bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Predictors of Serological Treatment Response in Early and Late Syphilis Among People Living With HIV
Authors: Spagnuolo Vincenzo , Poli Andrea , Galli Laura , Nozza Silvia , Bossolasco Simona , Cernuschi Massimo , Maillard Myriam , Hasson Hamid , Gianotti Nicola , Guffanti Monica , Lazzarin Adriano , Castagna Antonella 
Published: November 2018

Abstract

Background
Few studies have investigated predictors of serological response to syphilis treatment in people living with HIV (PLWH).

Methods
This was a retrospective, longitudinal study on PLWH who were diagnosed with and treated for syphilis who had an assessable serological response between January 2004 and June 2016. Serological treatment response (TR) was defined as a ≥4-fold decline in rapid plasma reagin (RPR) titers or a reversion to nonreactive (if RPR ≤1:4 at diagnosis) 12 months after treatment for early syphilis and 24 months after treatment for late syphilis. Factors associated with a TR were assessed with multivariate Cox proportional hazard models for recurrent events.

Results
A total of 829 episodes of syphilis (686 early, 143 late) in 564 patients were recorded. TR was observed in 732 (88%) syphilis episodes. The proportion of TR differed between early and late syphilis (89% vs 83%, respectively; P = .045). For early syphilis, TR was associated with a higher nadir CD4+ cell count (adjusted hazard ratio [AHR], 1.06; P = .029), an RPR titer &gt;1:32 at diagnosis (AHR, 1.26; P = .009), secondary syphilis (AHR, 1.29; P = .008), and cases of syphilis diagnosed in more recent calendar years (AHR, 1.36; P &lt; .0001). In late syphilis, TR was more likely to occur for first infections (AHR, 1.80; P = .027), for episodes that occurred in more recent years (AHR, 1.62; P = .007), and for RPR titers &gt;1:32 at diagnosis (AHR, 2.04; P = .002). TR was not associated with the type of treatment regimen in early and late syphilis.

Conclusions
Higher RPR titers at diagnosis and a diagnosis of syphilis that was made in more recent years were associated with TR in early and late syphilis.
Impact of occupational exposure on human microbiota
Authors: Lai Peggy S. , Christiani David C. 
Published: November 2018

Purpose of review
Recent evidence suggests that environmental exposures change the adult human microbiome. Here, we review recent evidence on the impact of the work microbiome and work-related chemical, metal and particulate exposures on the human microbiome.

Recent findings
Prior literature on occupational microbial exposures has focused mainly on the respiratory effects of endotoxin, but a recent study suggests that not all endotoxin is the same; endotoxin from some species is proinflammatory, whereas endotoxin from other species is anti-inflammatory. Work with animals can change the adult human microbiome, likely through colonization. Early studies in military personnel and animal models of gulf war illness show that military exposures change the gut microbiome and increase gut permeability. Heavy metal and particulate matter exposure, which are often elevated in occupational settings, also change the gut microbiome.

Summary
An emerging body of literature shows that work-related exposures can change the human microbiome. The health effects of these changes are currently not well studied. If work exposures lead to disease through alterations in the human microbiome, exposure cessation without addressing changes to the human microbiome may be ineffective for disease prevention and treatment.
A Fully Automated Method for the Determination of Serum Belatacept and Its Application in a Pharmacokinetic Investigation in Renal Transplant Recipients
Authors: Klaasen Rolf Anton , Egeland Erlend Johannessen , Chan Joe , Midtvedt Karsten , Svensson My , Bolstad Nils , Fellström Bengt , Holdaas Hallvard , Åsberg Anders , Bergan Stein , Vethe Nils Tore , Warren David John 
Published: November 2018

Background:
Belatacept (Nulojix; Bristol-Myers Squibb, New York, NY) is a biological immunosuppressive drug used for the prophylaxis of acute rejection after renal transplantation. Few studies have described belatacept pharmacokinetics, and the effect of therapeutic drug monitoring has not been investigated. We have developed a drug-capture assay (using drug target) to measure belatacept in serum and applied this assay in a pharmacokinetic study in renal transplant recipients.

