bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Therapeutic Success of Keloids Treated With Cryotherapy and Intralesional Corticosteroids Using Noninvasive Objective Measures
Authors: Schwaiger Hannah , Reinholz Markus , Poetschke Julian , Ruzicka Thomas , Gauglitz Gerd 
Published: December 2017

BACKGROUND
Intralesional corticosteroid injections combined with cryotherapy are considered a first-line therapy for keloids. However, objective evaluation on its efficacy is widely missing.

OBJECTIVE
In this study, the authors evaluated the therapeutic benefits of cryotherapy directly followed by intralesional crystalline triamcinolone acetonide injections using ultrasound and a 3D topographic imaging device.

MATERIALS AND METHODS
Fifteen patients with keloids were treated with cryotherapy and intralesional injections of triamcinolone acetonide for a total of 4 times at intervals of 4 weeks. Objective assessment was performed at each visit.

RESULTS
After the last treatment, a significant average reduction of scar volume of 34.3% and an average decrease in scar height of 41.3% as determined by 3D imaging was observed compared with baseline. Ultrasound revealed an average reduction of scar height of 31.7% and an average decrease in tissue penetration depth of 37.8% when compared with baseline measurements.

CONCLUSION
Objective measurements of relevant keloid characteristics as height, volume, and penetration depth help in quantifying the therapeutic effect. The observed results confirm that intralesional injections of crystalline triamcinolone acetonide combined with cryotherapy represent a powerful approach to reduce scar height and volume significantly.
Melanoma of the Face and Mohs Micrographic Surgery: Nationwide Mortality Data Analysis
Authors: Trofymenko Oleksandr , Bordeaux Jeremy S. , Zeitouni Nathalie C. 
Published: December 2017

BACKGROUND
Although Mohs micrographic surgery (MMS), narrow margin excision (NME), and wide margin excision (WME) are commonly used to treat melanoma of the face, there is a paucity of data comparing mortality outcomes for each method.

OBJECTIVE
To determine the association between surgical method used to treat cutaneous melanoma of the face and patient survival.

MATERIALS AND METHODS
A retrospective review of Surveillance, Epidemiology, and End Results registries for patients diagnosed with melanoma of the face between 2003 and 2012 was conducted.

RESULTS
The authors query resulted in 43,443 records. Patients with melanoma were more likely to undergo NME (57.79%) than WME (27.86%) or MMS (14.36%). Overall 5-year risk of death was higher with WME (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.00–1.23; p = .043) and NME (HR, 1.10; 95% CI, 1.00–1.20; p = .046) relative to MMS after adjusting for patient demographics, residence socioeconomic factors, and tumor characteristics. No statistically significant difference in melanoma-specific mortality was found between different surgical methods on multivariate analysis.

CONCLUSION
Patients with melanoma of the face treated with MMS had similar melanoma-specific mortality or overall survival outcome as patients treated by other surgical modalities.
The target invites a foe: antibody–drug conjugates in gynecologic oncology
Authors: Campos Maira P. , Konecny Gottfried E. 
Published: December 2017

Purpose of review
Antibody–drug conjugates (ADCs) represent a promising new class of cancer therapeutics. Currently more than 60 ADCs are in clinical development, however, only very few trials focus on gynecologic malignancies. In this review, we summarize the most recent advances in ADC drug development with an emphasis on how this progress relates to patients diagnosed with gynecologic malignancies and breast cancer.

Recent findings
The cytotoxic payloads of the majority of the ADCs that are currently in clinical trials for gynecologic malignancies or breast cancer are auristatins (MMAE, MMAF), maytansinoids (DM1, DM4), calicheamicin, pyrrolobenzodiazepines and SN-38. Both cleavable and noncleavable linkers are currently being investigated in clinical trials. A number of novel target antigens are currently being validated in ongoing clinical trials including folate receptor alpha, mesothelin, CA-125, NaPi2b, NOTCH3, protein tyrosine kinase-like 7, ephrin-A4, TROP2, CEACAM5, and LAMP1. For most ADCs currently in clinical development, dose-limiting toxicities appear to be unrelated to the targeted antigen but more tightly associated with the payload. Rational drug design involving optimization of the antibody, the linker and the conjugation chemistry is aimed at improving the therapeutic index of new ADCs.

