bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHORIOCAPILLARIS FLOW VOIDS IN CRYPTOCOCCAL CHOROIDITIS USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Vu Daniel M. , Thomas Akshay S. , Finn Avni P. , Grewal Dilraj S. 
Published: January 2018

Purpose:
To report an unusual case of cryptococcal choroiditis and highlight the multimodal imaging findings, particularly the choriocapillaris flow voids using optical coherence tomography angiography.

Methods:
Retrospective review of the clinical course of a single patient with cryptococcal choroiditis.

Results:
A 69-year-old man undergoing chemotherapy for T-cell prolymphocytic leukemia developed disseminated crytococcal neoformans infection. He developed bilateral cryptococcal choroiditis with multiple yellow-white choroidal lesion on fundoscopy in both eyes. Multimodal imaging of the choroidal lesions revealed flow voids at the level of the choriocapillaris on optical coherence tomography angiography that corresponded to hypocyanescent areas on indocyanine green angiography when registered and overlaid on the indocyanine green angiography images. The superficial and deep capillary plexuses were spared.

Conclusion:
This case illustrates that optical coherence tomography angiography was useful in demonstrating that the cryptococcal choroidal lesions impaired choriocapillaris perfusion but spared the superficial and deep retinal plexuses.
Early Corneal Innervation and Trigeminal Alterations in Parkinson Disease: A Pilot Study
Authors: Arrigo Alessandro , Rania Laura , Calamuneri Alessandro , Postorino Elisa Imelde , Mormina Enricomaria , Gaeta Michele , Marino Silvia , Di Lorenzo Giuseppe , Quartarone Angelo , Anastasi Giuseppe , Puzzolo Domenico , Aragona Pasquale 
Published: January 2018

Purpose:
To describe corneal innervation and trigeminal alterations in drug-naive patients with Parkinson disease (PD).

Methods:
A case series study was conducted by recruiting 3 early drug-naive patients with PD, 2 men and 1 woman (age: 72, 68, and 66, respectively). Ophthalmologic assessment included Ocular Surface Disease Index questionnaire, visual acuity by the logarithm of the minimum angle of resolution score, pupillary light reflexes, extrinsic ocular movements, corneal sensitivity, and slit-lamp examination. Corneal innervation parameter changes were evaluated in vivo using the Confoscan 4 confocal microscope, and they were compared with a control data set. The Heidelberg Retina Tomograph 3 (HRT3) has been used to assess retinal alterations in our patients, if compared with normal range values provided by the HRT3. Moreover, 3T magnetic resonance imaging (MRI) analysis of water diffusion property changes of trigeminal nerves was performed. All data were analyzed and compared with 2 control data sets made by 14 age-matched controls.

Results:
Patients with PD showed profound alterations of corneal innervation and of trigeminal diffusion MRI parameters, compared with controls. Strong differences (PD vs. controls) were found for deep nerve tortuosity (Kallinikos mean 19.94 vs. 2.13) and the number of beadings (mean 34.2 vs. 15.5). HRT3 retinal evaluation revealed less structural changes compared with the normal range. Diffusion MRI showed profound changes of white matter diffusion properties (PD vs. controls), with fractional anisotropy decrement (mean 0.3029 vs. 0.3329) and mean diffusivity increment (mean 0.00127 vs. 0.00106).

Conclusions:
Corneal innervation changes might occur earlier in patients with PD than in retinal ones. Confocal corneal innervation analysis might provide possible early biomarkers for a better PD evaluation and for its earlier diagnosis.
Refined Lab-score, a Risk Score Predicting Serious Bacterial Infection in Febrile Children Less Than 3 Years of Age
Authors: Leroy Sandrine , Bressan Silvia , Lacroix Laurence , Andreola Barbara , Zamora Samuel , Bailey Benoit , Da Dalt Liviana , Manzano Sergio , Gervaix Alain , Galetto-Lacour Annick 
Published: January 2018

Background:
The identification of serious bacterial infection (SBI) in children with fever without source remains a challenge. A risk score called Lab-score, based on C-reactive protein, procalcitonin and urinary dipstick results was derived to predict SBI. However, all biomarkers were initially dichotomized, leading to weak statistical reliability and lack of transportability across diverse settings. We aimed to refine and validate this risk-score algorithm.

