bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medium-term Outcomes of Unsutured Scleral Flap Trabeculectomies
Authors: Wang Bob Z. , Ang Ghee Soon , Meagher Peter 
Published: April 2016

Purpose:
To examine the clinical characteristics and medium-term outcomes of unsutured scleral flap trabeculectomies.

Patient and Methods:
A retrospective review of 45 patients who underwent 50 unsutured scleral flap trabeculectomies by a single ophthalmic surgeon. Information pertaining to each patient’s demographic details, preoperative assessment, surgical procedure, and 2 years of postoperative management were obtained.

Results:
The average age of patients was 72.4±12.5 (range, 30 to 97) years. The diagnosis was primary open-angle glaucoma in 38 (76.0%) cases. The average preoperative, 1 year postoperative and 2-year postoperative intraocular pressure (with number of topical antiglaucoma medications) were 20.8 (2.5), 13.2 (0.4), and 12.6 mm Hg (0.7), respectively. The procedure performed was a trabeculectomy alone in 32 (64.0%) cases, and combined trabeculectomy and phacoemulsification in 18 (36.0%) cases. Four were performed with mitomycin C. Three procedures (6%) had intraoperative complications (2 iris prolapses, 1 subconjunctival hemorrhage). Seven procedures were complicated by a postoperative choroidal detachment, which were managed conservatively and resolved spontaneously over time. There was 1 case (2%) of postoperative hypotony, which failed to resolve (intraocular pressure of <6 mm Hg for >3 months).

Conclusions:
The majority of unsutured scleral flap trabeculectomies had an acceptable risk profile and resulted in a decrease in the intraocular pressure at 2 years postoperatively.
Disseminated Tuberculosis With a Periprostatic Abscess in a Patient With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
Authors: Nambiar Puja H. , Short William R. 
Published: April 2016

Abstract
Disseminated tuberculosis (TB) is defined as the spread of Mycobacterium tuberculosis to 1 or more organs via hematogenous or lymphatic spread. Genitourinary TB is rare in developed nations, representing between 2% and 10% of extrapulmonary TB cases. Prostate involvement is uncommon; we present a case of disseminated TB resulting in a periprostatic abscess in a patient with advanced human immunodeficiency virus infection.
Altered pressure pain thresholds and increased wind-up in adult patients with chronic back pain with a history of childhood maltreatment: a quantitative sensory testing study
Authors: Tesarz Jonas , Eich Wolfgang , Treede Rolf-Detlef , Gerhardt Andreas 
Published: April 2016

Abstract
Childhood maltreatment (CM) has been associated with an increased risk of nonspecific chronic low back pain (nsCLBP). However, the mechanisms underlying this association are unclear. Therefore, this study considered whether distinct types of CM are accompanied by specific alterations in somatosensory function. A total of 176 subjects with nsCLBP and 27 pain-free controls (PCs) were included. The Childhood Trauma Questionnaire (CTQ) was used to categorize patients into 2 groups (abused/neglected vs nonabused/nonneglected) for 5 types of CM (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect). The standardized quantitative sensory testing protocol of the “German Research Network on Neuropathic Pain” was performed to obtain comprehensive profiles on somatosensory function, including detection and pain thresholds, pain sensitivity, and assessments of temporal summation (wind-up). Between 17.7% and 51.4% of subjects with nsCLBP reported CM, depending on the type of CM. Childhood Trauma Questionnaire subscores for emotional and sexual abuse were significantly higher in subjects with nsCLBP than in PCs. Compared with PCs, subjects with CM showed reduced pressure pain thresholds (PPTs), irrespective of the type of CM. Regarding distinct types of CM, subjects with nsCLBP with emotional abuse reported significantly higher wind-up than those without, and sexual abuse was accompanied by enhanced touch sensitivity. Our findings suggest that CM is nonspecifically associated with a decreased PPT in nsCLBP. Emotional abuse apparently leads to enhanced spinal pain summation, and sexual abuse leads to enhanced touch sensitivity. These results emphasize the importance of emotional abuse in nsCLBP and suggest that CM can induce long-term changes in adult somatosensory function.
Symptom profiles in the painDETECT Questionnaire in patients with peripheral neuropathic pain stratified according to sensory loss in quantitative sensory testing
Authors: Vollert Jan , Kramer Martin , Barroso Alejandro , Freynhagen Rainer , Haanpää Maija , Hansson Per , Jensen Troels S. , Kuehler Bianca M. , Maier Christoph , Mainka Tina , Reimer Maren , Segerdahl Märta , Serra Jordi , Solà Romà , Tölle Thomas R. , Treede Rolf-Detlef , Baron Ralf 
Published: April 2016