Summary
Antibody–drug conjugates can increase the efficacy and decrease the toxicity of their payloads in comparison with traditional cyctotoxic agents. A better and quicker translation of recent scientific advances in the field of ADCs into rational clinical trials for patients diagnosed with ovarian, endometrial or cervical cancer could create real improvements in tumor response, survival and quality of life for our patients.
TAMOXIFEN RETINOPATHY DURING TREATMENT OF AN INOPERABLE DESMOID TUMOR
Authors: Furst Meredith , Somogyi Marie B. , Wong Robert W. , Araujo Dejka , Harper Clio A. 
Published: December 2017

Purpose:
To evaluate the clinical significance and rarity of tamoxifen retinopathy after a long-term tamoxifen treatment for an inoperable desmoid tumor.

Methods:
Case report.

Results:
Tamoxifen retinopathy is a condition rarely observed in clinical practice. Although tamoxifen is typically a treatment for breast cancer patients, we present a 68-year-old woman taking tamoxifen for an inoperable desmoid tumor, an equally rare condition. She presented with bilaterally deteriorating vision over the course of a year. Fundoscopic examination revealed parafoveal deposits bilaterally. Spectral domain optical coherence tomography exhibited hyperreflective deposits in all layers of the retina. She had a cumulative treatment dose of 292 g of tamoxifen, and the medication was subsequently stopped. Her vision remained stable 3 months after the cessation of tamoxifen.

Conclusion:
The development of tamoxifen retinopathy in the treatment of a desmoid tumor makes this case a rare entity, and this is the first reported case of these two concomitant conditions to our knowledge. With the use of long-term tamoxifen as a primary treatment, we recommend screening at regular intervals by an ophthalmologist as an integral part of treatment.
Neuropathic-Like Ocular Pain and Nonocular Comorbidities Correlate With Dry Eye Symptoms
Authors: Chang Victoria S. , Rose Terri P. , Karp Carol L. , Levitt Roy C. , Sarantopoulos Constantine , Galor Anat 
Published: December 2017

Objective:
To evaluate the association between dry eye (DE) symptoms and neuropathic-like ocular pain (NOP) features, chronic pain conditions, depression, and anxiety in patients presenting for routine ophthalmic examinations.

Methods:
Two hundred thirty-three consecutive patients ≥18 years of age presenting to a comprehensive eye clinic between January and August 2016 were included in this study. Information on demographics, chronic pain conditions, medication use, DE symptoms (dry eye questionnaire, DEQ5), NOP complaints (burning; wind, light, and temperature sensitivity), depression, and anxiety indices (patient health questionnaire 9, PHQ-9 and symptom checklist 90-revised, SCL-90-R) were collected for each individual. Pearson correlation was used to evaluate strengths of association. Logistic regression analysis examined risk factors for any (DEQ5≥6) and severe (DEQ5≥12) DE symptoms.

Results:
The mean age of the population was 46.3 years (±13.0); 67.8% (n=158) were female. Per the DEQ5, 40.3% (n=94) had mild or greater DE symptoms and 12% (n=24) had severe symptoms. Severity of DE symptoms correlated with NOP complaints: burning (Pearson r=0.37, P<0.001); sensitivity to wind (r=0.37, P<0.001), sensitivity to light (r=0.34, P<0.001), and sensitivity to temperature (r=0.30, P<0.001). Sex, race, and ethnicity were not significant risk factors for DE symptoms. Risk factors for mild or greater DE symptoms included a greater number of chronic nonocular pain conditions (odds ratio [OR]=1.38, P<0.001), arthritic pain (OR=6.34, P<0.001), back pain (OR=2.47, P=0.004), headaches (OR=2.14, P=0.02), depression (OR=1.17, P<0.001), and anxiety (OR=1.13, P=0.02).

Conclusion:
Dry eye severity positively associated with NOP complaints, comorbid chronic pain conditions, and symptoms of depression and anxiety.
Utility of Novel Autoantibodies in the Diagnosis of Sjögren's Syndrome Among Patients With Dry Eye
Authors: Karakus Sezen , Baer Alan N. , Agrawal Devika , Gurakar Merve , Massof Robert W. , Akpek Esen K. 
Published: December 2017

Purpose:
To investigate the value of 3 novel autoantibodies [salivary protein 1 (SP1), carbonic anhydrase 6 (CA6), and parotid secretory protein (PSP)] in differentiating Sjögren's syndrome (SS)-related dry eye from non-SS dry eye.

