bluuebunny/crossref_metadata_2025_split huggingface dataset:
Axillary Ultrasound Fine Needle Aspiration Biopsy
Authors: Pesek Sarah E. , King Heather M. , Koelliker Susan , Raker Christina , Edmonson David , Dizon Don S. , Gass Jennifer 
Published: March 2017

Objectives:
Axillary ultrasound with fine needle aspiration (AXUSFNA) in early-stage breast cancer has required reappraisal. ACOSOG Z-0011 and after mapping of the axilla: radiotherapy or surgery have shown that women with limited nodal disease at sentinel lymph node biopsy got no survival advantage with completion axillary node dissection. We hypothesize that AXUSFNA may be sufficiently accurate for staging for some patients and sentinel lymph node biopsy need not be performed. We define the false negative rate (FNR) of AXUSFNA in different subsets of patients.

Materials and Methods:
This retrospective cohort study included node positive patients who also underwent AXUSFNA between 1/2006 and 12/2010 followed by axillary surgery. The FNR was calculated for the entire group and for subgroups determined by tumor, nodal, and ultrasound findings.

Results:
Out of ∼700 AXUSFNA patients, 128 node positive patients were included in the study. The overall AXUSFNA FNR was 35.9% (95% confidence interval, 28.1%-44.6%). There was a significantly higher FNR with smaller tumors and presence of ductal carcinoma in situ on multivariate analysis. On ultrasound, benign-appearing nodes had a higher FNR than indeterminate nodes (78.9% vs. 60.9%, P=0.2) and significantly higher than suspicious nodes (78.9% vs. 2.9%, P<0.0001).

Conclusions:
In our cohort, the FNR for AXUSFNA was comparable with the rate of residual disease in the control arms of Z-0011 (27.4%) and after mapping of the axilla: radiotherapy or surgery (33%). However, our analysis suggests that we may be able to identify more appropriate patients for AXUSFNA and halve the FNR. As primary tumor characteristics and genomics drive systemic therapeutic recommendations, there may be an ongoing role for AXUSFNA in axillary staging.
Autism Spectrum Disorder in Males with Sex Chromosome Aneuploidy: XXY/Klinefelter Syndrome, XYY, and XXYY
Authors: Tartaglia Nicole R. , Wilson Rebecca , Miller Judith S. , Rafalko Jessica , Cordeiro Lisa , Davis Shanlee , Hessl David , Ross Judith 
Published: March 2017

ABSTRACT:

Objective:
Neurodevelopmental concerns in males with sex chromosome aneuploidy (SCA) (XXY/Klinefelter syndrome, XYY, XXYY) include symptoms seen in autism spectrum disorder (ASD), such as language impairments and social difficulties. We aimed to: (1) evaluate ASD characteristics in research cohorts of SCA males under DSM-IV compared to DSM-5 criteria, and (2) analyze factors associated with ASD diagnoses in SCA.

Methods:
Evaluation of participants with XXY/KS (n=20), XYY (n=57) and XXYY (n=21) included medical history, cognitive/adaptive testing, Social Communication Questionnaire, Social Responsiveness Scale, Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, and DSM ASD criteria. Clinical impressions of ASD diagnostic category using the ADOS and DSM-IV criteria were compared to ADOS-2 and DSM-5 criteria. T-tests compared cognitive, adaptive, SES and prenatal vs. postnatal diagnoses between ASD and no ASD groups.

Results:
ASD rates in these research cohorts were 10% in XXY/KS, 38% in XYY, and 52% in XXYY using ADOS-2/DSM-5, and were not statistically different compared to DSM-IV criteria. In XYY and XXYY, the ASD group had lower verbal IQ and adaptive functioning compared to those without ASD. Many children without ASD still showed some social difficulties.

