bluuebunny/crossref_metadata_2025_split huggingface dataset:
CANDIDA ENDOPHTHALMITIS FROM THE REACTIVATION OF A DORMANT LENTICULAR FUNGAL ABSCESS IN A PREMATURE INFANT
Authors: Yanoga Fatoumata , Garcia-Gonzalez Jose M. , Greenwald Mark , Shapiro Michael J. , Blair Michael P. 
Published: June 2016

Background/Purpose:
To report a case of fungal endophthalmitis from reactivation of a dormant lenticular fungal abscess in a severely premature infant.

Methods:
Single retrospective case report.

Results:
A female born at 23 and 6/7 weeks and weighing 620 g was diagnosed at age 29 weeks post menstrual age with persistent tunica vasculosa lentis, lenticular opacity, and aggressive posterior retinopathy of prematurity, and received bilateral intravitreal injection of bevacizumab. At the time of injection she was receiving systemic antibiotics for sepsis and fungemia. The retinopathy of prematurity regressed, as did the tunica vasculosa lentis, but a small plaque remained on the lens. At 5.5 months of age, patient presented with hypopyon and elevated intraocular pressure. Culture of intraocular fluid demonstrated Candida albicans.

Conclusion:

Candida lenticular abscess is a rare complication of systemic fungemia in premature infants. Bevacizumab-induced regression of tunica vasculosa lentis may have decreased the ability of systemically administered antifungal medications to reach the colonized lens.
SPONTANEOUS CLOSURE OF MACULAR HOLE AFTER DRAINAGE OF SUBFOVEAL PERFLUOROCARBON LIQUID
Authors: Casswell Edward J. , Banerjee Philip J. , Charteris David G. , Sullivan Paul M. 
Published: June 2016

Purpose:
To report a rare case of macular hole formation after drainage of subretinal perfluorocarbon liquid (PFCL), which closed spontaneously.

Methods:
Retrospective case report. A 60-year-old was noted to have subfoveal PFCL after a macula-involving retinal detachment repair with silicone oil tamponade. Spectral domain optical coherence tomography (Spectralis; Heidelberg Engineering, Heidelberg, Germany) was used for postoperative imaging.

Results:
Two months postdetachment repair, the patient underwent removal of silicone oil and drainage of subfoveal PFCL using a 41-gauge cannula through a extrafoveal retinotomy. A full-thickness macular hole was noted 2 weeks postoperatively. This closed spontaneously 4 months later, with an improvement in vision, although there was evidence of subfoveal atrophy.

Conclusion:
Macular hole formation can occur after drainage of subfoveal PFCL, with a favorable prognosis if managed conservatively. The resultant foveal atrophy highlights the importance of early identification and removal of subretinal PFCL.
Evidence Supporting an Association Between Expression of Major Histocompatibility Complex II by Microglia and Optic Nerve Degeneration During Experimental Glaucoma
Authors: Chidlow Glyn , Ebneter Andreas , Wood John P.M. , Casson Robert J. 
Published: June 2016

Aim:
We acquired age-matched and sex-matched Sprague-Dawley rats from 2 independent breeding establishments. Serendipitously, we observed that constitutive, and bacterial toxin–induced, expression of major histocompatibility complex (MHC) class II RT1B chain in the uveal tract was much lower in one of the cohorts. Activated microglia are known to upregulate MHC II RT1B expression during optic nerve (ON) degeneration induced by raised intraocular pressure (IOP). We investigated whether, in a model of experimental glaucoma, microglial upregulation of MHC II RT1B was less efficacious and ON degeneration correspondingly less severe in the cohort of rats with low MHC II RT1B expression.

Methods:
Experimental glaucoma was induced by lasering the trabecular meshwork using a standard protocol. After 2 weeks of elevated IOP, retinal ganglion cells (RGC) survival, ON degeneration, and microglial responses were determined in both cohorts of rats.

Results:
Raised IOP-induced expression of MHC II RT1B by microglia was muted in the “Low” cohort compared with the “High” cohort. Axonal degeneration, RGC loss, and microgliosis were all significantly lower in the cohort of rats with low basal and induced expression of MHC II RT1B, despite both cohorts displaying IOP responses that were indistinguishable in terms of peak IOP and IOP exposure.

