bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPACT OF ETIOLOGY ON THE OUTCOME OF PEDIATRIC RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Huang Ying-Chen , Chu Yen-Chang , Wang Nan-Kai , Lai Chi-Chun , Chen Kuan-Jen , Hwang Yih-Shiou , Wu Wei-Chi 
Published: November 2017

Purpose:
To evaluate the clinical features and surgical outcomes of rhegmatogenous retinal detachment in pediatric patients and to identify the independent effect of each etiology on the outcome.

Methods:
A review of patients younger than 18 years who underwent vitreoretinal surgery was conducted at Chang Gung Memorial Hospital, Taoyuan, between 2008 and 2013. Patients were classified according to etiology. Multivariate logistic regression analysis was performed to evaluate the association between outcomes and each etiologic factor.

Results:
A total of 86 cases (mean age: 12.9 ± 4.8 years; 76.7% male) were included. The mean follow-up was 46.3 ± 23.9 months. In 90.7% of patients, at least one etiology could be identified, including myopia (55.8%), congenital or developmental disease (39.5%), trauma (27.9%), and previous intraocular surgery (17.4%). Among the risk factors examined in this study, congenital or developmental disease had the worst functional outcomes (P = 0.006). Myopia was a good prognostic factor for a better retinal reattachment rate (P = 0.030). Myopic rhegmatogenous retinal detachment had the lowest probability of surgical failure (8.08%), and idiopathic rhegmatogenous retinal detachment had the lowest likelihood of postoperative visual decline (4.65%).

Conclusion:
Myopia and congenital or developmental disease are the leading etiologies of pediatric rhegmatogenous retinal detachment. Different etiologies are associated with distinctive outcomes, and congenital and developmental diseases are independent prognostic factors of a poor response.
AIR/FLUID-DROPPING TECHNIQUE FOR INTRACAPSULAR DISTILLED WATER APPLICATION
Authors: Zhang Qi , Huang Liuhui , Jin Haiying , Li Jing , Zhao Peiquan 
Published: November 2017

Purpose:
We describe a simplified technique of intracapsular distilled water application for targeting lens epithelial cells using vitrectomy approach of fluid–air exchange and to evaluate the reliability and safety of this technique.

Methods:
Consecutive patients with cataract were randomly assigned to treatment group and control group. After the nucleus removal and cortical aspiration, the space of anterior chamber and capsular bag were maintained with continuous infusion of sterile air by using fluid–air exchange technique through side-port incision. Distilled water was dropped into the capsular bag using a specially designed syringe. A concave air–fluid surface (a physical phenomenon) insured the contact of distilled water with the inner surface of the capsule without overflowing from the bag. The distilled water remained in place for 3 minutes and was then removed by the syringe.

Results:
No intraoperative surgical complication was observed, and no damage to adjacent intraocular structures was observed during the postoperative follow-up. There was no statistical difference of corneal endothelial cell loss between the treatment group and the control group. Histological study confirmed damage to the lens epithelial cells from anterior capsular specimens treated by the technique.

Conclusion:
The simplified technique using vitrectomy approach is safe and specific for targeting lens epithelial cells without associated complications.
OPTICAL COHERENCE TOMOGRAPHY AND HISTOLOGY OF AGE-RELATED MACULAR DEGENERATION SUPPORT MITOCHONDRIA AS REFLECTIVITY SOURCES
Authors: Litts Katie M. , Zhang Yuhua , Freund K. Bailey , Curcio Christine A. 
Published: November 2017

Purpose:
Widespread adoption of optical coherence tomography has revolutionized the diagnosis and management of retinal disease. If the cellular and subcellular sources of reflectivity in optical coherence tomography can be identified, the value of this technology will be advanced even further toward precision medicine, mechanistic thinking, and molecular discovery. Four hyperreflective outer retinal bands are created by the exquisite arrangement of photoreceptors, Müller cells, retinal pigment epithelium, and Bruch membrane. Because of massed effects of these axially compartmentalized and transversely aligned cells, reflectivity can be localized to the subcellular level. This review focuses on the second of the four bands, called ellipsoid zone in a consensus clinical lexicon, with the central thesis that mitochondria in photoreceptor inner segments are a major independent reflectivity source in this band, because of Mie scattering and waveguiding.