Conclusion:
ASD rates in males with SCA are higher than reported for the general population. Males with Y chromosome aneuploidy (XYY and XXYY) were 4.8 times more likely to have a diagnosis of ASD than the XXY/KS group, and 20 times more likely than males in the general population (1 in 42 males, CDC 2010). ASD should be considered when evaluating social difficulties in SCA. Studies of SCA and Y-chromosome genes may provide insight into male predominance in idiopathic ASD.
Associations Among Behavioral Sleep Disturbance, Family Functioning, and Controller Medication Adherence in Children with Asthma
Authors: Sonney Jennifer T. , Segrin Chris , Ward Teresa M. 
Published: March 2017

ABSTRACT:

Objective:
This study examined the associations among child sleep disturbances, family functioning, and asthma controller medication adherence in school-age children with persistent asthma.

Methods:
Thirty-four children aged 6 to 11 years and a parent independently reported on asthma control and controller medication adherence. Parents also reported on family functioning (behavior control) and child sleep disturbances (bedtime resistance, daytime sleepiness). Hierarchical linear regression models tested sleep disturbance variables as predictors of family functioning and medication adherence. A mediation model tested behavior control as a mediator between sleep disturbance and medication adherence.

Results:
Seventy-nine percent of the children had well-controlled asthma. Despite a mean of 9.48 hours of child sleep per night, 73% of the children had clinically significant disturbed sleep. Controlling for child age, bedtime resistance accounted for 32% of the variance in family behavior control (F
(1,31) = 14.75, p < .01). Behavior control also significantly mediated the relationship between total sleep disturbance and medication adherence, with a standardized indirect effect of β = −.17 (95% confidence interval [CI], −.47 to −.03) for parent-reported adherence and β = −.12 (95% CI, −.36 to −.01) for child-reported adherence.

Conclusion:
Child behavioral sleep disturbances significantly predicted family behavior control. Although child sleep disturbances did not significantly predict asthma controller medication adherence, there was a significant indirect effect of sleep disturbance on medication adherence through compromised family behavior control. Developmentally appropriate behavioral sleep interventions may improve family functioning and child asthma controller medication adherence. Family functioning may also be an entry point for intervention to improve medication adherence.
RETINAL DETACHMENT AND RETROBULBAR CYSTS IN A LARGE COHORT OF OPTIC NERVE COLOBOMA
Authors: Chen Yufeng N. , Patel C.K. , Kertes Peter J. , Devenyi Robert G. , Blaser Susan , Lam Wai-Ching 
Published: March 2017

Purpose:
To examine the relationship between retinal detachment and retrobulbar cysts in patients with optic nerve coloboma (ONC) and Morning Glory syndrome (MGS).

Methods:
Patients diagnosed with either ONC or MGS were identified through a search of the Sick Kids database. Seventy-one patients either agreed to come in for a B-scan or had an incidental orbital B-scan or magnetic resonance imaging or both. Eyes with orbital B-scan ultrasound and/or magnetic resonance imaging images were assessed independently by two ophthalmologists and a radiologist for the presence of retrobulbar cysts. Retinal detachment was identified clinically with either indirect ophthalmoscopy or from fundus photographs.

Results:
Forty-five of 71 (63%) and 26/71 (37%) patients had ONC and MGS, respectively. Retinal detachment occurred significantly more often in eyes with MGS than with ONC (9/17 [53%] vs. 5/45 [11%], P = 0.03, respectively). Retrobulbar cysts were not detected more often in MGS than in ONC (11/45 [24%] vs. 7/26 [27%]; P = 1.0). Eyes with retrobulbar cysts were significantly more likely to be associated with retinal detachment than those without (7/18 [39%] vs. 7/53 [13%]; P = 0.04).

Conclusion:
Retinal detachment occurs more frequently in MGS than in ONC in a cohort of patients referred to a specialist children's retinal service. Eyes with retrobulbar cysts are more likely to be associated with retinal detachment.
RUTHENIUM-106 BRACHYTHERAPY IN THE TREATMENT OF CIRCUMSCRIBED CHOROIDAL HEMANGIOMA
Authors: Naseripour Masood , Maleki Arash , Astaraki Arezoo , Sedaghat Ahad , Jaberi Ramin , Lee Stacey , Azma Zohreh , Silpa-Archa Sukhum 
Published: March 2017

Purpose:
To examine the efficacy and safety of Ruthenium-106 plaque radiotherapy in the treatment of circumscribed choroidal hemangioma.

