bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central Toxic Keratopathy After Contact Lens Wear and Mechanical Debridement: Clinical Characteristics, and Visual and Corneal Tomographic Outcomes
Authors: Ting Darren Shu Jeng , Ghosh Saurabh 
Published: February 2019

Objectives:
To highlight the clinical characteristics, and visual and corneal tomographic outcomes of central toxic keratopathy (CTK) after contact lens (CL) wear and mechanical debridement.

Methods:
A retrospective observational case series with literature review.

Results:
Four patients (4 eyes) were included in this study; 3 (75%) females, mean age 29.3±8.1 years. The mean follow-up was 13.5±7.5 months. Early central or paracentral stromal opacification, assuming an inverse dome-shaped pattern observed under anterior-segment optical coherence tomography, with corneal flattening (Kmean 40.4±1.3 D) and thinning (mean thinnest pachymetry=404.8±29.4 microns) were observed in all cases. All patients had a recent use of CL wear, with three after mechanical debridement for recurrent corneal erosion syndrome. None of them had any previous laser refractive surgery (LRS). The mean corrected distance visual acuity improved from 20/40 (ranged 20/25–20/50) initially to 20/30 (ranged 20/20–20/40) at final follow-up, and the outcome was not influenced by the use of topical steroids. A mean improvement of corneal flattening (+Kmean 1.2±1.2 D), thinning (+123.5±23.8 microns), and astigmatism (−3.0±2.7 D), via epithelial and stromal remodeling, was observed up to 15 months after CTK. Persisting reduced corneal sensation was noted in all patients at the final follow-up.

Conclusions:
Central toxic keratopathy is not an exclusive complication of LRS, and it may occur after CL wear and mechanical debridement. Our findings are similar to those of LRS-related CTK and toxic peripheral keratopathy. Awareness of the clinical associations and understanding of the clinical course and tomographic characteristics of CTK helps obviate unnecessary investigation and overtreatment. Further studies are required to elucidate the underlying pathogenesis of this rare clinical entity.
Absorption and Extraction of Inflammatory Mediators From Contact Lens Materials
Authors: Chao Cecilia , Richdale Kathryn , Willcox Mark 
Published: February 2019

Objectives:
This report aimed to explore whether certain inflammatory mediators were absorbed, extracted, or bound by various contact lens materials.

Methods:
Comfilcon A, balafilcon A, omafilcon A, and etafilcon A were soaked in 500 and 100 pg/mL of interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), or interleukin-1 receptor antagonist (IL-1Ra), and also in combined solutions of inflammatory mediators (500 pg/mL or 100 pg/mL) separately. Lenses were then extracted in 1:1 2% trifluoroacetic acid:acetonitrile. The extracted and residual concentrations of inflammatory mediators were determined using enzyme-linked immunosorbent assays. Absorbed (control-residual) and firmly bound (absorbed–extracted) concentrations were calculated for analysis.

Results:
More MMP-9 was absorbed by omafilcon A (466±9 pg/mL) than balafilcon A (P=0.006; 437±11 pg/mL) or etafilcon A (P=0.001; 428±13 pg/mL) when soaked in 500 pg/mL, but no differences in 100 pg/mL. More MMP-9 remained firmly bound to omafilcon A (P=0.03; 174±3 pg/mL), comfilcon A (P=0.049; 168±34 pg/mL), and balafilcon A (P=0.01; 186±14 pg/mL) than etafilcon A (128±22 pg/mL). There were no differences in IL-8 absorption between lenses; however, more IL-8 remained firmly bound to omafilcon A (P=0.01; 336±25 pg/mL) than etafilcon A (106±133 pg/mL) when soaked in 500 pg/mL. No differences were found in concentrations of absorbed or firmly bound IL-1Ra between materials. When the mediators were combined, IL-8 was absorbed more in etafilcon A (P=0.03) than in other lens materials, but the absorbed IL-8 did not remain firmly bound.

Conclusions:
The uptake and extraction of inflammatory mediators from contact lenses was affected by competitive binding between the mediators.
Efficacy and Safety of Conjunctival Cystectomy Using High-Frequency Radiowave Electrosurgery: A Preliminary Report
Authors: Ji Min Jung , Lee Seung-Jun , Han Sang Beom , Hyon Joon Young 
Published: February 2019

Purpose:
To evaluate the efficacy and safety of conjunctival cystectomy using high-frequency radiowave electrosurgery.