Abstract
The painDETECT Questionnaire (PDQ) is commonly used as a screening tool to discriminate between neuropathic pain (NP) and nociceptive pain, based on the self-report of symptoms, including pain qualities, numbness, and pain to touch, cold, or heat. However, there are minimal data about whether the PDQ is differentially sensitive to different sensory phenotypes in NP. The aim of the study was to analyze whether the overall PDQ score or its items reflect phenotypes of sensory loss in NP as determined by quantitative sensory testing. An exploratory analysis in the Innovative Medicines Initiative Europain and Neuropain database was performed. Data records of 336 patients identified with NP were grouped into sensory profiles characterized by (1) no loss of sensation, (2) loss of thermal sensation, (3) loss of mechanical sensation, and (4) loss of thermal and mechanical sensation. painDETECT Questionnaire profiles were analyzed in a 2-factor analysis of variance. Patients with loss of thermal sensation (2 and 4) significantly more often reported pain evoked by light touch, and patients with loss of mechanical sensation (3 and 4) significantly more often reported numbness and significantly less often burning sensations and pain evoked by light touch. Although the PDQ was not designed to assess sensory loss, single items reflect thermal and/or mechanical sensory loss at group level, but because of substantial variability, the PDQ does not allow for individual allocation of patients into sensory profiles. It will be useful to develop screening tools according to the current definition of NP.
Digital Chromoendoscopy With i-Scan for In Vivo Prediction of Advanced Colorectal Neoplasia
Authors: Albrecht Heinz , Nägel Andreas , Tasdelen Hüseyin , Rath Timo , Grauer Martin , Vieth Michael , Neurath Markus F. , Neumann Helmut 
Published: April 2016

Background:
Recent studies have analyzed the potential of advanced endoscopic imaging techniques for differentiating hyperplastic and adenomatous colorectal lesions. Latest endoscopic resection techniques now also allow for treatment of more advanced staged lesions including treatment of early cancerous lesions.

Aims:
To assess the potential of the i-scan technology to differentiate between adenomatous polyps and advanced staged neoplasia.

Methods:
Consecutive patients undergoing colonoscopy at a tertiary referral center were included. After a dedicated training, participating endoscopists underwent a review of 298 unknown images of colonic lesions to assess colorectal lesion histology.

Results:
Overall accuracy for prediction of advanced staged neoplasia was 92.2% (sensitivity: 94.2%, specificity 90.9%). The positive and negative predictive values were calculated as 87.5% and 95.9%, respectively. The κ-value for differentiating adenomatous polyps and advanced staged neoplasia was 0.8193 (0.7894 to 0.8492). Intraobserver agreement was calculated with a κ-value of 0.9301 (0.8875 to 0.9727).

Conclusions:
Accurate interpretation of i-scan images for prediction of advanced colorectal neoplasia can successfully be performed even by nonexpert endoscopists with a high overall accuracy and excellent interobserver agreements.
Identifying familial hypercholesterolemia in acute coronary syndrome
Authors: Gencer Baris , Nanchen David 
Published: April 2016

Purpose of review
Familial hypercholesterolemia is a frequent genetic disorder characterized by elevated LDL-cholestrol and premature coronary heart disease. Familial hypercholesterolemia remains largely underdiagnosed in the general population and for many patients the initial clinical manifestation is acute coronary syndromes (ACS). Furthermore, many missed diagnosis of familial hypercholesterolemia can also occur during hospitalization for ACS. In this review, we aim to discuss the identification and prognosis of familial hypercholesterolemia after hospitalization for ACS.

Recent findings
The prevalence of familial hypercholesterolemia was about 10 times higher among patients hospitalized for ACS compared with the general population. Although 70% of patients with familial hypercholesterolemia were discharged with high-intensity statins, and 65% attended cardiac rehabilitation, less than 5% reached the recommended LDL-cholesterol target less than 1.8 mmol/l 1 year after ACS. Furthermore, patients with familial hypercholesterolemia and ACS were at high-risk of recurrence of cardiovascular events after discharge.