Methods:
Twenty-one eyes of 21 patients diagnosed with symptomatic circumscribed choroidal hemangioma who underwent Ruthenium-106 plaque radiotherapy were included in the study. Clinical response, ancillary tests finding improvement, and major side effects were evaluated.

Results:
From the initial to the 1-year follow-up visits, vision improved in 12 eyes (57%), was stable in 7 eyes (33%), and became worse in 2 eyes (10%). Based on fluorescein angiography and optical coherence tomography, subretinal fluid and cystoid macular edema resolved in all patients. Changes in logarithm of minimum angle of resolution visual acuity (P = 0.038); tumor thickness (P = 0.0001) and largest diameter (P = 0.007) on ultrasonography; and subfoveal thickness on optical coherence tomography (P < 0.0001), were statistically significant between the initial and the 1-year follow-up visits. Side effects as observed during the follow-up period included: radiation-related retinopathy in 5 (24%) eyes, radiation-related papillopathy in 1 eye (5%), and subretinal fibrosis in 2 eyes (10%). Subretinal fibrosis was the only permanent radiation-related side effect.

Conclusion:
Ruthenium-106 plaque radiotherapy is an effective and safe method of treatment for symptomatic circumscribed choroidal hemangiomas. The incidence of permanent visual loss is low with prompt treatment of complications.
CORRELATION BETWEEN CENTRAL FOVEAL THICKNESS AND VISUAL ACUITY IN PATIENTS WITH IDIOPATHIC VITREOMACULAR TRACTION
Authors: Uzel Mehmet M. , Citirik Mehmet , Ilhan Cagri , Tekin Kemal 
Published: March 2017

Purpose:
To evaluate the impact of preoperative central foveal thickness (CFT) on visual acuity after surgery in patients with idiopathic vitreomacular traction and to calculate a cut-off value in preoperative CFT.

Methods:
Thirty-five patients with idiopathic vitreomacular traction were evaluated retrospectively. A complete ophthalmological examination including spectral domain optical coherence tomography was performed preoperatively and at 12 months after the surgery. Receiver operating characteristic analysis was used to determine the critical point for the CFT associated with improvement of 10 or more letters in visual acuity on the Early Treatment Diabetic Retinopathy Study.

Results:
Among 35 patients, the mean CFT at postoperative 12 months was significantly decreased from baseline (P = 0.001). Preoperative CFT and visual improvement were not significantly correlated (r = −0.090, P = 0.605), whereas preoperative CFT and preoperative visual acuity were significantly correlated (r = 0.757, P < 0.001). Improvement in CFT and visual improvement were also correlated significantly (r = 0.449, P = 0.007). According to the receiver operating characteristic analysis, the threshold CFT was 471 μm. When 15 patients with CFT thickness under 471 μm were evaluated, preoperative CFT was significantly correlated with improvement in visual acuity after the surgery (r = 0.561, P = 0.030).

Conclusion:
Preoperative CFT is important for the visual prognosis of patients with vitreomacular traction. Preoperative CFT of these patients should be considered in surgical decisions.
MULTIMODALITY OCULAR IMAGING IN A CASE REPORT OF HYPERVISCOSITY SYNDROME ASSOCIATED WITH LYMPHOPLASMACYTIC LEUKEMIA: THE IMAGES TELL THE STORY
Authors: Choi Rene Y. , Jacoby Rachel , Shakoor Akbar 
Published: March 2017

Purpose:
To report the clinical course of a patient with ocular manifestations of hyperviscosity syndrome associated with Waldenström macroglobulinemia, and for the first time, video imaging of mobile emboli in the conjunctival and retinal vasculature.