Methods:
CD80 was used to trap belatacept onto streptavidin-coated wells. Captured drug was quantified using Eu3+-labeled protein A and time-resolved fluorescence. The assay was applied in a pilot pharmacokinetic study in renal transplanted patients receiving belatacept infusions. Belatacept serum concentrations were determined at several time points between belatacept infusions. A simple population pharmacokinetic model was developed to visualize measured and predicted belatacept serum concentrations.

Results:
The assay range was 0.9–30 mg/L with accuracy within 91%–99% and coefficients of variation ranging from 1.2% to 3.6%. Predilution extended the measurement range to 130 mg/L with an accuracy of 90% and coefficients of variation of 3.8%. Samples were stable during storage at 4°C for 15 days and during 2 freeze-thaw cycles. Belatacept concentrations were determined in a total of 203 serum samples collected during 26 infusion intervals from 5 renal transplant recipients. The population pharmacokinetic model visualized both measured and predicted concentrations.

Conclusions:
We have developed an automated, accurate, and precise assay for the determination of belatacept serum concentrations. The assay was successfully applied in a pharmacokinetic study in renal transplant recipients receiving belatacept infusions.
Malignant Glaucoma After Laser Peripheral Iridotomy
Authors: Greenfield Jason A. , Smiddy William E. , Greenfield David S. 
Published: November 2018

Purpose:
We describe a patient with primary angle-closure glaucoma who developed malignant glaucoma following laser peripheral iridotomy.

Methods:
A 58-year-old male presented with peripheral and central anterior chamber shallowing following an uncomplicated Nd: YAG laser peripheral iridotomy. Intraocular pressure (IOP) and B-scan echography were normal, and there was −1.5 Ddiopter asymmetric myopia. Despite treatment with aqueous suppression and cycloplegia for 7 months, the patient developed progressive myopic shift and anterior chamber shallowing.

Results:
The patient underwent 23-G pars plana vitrectomy and lensectomy using a standard 3-port technique, and sulcus posterior chamber intraocular lens implantation in the left eye. Twelve months postoperatively, the anterior chamber has remained deep, best-corrected visual acuity is 20/15, and the IOP is 11 mm Hg.

Conclusions:
Malignant glaucoma is a rare complication of laser iridotomy and should be considered in eyes with progressive anterior chamber shallowing and myopia despite normal IOP.
Recurrent Exposure of XEN Gel Stent Implant and Conjunctival Erosion
Authors: Arnould Louis , Theillac Vincent , Moran Sarah , Gatinel Damien , Grise-Dulac Alice 
Published: November 2018

Purpose:
The purpose of this study was to report a case of recurrent conjunctival erosion and XEN Gel Stent exposure after implantation in a primary open-angle glaucoma patient. Minimally invasive glaucoma surgery (MIGS) is a new approach in glaucoma surgery, and there is a lack of published data with regard to the management of postoperative ocular surface complications.

Methods:
This is a case report of a patient with a persistent corneal erosion after XEN Gel Stent implantation. A standalone MIGS surgery was planned for both eyes in this case of refractory glaucoma. Despite a first surgical revision, the patient was suffering from a chronic leaking bleb, an exposed XEN Gel Stent, and severe hypotonia in the left eye.

Results:
A free conjunctival autografting technique covered with a complementary amniotic membrane graft was performed under local anesthesia. One month following bleb revision, the intraocular pressure was 13 mm Hg on medical treatment, and slit-lamp examination showed a well-formed moderate bleb with no leakage.

Conclusions:
This is the first described case of the use of a free conjunctival autograft to treat a persistently leaking bleb after XEN Gel Stent implantation. This case highlights the potential complication of conjunctival erosion due to XEN Gel Stent implantation. It emphasizes the management of complicated filtration blebs after MIGS surgery.
Clinicopathologic Examination of Translucent Refractile Intraluminal Tissue Coagulum From the Proximal Tube of a Baerveldt Glaucoma Drainage Device
Authors: Lee Graham A. , Seo Shiney , Quagliotto Gary , Shah Peter 
Published: November 2018

Purpose:
To describe an unusual case of glaucoma drainage tube blockage.

