bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cataract Formation after YAG Laser Vitreolysis: Importance of Femtosecond Laser Anterior Capsulotomies in Perforated Posterior Capsules
Authors: Noristani Rozina , Schultz Tim , Dick H. Burkhard 
Published: September 2016

Purpose To report a patient who developed a white cataract after Nd:YAG laser vitreolysis with a posterior capsule defect. Methods Femtosecond laser-assisted capsulotomy was performed for optic capture fixation in a patient with a cataract due to a posterior capsule defect after Nd:YAG laser-vitreolysis. Results A 55-year-old, highly myopic woman presented with visual impairment 4 days after Nd:YAG laser vitreolysis due to preexisting floaters. The slit-lamp examination showed a mature white cataract; therefore, the intactness of the posterior capsule could not be judged. The patient underwent cataract surgery with femtosecond laser-assisted capsulotomy. Intraoperatively, a highly disrupted posterior capsule was observed. Intraocular lens (IOL) was implanted into the ciliary sulcus and the anterior circular and centered capsulotomy was used for posterior optic capture fixation. Then vitrectomy was performed. No intraoperative or postoperative complications occurred. Conclusions YAG laser vitreolysis presents a new and promising therapeutic approach for floaters. However, the complications are unknown. We describe the induction of cataract as a major complication. Furthermore, the femtosecond laser can ensure a circular and complete anterior capsulotomy, which is essential for optic capture fixation in these cases.
Choroidal Thickness and Visual Prognosis in Type 1 Lesion Due to Neovascular Age-Related Macular Degeneration
Authors: Hernández-Martínez Pablo , Dolz-Marco Rosa , Hervás-Marín David , Andreu-Fenoll Maria , Gallego-Pinazo Roberto , Arévalo José Fernando 
Published: September 2016

Purpose To evaluate the association between subfoveal choroidal thickness and the visual outcome in eyes with type 1 choroidal neovascularization (CNV) due to neovascular age-related macular degeneration (nAMD). Methods This was a retrospective, longitudinal, cross-sectional study including patients diagnosed with nAMD type 1 lesions managed with intravitreal injections of ranibizumab in a PRN strategy during 24 months. Retrospective chart review of patients with type 1 CNV recording the visual acuity, number of intravitreal injections, multimodal imaging data, and follow-up period was performed. Subfoveal choroidal thickness was measured using enhanced depth imaging scans obtained with spectral-domain optical coherence tomography. Results Twenty-five eyes of 21 patients were included. The mean baseline logMAR best-corrected visual acuity was 0.52 (+0.35) (median 0.5; range 0.1-1; interquartile range (IQR) 0.3-0.8) and improved to 0.39 (+0.39) (median 0.4; range 0.1-1; IQR 0.2-0.5) by the end of the follow-up (p = 0.038). Subfoveal choroidal thickness was 202.8 (+60.3) μm (median 218; range 81-285; IQR 146-258). Statistical mixed effects model demonstrated an association between rate of improvement of visual acuity with subfoveal choroidal thickness after 24 months (p<0.001) (95% confidence interval 0.0002-0.0001 logMAR month μm); higher thickness values were correlated with better visual acuity. Conclusions Thicker subfoveal choroid was associated with better visual outcomes in patients with type 1 CNV due to nAMD following a strict PRN regimen with intravitreal ranibizumab at 24 months of follow-up.
Spectral versus Time-Domain OCT in Detecting Preoperative Epiretinal Membranes that Accompany Macular Holes
Authors: Rao Prethy , Yonekawa Yoshihiro , Thomas Benjamin J. , Drenser Kimberly A. 
Published: September 2016