Summary
A systematic screening strategy to identify patients with familial hypercholesterolemia at the time ACS is required to maximize secondary prevention and improve lipid management. It is expected that a substantial number of familial hypercholesterolemia patients would benefit from more effective lipid-lowering drugs after ACS, in addition to statins.
Doxorubicin‐Induced Gut Toxicity in Piglets Fed Bovine Milk and Colostrum
Authors: Shen René L. , Rathe Mathias , Jiang Pingping , Pontoppidan Peter E.L. , Heegaard Peter M.H. , Müller Klaus , Sangild Per T. 
Published: April 2016

ABSTRACTObjective:Chemotherapy‐induced intestinal toxicity is a common adverse effect of cancer treatment. We hypothesized that a milk diet containing bovine colostrum (BC) would reduce intestinal toxicity in doxorubicin‐treated piglets.Methods:“Study 1” investigated intestinal parameters 9 days after a single dose of doxorubicin (1 × 75 mg/m2) in piglets fed bovine milk enriched with whey protein (BM). In “study 2,” responses to doxorubicin treatment were investigated in piglets receiving either 7 BC feedings per day (Only‐BC, n = 13), 4 BC feedings (High‐BC, n = 13), 2 BC feedings (Low‐BC, n = 14), or no BC (only BM, n = 13).Results:Doxorubicin treatment induced clinical signs of intestinal toxicity with diarrhea and weight loss, relative to controls (P < 0.05). White blood cells, hexose absorptive function, plasma citrulline, weights of intestine, colon, and spleen were reduced, whereas gut permeability and plasma C‐reactive protein levels were increased (all P < 0.05). Limited or no effects were observed for digestive enzymes, proinflammatory cytokines, or tight‐junction proteins in the intestine. Increasing BC supplementation to doxorubicin‐treated piglets (study 2) had no consistent effects on plasma C‐reactive protein and citrulline levels, intestinal morphology, digestive enzymes, permeability, or proinflammatory cytokines. Only‐BC pigs, however, had lower diarrhea severity toward the end of the experiment (P < 0.05 vs BM) and across the BC groups, intestinal toxicity was reduced (P < 0.01).Conclusions:Doxorubicin‐treated piglets are relevant for studying chemotherapy‐induced gut toxicity. Colostrum supplementation had limited effects on doxorubicin‐induced toxicity in milk‐fed piglets suggesting that colostrum and a bovine milk diet enriched with whey protein provided similar protection of the developing intestine from chemotherapy‐induced toxicity.
Accuracy of Prediction Formulae for the Assessment of Resting Energy Expenditure in Hospitalized Children
Authors: Agostoni Carlo , Edefonti Alberto , Calderini Edoardo , Fossali Emilio , Colombo Carla , Battezzati Alberto , Bertoli Simona , Milani Gregorio , Bisogno Arianna , Perrone Michela , Bettocchi Silvia , De Cosmi Valentina , Mazzocchi Alessandra , Bedogni Giorgio 
Published: April 2016

ABSTRACTBackground and Aim:The resting energy expenditure (REE) of ill children is commonly estimated from prediction formulae developed in healthy children. The aim of the present study was to evaluate the accuracy of commonly employed REE prediction formulae versus indirect calorimetry in hospitalized children.Methods:We performed a cross‐sectional study of 236 infants, children, and adolescents consecutively admitted to the Intermediate Care, Nephrology, Intensive Care, Emergency, and Cystic Fibrosis Units of the De Marchi Pediatric Hospital (Milan, Italy) between September 2013 and March 2015. REE was measured by indirect calorimetry and estimated using the World Health Organization (WHO), Harris‐Benedict, Schofield, and Oxford formulae.Results:The mean (standard deviation) difference between the estimated and measured REE was: −1 (234) kcal/day for the WHO formula; 82 (286) kcal/day for the Harris‐Benedict formula; 2 (215) kcal/day for the Schofield‐weight formula; −2 (214) kcal/day for the Schofield‐weight and height formula; and −5 (221) kcal/day for the Oxford formula. Even though the WHO, Schofield, and Oxford formulae gave accurate estimates of REE at the population level (small mean bias), all the formulae were not accurate enough to be employed at the individual level (large SD of bias).Conclusions:The WHO, Harris‐Benedict, Schofield, and Oxford formulae should not be used to estimate REE in hospitalized children.
Directional Optical Coherence Tomography Reveals Reliable Outer Nuclear Layer Measurements
Authors: Tong Kevin K. , Lujan Brandon J. , Zhou Yixiu , Lin Meng C. 
Published: April 2016

ABSTRACT

Purpose
Directional Optical Coherence Tomography (D-OCT) is a method used to optically segment and identify the outer nuclear layer (ONL) in vivo. The purpose of this study was to determine the repeatability and reproducibility of D-OCT ONL thickness measurements in healthy eyes.