Methods:
Forty-six dry eye patients with SS (SS dry eye), 14 dry eye patients without SS (non-SS dry eye), and 25 controls were included. The 2012 American College of Rheumatology classification criteria were used for the diagnosis of SS. After a detailed review of systems, the Ocular Surface Disease Index questionnaire, Schirmer test without anesthesia, tear film breakup time, and ocular surface staining were performed to assess dry eye. All participants underwent serological testing using a commercially available finger prick kit.

Results:
Thirty-seven patients with SS (80.4%) had a positive traditional autoantibody and 28 (60.9%) had a positive novel autoantibody. Traditional autoantibodies were absent in all non-SS dry eye patients and controls. Novel autoantibodies were present in 7/14 (50%) non-SS dry eye patients and 4/25 (16%) controls. Among 3 novel autoantibodies, anti-CA6 was significantly more prevalent in the SS and non-SS dry eye groups than in controls (52.2% vs. 42.9% vs. 8.0%, P = 0.001). Dry eye patients with positive anti-CA6 alone were significantly younger than patients with only traditional autoantibodies. Anti-CA6 was associated with worse dry eye signs and symptoms.

Conclusions:
Anti-CA6 was the most prevalent novel autoantibody in patients with dry eye, and was associated with younger age and more severe disease. Longitudinal studies are needed to determine whether anti-CA6 is a marker for early SS or perhaps another form of an autoimmune dry eye disease.
Corneal Transplantation in New Zealand 2000 to 2009
Authors: Crawford Alexandra Z. , Krishnan Thiyagaraj , Ormonde Susan E. , Patel Dipika V. , McGhee Charles N. 
Published: December 2017

Purpose:
To quantify all minor/major adverse events in a large cohort of consecutive corneal transplants, particularly in respect to penetrating keratoplasty (PKP).

Methods:
All corneal transplants in the Auckland region over a 10-year period (2000–2009) were identified through the New Zealand National Eye Bank. Relevant clinical records were assessed for this period and 2 years after. All intraoperative or postoperative adverse events/complications, visual acuity, and graft outcomes were recorded.

Results:
Detailed data were available for 941 (94.5%) of 996 procedures in the study period, including 834 PKPs, 73 deep anterior lamellar keratoplasties, 28 Descemet stripping endothelial keratoplasties, and 6 tectonic keratoplasties. Intraoperative adverse events occurred in 117 (12.4%) procedures, most commonly positive vitreous pressure (6.3%). Postoperative adverse events included elevated intraocular pressure (21.3%, >30 mm Hg), graft rejection (29.8%), suture-related complications (30.1%), dry eye (15.9%), epithelial defect (9.8%), wound compromise (3.4%), microbial keratitis (3.2%), and endophthalmitis (0.6%). At 2 years, 58.7% of eyes achieved best-corrected visual acuity of ≥6/12 (20/40) and 69.6% achieved ≥6/18 (20/60). Graft survival at 2 years was 87.9%, 92.3%, and 100% for PKP, deep anterior lamellar keratoplasty, and Descemet stripping endothelial keratoplasty, respectively.

Conclusions:
In this study of 941 consecutive, principally penetrating, corneal transplants, adverse events were found to be more common than typically reported. In an era in which PKP is increasingly substituted by lamellar surgery, this provides useful insight into operative and postoperative adverse events in penetrating surgery.
Characterization of Corneal Endothelial Injury During Penetrating Keratoplasty
Authors: Vo Thomas A. , Oakey Zack , Garg Sumit 
Published: December 2017

Purpose:
To characterize corneal endothelial injury during penetrating keratoplasty in a controlled wet laboratory environment using human tissue. To identify potential areas or steps within surgery in which insult to the corneal endothelium may be most affected by trauma during routine penetrating keratoplasty.

Methods:
Human donor corneas (n = 12) with intact endothelium underwent experimental penetrating keratoplasty. Endothelial injury was evaluated after each suture quartile using trypan staining, a validated modality for assessing endothelial injury. Insult was quantified using high-resolution photography and computer software.