Methods:
The Lab-score was refined using a secondary analysis of a multicenter cohort study of children with fever without source via multilevel regression modeling. The external validation was conducted on data from a Canadian cohort study.

Results:
Eight hundred seventy-seven children (24% SBI) were included for the derivation study, and 347 (16% SBI) for validation. Only C-reactive protein, procalcitonin, age and urinary dipstick remained independently associated with SBI. The model achieved an area under the receiver operating characteristic (ROC) curve of 0.94 (95% confidence interval [CI]: 0.93–0.96), which was significantly higher than any other isolated biomarker (P < 0.0001), and the original Lab-score (P < 0.0001). According to a decision curve analysis, the model yielded a better strategy than those based on independently considered biomarkers, or on the original Lab-score. The threshold analysis led to a cutoff that yielded 96% (95% CI: 92–98) sensitivity and 73% (95% CI: 70–77) specificity. The external validation found similar predictive abilities: 0.96 area under the ROC curve (95% CI: 0.93–0.99), 95% sensitivity (95% CI: 85–99) and 87% specificity (95% CI: 83–91).

Conclusion:
The refined Lab-score demonstrated higher prediction ability for SBI than the original Lab-score, with promising wider applicability across settings. These results require validation in additional populations.
Match Situations Leading to Head Injuries in Professional Male Football (Soccer)—A Video-Based Analysis Over 12 Years
Authors: Beaudouin Florian , aus der Fünten Karen , Tröß Tobias , Reinsberger Claus , Meyer Tim 
Published: January 2018

Objective:To identify risk situations promoting head injuries in professional male football (soccer) and to investigate the impact of a rule change in 2006 punishing elbow-head contacts.Design:Analysis of video sequences of head events leading to head injury.Participants:Professional football players of the first male German Bundesliga.Main Outcome Measures:Observational criteria of head impacts on video recordings (players' actions preceding head injuries, foul play—referee's decision and assessment of rater, ball possession, on-pitch medical treatment, and consequences of head impact).Results:Three hundred thirty-four head injuries were reported in kicker Sportmagazin corresponding to an incidence rate of 2.25 (95% confidence interval 2.01-2.51) per 1000 player match hours. The injured player predominantly jumped (60%), headed the ball (36%), or ran forwards (20%); the noninjured players mainly jumped (64%), headed the ball (27%), or raised the elbow to the head (23%). Free ball situations (2 players challenge for the ball) caused most of the head injuries (81%). The players' action “raising the elbow” during a head injury seemed to be lower after the rule change.Conclusions:Jumping for the ball with the intention of heading is the predominant action associated with head injury risk. Head injuries occur most often when players challenge for the ball in a header duel. As head injuries bear the potential risk of long-term health sequelae, the identification of situational circumstances is essential to develop preventative means in the future.
Combined Anterolateral, Anterior, and Anteromedial Ankle Impingement in an Adolescent Soccer Player: A Case Report and Review of the Literature
Authors: Cosma Dan I. , Vasilescu Dana E. , Corbu Andrei , Todor Adrian , Valeanu Madalina , Ulici Alexandru 
Published: January 2018

Abstract:
A unique case of combined anterolateral, anterior, and anteromedial ankle impingement in an adolescent soccer player is presented in this article. To the best of our knowledge, this is the only report of circumferential, massive, anterior ankle impingement in children described in the literature. The importance of proper diagnosis and treatment of such a lesion is illustrated in this case report. We also emphasize that clinical examination combined with 3D computed tomography scan reconstruction is an excellent and cost-effective imaging modality that can help with the diagnosis of anterior ankle impingement. Finally, open surgical treatment showed excellent results in an elite athlete.
Rare monogenic causes of primary adrenal insufficiency
Authors: Narumi Satoshi 
Published: January 2018

Purpose of review
Monogenic disorders play significant roles in the pathogenesis of childhood-onset primary adrenal insufficiency (PAI). The most common form of PAI is congenital adrenal hyperplasia (CAH), which includes the enzymatic defects of the steroidogenic pathway. This review focuses on less common forms of monogenic PAI (i.e. non-CAH monogenic PAI) with particular attention on their cause, clinical phenotypes and genetic epidemiology.