Methods
Sixteen healthy eyes of sixteen subjects were imaged using the Cirrus SD-OCT. The OCT beam entry position was varied horizontally and vertically through the pupil, and cross-sectional images were obtained at baseline and 1-month follow-up by two observers. Detailed segmentation was performed to quantify the thickness of ONL without the inclusion of overlying Henle Fiber Layer. Inter-observer, intra-observer, and inter-visit variability was evaluated using Bland-Altman and coefficient of variation analysis for each category.

Results
All 16 eyes were successfully imaged, registered, and segmented. The maximum mean (SD) inter-operator difference was 2.6 (4.8) μm. The maximum mean (SD) intra-operator difference was 2.4 (5.3) μm. There was no statistically significant difference in ONL measurements detected between baseline and follow-up (p > 0.05). The mean (SD) differences measured across visits by one operator varied from −1.6 (3.1) to 1.1 (6.1) μm. The mean (SD) coefficient of variance (CV%) for all sectors with horizontal orientation was 9.1% (2.3%), 10.1% (2.5%), and 8.6% (2.3%) for inter-observer, intra-observer, and inter-visit, respectively. The mean (SD) coefficient of variance (CV%) for all sectors with vertical orientation was 8.3% (1.8%), 6.9% (1.4%), and 8.3% (2.1%) for inter-observer, intra-observer, and inter-visit, respectively. The majority of the variation of paired repeated measurements originated from between-subject variance. The within-subject variance accounted for less than 1% of the total variability.

Conclusions
ONL thickness measurements can be quantified with good repeatability and reproducibility using D-OCT. Identifying the magnitude of D-OCT variability among normal subjects will allow for improved development of future clinical studies that quantitatively track the progression of macular pathology.
Predicting Accommodative Response Using Paraxial Schematic Eye Models
Authors: Ramasubramanian Viswanathan , Glasser Adrian 
Published: April 2016

ABSTRACT

Purpose
Previous ultrasound biomicroscopy (UBM) studies showed that accommodative optical response (AOR) can be predicted from accommodative biometric changes in a young and a pre-presbyopic population from linear relationships between accommodative optical and biometric changes, with a standard deviation of less than 0.55D. Here, paraxial schematic eyes (SE) were constructed from measured accommodative ocular biometry parameters to see if predictions are improved.

Methods
Measured ocular biometry (OCT, A-scan, and UBM) parameters from 24 young and 24 pre-presbyopic subjects were used to construct paraxial SEs for each individual subject (individual SEs) for three different lens equivalent refractive index methods. Refraction and AOR calculated from the individual SEs were compared with Grand Seiko (GS) autorefractor measured refraction and AOR. Refraction and AOR were also calculated from individual SEs constructed using the average population accommodative change in UBM measured parameters (average SEs).

Results
Schematic eye calculated and GS measured AOR were linearly related (young subjects: slope = 0.77, r2 = 0.86; pre-presbyopic subjects: slope = 0.64, r2 = 0.55). The mean difference in AOR (GS − individual SEs) for the young subjects was −0.27D and for the pre-presbyopic subjects was 0.33D. For individual SEs, the mean ± SD of the absolute differences in AOR between the GS and SEs was 0.50 ± 0.39D for the young subjects and 0.50 ± 0.37D for the pre-presbyopic subjects. For average SEs, the mean ± SD of the absolute differences in AOR between the GS and the SEs was 0.77 ± 0.88D for the young subjects and 0.51 ± 0.49D for the pre-presbyopic subjects.

