of consistency was weaker between corresponding paired eyes of the twins than between the right and left eyes within each individual. The level of consistency of the AL was the strongest in both comparisons. The level of consistency of both PPA-related factors and tilt ratio between the corresponding paired eyes of the twins was weaker in the group with a larger intertwin difference of AL than in the group with a smaller difference. Subgroup analyses by age (older age group, 45.3±6.3 y; younger age group, 32.4±2.7 y) showed that the level of consistency of PPA-related factors was weaker in the older age group than in the younger age group, after adjusting the AL.

Conclusions:
Unlike AL and cup-to-disc ratio, similarity of PPA between MZ twins decreased with age, suggesting that PPA could be formed as a result of various factors in addition to genetic ones.
Preimplantation genetic testing for Huntington disease: the perspective of one Portuguese center
Authors: Ferreira Diogo , Carvalho Berta , Neto Ana P. , Silva Joaquina , Póvoa Ana M. , Barros Alberto , Carvalho Filipa 
Published: September 2019

Abstract

Background:
Huntington disease (HD) is an autosomal dominant late-onset neurodegenerative disease caused by an unstable cytosine-adenine-guanine trinucleotide repeat expansion in the huntingtin (HTT) gene. Preimplantation genetic testing (PGT) is a diagnostic procedure available for these individuals, because they carry a high risk of transmitting this genetic condition to their offspring.

Methods:
Information about 15 HD couples referred for PGT and 21 cycles performed from 2009 to 2018 was collected retrospectively. PGT provide direct testing of embryos obtained after intracytoplasmic sperm injection, using polymerase chain reaction multiplex as the genetic testing protocol.

Results:
PGT for HD was performed in 15 couples, with no history of previous attempts, in a total of 21 cycles. The mean number of biopsied embryos per cycle was 4.9. The amplification efficiency in blastomeres was 87.4%. From the 90 amplified embryos, 32 were normal and suitable for transfer. The mean number of transferred embryos per couple was 1.2.
Overall, 3 positive human chorionic gonadotropin tests were obtained in 3 couples, resulting in 2 clinical pregnancies. The 2 ongoing clinical pregnancies had normal evolution, and culminated in 2 deliveries, resulting in the birth of 2 healthy children.

Conclusions:
PGT for HD is considered an effective and safe reproductive option for couples who are at risk of transmitting HD, when proper genetic and reproductive counseling is warranted.
Clinical outcomes of a modified all-inside arthroscopic repair of anterior talofibular ligament for chronic ankle instability
Authors: Wei Shijun , Liu Shaobing , Han Fang , Xu Feng , Cai Xianhua 
Published: September 2019

Abstract
The present study was conducted to evaluate the clinical outcomes of a modified all-inside arthroscopic repair technique via anterolateral and accessory anterolateral port for anterior talofibular ligament (ATFL) repair. A consecutive series of 32 patients (34 ankles) with chronic ankle instability were included and treated with the modified all-inside arthroscopic repair. The function was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analog score (VAS) score system, the Sefton grading system, and the anterior drawer test and talar tilt test. A total of 29 cases (30 ankles) were followed up for a mean of 33.7 ± 4.5 (range 30–44) months. Based on the Sefton grading system, 12 patients were regarded as excellent, 13 were good, 2 were fair, and 2 were poor. Twenty-five cases (86.2%) achieved satisfactory functional results. Ankle mobility returned to normal in 93% of patients. The AOFAS scores increased from 55.1 ± 12.3 (range 25–69) preoperatively to 89.7 ± 5.9 (range 74–100) (P < .001) at the last follow-up, while the VAS score decreased significantly (P < .001). There was no wound infection or nerve injury in all cases. In conclusion, based on high satisfaction rate in terms of ankle mobility and low complication rate, the modified all-inside arthroscopic repair of ATFL via anterolateral and accessory anterolateral port appears to be an effective treatment method for chronic ankle instability. Further studies are needed.
A series of 10 malignant triton tumors in one institution
Authors: Bian Yanyan , Yongbo Xiang , Xi Zhou , Zhao Dachun , Wu Huanwen , Liu Yong 
Published: September 2019

Abstract
Malignant triton tumor (MTT) is an extraordinarily uncommon and aggressive tumor which have poor prognosis. Malignant peripheral nerve sheath tumors with additional rhabdomyoblasts are found in MTT histologically. The prognosis of patients is poor. The goal of our study is to describe the largest number of cases characteristic and outcome, to our knowledge, such a presentation was not described in the English-language literature until now.
From 1999 to 2014, 10 patients (5 women and 5 men) with a malignant triton tumor were treated at our institution. All these cases were followed-up and patient charts were analyzed for outcome.
In our study, 3 cases of the Malignant triton tumors originate in the head, 2 cases in the joints, 2 cases in the retroperitoneum, 2 cases in the soft tissues of the thoracic wall, and 1 case in the prostate. Neoplasm associated with pain was the main manifestation. Patients have a poor prognosis. Completely surgical excision of the tumor is the only treatment. Additional radiation or chemotherapy show little effect.
Malignant triton tumor is a rare sarcoma. The high probability of developing local recurrence and distant metastases could account for its poor prognosis.
Prevention and control strategies for children Kashin–Beck disease in China
Authors: Yu Fang-fang , Qi Xin , Shang Yan-na , Ping Zhi-guang , Guo Xiong 
Published: September 2019