Methods and Patient:
A 60-year-old woman with newly diagnosed Waldenström macroglobulinemia, with no visual complaints was evaluated by the Ophthalmology service for a baseline ocular examination.

Results:
At presentation, ocular examination revealed a visual acuity of 20/25 in each eye. Slit lamp examination showed mobile white emboli throughout the conjunctival vasculature of both eyes, which was captured on video. Dilated fundus examination revealed peripheral vascular occlusion along with extensive collateral formation in both eyes and as dilation of vessels at the posterior pole of the left eye. Mobile arterial and venous emboli were also observed in the retinal vasculature, which were captured with slit-lamp color and infrared reflectance video imaging.

Conclusion:
Hyperviscosity syndrome is a rare circulation sequelae that occurs when blood is thickened secondary to an increase in immunoglobulins or a hyperproliferation of blood components as in bone marrow dyscrasias. The increase in viscosity is plainly observable in the retinal circulation, and this syndrome is often diagnosed based on visual symptoms and fundus examination. We report a patient with Waldenström macroglobulinemia who presented with multiple ocular manifestations of hyperviscosity syndrome despite the absence of visual complaints. Ophthalmologists should be aware that regardless of the lack of any subjective visual changes, ocular findings of hyperviscosity syndrome should prompt quick referral to a Hematology Oncologist for evaluation of other end-organ damage. We also for the first time, provide video documentation of mobile emboli in the conjunctival and retinal vasculature.
IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME CAUSING PROGRESSIVE OPTIC NERVE EDEMA IN CRYPTOCOCCAL MENINGITIS
Authors: Werner Astrid C. , Vuong Laurel N. , Hedges Thomas R. , Baumal Caroline R. 
Published: March 2017

Purpose:
To report an human immunodeficiency virus–positive patient undergoing therapy for cryptococcal meningitis who developed progressive optic disk edema that was steroid responsive.

Methods:
Observational case report.

Results:
One month after commencing antifungal treatment for cryptococcal meningitis, the patient developed bilateral, progressive, recurrent optic disk edema with subretinal fluid that coincided with initiation of highly active antiretroviral therapy and recovery of CD4+ cell counts. Lumbar puncture revealed normal opening pressure, and cerebrospinal fluid showed no recurrence of cryptococcal infection. There was no evidence of uveitis. The patient rapidly improved with a 5-day course of high-dose intravenous methylprednisolone.

Conclusion:
Recurrent optic disk edema with loss of vision after treatment of cryptococcal meningitis in the setting of normal intracranial pressure may represent a unique manifestation of immune reconstitution inflammatory syndrome localized to the optic nerve without uveitis. This is consistent with the temporal relationship between starting highly active antiretroviral therapy, CD4+ count recovery, and the development of progressive disk edema in the study patient. Isolated optic nerve inflammation as a manifestation of immune reconstitution inflammatory syndrome has not been widely reported.
The Association Between Clinical Features Seen on Fundus Photographs and Glaucomatous Damage Detected on Visual Fields and Optical Coherence Tomography Scans
Authors: Alhadeff Paula A. , De Moraes Carlos G. , Chen Monica , Raza Ali S. , Ritch Robert , Hood Donald C. 
Published: March 2017

Purpose:
To classify the appearance of the optic disc seen on fundus photographs of healthy subjects and patients with or suspected glaucoma whose diagnosis was based upon visual fields (VFs) and spectral-domain optical coherence tomography (sdOCT) results.