Conclusions
Individual paraxial SEs predict AOR, on average, with a standard deviation of 0.50D in young and pre-presbyopic subject populations. Although this prediction is only marginally better than from individual linear regressions, it does consider all the ocular biometric parameters.
Using Nurse Practitioners to Optimize Patient Flow in a Pediatric Emergency Department
Authors: Muller Karen , Chee Zoe , Doan Quynh 
Published: April 2016

ObjectivesUsing nurse practitioners (NPs) in pediatric emergency departments (PEDs) is commonplace in the United States, yet little is known on the impact of NPs on patient flow measures in these environments. This study quantifies the impact of NPs on 2 common measures of patient flow.MethodsWe conducted a retrospective cohort study using administrative data from an academic tertiary care PED. Mean shift length of stay (LOS) and the daily proportion of patients leaving without being seen (LWBS) by a clinician were compared between shifts with and without NPs on duty, matched for external variables affecting the level of activity in the department. Multivariate regression analyses were also conducted to further adjust for covariates such as the total number of PED care providers, patient acuity distribution, and total volume seen in the ED.ResultsDespite a slightly reduced total number of providers present on shifts with NPs on duty, a modest but statistically significant reduction in mean shift LOS (−19.11 minutes [95% confidence interval (CI), −31.01 to −7.22]) and daily proportion of LWBS (−1.11% [95% CI, −1.97% to −0.26%]) was observed for shifts with NPs compared with shifts without NPs on duty. Regression analyses showed that incremental NPs on shift were associated with a decreased LOS (−18.76 minutes [95% CI, −24.51 to −13.02]) as well as a reduced odds of LWBS (odds ratio, 0.56; 95% CI, 0.37–0.87).ConclusionsNurse practitioners have a modest impact on patient flow measures in a PED and are a valuable resource to optimize patient flow.
Pediatric Disaster Triage System Utilization Across the United States
Authors: Nadeau Nicole L. , Cicero Mark X. 
Published: April 2016

Objectives
The study goal was to determine which pediatric disaster triage (PDT) systems are used in US states/territories and whether there is standardization to their use. Secondary goals were to understand user satisfaction with each system, user preferences, and the nature and magnitude of incidents for which the systems are activated.

Methods
A survey was developed regarding PDT systems used in each state/territory, satisfaction with those used, preference for specific systems, and type and magnitude of incidents prompting system activation. The survey was distributed to emergency medical services for children leads in each state/territory.

Results
Eighty-six percent of states/territories responded. Eighty-eight percent of respondents used some formal PDT system, 50% of whom reported utilization of multiple systems. JumpSTART was most commonly used, most often in conjunction with other systems. Of formal systems, JumpSTART has been in use the longest. JumpSTART was also preferred by 71% of those stating a preference; it tied with Smart for median satisfaction level. Although types of incidents prompting system activation was similar across responding states/territories, number of patients prompting activation varied from 1 to 3 to greater than 20, median range of 4 to 7.

Conclusions
Most states/territories use some formal PDT system; few have 1 standardized approach. JumpSTART is predominantly used and is preferred by most respondents. With all systems, there is marked variation in number of patients prompting activation although the reported nature of incidents prompting activation is similar.
Imaging for Suspected Appendicitis
Authors: Menoch Margaret , Simon Harold K. , Hirsh Daniel , Shim Young , Baxter Amy L. , Clifton Matthew , Kim Daniel , Sturm Jesse J. 
Published: April 2016

Background
Little is known regarding the effect of different emergency department (ED) practice models on computed tomography (CT) and ultrasound (US) utilization for suspected appendicitis in the ED and through the potential inpatient hospital stay.

Objectives
Examination rates of CT and US for suspected appendicitis at 2 different pediatric EDs (PEDs) through hospital admission: an academic affiliated tertiary PED (site A) compared with a private practice tertiary care PED (site B).

Methods
All visits with the ICD-9 (International Classification of Diseases, Ninth Revision) chief complaint of abdominal pain were retrospectively examined from May 1, 2009, to February 21, 2012. Suspected appendicitis visits were defined as any visit with the chief complaint of abdominal pain where a complete blood cell count was obtained. Abdominal CT and US in the PED and during hospital admission were compared across the 2 sites. Return visits within 72 hours were evaluated for any missed appendicitis.

Results
Overall appendicitis rates were similar at both sites: site A, 4.7%; site B, 4.0%. The odds of having a CT scan performed during visits to the PED for abdominal pain were significantly higher at site B (odds ratio [OR], 3.19; 95% confidence interval [95% CI], 2.74–3.71), whereas the odds of having an US at site B were the opposite (OR, 0.34; 95% CI, 0.28–0.40). When evaluating only the admitted visits, the odds of having a CT were also greater at site B (OR, 2.32; 95% CI, 1.86–2.94) and having an US were less (OR, 0.57; 95% CI, 0.44–0.73).

Conclusions
In this study of 2 PEDs with differing practice models, we identified a dramatic difference in imaging utilization among patients with suspected appendicitis.