Conclusions:
Expression of MHC II RT1B by activated microglia in the ON during experimental glaucoma was associated with more severe RGC degeneration. Further studies are needed to elucidate the role of MHC II during experimental glaucoma.
Tuberculosis Infection Status Post Partial Knee Arthroplasty
Authors: Brown Sheldon , Berger Ryan , Ramgopal Moti , Dahya Vishal 
Published: June 2016

Abstract
A 55-year-old hospitalized woman presented with a right knee wound and associated swelling, hemarthrosis, and persistent pain 2 weeks after undergoing a right knee hemiarthroplasty. The right knee wound was cultured and results revealed Mycobacterium tuberculosis. Right knee hardware was removed; irrigation and debridement were performed. An antibiotic spacer impregnated with isoniazid was then inserted into the wound cavity. The patient successfully completed a 6-month regimen of antituberculosis medication therapy, and subsequent knee cultures were negative. A total knee arthroplasty revision was performed following eradication of tuberculosis and the patient remained symptom free with a fully functional total knee arthroplasty.
Epstein-Barr Virus With Underlying Advanced Human Immunodeficiency Virus Infection Causing Bilateral Peripheral Facial Palsy and Aseptic Meningitis
Authors: Shandal Varun , Lachman Tim 
Published: June 2016

Abstract
Many viral infections causing unilateral peripheral facial palsy (PFP) are well described. They infrequently produce bilateral PFP. Human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) are known to cause bilateral PFP independently. Bilateral PFP from EBV is reported mainly in children; it rarely occurs in an adult. Advanced HIV infection makes an adult more likely to have EBV-related bilateral PFP. We describe a patient with bilateral peripheral facial weakness from EBV with an underlying HIV infection.
End-Stage Mycobacteria Pneumonia in Older Women
Authors: Patel Neha , Nanjappa Sowmya , Yacoub Abraham Tareq , Greene John N. 
Published: June 2016

Abstract

Mycobacterium abscessus lung disease, although rare, has become increasingly difficult to treat. Currently, there is no standardized treatment regimen regarding when to start antibiotic therapy and how to construct treatment regimens. In general, there has been an increased level of interest in nontuberculous mycobacterium (NTM) infections, most likely secondary to the association of NTM infection with acquired immune deficiency syndrome and recognition that NTM pulmonary infections are encountered with increasing frequency in other immunocompromised populations. With increasing prevalence, there is an increased need for standardized diagnosis and treatment. Here we discuss 3 cases of end-stage mycobacteria pneumonia in elderly women and the various treatment regimens used.
Using a graphical risk tool to examine willingness to take migraine prophylactic medications
Authors: Turner Dana P. , Golding Adrienne N. , Houle Timothy T. 
Published: June 2016

Abstract
Many migraine sufferers use daily prophylactic therapy to reduce the frequency of their headache attacks. The Food and Drug Administration has approved several different medications for migraine prophylaxis, but it is not clear whether sufferers perceive these treatments to provide clinically significant benefits given their side effect profiles. Three hundred headache sufferers were recruited from the community and local headache clinics using print and television advertising. Participants reported experiencing problematic headache attacks with a median (IQR) frequency of 7.0 (4-13) headache days per month. These sufferers participated in a cross-sectional, single-site, study that used a specially designed computer assessment task. Participants were instructed on the probability of experiencing the 3 most commonly experienced side effects for several blinded medication profiles: divalproex sodium, venlafaxine, gabapentin, propranolol, and topiramate. After learning the likelihood of experiencing side effect profiles of each medication, participants were asked whether they would be willing to take the medication for a given headache reduction level, which ranged from 0 to 7 days per month. The side effect profile for divalproex sodium was associated with the smallest willingness to take, with gabapentin, propranolol, and topiramate perceived to be much more agreeable. However, <60% of participants reported willingness to take any of these medications even if they provided a 50% reduction in headache frequency. Several general predictors of willingness to take were observed including high headache-related disability, depressive symptoms, and pain medication concerns including fear of tolerance. These findings suggest that if properly informed of the side effect profiles of these medications, many patients might opt for other treatments.
Does association of opioid use with pain and function differ by fibromyalgia or widespread pain status?
Authors: Turner Judith A. , Shortreed Susan M. , Saunders Kathleen W. , LeResche Linda , Thielke Stephen , Von Korff Michael 
Published: June 2016