Purpose To compare the sensitivities of spectral-domain optical coherence tomography (SD-OCT) versus time-domain OCT (TD-OCT) in identifying epiretinal membranes (ERM) preoperatively in patients who underwent surgery for full-thickness macular holes (FTMH). Methods This is an interventional retrospective case series of 59 eyes diagnosed with FTMHs who underwent 25-G pars plana vitrectomy with internal limiting membrane peeling between 2009 and 2015. Preoperative OCTs were obtained by SD-OCT (Spectralis, Heidelberg, Germany) or TD-OCT (Stratus, Carl Zeiss Meditec, Dublin, CA, USA). Volume scans were reviewed for ERM accompanying the FTMH. This was compared to indocyanine green-negative staining and intraoperative findings of ERM as the gold standard. Results Baseline characteristics between the SD-OCT and TD-OCT groups were comparable. Mean duration of postoperative follow-up was 41.4 weeks (±49.0). Of 59 eyes, 33 (55.9%) exhibited an ERM intraoperatively. Four ERMs (SD-OCT group) compared to 12 (TD-OCT group) were not visualized on preoperative OCT (p = 0.003). Sensitivity and specificity of SD-OCT in ERM detection was 79% and 100% compared to 14% and 91% for TD-OCT. Visual acuity improved in both arms (0.5 and 0.3 logMAR units in SD-OCT and TD-OCT, respectively (p = 0.002, 0.0002). Conclusions We found that SD-OCT was superior to TD-OCT in identifying the presence of ERM preoperatively in patients who underwent macular hole surgery. Since ERMs may decrease the chance of successful pharmacologic vitreolysis, we recommend using SD-OCT over TD-OCT in the evaluation of patients with FTMH to more accurately identify ERMs and allow more comprehensive treatment decisions (pharmacologic versus surgical).
Intravitreal Dexamethasone in the Management of Acute Endophthalmitis: A Comparative Retrospective Study
Authors: Moisseiev Elad , Abbassi Sam , Park Susanna S. 
Published: September 2016

Purpose To compare the clinical outcome of eyes with acute bacterial endophthalmitis treated with intravitreal injection of antibiotics with or without intravitreal dexamethasone. Methods This was a retrospective chart review of 63 eyes diagnosed with acute bacterial endophthalmitis and treated with vitreous tap and intravitreal injection of antibiotics, 19 eyes (30.2%) with and 44 eyes (69.8%) without concurrent intravitreal dexamethasone. Results Visual acuity had significantly improved by 1 week and was maintained long-term (p<0.001). There were no differences in visual outcome or rates of ocular complications between the groups. None of the eyes treated with dexamethasone required repeated intravitreal antibiotic injection while 6 (13.6 %) of the other eyes required repeated intravitreal antibiotic injection (p = 0.09). A subset analysis of 21 eyes that presented with light perception/no light perception vision where vitrectomy was not possible demonstrated that intravitreal antibiotic injection improved vision and achieved similar visual gain as in eyes that presented with hand motion vision or better, with no higher complication rates. Conclusions No adverse effect of intravitreal dexamethasone in the acute management of infectious endophthalmitis was noted. A trend toward less need for repeat intravitreal antibiotic therapy was noted in eyes with acute bacterial endophthalmitis treated with concurrent intravitreal dexamethasone at presentation.
Partial LVAD Restores Ventricular Outputs and Normalizes LV but not RV Stress Distributions in the Acutely Failing Heart in Silico
Authors: Sack Kevin L. , Baillargeon Brian , Acevedo-Bolton Gabriel , Genet Martin , Rebelo Nuno , Kuhl Ellen , Klein Liviu , Weiselthaler Georg M. , Burkhoff Daniel , Franz Thomas , Guccione Julius M. 
Published: September 2016

Purpose Heart failure is a worldwide epidemic that is unlikely to change as the population ages and life expectancy increases. We sought to detail significant recent improvements to the Dassault Systèmes Living Heart Model (LHM) and use the LHM to compute left ventricular (LV) and right ventricular (RV) myofiber stress distributions under the following 4 conditions: ( 1 ) normal cardiac function; ( 2 ) acute left heart failure (ALHF); ( 3 ) ALHF treated using an LV assist device (LVAD) flow rate of 2 L/min; and ( 4 ) ALHF treated using an LVAD flow rate of 4.5 L/min. Methods and Results Incorporating improved systolic myocardial material properties in the LHM resulted in its ability to simulate the Frank-Starling law of the heart. We decreased myocardial contractility in the LV myocardium so that LV ejection fraction decreased from 56% to 28%. This caused mean LV end diastolic (ED) stress to increase to 508% of normal, mean LV end systolic (ES) stress to increase to 113% of normal, mean RV ED stress to decrease to 94% of normal and RV ES to increase to 570% of normal. When ALHF in the model was treated with an LVAD flow rate of 4.5 L/min, most stress results normalized. Mean LV ED stress became 85% of normal, mean LV ES stress became 109% of normal and mean RV ED stress became 95% of normal. However, mean RV ES stress improved less dramatically (to 342% of normal values). Conclusions These simulations strongly suggest that an LVAD is effective in normalizing LV stresses but not RV stresses that become elevated as a result of ALHF.
Statistical Optimization of Chitosan Nanoparticles as Protein Vehicles, Using Response Surface Methodology
Authors: Kiaie Nasim , Aghdam Rouhollah M. , Tafti Seyed H.A. , Emami Shahriar H. 
Published: September 2016