Methods:
We review the evolution of Band 2 nomenclature in published literature and discuss the origins of imaging signals from photoreceptor mitochondria that could make these organelles visible in vivo.

Results:
Our recent data pertain to outer retinal tubulation, a unique neurodegenerative and gliotic structure with a highly reflective border, prominent in late age-related macular degeneration. High-resolution histology and multimodal imaging of outer retinal tubulation together provide evidence that inner segment mitochondria undergoing fission and translocation toward the nucleus provide the reflectivity signal.

Conclusion:
Our data support adoption of the ellipsoid zone nomenclature. Identifying subcellular signal sources will newly inform clinical.
COMBINING EXTERNAL NEEDLE DRAINAGE AND SCLERAL BUCKLING WITH VITRECTOMY FOR THE REPAIR OF BULLOUS RETINAL DETACHMENTS
Authors: Chen Judy J. , Kalevar Ananda , Jumper James Michael 
Published: November 2017

Purpose:
To describe a technique of combined scleral buckle with external needle drainage and vitrectomy in the treatment of bullous exudative retinal detachment, schisis detachment, or bullous retinoschisis threatening the fovea.

Methods:
A retrospective chart review of four eyes of four patients who underwent the procedure described.

Results:
Four eyes of four patients who underwent combined scleral buckling with external needle drainage and vitrectomy by a single surgeon for a bullous exudative retinal detachment, schisis detachment, or bullous retinoschisis threatening the fovea were included in this series. All four patients were attached after a single surgical intervention. No patient developed complications from the external drainage.

Conclusion:
External needle drainage of bullous subretinal or intraschisis fluid in combination with vitrectomy is a successful technique for treating bullous exudative retinal detachments, schisis detachment, or foveal-threatening retinoschisis. The technique avoids many complications associated with conventional drainage procedures. Long-term results seem promising because of extended follow-up demonstrating sustained anatomical success with a single intervention.
CELLULAR IMAGING OF THE TAPETAL-LIKE REFLEX IN CARRIERS OF RPGR-ASSOCIATED RETINOPATHY
Authors: Kalitzeos Angelos , Samra Ranjit , Kasilian Melissa , Tee James J. L. , Strampe Margaret , Langlo Christopher , Webster Andrew R. , Dubra Alfredo , Carroll Joseph , Michaelides Michel 
Published: November 2017

Purpose:
To examine the features of the tapetal-like reflex (TLR) in female carriers of RPGR-associated retinopathy by means of adaptive optics scanning light ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography.

Methods:
Nine molecularly confirmed RPGR carriers and three healthy controls underwent ocular examination and the following retinal imaging modalities: color photography, near-infrared reflectance, fundus autofluorescence, spectral domain optical coherence tomography, and AOSLO. After identifying TLR areas across all imaging modalities, normalized local contrast of outer retinal bands on spectral domain optical coherence tomography was calculated and AOSLO-acquired photoreceptor mosaic analysis was performed.

Results:
Seven carriers had TLR areas, which colocalized with increased rod photoreceptor reflectivity on confocal AOSLO and reduced cone photoreceptor densities. Parafoveal TLR areas also exhibited reduced local contrast (i.e., increased reflectivity) of the outer retinal bands on spectral domain optical coherence tomography (inner segment ellipsoid zone and outer segment interdigitation zone). Healthy controls did not show TLR.

Conclusion:
The cellular resolution provided by AOSLO affords the characterization of the photoreceptor mosaic in RPGR carriers with a TLR. Features revealed include reduced cone density, increased cone inner segment diameter, and increased rod outer segment reflectivity.
PERIVASCULAR GRANULOMATA IN THE RETINA DEMONSTRATED BY EN FACE OPTICAL COHERENCE TOMOGRAPHY IN A PATIENT WITH BLAU SYNDROME
Authors: Friesen Erika T. , Phasukkijwatana Nopasak , Tsui Irena , Berkenstock Meghan K. , Holland Gary N. , Sarraf David 
Published: November 2017

Purpose:
To describe the multimodal retinal imaging findings of a case of Blau syndrome.