Patients:
A 76-year-old woman presented with left endothelial graft failure. Her previous ocular history included primary open-angle glaucoma diagnosed for 15 years and Fuch’s endothelial dystrophy. Three years before presentation, the left eye required a Descemet stripping endothelial keratoplasty followed by a trabeculectomy with mitomycin C and subsequent Baerveldt tube insertion 3 years previously. Intraocular pressures were right 9 and left 19 mm Hg. The endothelial graft demonstrated supra-temporal edema, in proximity to the sulcus placed tube tip.

Methods:
A repeat endothelial keratoplasty was undertaken. During surgery, an attempt to flush the tube ab internally with balanced salt solution on a 27-G Rycroft cannula, resulted in extrusion of a long translucent tubular plug from within the silicone tube into the anterior chamber. This was removed with intraocular forceps and sent for histopathology. The endothelial keratoplasty was performed and an air bubble placed in the anterior chamber.

Results:
The histopathology was reported as fibrinohemorrhagic material associated with refractile material, detected under polarized light microscopy. At 6 months follow-up, the graft was clearing well, the tube in situ and the intraocular pressure 6 mm Hg.

Conclusions:
One possible cause of the refractile material within the specimen is spalled particles of silicone, presumably from the tube. This finding potentially questions the long-term stability of silicone products in the eye and may be a cause of capsular fibrosis around the glaucoma drainage device plate.
Obesity increases the risk of chronic pain development after motor vehicle collision
Authors: Mauck Matthew C. , Hu JunMei , Sefton Christopher , Swor Robert A. , Peak David A. , Jones Jeffrey S. , Rathlev Niels K. , Lee David C. , Domeier Robert M. , Hendry Phyllis L. , McLean Samuel A. 
Published: November 2018

Abstract
Obesity has been found to increase the risk of musculoskeletal pain (MSP) in other settings, but to our knowledge, the influence of increased body mass index on pain outcomes after common trauma exposures such as motor vehicle collision (MVC) has not been assessed. In addition, obesity results in biomechanical changes, as well as physiologic changes including reduced hypothalamic pituitary adrenal axis negative feedback inhibition, but mechanisms by which obesity may result in worse post-traumatic outcomes remain poorly understood. In this study, we evaluated the influence of body mass index on axial and overall MSP severity (0-10 numeric rating scale) 6 weeks, 6 months, and 1 year after MVC among 917 European Americans who presented to the emergency department for initial evaluation. After adjusting for an array of sociodemographic factors, obesity (particularly morbid obesity) was an independent risk factor for worse MSP after MVC (eg, RR 1.41 [95% CI 1.11, 1.80] for moderate or severe MSP 6 months after MVC among morbidly obese vs normal weight MVC survivors). Interestingly, substantial effect modification was observed between obesity risk and a genetic variant known to reduce hypothalamic pituitary adrenal axis negative feedback inhibition (FKBP5 rs9380526). (eg, 41% vs 16% increased risk of moderate or severe MSP at 6 months among obese individuals with and without the risk allele.) Further studies are needed to elucidate mechanisms underlying chronic pain development in obese trauma survivors and to develop interventions that will reduce chronic pain severity among this common, at-risk group.
Pioglitazone, a PPARγ agonist, reduces cisplatin-evoked neuropathic pain by protecting against oxidative stress
Authors: Khasabova Iryna A. , Khasabov Sergey G. , Olson Julie K. , Uhelski Megan L. , Kim Amy H. , Albino-Ramírez Alejandra M. , Wagner Chad L. , Seybold Virginia S. , Simone Donald A. 
Published: November 2018