Patients and Methods:
One eye of 100 patients with or suspected glaucoma and 62 healthy subjects were prospectively tested with 24-2 and 10-2 VF and macular and disc sdOCT cube scans. All eyes with or suspected glaucoma had a 24-2 mean deviation better than −6.0 dB and an abnormal appearing disc on stereophotographs. The retinal ganglion cell plus inner plexiform layer (RGC+) from the macular scans and the retinal nerve fiber layer (RNFL) from the macular and disc scans were segmented and converted to probabilities plots. An eye was considered “glaucoma” if the sdOCT probability plots showed an abnormality in a region that corresponded to a defect seen on the 24-2 and/or 10-2 VF total deviation plot. Similarly, an eye was considered “suspect” only if both the sdOCT and VF plots were normal. Healthy subjects (normal VFs and sdOCT) were classified as “controls” and used as reference for comparisons. Glaucoma specialists reviewed the stereophotographs and classified eyes based on the presence of signs suggestive of glaucomatous optic neuropathy.

Results:
The pattern of clinical signs of glaucomatous optic neuropathy seen on stereophotographs was statistically different between glaucoma (P<0.001) and suspects (P<0.001) vs. controls and explained up to 68% of the total variance of the diagnosis based upon sdOCT and VFs. Vertical cup-to-disc>0.6, focal neuroretinal rim thinning, focal RNFL loss, and violation of the ISNT rule had the best performance to differentiate glaucoma and suspects from controls. Compared with the suspect group, glaucoma eyes (abnormal sdOCT and VF tests) were more likely to have vertical cup-to-disc>0.6 (92% vs. 69%, P=0.003), diffuse rim (53% vs. 9%, P<0.001) and RNFL (61% vs. 26%, P<0.001) thinning, and β-zone parapapillary atrophy (68% vs. 17%, P<0.001).

Conclusions:
Focal and diffuse signs of glaucoma damage seen on stereophotographs often match damage shown on VFs and sdOCT. In addition, damage shown on VFs and sdOCT is often missed during clinical evaluation. Longitudinal studies ought to differentiate focal signs of glaucoma damage seen on stereophotography from false-positives or very early loss.
M&S Smart System Contrast Sensitivity Measurements Compared With Standard Visual Function Measurements in Primary Open-Angle Glaucoma Patients
Authors: Liu Jessica L. , McAnany J. Jason , Wilensky Jacob T. , Aref Ahmad A. , Vajaranant Thasarat S. 
Published: March 2017

Purpose:
To evaluate the nature and extent of letter contrast sensitivity (CS) deficits in glaucoma patients using a commercially available computer-based system (M&S Smart System II) and to compare the letter CS measurements to standard clinical measures of visual function.

Methods:
Ninety-four subjects with primary open-angle glaucoma participated. Each subject underwent visual acuity, letter CS, and standard automated perimetry testing (Humphrey SITA 24-2). All subjects had a best-corrected visual acuity (BCVA) of 0.3 log MAR (20/40 Snellen equivalent) or better and reliable standard automated perimetry (fixation losses, false positives, and false negatives <33%). CS functions were estimated from the letter CS and BCVA measurements. The area under the CS function (AUCSF), which is a combined index of CS and BCVA, was derived and analyzed.

Results:
The mean (± SD) BCVA was 0.08±0.10 log MAR (∼20/25 Snellen equivalent), the mean CS was 1.38±0.17, and the mean Humphrey Visual Field mean deviation (HVF MD) was −7.22±8.10 dB. Letter CS and HVF MD correlated significantly (r=0.51, P<0.001). BCVA correlated significantly with letter CS (r=−0.22, P=0.03), but not with HVF MD (r=−0.12, P=0.26). A subset of the subject sample (∼20%) had moderate to no field loss (≤−6 dB MD) and minimal to no BCVA loss (≤0.3 log MAR), but had poor letter CS. AUCSF was correlated significantly with HVF MD (r=0.46, P<0.001).