Methods:
Case report. The multimodal retinal imaging findings, including widefield angiography, cross-sectional and en face spectral domain optical coherence tomography, and optical coherence tomography angiography, of a case of Blau syndrome are described.

Results:
A 12-year-old Hispanic girl with polyarticular arthritis, skin rash, and panuveitis was diagnosed with a rare condition referred to as Blau syndrome. Genetic testing identified an NOD2 mutation. Cross-sectional and en face optical coherence tomography illustrated presumed perivascular granulomata in the middle retina. Optical coherence tomography angiography failed to display flow within these lesions.

Conclusion:
This report illustrates the presence of a remarkable distribution of perivascular, presumably granulomatous, retinal lesions in the middle retina. Similar perivascular granulomata have been noted in the histopathological analysis of ocular sarcoidosis.
Antipsychotic Polypharmacy and Its Relation to Metabolic Syndrome in Patients With Schizophrenia
Authors: Aly El-Gabry Dina M. , Abdel Aziz Karim , Okasha Tarek , Azzam Hanan , Okasha Ahmed 
Published: November 2017

Abstract

Purpose/Background
Few studies have examined the relationship between antipsychotic polypharmacy and metabolic syndrome in schizophrenia. Some studies suggest that antipsychotic polypharmacy may be associated with greater metabolic risk, whereas other studies suggest that this is uncertain. To date, there have been no studies in Egypt or the Arab world that have investigated this relationship. We sought to compare subjects with schizophrenia receiving antipsychotic polypharmacy and monotherapy as regards metabolic outcomes and to investigate medication-related factors associated with metabolic syndrome.

Methods/Procedures
We recruited 118 subjects with schizophrenia and compared between those receiving antipsychotic polypharmacy (86 subjects) and monotherapy (32 subjects) as regards demographic, clinical, metabolic, and antipsychotic medication characteristics. We examined the effect of antipsychotic-related factors an outcome of metabolic syndrome.

Findings/Results
The prevalence of metabolic syndrome in our sample was 38.1%. Except for gender, there was no statistically significant difference as regards demographic and clinical characteristics, rates of metabolic syndrome, or for individual metabolic parameters. We found a statistically significant difference (P < 0.05) between the 2 groups as regards the number, dose, and duration of intake and for the number of subjects receiving typical antipsychotics (oral and depot) and a number of individual antipsychotic medications. Using logistic regression, receiving haloperidol depot was the only antipsychotic-related factor predictive for metabolic syndrome.

Implications/Conclusions
The prevalence of metabolic syndrome does not differ in schizophrenia whether patients are receiving polypharmacy and monotherapy nor do they differ for individual metabolic parameters. Most antipsychotic-related characteristics did not predict for metabolic syndrome.
Health Burden and Socioeconomic Disparities From Hearing Loss: A Global Perspective
Authors: Ramsey Tam , Svider Peter F. , Folbe Adam J. 
Published: November 2017

Objectives/Hypothesis:
To characterize the disability-related health burden of hearing loss (HL) at a global level, with a focus on socioeconomic health disparities.

Methods:
The global burden of HL, as calculated by disability-adjusted life years (DALYs) per 100,000 individuals, was evaluated for 184 countries. Data from 5-year intervals encompassing 1990 to 2015 were organized by human development index (HDI) categorizations as specified by the U.N. Development Program (UNDP). Gini coefficients and concentration indices were used to evaluate global inequality in HL burden over this time period.

Results:
There was a global lack of improvement in hearing loss burden over 25 years. National HL burden, as measured by age-standardized DALYs, had an inverse relationship with successive level of development (p < 0.0001). Global inequalities in HL burden as measured by the concentration index decreased from 1990 to 2005, remained stable between 2005 and 2010, and slightly increased from 2010 to 2015. Central Sub-Saharan Africa, followed by Eastern Sub-Saharan Africa and South Asia, had the greatest rates of disease burden in 2015.