Abstract
Painful peripheral neuropathy is a dose-limiting side effect of cisplatin treatment. Using a murine model of cisplatin-induced hyperalgesia, we determined whether a PPARγ synthetic agonist, pioglitazone, attenuated the development of neuropathic pain and identified underlying mechanisms. Cisplatin produced mechanical and cold hyperalgesia and decreased electrical thresholds of Aδ and C fibers, which were attenuated by coadministration of pioglitazone (10 mg/kg, intraperitoneally [i.p.]) with cisplatin. Antihyperalgesic effects of pioglitazone were blocked by the PPARγ antagonist T0070907 (10 mg/kg, i.p.). We hypothesized that the ability of pioglitazone to reduce the accumulation of reactive oxygen species (ROS) in dorsal root ganglion (DRG) neurons contributed to its antihyperalgesic activity. Effects of cisplatin and pioglitazone on somatosensory neurons were studied on dissociated mouse DRG neurons after 24 hours in vitro. Incubation of DRG neurons with cisplatin (13 µM) for 24 hours increased the occurrence of depolarization-evoked calcium transients, and these were normalized by coincubation with pioglitazone (10 µM). Oxidative stress in DRG neurons was considered a significant contributor to cisplatin-evoked hyperalgesia because a ROS scavenger attenuated hyperalgesia and normalized the evoked calcium responses when cotreated with cisplatin. Pioglitazone increased the expression and activity of ROS-reducing enzymes in DRG and normalized cisplatin-evoked changes in oxidative stress and labeling of mitochondria with the dye MitoTracker Deep Red, indicating that the antihyperalgesic effects of pioglitazone were attributed to its antioxidant properties in DRG neurons. These data demonstrate clear benefits of broadening the use of the antidiabetic drug pioglitazone, or other PPARγ agonists, to minimize the development of cisplatin-induced painful neuropathy.
Cortical integration of bilateral nociceptive signals: when more is less
Authors: Northon Stéphane , Rustamov Nabi , Piché Mathieu 
Published: November 2018

AbstractIntegration of nociceptive information is essential to produce adapted responses, to promote body integrity and survival. However, how the brain integrates nociceptive inputs from different body areas remains unknown. The aim of this study was to examine the cortical integration of bilateral nociceptive inputs evoked by laser heat stimuli. Sixteen healthy volunteers (8 F, 8 M; age: 25.5 ± 4.3) were recruited to participate in one session during which painful laser stimuli were applied to their hands with 2 Nd:YAP laser systems. Electroencephalographic activity was recorded to measure laser-evoked potentials and event-related spectral perturbations. Twenty nociceptive stimuli were applied in each of the 4 counterbalanced conditions: (1) right hand, (2) left hand, and both hands with (3) attention to the right or (4) attention to the left. Compared with unilateral conditions, N2 and P2 peak amplitude as well as gamma oscillation power were decreased in bilateral conditions (P< 0.05), but these effects were not affected by the direction of attention (P> 0.1). By contrast, pain was not significantly different in any condition (P> 0.05). These findings show that although more nociceptive inputs reach the brain with multiple nociceptive stimuli, their sensory representation is decreased while pain perception remains unchanged. These interactions between cerebral processing of nociceptive information from different body regions could support coordinated behavioral responses when pain origins from multiple sources.
Physical activity in adolescents and children and relationship to metabolic health
Authors: Whooten Rachel , Kerem Liya , Stanley Takara 
Published: November 2018

Purpose of review
To summarize the recent developments relating to the role of physical activity in improving insulin resistance and metabolic syndrome in children and adolescents.

Recent findings
The current literature strengthens previous findings on the relationship between physical activity and metabolic health in children; suggests a protective role for physical activity in the setting of obesity; examines population-specific findings; addresses specific effects of different modalities of physical activity in improving health; reveals potential mediators in the relationship between physical activity and metabolic health; and suggests new markers of metabolic health that could potentially be used as outcomes in future physical activity studies.

Summary
Recent research generally confirms the role of physical activity in decreasing insulin resistance and metabolic syndrome in children and adolescents. However, the current literature is limited by unstandardized research methods and definitions, and also aggregation of different age groups, genders, and weight status. Future research should address these issues to offer targeted physical activity interventions.
Histopathologic analysis in the diagnosis and management of chronic rhinosinusitis
Authors: Shay Aryan D. , Tajudeen Bobby A. 
Published: November 2018

Purpose of review
New research in the pathogenesis of chronic rhinosinusitis has shed light on an emerging classification system based on endotypes, which help to explain the individualized mechanism of disease in patients suffering from chronic rhinosinusitis with and without nasal polyps. The purpose of this review is to advocate the use of structured histopathologic analysis in the diagnosis and management of patients affected by chronic rhinosinusitis with and without polyps.

Recent findings
Numerous studies have demonstrated the role of inflammation in chronic rhinosinusitis and the ensuing histopatholgic changes. Few studies have implemented structured histopathologic analysis to guide diagnosis and treatment. Individualized therapy including biotherapeutics and comprehensive surgery has shown to improve outcomes in patients with refractory disease.