Methods:
This retrospective study included 11 patients who underwent conjunctival cystectomy using high-frequency radiowave electrosurgery and had a follow-up of at least 6 months. Briefly, conjunctival opening with a diameter of 1 mm was made with using high-frequency radiowave electrosurgery (Ellman Surgitron; Ellman International, Inc., Hewlett, NY) in cut mode. The cyst was then extracted using a nontoothed forceps through the opening without rupture. Medical record of the patients was reviewed.

Results:
In all the 11 patients, conjunctival wound healed in 1 week without any complication. No recurrence was detected in any patients over the 6-month follow-up.

Conclusions:
Conjunctival cystectomy with the adjunctive use of high-frequency radiowave electrosurgery was shown to be effective and safe.
Systematic Review on Therapeutic Strategies to Minimize Corneal Stromal Scarring After Injury
Authors: Kwok Sum S. , Shih Kendrick C. , Bu Yashan , Lo Amy C.-Y. , Chan Tommy C.-Y. , Lai Jimmy S.-M. , Jhanji Vishal , Tong Louis 
Published: February 2019

Objectives:
To evaluate recent studies on available and experimental therapies in preventing or minimizing corneal stromal scarring after injury.

Methods:
We performed an Entrez PubMed literature search using keywords “cornea,” “scarring,” “haze,” “opacity,” “ulcer,” “treatments,” “therapies,” “treatment complications,” and “pathophysiology” resulting in 390 articles of which 12 were analyzed after filtering, based on English language and publication within 8 years, and curation for relevance by the authors.

Results:
The 12 articles selected included four randomized control trials (RCTs) (two were double-blinded placebo-controlled RCTs, one was a prospective partially masked RCT, and one was an open-label RCT), two retrospective observational studies, and six laboratory-based studies including two studies having in vivo and in vitro experiments, one was in vivo study, one was ex vivo study, and the last two were in vitro studies. The current mainstay for preventing or minimizing corneal scarring involves the use of topical corticosteroids and local application of mitomycin C. However, supportive evidence for their use in clinical practice from well-designed RCTs is lacking. Laboratory studies on topical rosiglitazone therapy, vitamin C prophylaxis, gene therapy, and stem cell therapy have shown promising results but have yet to be translated to clinical research.

Conclusion:
There is a need for more robust randomized controlled trials to support treatments using topical corticosteroids and mitomycin C. Furthermore, their clinical efficacy and safety profile should be compared with new treatments that have shown promising results in the laboratory setting. Ultimately, the goal should be to personalize cornea scarring treatment according to the most effective treatment for the specific underlying pathology.
Evaluation of Long-Term Corneal Morphology After Photorefractive Keratectomy by In Vivo Confocal Microscopy and Specular Microscopy; 20-Year Follow-Up
Authors: Bilgihan Kamil , Yesilirmak Nilufer , Altay Yesim , Tefon Atike B. , Ozdemir Huseyin B. , Ozdogan Sibel , Kocamaz Mehmet F. , Gurelik Gokhan 
Published: February 2019

Purpose:
To evaluate long-term corneal morphological changes after photorefractive keratectomy (PRK) using in vivo confocal microscopy (IVCM) and specular microscopy.

Methods:
This comparative case–control study included 16 eyes of 8 patients who underwent PRK for mild to moderate myopia 20 years ago and 30 eyes of 15 sex- and age-matched healthy controls. Corneal epithelial cells, sub-basal nerves, keratocytes (anterior, midstromal, and posterior), and endothelial cells were evaluated in both groups 10 and 20 years after surgery. Long-term visual outcomes were also recorded.

Results:
In vivo confocal microscopy examination revealed similar epithelial morphology, sub-basal nerve fiber morphology/density, mid/posterior stromal keratocyte density, and endothelial cell density between PRK patients and controls at their 10th and 20th year follow-up. Anterior stromal keratocyte density was lower at 10th year; however, it reached to control group value at 20th year follow-up. Extracellular matrix reflectivity was slightly higher, and there was a trace subepithelial corneal haze in PRK group (milder in 20th year than 10th year) compared with controls. At the 20th year, uncorrected distance visual acuity was 20/20 or more in 6 eyes (37.5%), 20/40 or more in 16 eyes (100%), and all eyes had corrected distance visual acuity of 20/20 or better (spherical equivalent −0.31±0.37 D).