Recent findings
Non-CAH monogenic PAI can be classified into three major categories: first, adrenocorticotropic hormone resistance, second, impaired adrenal redox homeostasis and third, defective organogenesis of the adrenal glands. The clinical phenotypes of the mutation-carrying patients vary depending on the responsible gene, and they are partially explained by the tissue RNA expression patterns. Genetic epidemiology studies conducted in Turkey and Japan showed that about 80% of PAI of unknown cause was monogenic.

Summary
Genetic basis of non-CAH monogenic PAI had been less clearly understood than CAH; however, significant advances have been made with use of new research techniques such as next-generation sequencing. Understanding of these rare forms of PAI may contribute to clarifying the physiology and pathology of the adrenal glands.
The lysophosphatidic acid acyltransferases (acylglycerophosphate acyltransferases) family: one reaction, five enzymes, many roles
Authors: Bradley Ryan M. , Duncan Robin E. 
Published: January 2018

Purpose of review
Lysophosphatidic acid acyltransferases (LPAATs)/acylglycerophosphate acyltransferases (AGPATs) are a homologous group of enzymes that all catalyze the de novo formation of phosphatidic acid from lysophosphatidic acid (LPA) and a fatty acyl-CoA. This review seeks to resolve the apparent redundancy of LPAATs through examination of recent literature.

Recent findings
Recent molecular studies suggest that individual LPAAT homologues produce functionally distinct pools of phosphatidic acid, whereas gene ablation studies demonstrate unique roles despite a similar biochemical function. Loss of the individual enzymes not only causes diverse effects on down-stream lipid metabolism, which can vary even for a single enzyme from one tissue to the next, but also results in a wide array of physiological consequences, ranging from cognitive impairment, to lipodystrophy, to embryonic lethality.

Summary
LPAATs are critical mediators of cell membrane phospholipid synthesis, regulating the production of specific down-stream glycerophospholipid species through generation of distinct pools of phosphatidic acid that feed into dedicated biosynthetic pathways. Loss of any specific LPAAT can lead to alterations in cellular and organellar membrane phospholipid composition that can vary for a single enzyme in different tissues, with unique pathophysiological implications.
Salivary duct carcinoma
Authors: D’heygere Emmanuel , Meulemans Jeroen , Vander Poorten Vincent 
Published: January 2018

Purpose of review
The review puts new information on geno- and phenotype of salivary duct carcinoma (SDC) in the perspective of the updated 2017 WHO classification.

Recent findings
The proportion of SDC is increasing. This may be because of a true rise in incidence, but certainly to better diagnostic tests and changed WHO definitions. In this light, a substantial proportion of carcinoma expleomorphic adenoma is now attributed to the category of SDC. ‘Low-grade SDC’ and ‘SDC in-situ’ of the former WHO classification, are now named low-grade and high-grade intraductal carcinoma (IDC), respectively. Recent series quantify biologic aggressiveness: perineural growth, vascular invasion, and extracapsular extension in lymph node metastasis are each observed in two out of three patients with SDC. Most patients die within 3 years, but once 5-year disease-free survival is reached, further disease activity is exceptional. The typical molecular biological profile with high human epidermal growth factor receptor 2 and androgen receptor expression is increasingly successfully exploited in clinical trials for advanced SDC.

Summary
The aggressive SDC is increasingly diagnosed. Despite intensive combined surgery and radiation therapy, many patients recur, for whom new bullets, targeting the molecular biological mechanisms, are the subject of ongoing clinical trials.
The physiology of neonatal resuscitation
Authors: Hooper Stuart B. , Kitchen Marcus J. , Polglase Graeme R. , Roehr Charles C. , te Pas Arjan B. 
Published: January 2018

Purpose of review
As the infant's physiology changes dramatically after birth, modern neonatal resuscitation approaches should detect and be modified in response to these changes. This review describes the changes in respiratory physiology at birth and highlights approaches that can assist these changes.