Summary
Structured histopathologic analysis can provide helpful information on the endotype of chronic rhinosinusitis. Routine use in clinical practice should be standardized especially in cases of chronic rhinosinusitis refractory to medical therapy and/or surgery.
Indications and endonasal treatment of petrous apex cholesterol granulomas
Authors: Kohanski Michael A. , Palmer James N. , Adappa Nithin D. 
Published: November 2018

Purpose of review
Lesions of the petrous apex of the temporal bone can be challenging to access and approaches laterally through the mastoid as well as medially through an endonasal approach are utilized to access this region while preserving function of adjacent structures. Cholesterol granulomas of the petrous apex requiring surgery are marsupialized to prevent expansion of the inflamed cyst and relieve associated clinical symptoms. The endonasal approach to the petrous apex has in the past been limited to lesions medial to the internal carotid artery.

Recent findings
Endoscopic approaches have been developed to expand the range of petrous apex lesions that are accessible endonasally. These endonasal corridors include a nasopharyngeal/transclival corridor, lateralization of the internal carotid artery to create an expanded medial window, a pterygopalatine infrapetrosal approach, and a contralateral maxillary approach, which allow improved access to the inferior and lateral petrous apex. Nasoseptal flaps may reduce the risk of postoperative stenosis of the drainage tract.

Summary
Endoscopic endonasal approaches can be used safely to address both medial and lateral/inferior petrous apex lesions. Morbidity of these procedures is low and use of a nasoseptal flap may limit restenosis of the drainage pathway.
Measuring alloantibodies: a matter of quantity and quality
Authors: Kiernan Jeffrey J. , Ellison Cynthia A. , Tinckam Kathryn J. 
Published: November 2018

Purpose of review
This review describes the utility and limitations of measure for assessing the presence, relative strength, and clinical impact of human leukocyte antigen (HLA) alloantibodies, as well as the other qualitative features of antibodies that are important considerations in assessing patient risk.

Recent findings
Using MFI as a measure of antibody amount is limited for a variety of reasons. Standardized serum manipulations such as ethylene-diamine-tetra-acetic acid treatment or serum dilution results in better definition of relationships between MFI and antibody titer or complement activation, toward greater alignment in defining positivity. Increased understanding of HLA epitopes has improved the ability to precisely define donor specific HLA antibody (DSA) specificities and the analysis of structural HLA Class II epitope mismatches in donor–recipient pairs may assist in the prevention of de novo DSA development. Studies of antibody isotypes and immunopathological mechanisms underlying graft injury mediated by non-HLA antibodies are expanding the assessemnt of immunological risk.

Summary
Careful analysis of both semiquantitative and qualitative properties of donor-specific antibodies continues to improve our ability to study the effects of DSA on clinical outcomes in solid organ transplantation.
Apolipoprotein L1 and kidney transplantation
Authors: Tedla Fasika M. , Yap Ernie 
Published: November 2018

Purpose of review
Consistent associations between variants of the apolipoprotein L1 (APOL1) gene and nondiabetic nephropathy have been reported in individuals of African descent. Donor APOL1 genotype has also been linked to shorter renal allograft survival. This review summarizes recent advances in understanding the biology of APOL1 and their implications to kidney donors and recipients.

Recent findings
Approximately 12–13% of African Americans have two renal risk APOL1 variants but most do not develop kidney disease. Although the exact mechanisms linking APOL1 genotype to renal injury are not known, evidence from new experimental models suggests APOL1 mutations may accelerate age-related podocyte loss. Recent epidemiological studies indicate potential kidney donors with high-risk APOL1 variants have increased risk of chronic kidney disease (CKD) and donors with high-risk APOL1 variants have lower estimated glomerular filtration rate (eGFR) than those with low-risk variants. The absolute risk of CKD in otherwise healthy individuals carrying high-risk APOL1 mutations is likely low.

Summary
Recent studies suggest high-risk APOL1 mutations in kidney donors are linked to shorter graft survival and lower postdonation eGFR. APOL1 genotyping may be used as one of many factors that contribute to assessment of the risk of postdonation CKD and informed decision making.