Conclusions:
To our knowledge, this analysis is the first to investigate socioeconomic-related inequalities in hearing loss burden using statistical tools such as the Gini coefficient and concentration index. Although inequalities have largely decreased in recent decades, the global burden of hearing loss remains high and there are recent signs of increased inequality. These data suggest that a greater distribution of hearing care resources may need to be directed towards developing countries to combat global hearing loss burden.

Level of Evidence: III
Cochlear Implantation in a Patient With Sickle Cell Disease With Early Cochlear Sclerosis
Authors: Kim Seon Jeong , Taheri Muhammad Reza , Merkison Marquitta , Monfared Ashkan 
Published: November 2017

Objective:
We report a case of bilateral sudden sensorineural hearing loss (SNHL) and early cochlear sclerosis in a patient with sickle cell disease.

Methods:
A 19-year-old female presented with sequential bilateral sudden SNHL and early cochlear sclerosis. Cochlear implantation was performed.

Results:
Early cochlear fibrosis in the hook region and basal turn was encountered within a few months of deafness. Implantation required serial dilation using various insertion guides. Postsurgical telemetry readings revealed 19 electrodes (7 paired basal electrodes, 5 single apical electrodes) in a good working order with low impedances in bilateral ears. Activation of the processors successfully provided access to the speech frequency range in both the ears.

Conclusion:
This is the first case of intraoperative documentation of rapid cochlear sclerosis in a patient with SNHL caused by sickle cell disease. Early cochlear implantation should be considered in these patients, and otolaryngologists should be aware of the possibility of rapid cochlear sclerosis without ossification in these patients.
Celiac Disease by the Age of 13 Years Is Not Associated With Probiotics Administration in Infancy
Authors: Savilahti Emma Merike , Ilonen Jorma , Kukkonen Anna Kaarina , Savilahti Erkki , Kuitunen Mikael 
Published: November 2017

ABSTRACTProbiotics are theoretically promising in primary prevention of celiac disease (CD), but research evidence on the topic is scarce. We used the data and material of a clinical double‐blind randomized placebo‐controlled trial on primary allergy prevention (n = 1223) to investigate in an exploratory study whether administration of a mix of pro‐ and prebiotics during late pregnancy and first 6 months of life was associated with prevalence of CD during 13‐year follow‐up. Children who fulfilled diagnostic criteria for CD (n = 11) and subjects with a serum sample available for analyzing CD antibodies (n = 867) were included. CD or elevated tissue transglutaminase IgA antibodies were not associated with probiotics or placebo. Nor were there any associations with the mode of delivery, the duration of exclusive or total breast‐feeding, or respiratory infections during the first 2 years of life. Allergic diseases or sensitization by the age of 2 or 5 years were not clearly associated with the development of CD.
An Autopsy Case of Sudden Death in Neurofibromatosis Type 1 With Pheochromocytoma and Myocarditis
Authors: Takamiya Masataka , Niitsu Hisae , Saigusa Kiyoshi 
Published: November 2017

Abstract
An autopsy case of sudden death in a 33-year-old man with neurofibromatosis type 1 (von Recklinghausen disease), pheochromocytoma, and myocarditis is reported. The decedent was found in his bedroom in cardiopulmonary arrest. Polypoid, elastic dermal papules on the neck, chest, abdomen, and back, and flat dark-brown macules on the chest and abdomen were observed. Flat, ovoid, dark-brown freckles were present in both axillae. Examination of the right adrenal gland revealed a tumor measuring 5 cm × 5 cm × 3 cm. Microscopic examination of the myocardium revealed moderate neutrophilic and lymphocytic infiltrates. In the right adrenal gland, tumor cells contained abundant granular eosinophilic cytoplasm and exhibited cell-nesting with an alveolar pattern (Zellballen). Polygonal cells were seen together with rich vascular networks. Immunohistochemical analyses showed cells diffusely positive for chromogranin A and dopamine β-hydroxylase. Furthermore, blood from the right heart and the right common iliac vein contained high concentrations of serum epinephrine, norepinephrine, and dopamine. Death was attributed to adrenal crisis: circulatory failure caused by excessive catecholamines produced by the pheochromocytoma. In addition, myocarditis, which had been induced chronically by catecholamines, would have also contributed adversely to the clinical course. Pheochromocytoma and myocarditis should be considered when sudden death occurs in the setting of neurofibromatosis type 1.
Does Specialty Training and Practice Setting Affect Adherence to the Pediatric Emergency Care Applied Research Network Criteria for Pediatric Head Trauma?
Authors: Tama Maria , Andharia Neel , Bufano Collin , Greenstein Josh , Khodorkovsky Boris 
Published: November 2017