Conclusions:
Photorefractive keratectomy in low to moderate myopia seems to be safe and effective method in the long term with preserving corneal morphology (including anterior stromal keratocyte and sub-basal nerve fiber density) and refractive outcomes as shown in this study. In appropriate patients, this method can be considered confidently.
Improved Clinical Outcome After Treatment of Mycobacterium abscessus Complex Pulmonary Disease in Children With Cystic Fibrosis
Authors: Chacko Archana , Wen Sophie C. H. , Hartel Gunter , Kapur Nitin , Wainwright Claire E. , Clark Julia E. 
Published: February 2019

Background:

Mycobacterium abscessus complex pulmonary disease (M. abscessus PD) in cystic fibrosis (CF) is challenging to treat. Current guideline therapeutic regimens involving an intensive phase of intravenous (IV) antibiotics followed by a consolidation phase of inhaled and oral antibiotics are not evidence-based. The objectives of this study were to characterize the clinical outcomes and clearance of Mycobacterium abscessus complex (M. abscessus) from respiratory cultures in children with CF M. abscessus PD.

Methods:
This retrospective longitudinal cohort analysis evaluated the first course of treatment for M. abscessus PD in 33 children in Queensland, Australia between 2001 and 2015. Spirometry and nutritional outcomes 2 years pretreatment and 1 year posttreatment were compared with clearance or relapse/persistence of Mycobacterium abscessus complex from respiratory cultures.

Results:
Nine of 18 children who completed therapy, cleared infection. Three of 7 children who completed only intensive therapy cleared sputum compared with 0/8 children who did not. The trajectory of the percent predicted forced expiratory volume in 1 s and age standardized body mass index significantly improved posttreatment in those that cleared sputum (P < 0.0001).

Conclusions:
These results suggest that current treatment recommendations for M. abscessus PD are associated with some success in clearing infection in children with CF and improvement in lung function and body mass index. Clinical trials are required to determine the best treatment approaches.
Paenibacillus alvei Multifocal Cavitary Lung Abscesses in an Immunocompetent Man
Authors: Ferguson John , Gailey Michael , Volk Stacy 
Published: February 2019

Abstract

Paenibacillus alvei (formerly Bacillus alvei) is infrequently recognized as a pathogenic bacterium in humans. P. alvei has historically been considered a nonvirulent organism found in soil and water sources and most well-described in European foulbrood, a disease of honeybees. Few case reports have been described in humans, none of which include cavitary lung abscess formation. We describe a case of multifocal lung abscesses secondary to P. alvei in an immunocompetent man and review the literature of other case reports in humans. Identification of P. alvei remains challenging, and the biochemical tests to make the diagnosis are reviewed. Treatment is generally guided by in vitro susceptibility patterns, and we will review the clinical case reports that have resulted in successful treatment of this bacterium.
Association Between Body Mass Index and Mortality in Patients With Gram-Negative Bloodstream Infections
Authors: Lines Jacob , Yang Zhengguan , Bookstaver Paul Brandon , Catchings Erin , Justo Julie Ann , Kohn Joseph , Albrecht Helmut , Al-Hasan Majdi N. 
Published: February 2019

Background
Obesity is an established risk factor for many infections. Emerging data demonstrate that increased body mass index (BMI) may paradoxically protect against mortality in several disease processes. The interaction between BMI and mortality in gram-negative bloodstream infections (GN-BSIs) remains unclear.

Aim
This retrospective cohort study examines the impact of BMI on mortality in patients with GN-BSI.

Materials and Methods
Hospitalized adults with first episodes of GN-BSI from 2010 to 2015 were identified. Patients were grouped by BMI in kilograms per meter squared as normal weight (18.5–24.9; reference), overweight (25.0–29.9), obese (30.0–39.9), and morbidly obese (≥40). Multivariate Cox proportional hazards regression was used to examine risk factors for 28-day mortality after GN-BSI.

Results
Among 1069 unique patients with GN-BSI, 352 (33%) were normal weight, 319 (30%) were overweight, 303 (28%) were obese, and 95 (9%) were morbidly obese. Overall, mean age was 63 years, and 54% were women. Crude 28-day mortality was higher in the normal-weight group (21.5%) than in the overweight (11.7%), obese (11.8%), and morbidly obese groups (8.7%; P = 0.003). After adjustments for age, chronic comorbidities, acute severity of illness, and antimicrobial therapy in a multivariate model, overweight BMI remained independently associated with reduced mortality (adjusted hazards ratio [aHR], 0.53; 95% confidence intervals [CI], 0.31–0.88; P = 0.01). There was no significant reduction in mortality in obese (aHR, 0.72; 95% CI, 0.43–1.15; P = 0.17) and morbidly obese patients (aHR, 0.71; 95% CI, 0.27–1.56; P = 0.41).