Background There has been increased attention given to polymeric nanoparticles as protein carriers. In this regard, chitosan/tripolyphosphate (TPP) nanoparticles are considered to be a simple and efficient carrier. However, to have an ideal protein release profile, we need to optimize the properties of the carrier. Methods This study examined the influence of 4 critical process parameters on the physicochemical characteristics of final nanoparticles. Chitosan-based nanoparticles were produced by ionic gelation, and then the size, polydispersity and zeta potential of those resulting nanoparticles were evaluated. Subsequently, the encapsulation efficiency of bovine serum albumin as model protein was investigated. Results The morphologies of nanoparticles were characterized using field emission scanning electron microscopy (FE-SEM). Linear mathematical models were presented for each response through 3 levels using Central Composite Design with the help of design of experiments software, and formulation optimization was performed. Conclusions Such research will serve as a basic study in protein loading into TPP cross-linked chitosan nanoparticles.
From Honeycomb- to Microsphere-Patterned Surfaces of Poly(Lactic Acid) and a Starch-Poly(Lactic Acid) Blend via the Breath Figure Method
Authors: Duarte Ana Rita C. , Maniglio Devid , Sousa Nuno , Mano João F. , Reis Rui L. , Migliaresi Claudio 
Published: September 2016

Background This study investigated the preparation of ordered patterned surfaces and/or microspheres from a natural-based polymer, using the breath figure and reverse breath figure methods. Methods Poly(D,L-lactic acid) and starch poly(lactic acid) solutions were precipitated in different conditions – namely, polymer concentration, vapor atmosphere temperature and substrate – to evaluate the effect of these conditions on the morphology of the precipitates obtained. Results The possibility of fine-tuning the properties of the final patterns simply by changing the vapor atmosphere was also demonstrated here using a range of compositions of the vapor phase. Porous films or discrete particles are formed when the differences in surface tension determine the ability of polymer solution to surround water droplets or methanol to surround polymer droplets, respectively. In vitro cytotoxicity was assessed applying a simple standard protocol to evaluate the possibility to use these materials in biomedical applications. Moreover, fluorescent microscopy images showed a good interaction of cells with the material, which were able to adhere on the patterned surfaces after 24 hours in culture. Conclusions The development of patterned surfaces using the breath figure method was tested in this work for the preparation of both poly(lactic acid) and a blend containing starch and poly(lactic acid). The potential of these films to be used in the biomedical area was confirmed by a preliminary cytotoxicity test and by morphological observation of cell adhesion.
Anisotropy in the Viscoelastic Response of Knee Meniscus Cartilage
Authors: Coluccino Luca , Peres Chiara , Gottardi Riccardo , Bianchini Paolo , Diaspro Alberto , Ceseracciu Luca 
Published: September 2016

Background The knee meniscus is instrumental to stability, shock absorption, load transmission and stress distribution within the knee joint. Such functions are mechanically demanding, and replacement constructs used in meniscus repair often fail because of a poor match with the surrounding tissue. This study focused on the native structure–mechanics relationships and on their anisotropic behavior in meniscus, to define the target biomechanical viscoelastic properties required by scaffolds upon loading. Methods To show regional orientation of the collagen fibers and their viscoelastic behavior, bovine lateral menisci were characterized by second harmonic generation microscopy and through time-dependent mechanical tests. Furthermore, their dynamic viscoelastic response was analyzed over a wide range of frequencies. Results and conclusions Multilevel characterization aims to expand the biomimetic approach from the structure itself, to include the mechanical characteristics that give the meniscus its peculiar properties, thus providing tools for the design of novel, effective scaffolds. An example of modeling of anisotropic open-cell porous material tailored to fulfill the measured requirements is presented, leading to a definition of additional parameters for a better understanding of the load transmission mechanism and for better scaffold functionality.
Evaluation of Calcium Dihydroxide- and Silver-Coated Implants in the Rat Tibia
Authors: Harrasser Norbert , de Wild Michael , Gorkotte Johannes , Obermeier Andreas , Feihl Susanne , Straub Melanie , von Eisenhart-Rothe Ruediger , Gollwitzer Hans , Rüegg Jasmine , Moser Walter , Gruner Philipp , Burgkart Rainer 
Published: September 2016