Abstract
Many consider chronic opioid therapy (COT) to be ineffective for fibromyalgia, but empirical evidence is limited. Among patients identified as initiating COT, we examined whether fibromyalgia was associated with different relationships of opioid use to pain and activity interference outcomes 12 months later. We obtained electronic data on diagnoses and opioid prescriptions. We obtained patient self-report data, including pain and activity interference measures, at baseline, 4 months, and 12 months. Among 1218 patients, 429 (35%) met our definition of fibromyalgia. Patients with and without fibromyalgia who had intermittent/lower-dose or regular/higher-dose opioid use at 12 months had similar 12-month pain intensity scores. However, among patients with minimal/no opioid use at 12 months, 12-month pain intensity was greater for those with fibromyalgia (adjusted mean = 5.15 [95% confidence interval, 4.80–5.51]; 0-10 scale) than for those without (4.44 [4.15–4.72]). Similar patterns were observed for 12-month activity interference. Among patients who discontinued opioids by 12 months, those with fibromyalgia were more likely to report bothersome side effects and less likely to report pain improvement as important reasons for discontinuation (P < 0.05). In sum, at 12 months, among patients who had discontinued opioids or used them minimally, those with fibromyalgia had worse outcomes and were less likely to have discontinued because of pain improvement. Among patients continuing COT, pain and activity interference outcomes were worse than those of patients with minimal/no opioid use and did not differ for those with fibromyalgia vs those with diverse other chronic pain conditions.
Combined glutamate and glutamine levels in pain-processing brain regions are associated with individual pain sensitivity
Authors: Zunhammer Matthias , Schweizer Lauren M. , Witte Vanessa , Harris Richard E. , Bingel Ulrike , Schmidt-Wilcke Tobias 
Published: June 2016

Abstract
The relationship between glutamate and γ-aminobutyric acid (GABA) levels in the living human brain and pain sensitivity is unknown. Combined glutamine/glutamate (Glx), as well as GABA levels can be measured in vivo with single-voxel proton magnetic resonance spectroscopy. In this cross-sectional study, we aimed at determining whether Glx and/or GABA levels in pain-related brain regions are associated with individual differences in pain sensitivity. Experimental heat, cold, and mechanical pain thresholds were obtained from 39 healthy, drug-free individuals (25 men) according to the quantitative sensory testing protocol and summarized into 1 composite measure of pain sensitivity. The Glx levels were measured using point-resolved spectroscopy at 3 T, within a network of pain-associated brain regions comprising the insula, the anterior cingulate cortex, the mid-cingulate cortex, the dorsolateral prefrontal cortex, and the thalamus. GABA levels were measured using GABA-edited spectroscopy (Mescher–Garwood point-resolved spectroscopy) within the insula, the anterior cingulate cortex, and the mid-cingulate cortex. Glx and/or GABA levels correlated positively across all brain regions. Gender, weekly alcohol consumption, and depressive symptoms were significantly associated with Glx and/or GABA levels. A linear regression analysis including all these factors indicated that Glx levels pooled across pain-related brain regions were positively associated with pain sensitivity, whereas no appreciable relationship with GABA was found. In sum, we show that the levels of the excitatory neurotransmitter glutamate and its precursor glutamine across pain-related brain regions are positively correlated with individual pain sensitivity. Future studies will have to determine whether our findings also apply to clinical populations.
Intravenous lipid emulsions in the critically ill: an update
Authors: Manzanares William , Langlois Pascal L. , Hardy Gil 
Published: June 2016

Purpose of review
Purpose of the review is to summarize recent research addressing the role of intravenous lipid emulsions (IVLEs) in the critically ill.

Recent findings
Soybean oil-based IVLEs, which are high in the omega-6 polyunsaturated fatty acids, have been largely used in parenteral nutrition over the last several decades. However, it is now generally accepted that the higher content of phytosterols and polyunsaturated fatty acids in soybean oil IVLE may adversely affect the immunological and inflammatory status of the critically ill. In the last few years, alternative IVLEs with lower soybean oil content have been associated with important improvements in clinical outcomes, such as mortality, mechanical ventilation days, and ICU length of stay. Olive oil and fish oil IVLEs have been reported to reduce the incidence of infections, with no clear benefits in other clinical outcomes. Despite the promising results with these new parenteral nutrition strategies, the optimum composition, dosage and indication for alternative IVLEs still remain controversial. Nevertheless, according to current knowledge alternative IVLEs may be associated with improved clinical outcomes and should be considered in critically ill patients requiring parenteral nutrition.