Conclusions
Compared with normal BMI, overweight patients had improved survival after GN-BSI. However, this potential protective effect was lost in obese and morbidly obese patients.
Contrasting the Clinical Presentation and Prevalence of Septic, Reactive, and Crystal Arthritis in Patients With Hematologic and Solid Malignancies
Authors: Coba George A. , Velez Ana P. , Joyce David M. , Greene John N. 
Published: February 2019

Background
The development of septic arthritis requires rapid identification and treatment to prevent serious and irreversible complications in cancer patients. This is further emphasized by the fact that many cancer patients are immunocompromised either through the nature of their disease or through their treatment. Septic arthritis, crystal-induced arthritis (CIA), and reactive arthritis (RA) all present in a similar fashion with erythematous, edematous, painful joints.

Methods
A retrospective review was performed using data compiled from patient charts at the Moffitt Cancer Center between the dates of January 1, 2010, and February 22, 2018. Of the original 56 patients who had joint aspirations, 45 met the inclusion criteria of also having either a solid or hematologic malignancy.

Results
Analysis of the study population suggests that septic arthritis or CIA is significantly less common compared with RA in cancer patients. In addition, the development of septic arthritis is strongly associated with both prosthetic joints and nearby malignancies. Calcium pyrophosphate crystal-induced and monosodium urate CIA presents similar to septic arthritis. Lastly, synovial fluid analysis distinguishes the etiologies of arthritis more accurately compared with serum analysis.

Conclusions
The data collected in the study support the conclusion that oncology patients presenting with an inflamed joint are more likely to have RA and unlikely to have septic arthritis unless associated with a prosthesis or nearby malignancy. Reactive arthritis is most common and readily resolves with chemotherapy and anti-inflammatory therapy with no joint destruction and rarely recurs. Lastly, synovial fluid analysis is necessary to diagnose and/or rule out specific arthritis causes.
Pharmacokinetics and Pharmacodynamics of Immediate-Release Versus Extended-Release Guanfacine in Adult Daily Smokers
Authors: Verplaetse Terril L. , Roberts Walter , Moore Kelly E. , Peltier MacKenzie R. , Oberleitner Lindsay M. , McKee Sherry A. 
Published: February 2019

Abstract

Background
Guanfacine is Food and Drug Administration approved for hypertension and attention-deficit hyperactivity disorder and has been used off-label for migraine prophylaxis, heroin withdrawal, and more recently smoking cessation. Previous studies have shown positive effects of 3 mg/d of immediate-release (IR) guanfacine on smoking outcomes, but the dose equivalency of the IR and extended-release (ER) formulations is unknown.

Procedures
A within-subject design was used to compare the pharmacokinetics and pharmacodynamics of 3 mg/d of IR, 4 mg/d of ER, and 6 mg/d of ER guanfacine in adult daily smokers (n = 5). Plasma medication levels, vital signs, cigarettes per day, tobacco craving, and adverse events were assessed. Medication was titrated to stable dosing after each laboratory day (3 mg/d IR, then 4 mg/d ER, then 6 mg/d ER).

Results
Plasma medication levels did not differ between the 3 mg/d of IR and 4 mg/d of ER doses after 24 hours from last dose and were highest at the 6 mg/d of ER dose (3 mg/d IR: M = 3.40 ng/mL, SE = 0.34 vs 4 mg/d ER: M = 3.46 ng/mL, SE = 0.67 vs 6 mg/d ER: M = 5.92 ng/mL, SE = 1.02). All doses of guanfacine decreased heart rate and blood pressure from baseline. Absolute values of cigarettes per day (6 mg/d ER) and tobacco craving (4 and 6 mg/d ER) were lowest with the ER formulations. Treatment-emergent adverse events were subject rated as minimal to mild, except dry mouth.

Conclusions
We demonstrated similar pharmacokinetic profiles between 3 mg/d of IR guanfacine and 4 mg/d of ER guanfacine, as hypothesized. All doses of guanfacine were well tolerated.
Comparison of mycophenolate mofetil with standard treatment for autoimmune hepatitis: a meta-analysis
Authors: Yu Zhen-Jun , Zhang Lu-Lu , Huang Ting-Ting , Zhu Jian-Sheng , He Ze-Bao 
Published: February 2019

Objective
To systematically evaluate the efficacy of mycophenolate mofetil (MMF) compared with the standard treatment for autoimmune hepatitis.