Abstract

Background:
To evaluate prevention and control strategies for children with Kashin–Beck disease (KBD) in China through a systematic review and meta-analysis.

Methods:
We conducted literature searches of articles indexed in Web of Knowledge, PubMed, Springerlink, Elsevier, the Chinese National Knowledge Infrastructure, and Wanfang data until February 2019. Search terms included “Kashin–Beck disease” or “KBD,” and “improvement of water” or “change of grain” or “salt-rich selenium” or “comprehensive measures.” Eligible studies were prospective trials of interventions in endemic area. Data extraction was performed by 2 independent authors using predefined data fields that also included quality evaluation.

Results:
We screened 1183 potentially relevant articles, and included 22 studies that reported 24 trials, with data from 3700 healthy children and 2961 children KBD. The pooled odds ratios (ORs) and confidence intervals (95% CIs) for primary prevention new incidence in healthy children following interventions to comprehensive measures, change of grain, salt-rich selenium, and improvements of water were 0.15 (0.02, 0.95), 0.15 (0.03, 0.70), 0.19 (0.09, 0.38), and 0.20 (0.09, 0.42), respectively. The OR (95% CI) for clinical improvement in children KBD following interventions to improvement of water, salt-rich selenium, comprehensive measures, and change of grain were 5.03 (3.21, 7.89), 4.39 (3.15, 6.11), 2.98 (1.61, 5.52), and 2.35 (1.59, 3.47), respectively. All interventions showed significant differences and were effective (P < .05).

Conclusion:
Comprehensive measures and change of grain were the most effective measures in preventing new case, whereas improvement of water and salt-rich selenium resulted in clinical improvements in children KBD.
Apatinib is effective as third-line and more treatment of advanced metastatic non-small-cell lung cancer
Authors: Leng Jiao , Li Dai-Rong , Huang Lu-Mi , Ji Xiao-Hui , Wang Dong-Lin 
Published: September 2019

Abstract
No standard methods are recommended for patients with advanced metastatic non-small-cell lung cancer (NSCLC) experiencing progression after 2 or more lines treatment now. The aim of this retrospective study was to assess the efficacy and safety of apatinib in metastatic NSCLC patients after second-line or more treatments failure in a real-world setting.
A total of 52 advanced NSCLC patients who experienced progression after second-line and more treatments and received apatinib from March 2016 to February 2018 were retrospectively reviewed. Patients were treated with oral apatinib 500 mg QD (take the medicine once a day), every 4 weeks for a cycle. Responding and stable patients continued the treatment until progression or intolerable toxicity. The overall survival (OS), progression-free survival (PFS), objective remission rate (ORR) and disease control rate (DCR), and side effects of the drug were collected and reviewed.
The ORR and the DCR were 6.9% and 67.4%. The median PFS and median OS of all patients were 3.8 months and 5.8 months, respectively. The Eastern Cooperative Oncology Group score was the independent influencing factor of PFS and OS for the advanced NSCLC patients who were treated with apatinib after second-line and above standard regimens (PFS: hazard ratio [HR] = 4.446, 95% confidence interval [CI]: 1.185–16.678, P = .027 and OS: HR = 8.149, 95% CI: 1.173–56.596, P = .034). The most common adverse events apatinib-related included hypertension (19.2%), hand-foot syndrome (11.5%), and mucous membrane reaction (17.3%). And treatment-related grade 3/4 toxicities were low.
Apatinib showed favorable efficacy and safety and could be a treatment option in patients with advanced NSCLC experiencing progression after second-line and more treatment.
Effectiveness of the traditional Japanese Kampo medicine Yokukansan for chronic migraine
Authors: Akiyama Hisanao , Hasegawa Yasuhiro 
Published: September 2019

Abstract

Rationale:
The traditional Japanese Kampo medicine Yokukansan (TSUMURA Yokukansan extract granules) was originally used to treat neurosis, insomnia, night crying, and irritability and/or agitation in infants and recently it has also been used for neuropsychiatric symptoms in Alzheimer's disease or other dementia in Japan. Furthermore, several recent studies have reported the efficacy of Kampo medicines for various types of headache. Here, we report a case of severe chronic migraine refractory to prophylactic therapy using various western medicines and Japanese Kampo medicines that had resulted in a leave of absence from work, but for which the frequency and severity were markedly decreased by Yokukansan (2.5 g 3 times/d), enabling the patient to return to work fully.