Summary
There is a growing body of evidence suggesting that improved clinical outcomes can be achieved with selective use of alternative IVLEs in parenteral nutrition regimens for the critically ill. More high quality trials are needed, to better evaluate the efficacy of alternative IVLEs.
Update on perioperative acute kidney injury
Authors: Goren Or , Matot Idit 
Published: June 2016

Purpose of review
In this review, we discuss the latest updates on perioperative acute kidney injury (AKI) and the specific considerations that are relevant to different surgeries and patient populations.

Recent findings
AKI diagnosis is constantly evolving. New biomarkers detect AKI early and shed a light on the possible cause of AKI. Hypotension, even for a short duration, is associated with perioperative AKI. The debate on the deleterious effects of chloride-rich solutions is still far from conclusion. Remote ischemic preconditioning is showing promising results in the possible prevention of perioperative AKI. No definite data show a beneficiary effect of statins, fenoldepam, or sodium bicarbonate in preventing AKI.

Summary
Perioperative AKI is prevalent and associated with significant morbidity and mortality. Considering the lack of effective preventive or therapeutic interventions, this review focuses on perioperative AKI: measures for early diagnosis, defining risks and possible mechanisms, and summarizing current knowledge for intraoperative fluid and hemodynamic management to reduce risk of AKI.
Deficiency in Mucosa‐associated Lymphoid Tissue Lymphoma Translocation 1
Authors: Charbit‐Henrion Fabienne , Jeverica Anja K. , Bègue Bernadette , Markelj Gasper , Parlato Marianna , Avčin Simona Lucija , Callebaut Isabelle , Bras Marc , Parisot Mélanie , Jazbec Janez , Homan Matjaz , Ihan Alojz , Rieux‐Laucat Frédéric , Stolzenberg Marie‐Claude ,   GENIUS Group, Ruemmele Frank M. , Avčin Tadej , Cerf‐Bensussan Nadine 
Published: June 2016

ABSTRACTObjective:Early‐onset inflammatory bowel diseases can result from a wide spectrum of rare mendelian disorders. Early molecular diagnosis is crucial in defining treatment and in improving life expectancy. Herein we aimed at defining the mechanism of an immunodeficiency‐polyendrocrinopathy and enteropathy‐X‐linked (IPEX)–like disease combined with a severe immunodeficiency in 2 siblings born from distantly related parents.Methods:Whole exome sequencing was performed on blood‐extracted genomic DNA from the 2 affected children and their parents on the genomic platform of Institut IMAGINE. Candidate gene mutation was identified using the in‐house software PolyWeb and confirmed by Sanger sequencing. Protein expression was determined by western blot. Flow cytometry was used to assess consequences of the mutation on lymphocyte phenotype and nuclear factor‐kappa B (NF‐κB) activation at diagnosis and after treatment by hematopoietic stem cell transplantation.Results:We identified a homozygous missense mutation in mucosa‐associated lymphoid tissue lymphoma translocation 1 gene (MALT1), which precluded protein expression. In keeping with the known function of MALT1, NF‐κB–dependent lymphocyte activation was severely impaired. Moreover, there was a drastic reduction in Forkhead box P3 (FOXP3) regulatory T cells accounting for the IPEX‐like phenotype. Following identification of the mutation, both children received hematopoietic stem cell transplantation, which permitted full clinical recovery. Immunological workup at 6 and 12 months after transplantation showed normal NF‐κB activation and correction of regulatory T cells frequency.Conclusions:Along with FOXP3, interleukin 2 receptor alpha chain (IL2RA), and cytotoxic T‐lymphocyte protein 4 precursor (CTLA‐4) mutations, MALT1 deficiency should now be considered as a possible cause of IPEX‐like syndrome associated with immunodeficiency that can be cured by hematopoietic stem cell transplantation.
A Quality Improvement Initiative to Improve Patient Adherence to Vitamin Supplementation in Cystic Fibrosis
Authors: Garavaglia Lisa , Duncan Christina , Toucheque Malorie , Farley Allilene , Moffett Kathryn S. 
Published: June 2016