Methods
Medline (PubMed), Embase, and Cochrane Library databases were searched between 1966 and June 2018 for studies on prednisone and/or azathioprine/mycophenolate mofetil in autoimmune hepatitis. The keywords and descriptor terms used were ‘hepatitis’, ‘autoimmunity’, ‘prednisone’, ‘prednisolone’, ‘azathioprine’, and ‘mycophenolate mofetil’. The Z test and Cochrane Q test were used in the statistical analysis.

Results
Seven hundred and eighty-eight related articles were found; 779 studies were excluded after further review. Ultimately, seven studies (583 participants) were included. The remission rate of aminotransferase and immunoglobulin (Ig)-G levels with standard treatment was 33.33–86.67%, and the nonresponse rate was 15.15–66.67%. Although the remission rate of the aminotransferase level with prednisone and MMF was 55.17–88.89% and that of the IgG level was 61.16–88.89%, the nonresponse rate was 6.42–33.33%. Remission rates of the aminotransferase level (P<0.05, I
2=49%) and IgG level (P<0.01, I
2=0) with MMF were superior to those of standard treatment, and the nonresponse rate was lower (P<0.01, I
2=0). For those with no response to the standard treatment who were switched to MMF, the remission rates were 0, 13.33, 22.22, 25, and 34.04%. Sequential treatment with MMF was effective (P<0.01, I
2=90%).

Conclusion
Compared with the standard treatment, the combination of prednisone and MMF as a first-line treatment enables patients with autoimmune hepatitis to obtain higher remission rates of aminotransferase and IgG levels and a lower nonresponse rate. The validity and safety of long-term MMF use needs investigated further.
Treatment options for nonalcoholic fatty liver disease: a double-blinded randomized placebo-controlled trial
Authors: Anushiravani Amir , Haddadi Niloufar , Pourfarmanbar Maedeh , Mohammadkarimi Vahid 
Published: February 2019

Introduction
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide and is becoming the most frequent indication of liver transplantation. Cardiovascular disease is the main cause of death in these patients. There is no Food and Drug Association-approved medication for NAFLD patients. We aimed to provide more robust evidence on the use of medications that are inexpensive and available, namely, metformin, silymarin, pioglitazone, and vitamin E, for treating NAFLD.

Materials and methods
We conducted a randomized double-blinded, placebo-controlled trial on 150 consecutive patients with NAFLD who were assigned to five groups: lifestyle plus placebo, metformin 500 mg/day, silymarin 140 mg/day, pioglithasone 15 mg/day, and vitamin E 400 IU/day, all for 3 months. Anthropometric and biochemical variables were measured at baseline and 3 months later.

Results
The mean age of the patients was 47.0±9.1 (range: 18–65) years and the sex distribution was 73 (48.7%) women and 77 (51.3%) men. Patients in all groups showed a significant improvement in anthropometric parameters such as waist circumference and BMI. There was no statistically significant difference in alanine transaminase and aspartate transaminase in the control group after treatment (P=0.51, 0.18, respectively); however, both liver enzymes decreased significantly in the other groups.

Discussion and conclusion
This randomized double-blinded placebo-controlled clinical trial suggested a significant benefit of silymarin, pioglitazone, and vitamin E in improving liver aminotransferases in patients with NAFLD after only 3 months, without exerting any specific side effects.
Epithelial Claudin Proteins and Their Role in Gastrointestinal Diseases
Authors: Kim David Y. , Furuta Glenn T. , Nguyen Nathalie , Inage Eisuke , Masterson Joanne C. 
Published: February 2019

ABSTRACTOur bodies are protected from the external environment by mucosal barriers that are lined by epithelial cells. The epithelium plays a critical role as a highly dynamic, selective semipermeable barrier that separates luminal contents and pathogens from the rest of the body and controlling the absorption of nutrients, fluid and solutes. A series of protein complexes including the adherens junction, desmosomes, and tight junctions function as the principal barrier in paracellular diffusion and regulators of intracellular solute, protein, and lipid transport. Tight junctions are composed of a series of proteins called occludins, junctional adhesion molecules, and claudins that reside primarily as the most apical intercellular junction. Here we will review one of these protein families, claudins, and their relevance to gastrointestinal and liver diseases.