Results:
Statistical significance was found in the change in staining between quartiles as determined by repeated-measures analysis of variance (F
3,11 = 5.83, P < 0.0044). A post hoc Tukey test indicated that the change in staining during the first quartile (3.38% ± 0.5%) was significantly lower than the remaining quartiles at P < 0.021. The change in staining did not differ significantly between the second (8.36% ± 1.2%), third (7.88% ± 1.2%), and fourth (7.73% ± 0.9%) quartiles at P > 0.97.

Conclusions:
Evidence from this investigation suggests that injury to the endothelium occurs most during the second quartile. This may be a promising area in which clinicians could target their efforts to avoid injury to this vital tissue layer for best surgical outcomes and graft longevity.
Comparison of Sulfur Hexafluoride (SF6) and Air Tamponade in Noniridectomized Descemet Membrane Endothelial Keratoplasty
Authors: Einan-Lifshitz Adi , Sorkin Nir , Boutin Tanguy , Showail Mahmood , Borovik Armand , Jamshidi Farzad , Chan Clara C. , Rootman David S. 
Published: December 2017

Purpose:
To compare the efficacy and safety of 20% sulfur hexafluoride gas (SF6) and air tamponade in patients who underwent noniridectomized Descemet membrane endothelial keratoplasty (DMEK).

Methods:
A retrospective chart review of patients who underwent DMEK with either air or SF6 tamponade: 41 eyes received air tamponade (group 1) and 41 received SF6 tamponade (group 2). Best spectacle-corrected visual acuity, endothelial cell density, and complications including graft detachment and elevated intraocular pressure were compared.

Results:
The mean follow-up time was 8 ± 4 months in group 1 and 3 ± 2 months in group 2. Mean best spectacle-corrected visual acuity improved from 1.12 ± 0.88 to 0.64 ± 0.78 logarithm of the minimum angle of resolution (logMAR) in group 1 (P = 0.009) and from 1.00 ± 0.78 to 0.62 ± 0.53 logMAR in group 2 (P = 0.006). The graft detachment rate was 39% (16 eyes) in group 1 and 42% (17 eyes) in group 2 (P = 0.822). The rate of graft detachment larger than one third of the graft area was 17% in group 1 and 20% in group 2 (P = 0.775). Rebubbling was performed in 26.8% and 20% of eyes in group 1 and 2, respectively (P = 0.43). Average endothelial cell loss was 32% in group 1 and 33% in group 2 (P = 0.83). In the immediate postoperative period, elevated intraocular pressure was observed in 2 eyes (5%) in group 1 and in 4 eyes (10%) in group 2 (P = 0.4). There was 1 primary graft failure in each group.

Conclusions:
Use of air with it being readily available and short acting is a good method of Descemet membrane tamponade in noniridectomized DMEK.
Clinical Features, Antibiotic Susceptibility Profile, and Outcomes of Infectious Keratitis Caused by Stenotrophomonas maltophilia
Authors: Palioura Sotiria , Gibbons Allister , Miller Darlene , O'Brien Terrence P. , Alfonso Eduardo C. , Spierer Oriel 
Published: December 2017

Purpose:

Stenotrophomonas maltophilia, an uncommon cause of infectious keratitis, is difficult to treat because of its resistance to multiple antibiotics. The purpose of this study is to describe the clinical features, antibiotic susceptibility profile, and outcomes of S. maltophilia keratitis.

Methods:
A retrospective review of records from 1987 to 2016 identified 26 eyes of 26 patients who were treated at the Bascom Palmer Eye Institute for an S. maltophilia corneal ulcer. Clinical data were analyzed as to predisposing factors, clinical presentation, antibiotic susceptibility, treatment selection, and clinical outcomes.

Results:
Median age at presentation was 65 years (range, 16–98). Twelve patients were using topical corticosteroids, 8 patients had a history of penetrating keratoplasty, and 9 were contact lens wearers. All patients received topical antibiotics, 2 required therapeutic penetrating keratoplasty, and 1 was enucleated. At presentation, 57.7% (15/26) of the patients had visual acuity of 20/400 or worse. At the final visit, only 30.4% (7/23) of the patients had visual acuity worse than 20/400, whereas 65.2% (15/23) of the patients had 20/100 or better. Almost all isolates (25/26, 96.2%) were susceptible to fluoroquinolones and 77.3% (17/22) of them to polymyxin B/trimethoprim. Only 33.3% (5/15) of the tested isolates were susceptible to aminoglycosides and 58.3% (7/12) to cephalosporins.