Recent findings
To better target assistance given to infants at birth, the changes in lung physiology have been classified into three phases. The first phase involves lung aeration. As little or no gas exchange can occur, assistance should focus on airway liquid clearance. During the second phase, as airway liquid resides in lung tissue, assistance should focus on minimizing the complications associated with lung edema. The third phase occurs whenever the liquid is cleared from the tissue and respiratory mechanics stabilize. Although more traditional approaches are most effective during this phase, this is not the case for the first two phases. Furthermore, the glottis actively adducts during apnea in newborns and so noninvasive respiratory support requires the infant to be breathing so that the glottis will open.

Summary
The respiratory support provided to infants at birth should match the infant's changing physiology during transition, which requires a more sophisticated approach and equipment than current recommendations.
The importance of cohort research starting early in life to understanding child health
Authors: Paneth Nigel , Monk Catherine 
Published: January 2018

Purpose of review
The current review addresses the importance of the prospective cohort design in large, unselected populations starting early in life for understanding the origins of childhood health disorders.

Recent findings
Cohort studies originating in healthy populations have contributed to great advances in health, especially in cardiovascular diseases, but have only recently been applied systematically to study the origins of childhood disorders. Several large population-based pregnancy and/or birth cohorts have been developed in different parts of the world, and these are beginning to contribute to better understanding of the underlying causes of rare but important childhood disorders, such as autism. The environmental influences on child health outcomes (ECHO) Program is distinct in leveraging and building upon 84 existing cohorts to prospectively investigate the role of early-life exposures and underlying biological mechanisms in childhood health and disease, specifically perinatal conditions, obesity, neurodevelopmental disorders, asthma and related pulmonary disorders as well as optimum child health. ECHO is expected to comprise approximately 50 000 children. It is the first US study of this size and scope since the US Collaborative Perinatal Project of 1959–1966.

Summary
The ECHO project represents a new approach to cohort studies in childhood, efficiently making use of extant cohorts while adding new data collection elements that should permit novel insights into the underlying causes of several important pediatric conditions.
Pediatric Gastroesophageal Reflux Clinical Practice Guidelines
Authors: Rosen Rachel , Vandenplas Yvan , Singendonk Maartje , Cabana Michael , DiLorenzo Carlo , Gottrand Frederic , Gupta Sandeep , Langendam Miranda , Staiano Annamaria , Thapar Nikhil , Tipnis Neelesh , Tabbers Merit 
Published: January 2018

ABSTRACTThis document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated. A systematic literature search was performed from October 1, 2008 (if the question was addressed by 2009 guidelines) or from inception to June 1, 2015 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Clinical Trials. The approach of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to define and prioritize outcomes. For therapeutic questions, the quality of evidence was also assessed using GRADE. Grading the quality of evidence for other questions was performed according to the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS) and Quality in Prognostic Studies (QUIPS) tools. During a 3‐day consensus meeting, all recommendations were discussed and finalized. In cases where no randomized controlled trials (RCT; therapeutic questions) or diagnostic accuracy studies were available to support the recommendations, expert opinion was used. The group members voted on each recommendation, using the nominal voting technique. With this approach, recommendations regarding evaluation and management of infants and children with GERD to standardize and improve quality of care were formulated. Additionally, 2 algorithms were developed, 1 for infants <12 months of age and the other for older infants and children.
Relationship Between the DSM-5 Anxious Distress Specifier and the Hamilton Depression Rating Scale Anxiety/Somatization Factor
Authors: Zimmerman Mark , Clark Heather , McGonigal Patrick , Harris Lauren , Guzman Holst Carolina , Martin Jacob 
Published: January 2018