Objective
The goal was to determine the effects of specialty training and practice settings on the adherence to the Pediatric Emergency Care Applied Research Network (PECARN) criteria.

Methods
A retrospective study was conducted on a 2-campus hospital. Chart documentation was used to determine adherence to PECARN criteria. Inclusion criteria were any traumatic head injury within 24 hours in patients younger than 18 years over a 1-year period. Specialty training was subdivided into 3 groups: pediatric emergency medicine, emergency medicine (EM), and general pediatrics. The 2 hospital campuses are distinctly different practice settings, one being an academic practice setting, which is also a trauma center that has a dedicated pediatric emergency department, staffed by pediatric emergency medicine, EM, and general pediatrics physicians, and the second campus is a community practice and is staffed solely by EM physicians. Statistical analysis was performed using χ2 and Cochran-Mantel-Haenszel tests. All analyses were 2-sided, and P < 0.05 was considered statistically significant.

Results
A total of 709 pediatric patients with traumatic head injuries were analyzed. Overall adherence to PECARN criteria was 93%. No statistical difference was found between different specialty training on the academic campus. In addition, the rate of adherence among EM physicians at the academic and community settings was 94.8% versus 86.5%, respectively (P = 0.004).

Conclusions
Practice setting had an effect on adherence to PECARN criteria in pediatric patients with acute traumatic head injury. The same determination on adherence was not demonstrated among physicians with different specialty trainings.
The Impact of Autologous Breast Reconstruction on Body Mass Index Patterns in Breast Cancer Patients: A Propensity-Matched Analysis
Authors: Cho Eugenia H. , Shammas Ronnie L. , Glener Adam D. , Greenup Rachel A. , Hwang E. Shelley , Hollenbeck Scott T. 
Published: November 2017

Background:
Weight gain is common in breast cancer patients and increases the risk of recurrence and mortality. The authors assessed the impact of autologous breast reconstruction on body mass index patterns after diagnosis in mastectomy patients.

Methods:
Women undergoing therapeutic mastectomy at the authors’ institution from 2008 to 2010 were identified. Patients undergoing no breast reconstruction or autologous breast reconstruction were propensity-matched by age at diagnosis, baseline obesity, mastectomy laterality, and adjuvant therapies. Multivariable regression was used to estimate covariate associations with percentage body mass index change and percentage body mass index change greater than 5.0 percent at 1 to 4 years after diagnosis.

Results:
Of 524 total patients, 80 propensity-matched pairs were identified. In multivariable regression, women undergoing immediate autologous breast reconstruction had reduced body mass index changes after diagnosis, compared with nonreconstruction patients, at 1 year (β = −5.25 percent; p < 0.01), 2 years (β = −8.78 percent; p < 0.01), and 3 years (β = −7.21 percent; p < 0.01). After 4 years, all autologous reconstruction was predictive of reduced body mass index changes (β = −3.54 percent; p = 0.02). Higher body mass index increases were observed among women who were leaner at diagnosis (p < 0.01 at 1 year) and received chemotherapy (p = 0.02 at 3 years; p = 0.04 at 4 years).

Conclusions:
Women undergoing autologous breast reconstruction gained less weight after diagnosis than nonreconstruction patients. Normal baseline body mass index and chemotherapy were predictive of greater body mass index increases. These findings may guide targeted weight management strategies in high-risk patients to maximize survival rates.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.