Conclusions:
The present study is the first to evaluate letter CS in glaucoma using the digital M&S Smart System II display. Letter CS correlated significantly with standard HVF MD measurements, suggesting that letter CS may provide a useful adjunct test of visual function for glaucoma patients. In addition, the significant correlation between HVF MD and the combined index of CS and BCVA (AUCSF) suggests that this measure may also be useful for quantifying visual dysfunction in glaucoma patients.
Visual Field Defects in Young Patients With Open-angle Glaucoma: Comparison Between High-tension and Normal-tension Glaucoma
Authors: Park Ji-Hye , Yoo Chungkwon , Park Jinhwan , Kim Yong Yeon 
Published: March 2017

Purpose:
To investigate the clinical features of young Korean patients with open-angle glaucoma (OAG), and to compare visual field (VF) defects between patients with normal-tension glaucoma (NTG) and those with high-tension glaucoma (HTG).

Materials and Methods:
Patients with OAG younger than 40 years of age were divided into NTG and HTG groups based on untreated intraocular pressure (IOP) level. The patients were matched according to the mean deviation of standard automated perimetry. VFs were divided into 2 pairs of corresponding areas across the horizontal meridian, and the depths of VF defects were compared. Tilt ratio and torsion degree of their optic discs were also compared between the 2 groups.

Results:
Thirty-four pairs of NTG and HTG eyes were matched. Although untreated IOP showed intergroup differences, there was no difference in age, refractive error, tilt ratio, torsion degree, and depth of VF defects between the 2 groups. However, NTG eyes showed deeper VF defects in the superior paracentral area than in the inferior paracentral area (−8.29±9.33 vs. −4.45±6.03 dB, P=0.038), whereas the HTG eyes showed symmetric VF defects. Moreover, the superior paracentral area showed deeper VF defects compared with the superior arcuate area in the NTG group (P=0.002).

Conclusions:
Young patients with NTG showed asymmetric VF defects in the paracentral area, whereas those with HTG did not show such asymmetric defects. This suggests that the level of IOP may affect the pattern of VF defects in young patients with OAG. However, these findings may not be generalizable to other populations.
Relationship of Optic Nerve Structure and Function to Peripapillary Vessel Density Measurements of Optical Coherence Tomography Angiography in Glaucoma
Authors: Rao Harsha L. , Pradhan Zia S. , Weinreb Robert N. , Dasari Srilakshmi , Riyazuddin Mohammed , Raveendran Sharanya , Puttaiah Narendra K. , Venugopal Jayasree P. , Rao Dhanaraj A.S. , Devi Sathi , Mansouri Kaweh , Webers Carroll A.B. 
Published: March 2017

Purpose:
To evaluate the sectoral and global structure-structure (vessel density-retinal nerve fiber layer thickness) and structure-function (vessel density-visual sensitivity loss) relationships of peripapillary vessel density measurements on optical coherence tomography angiography in primary open-angle glaucoma and to determine if fractional polynomial (FP) models characterize the relationships better than linear models.

Materials and Methods:
In a cross-sectional study, structure-structure and structure-function relationships of peripapillary vessel densities were determined in 227 eyes of 143 subjects (63 control and 164 primary open-angle glaucoma eyes) who had undergone standard automated perimetry and optical coherence tomography testing within 6 months of each other, using linear and FP models. FP model evaluates the relationship between the dependent and the best-fitting fractional powers of the independent variable. Strength of relationship was reported as coefficient of determination (R
2).

Results:

R
2 values for structure-structure associations using linear models (0.53 for superotemporal sector, 0.61 for inferotemporal, and 0.53 for average measurements) were significantly less (P<0.05) than that determined using FP models (0.57, 0.65, and 0.55, respectively). R
2 values for structure-function associations using linear models (0.35 for superotemporal vessel density-inferotemporal visual sensitivity loss, 0.49 for inferotemporal vessel density-superotemporal visual sensitivity loss, and 0.39 for average vessel density-average visual sensitivity loss) were significantly less than that determined using FP models (0.43, 0.58, and 0.47, respectively).

Conclusions:
The inferotemporal peripapillary vessel density showed the strongest association with the corresponding retinal nerve fiber layer thickness and visual sensitivity loss in the global and sectoral regions studied. The FP models were significantly better than linear models in describing these relationships.