Abstract
We examined the association between the Hamilton Depression Scale (HAMD) approach to classifying depressed patients into anxious and nonanxious subgroups and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) anxious distress specifier subtyping. Two hundred two depressed patients were interviewed with semistructured diagnostic interviews. Patients were rated on the 17-item HAMD and the Hamilton Anxiety Rating Scale and completed the Clinically Useful Anxiety Outcome Scale. Both approaches toward identifying anxiety in depressed patients resulted in most of the patients meeting the anxiety subtype. Both subtyping methods were significantly correlated with clinician-rated and self-report measures of anxiety, and scores on the anxiety scales were higher in the patients who met the anxious subtype. However, DSM-5 anxious distress subtyping was only marginally associated with the HAMD anxiety/somatization factor subtyping approach (k = 0.21), and dimensional scores were only moderately correlated (r = 0.50). These findings indicate that the DSM-5 and HAMD approaches toward identifying an anxious subtype of depression are not interchangeable.
Site Variability in Regulatory Oversight for an International Study of Pediatric Sepsis
Authors: Michelson Kelly N. , Reubenson Gary , Weiss Scott L. , Fitzgerald Julie C. , Ackerman ; Kate K. , Christie ; LeeAnn , Bush ; Jenny L. , Nadkarni Vinay M. , Thomas Neal J. , Schreiner Mark S. 
Published: January 2018

Objectives:
Duplicative institutional review board/research ethics committee review for multicenter studies may impose administrative burdens and inefficiencies affecting study implementation and quality. Understanding variability in site-specific institutional review board/research ethics committee assessment and barriers to using a single review committee (an increasingly proposed solution) can inform a more efficient process. We provide needed data about the regulatory oversight process for the Sepsis PRevalence, OUtcomes, and Therapies multicenter point prevalence study.

Design:
Survey.

Setting:
Sites invited to participate in Sepsis PRevalence, OUtcomes, and Therapies.

Subjects:
Investigators at sites that expressed interest and/or participated in Sepsis PRevalence, OUtcomes, and Therapies.

Interventions:
None.

Measurements and Main Results:
Using an electronic survey, we collected data about 1) logistics of protocol submission, 2) institutional review board/research ethics committee requested modifications, and 3) use of a single institutional review board (for U.S. sites). We collected surveys from 104 of 167 sites (62%). Of the 97 sites that submitted the protocol for institutional review board/research ethics committee review, 34% conducted full board review, 54% expedited review, and 4% considered the study exempt. Time to institutional review board/research ethics committee approval required a median of 34 (range 3-186) days, which took longer at sites that required protocol modifications (median [interquartile range] 50 d [35–131 d] vs 32 d [14–54 d)]; p = 0.02). Enrollment was delayed at eight sites due to prolonged (> 50 d) time to approval. Of 49 U.S. sites, 43% considered using a single institutional review board, but only 18% utilized this option. Time to final approval for U.S. sites using the single institutional review board was 62 days (interquartile range, 34–70 d) compared with 34 days (interquartile range, 15–54 d) for nonsingle institutional review board sites (p = 0.16).

Conclusions:
Variability in regulatory oversight was evident for this minimal-risk observational research study, most notably in the category of type of review conducted. Duplicative review prolonged time to protocol approval at some sites. Use of a single institutional review board for U.S. sites was rare and did not improve efficiency of protocol approval. Suggestions for minimizing these challenges are provided.
Effect of Polydeoxyribonucleotide Injection in a Patient With Carpal Tunnel Syndrome
Authors: Park Jin-Sung , Park Donghwi 
Published: January 2018

Abstract
Ultrasound-guided corticosteroid injection into the carpal tunnel is widely performed for the management of carpal tunnel syndrome. However, this injection may worsen the condition in patients with type 2 diabetes mellitus. Polydeoxyribonucleotide was recently recognized as a substitute for corticosteroid because of its anti-inflammatory effects. A 41-yr-old woman with type 2 diabetes mellitus was admitted to our rehabilitation clinic with a 1-mo history of numbness and tingling in her right hand and first three fingers tips. She declined corticosteroid treatment because of a previous episode of uncontrolled blood glucose levels after corticosteroid injection. Therefore, ultrasound-guided polydeoxyribonucleotide injections into the carpal tunnel were carried out. At the 6-mo follow-up, the patient demonstrated an improvement in the carpal tunnel syndrome symptoms without any complications. Thus, polydeoxyribonucleotide injections into the carpal tunnel can be an alternative to corticosteroid injections for carpal tunnel syndrome if there are limitations because of adverse effects of the latter.