Background Silver ions (Ag+) have strong antibacterial effects, and silver-coated materials are in widespread clinical use. However, the application of silver-coated medical devices is not without concerns: its use with direct bone contact is not established, and systemic toxic side effects of released Ag+ have been described. Therefore, alternative bactericidal coatings with a more localized way of acting – e.g., calcium dihydroxide, Ca(OH)2 (CH) – would be advantageous. Methods A new rat model of the animal's tibial metaphysis was developed. In the left proximal tibiae of 36 male Wistar rats, titanium screws were implanted. The screws were coated with hydroxyapatite (HA; 12 animals: group I), low-dosed HA silver (HA-Ag; 12 animals: group II) and CH (12 animals: group III). After 6 weeks, all rats were sacrificed. The implants were evaluated for morphological changes on their surfaces, by light microscopy, scanning electron microscopy and energy-dispersive X-ray spectroscopy; for osteointegration, by measurement of resistance to removal; and for bacterial colonization, by quantitative culture analysis. Additionally, the tibial bone was investigated histologically for signs of osteomyelitis and sonicated to detect bacterial loads. Results (i) No microbiological or histological signs of infection could be determined on any of the screws or the surrounding bone. (ii) The bone-implant interface analysis revealed extensive bone formation and direct bone-implant contact on all HA, HA-Ag and HA-CH coated screws. (iii) HA and HA-Ag were partially, and CH was fully, degraded on the screw coating, allowing host bone to osteointegrate.
The Role of MDM4 SNP34091 A>C Polymorphism in Cancer: A Meta-Analysis on 19,328 Patients and 51,058 Controls
Authors: Jin Xin , Zhao Wenchao , Zheng Minghua , Zhou Peng , Niu Tianli 
Published: September 2016

Background Cancer is one of the leading causes of death in the world. Several observational studies have suggested a significant association of the MDM4 SNP34091 A>C polymorphism with cancers. However, the results of the published studies are inconsistent. Materials and methods PubMed, Embase/Ovid and the Chinese National Knowledge Infrastructure were searched for relevant studies with a time limit of April 20, 2016. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of the association between MDM4 polymorphism and cancer risk. Publication bias was estimated using Begg's funnel plots and Egger's regression test. Results A total of 19,328 patients and 51,058 controls were included in the analysis. Overall, a significantly decreased risk of cancer was associated with MDM4 SNP34091 polymorphism for the allele model (C vs. A, OR = 0.715, 95% CI: 0.622-0.821, p = 0.000), dominant model (CC + AC vs. AA, OR = 0.684, 95% CI: 0.563-0.831, p = 0.000), recessive model (CC vs. AC + AA, OR = 1.139, 95% CI = 1.055-1.230, p = 0.001) and heterozygote model (AC vs. AA, OR = 0.687, 95% CI = 0.568-0.832). In the subgroup analysis by cancer type, no significant association was found in the breast cancer subgroup. In the subgroup analysis by geographical region, 2 genetic models, the allele and heterozygote models, showed a significant association in Chinese populations. Conclusions The results of our meta-analysis showed that the MDM4 SNP34091 A>C polymorphism may function as a protective factor against cancer risk.
Serum Mesothelin, Osteopontin and Vimentin: Useful Markers for Clinical Monitoring of Malignant Pleural Mesothelioma
Authors: Bonotti Alessandra , Simonini Silvia , Pantani Elena , Giusti Laura , Donadio Elena , Mazzoni Maria Rosa , Chella Antonio , Marconi Letizia , Ambrosino Nicolino , Lucchi Marco , Mussi Alfredo , Cristaudo Alfonso , Foddis Rudy 
Published: September 2016