ABSTRACTObjectives:Patients with cystic fibrosis (CF) and pancreatic insufficiency are prescribed fat‐soluble vitamins, although compliance remains low. Our objective was to identify patient and caregiver knowledge deficits regarding vitamin supplementation, provide targeted education, and examine serum vitamin levels pre‐and posteducation.Methods:This prospective quality improvement study involved 118 patients. A vitamin knowledge survey was given to patients/caregivers during a clinic visit, education was provided targeting knowledge deficits, and the survey was re‐administered at the next clinic visit. Serum vitamin levels were collected at pre‐ and postsurvey.Results:Results showed significant pre‐post increases for patient and caregiver knowledge scores, and significant decreases in self‐reported nonadherence to vitamin use and number of reported barriers affecting adherence. A significant change in vitamin E level to therapeutic range post‐education was demonstrated.Conclusions:Our brief, targeted educational interventions regarding vitamin supplementation showed utility in a routine clinic setting.
A New Formulation of Oral Viscous Budesonide in Treating Paediatric Eosinophilic Oesophagitis
Authors: Oliva Salvatore , Rossetti Danilo , Papoff Paola , Tiberti Antonio , Rossi Paolo , Isoldi Sara , Amil Dias Jorge , Lucarelli Sandra , Cucchiara Salvatore 
Published: June 2016

ABSTRACTObjectives:Oral viscous budesonide is a recent therapeutic option for eosinophilic oesophagitis (EoE) compared with dietary restriction and inhaled steroids. This single‐centre, open‐label, not blinded study aims to evaluate the efficacy and safety of a new, preprepared oral viscous budesonide suspension (PVB) in children and adolescents with EoE.Methods:We treated 36 children with PVB (29 boys; median age 12 years) with EoE diagnosed according to European Society for Paediatric Gastroenterology Hepatology and Nutrition guidelines. Patients <150 and >150 cm height received 2 and 4 mg PVB daily, respectively, for 12 weeks. Upper gastrointestinal endoscopy was performed at baseline, after 12 weeks of therapy and 24 weeks after the end of therapy. Baseline and post‐treatment scores were calculated for symptoms, endoscopy, and histology. Serum cortisol was performed at baseline, 12, and 36 weeks.Results:At the end of PVB trial, endoscopy showed macroscopic remission in 32 patients (88.9%), whereas at histology median pre‐ and post‐treatment peak eosinophil count/high power field (HPF) markedly decreased from 42.2 (range: 15–100) to 2.9 (range: 0–30); moreover, mean symptom and histology scores impressively improved compared with baseline (P < 0.01). At 24 weeks after the end of PVB therapy, endoscopy showed oesophageal relapse in 21 patients (58.3%), whereas 15 (41.7%) were still in remission. Seven children (19.4%) with positive multichannel intraluminal impedance‐pH were treated also with proton pump inhibitors. No significant difference between pre‐/post‐treatment morning cortisol levels occurred.Conclusions:The new PVB suspension presented in the present study is effective and safe for treating children with proven EoE. Larger placebo‐controlled clinical trials would provide more information about dosing, efficacy, and long‐term safety of this formulation, specifically designed for the oesophagus.
Psychometric Properties of the Kessler 10 Scale in Chinese Parents of Children With Cancer
Authors: Bu Xiu-qing , You Li-ming , Li Yong , Liu Ke , Zheng Jing , Yan Tie-bin , Chen Shao-xian , Zhang Li-feng 
Published: June 2016

Background:The Kessler Psychological Distress Scale (K10) has been widely used in rating psychological distress in general and clinical populations. However, whether it can be used in parents of children with cancer is unknown. Still lacking is the evidence on its reliability and validity in culturally diverse groups.Objective:The aim of this study was to translate the K10 into Mandarin Chinese and test its psychometric properties (especially the factor structure) of the Chinese version (C-K10) in parents of children with cancer.Methods:By convenience sampling, 2 samples of parents of children with cancer (sample I, n = 206, and sample II, n = 103) were surveyed in Guangzhou, China. Sample I completed the C-K10, and the internal consistency reliability and exploratory factor analysis of the C-K10 were estimated. Sample II completed the C-K10, the State Subscale of State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale; confirmatory factor analysis and concurrent validity estimates were completed.Results:The C-K10 demonstrated strong internal consistency reliability (Cronbach’sα= .93). Both exploratory and confirmatory factor analyses supported a 2-factor structure (ie, anxiety and depression). The concurrent validity was moderate with Pearson correlations greater than 0.50 (P< .001).Conclusion:The C-K10 demonstrated very acceptable reliability and validity in screening psychological distress in Chinese parents of children with cancer.Implications for Practice:This study provides evidence that the C-K10 is a valid tool that can be used in clinical settings to screen for psychological distress in Chinese parents of children with cancer.