Patient concerns:
The patient was a 39-year-old woman with a diagnosis of migraine without aura, which started around the age of 17 years and had been well managed with oral triptan preparations. However, due to lifestyle changes after childbirth, the frequency and severity of migraine increased at 38 years of age, prompting her to visit our hospital.

Diagnoses:
Our initial examination found no neurological abnormality, and our diagnosis was also migraine without aura based on the International Classification of Headache Disorders version 3.

Interventions:
Her migraine had become refractory to several western medicines (lomerizine hydrochloride, propranolol, sodium valproate, amitriptyline, and duloxetine) and 2 Japanese Kampo medicines (Goshuyuto and Chotosan). The migraine episodes worsened, and consequently she took a leave of absence from work.

Outcomes:
Yokukansan was then tried, and this markedly improved the chronic migraine, enabling her full return to work.

Lessons:
Yokukansan might have exerted a prophylactic effect on chronic migraine via its action on the glutamatergic and serotonergic systems, inhibitory action on orexin A secretion, and anti-inflammatory action. Yokukansan might be useful as a prophylactic for migraine worldwide, and a future large-scale clinical study is warranted.
Ophthalmic artery occlusion combined with superior sagittal sinus thrombosis caused by hyaluronic acid injection for facial soft tissue augmentation
Authors: Yao Bangtao , Shen Feifei , Zhao Xiaogui , Liu Gang , Ding Yuhua 
Published: September 2019

Abstract

Rationale:
Cosmetic hyaluronic acid injections for facial soft tissue augmentation are gaining popularity because of their convenience and favorable outcomes. Several associated complications have been described; however, ophthalmic artery occlusion (OAO) combined with superior sagittal sinus thrombosis (SSST) has been rarely reported.

Patient concerns:
A 21-year-old woman presented with sudden loss of vision and severe pain in the left eye, right upper limb weakness, and headache immediately after hyaluronic acid injection on the left side of her forehead.

Diagnosis:
Clinical manifestations and multimodal imaging, including spectral-domain optical coherence tomography, fundus fluorescein angiography, and digital subtraction angiography, indicated OAO and SSST.

Interventions:
Various clinical examinations were performed, and the patient was treated by thrombolysis, corticosteroids, oxygen therapy, a formula for the nourishment of the optic nerve, and measures for improving the microcirculation.

Outcomes:
The treatment response was closely observed. The intracerebral hemorrhages were absorbed after 2 weeks of treatment, while the clinical manifestations, including ocular pain, headache, and limb dysfunction, were gradually alleviated. However, the visual acuity in the left eye remained at no light perception.

Lessons:
Cosmetic hyaluronic acid injection can result in emergent and catastrophic complications that require immediate treatment. Thus, the development of appropriate prevention and management protocols for such scenarios is considered crucial.
Treatment of distal metaphyseal tibia fractures using an external fixator in children
Authors: Dai Jin , Wang Xiaodong , Zhang Fuyong , Zhu Lunqing , Zhen Yunfang 
Published: September 2019

Abstract

Introduction:
Current treatment of pediatric distal metaphyseal tibial/fibular fractures is challenging due to poor skin and soft tissue coverage and limited blood supply to the distal tibia area in children. It remains unknown whether the SK combined external fixator (made by Double Medical Technology Inc., China) is effective for the treatment of distal metaphyseal tibia/fibula fractures in children.

Hypothesis:
We hypothesized that SK combined external fixator could achieve satisfying outcomes for pediatric distal metaphyseal tibia/fibula fractures.

Patients and methods:
A total of 19 pediatric patients with a median age of 6 years (range: 3.8–12.0 years), who had distal tibia/fibula metaphyseal fractures and attended our hospital between January 2017 and November 2017, were evaluated. All patients with tibia fracture had closed reduction and percutaneously fixed SK combined external fixators. Radiographs were taken at an average of every 4 weeks to evaluate the healing of the fracture. Complications were recorded, and the stability of the pin clamp and rod were also checked. Follow-up was conducted for up to 13 months. All patients provided informed consent for publication of the case.

Results:
All patients achieved a satisfactory clinical outcome at the final follow-up. Weight-bearing exercises were started at post-operative 2 weeks. Bone union was obtained at 8 weeks post-operation on average. No delayed healing or nonunion was observed, although one case of pin site infection and three cases of pin clamp loosening occurred.

Discussion:
Three-dimensional SK combined external fixators are light, easy to apply, minimally invasive, and result in low rates of complications. They provide excellent stability for pediatric distal tibia/fibula metaphyseal fractures.

Level of evidence:
IV.