Introduction Malignant pleural mesothelioma (MPM) is a relatively rare tumor, with the epithelioid type occurring more frequently. Several biomarkers have been suggested for screening and early diagnosis of MPM. Currently, high levels of soluble mesothelin-related peptides (SMRP), plasma osteopontin (pOPN) and vimentin have been reported in patients with MPM as promising markers for diagnosis, but their clinical use in monitoring is still discussed. The aim of our study was to evaluate the usefulness of these substances as markers of the clinical response to treatment in patients suffering from epithelioid mesothelioma. Methods 219 serum samples from 56 patients were collected during follow-up and the clinical response to therapy was recorded. Percentage differences between 2 consecutive measurements of SMRP, osteopontin and vimentin (Δ markers) by means of commercially available kits were correlated with changes in the clinical course. Results Δ SMRP, Δ pOPN and Δ vimentin showed statistically significant differences between the disease categories stable disease, partial response and disease progression (p = 0.0001, p = 0.035 and p = 0.0025 for SMRP, pOPN and vimentin, respectively). Moreover, contingency table analysis showed statistically significant differences between clinical response and Δ of each marker clustered into 3 groups (<-20%, between -20% and +20%, >+20%). Conclusions The time course of Δ SMRP and Δ vimentin was strongly associated with disease status, and so was the time course of pOPN, albeit to a lesser extent. These markers appear to be particularly effective in cases of partial response and disease progression, while their possible use in stable disease should be better investigated.
Does Endometriosis Affect PAPP-A Concentration in First Trimester Fetal Screening Test?
Authors: Corigliano Maria Caterina , Martelli Federica , Capogna Maria Vittoria , Bruno Antonella , Sorge Roberto , Sarta Simona , Piccione Emilio , Pietropolli Adalgisa 
Published: September 2016

Objective Pregnancy-associated plasma protein A (PAPP-A) is a macromolecular glycoprotein. The peritoneal fluid of women affected by endometriosis shows a significant increase of PAPP-A levels. Given the important role of PAPP-A in first trimester screening test, we wondered if its presence in the peritoneal fluid of women with endometriosis could affect biochemical parameters of the test performed during pregnancy. Methods A prospective study enrolled 78 women with singleton pregnancy who performed combined test between 11 + 0 and 13 + 6 weeks of gestation: 25 women with previous histological diagnosis of endometriosis and 53 women without. All patients were sampled to determine PAPP-A concentrations. Serum levels of PAPP-A were expressed in UI/L and in MoM (multiples of median). The two groups – endometriosis women and non-endometriosis women – were compared in order to find a possible different concentration of serum PAPP-A. Results We found an increased concentration of both PAPP-A UI/L and PAPP-A MoM in deep endometriosis patients versus ovarian endometriosis with significant difference in PAPP-A MoM (p = 0.018). We also found a significant association between the stage of the disease and PAPP-A UI/L and MoM levels (PAPP-A UI/L p = 0.05, PAPP-A MoM p = 0.01). Conclusions Women with deep endometriosis show increased serum PAPP-A concentrations compared to women with ovarian endometriosis. Likewise, women with moderate or severe stage of the disease show increased serum PAPP-A concentrations compared to women with minimum or mild disease. This increase could affect first trimester aneuploidy screening test and endometriosis could represent a confounding factor in the calculation of aneuploidy risk.
Low-Angled Peripheral Intravenous Catheter Tip Placement Decreases Phlebitis
Authors: Tanabe Hidenori , Murayama Ryoko , Yabunaka Koichi , Oe Makoto , Takahashi Toshiaki , Komiyama Chieko , Sanada Hiromi 
Published: September 2016

Introduction Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. Methods Observational studies were carried out at a medical ward in a university hospital. Infusion therapy was administered to one group of patients in 2014 using Teflon catheters (control group, n = 200), and to another group of patients in 2015 using polyurethane catheters (investigational group, n = 207). The symptoms were assessed according to a scale developed by the Infusion Nurses Society. Long-axis ultrasonography images taken immediately before catheter removal were used to measure the angle between the central line of the catheter within 2 mm from the distal point and a tangent to the vessel wall. Results There were no significant differences between the two groups with respect to sex, age, and medical diagnosis. In the control and investigational groups, the rates of phlebitis were 37% (73/200) and 17% (36/207), respectively (p<0.001). The median angles of the catheter tip were 7.8° and 4.1°, respectively (p<0.001). Phlebitis occurred more frequently when the catheter-tip was placed at angle >5.8°. Discussion The frequency of phlebitis was lower in the polyurethane, in which the catheter was placed at lower angle, almost parallel to the vessel. Our results will aid in developing new catheters and in improving PIVC-securement techniques.