Conclusions:
Infectious keratitis due to S. maltophilia presents a treatment challenge because of its resistance to aminoglycosides and cephalosporins, which are typically used for empiric broad-spectrum gram-negative coverage as fortified solutions. Fluoroquinolones and polymyxin B/trimethoprim should be considered instead in cases of S. maltophilia infection.
Meibography of Eyes With Sequelae of Trachoma
Authors: AlDarrab Abdulrahman , Al-Faky Yasser H. , Mousa Ahmed , Alsuhaibani Adel H. 
Published: December 2017

Purpose:
To study the effect of trachoma on meibomian glands using infrared meibography and to correlate the results with tear film parameters.

Methods:
This is a prospective cohort study in which 86 eyes of healthy volunteers and 90 eyes with trachoma were included. Clinical assessment was performed including the following: slit-lamp examination looking for signs of sequelae of trachoma, tear breakup time (TBUT), superficial punctate keratopathy (SPK), Schirmer II test (with anesthesia), and meibum score. Noncontact meibography was performed on both upper and lower eyelids separately using the meibograde system, which involved distortion of the meibomian gland, shortening, and dropout.

Results:
Lid margin abnormalities (telangiectasia, lid margin swelling, and hyperemia) were all significantly higher in the trachoma group. The mean SPK (1.36), meibum score (1.76), meibography dropout, distortion, shortening, and total meibography (8.19 for upper eyelids and 3.81 for lower eyelids) were all significantly higher in the trachoma group (P < 0.001) compared with the normal group were SPK (0.88), meibum score (0.16), and total meibography (1.24 for upper eyelids and 0.92 for lower eyelids). Mean TBUT (4.2 s) was significantly shorter in the trachoma group than in the normal group (10.3 s) (P < 0.001). There was no significant difference between both groups in the Schirmer II test.

Conclusions:
Meibography of patients with sequelae of trachoma was in agreement with the histopathologic studies. Upper eyelids were much more affected than the lower eyelids. TBUT, SPK, and meibum score were correlated with the status of meibomian glands and meibography, which were significantly different in the trachoma group.
Evidence for Rise in Meningococcal Serogroup C Bactericidal Antibody Titers in the Absence of Booster Vaccination in Previously Vaccinated Children
Authors: Badahdah Al-Mamoon , Khatami Ameneh , Tashani Mohamed , Rashid Harunor , Booy Robert 
Published: December 2017

Background:
The introduction of meningococcal serogroup C (MenC) conjugate vaccines in the United Kingdom and Australia led to an impressive decline in the incidence of invasive disease. This study examined bactericidal antibody titers over time in the UK and Australian children who received a MenC conjugate vaccine in early childhood to test the hypothesis that ongoing boosting of immunity in the absence of further doses of vaccine in some children may contribute to ongoing protection from disease.

Methods:
Serum bactericidal assay using rabbit complement (rSBA) titers at each follow-up visit were compared with all preceding visits to identify any ≥4-fold rise in titers. The proportion of children with a ≥4-fold rise in rSBA titers in paired sera at any visit-to-visit comparison was calculated.

Results:
Of 392 children with at least one set of paired sera in the Australian cohort, 72 (18.4%) had a ≥4-fold increase in rSBA titers at least one year after vaccination, including six children (1.5%) who showed evidence of boosting twice. Of 234 children with at least one set of paired sera in the UK cohort, 39 (16.7%) had a ≥4-fold rise in rSBA titers at least one year after vaccination including 2 children (0.9%) with evidence of boosting twice.

Conclusions:
A substantial minority of children immunized with MenC conjugate vaccine in early childhood had a rise in bactericidal antibody titers in the years after immunization in the absence of booster vaccination. This occurs most commonly at around 6–7 years of age corresponding to school entry and greater social mixing and might indicate exposure to MenC carriage.
Acute Pharyngitis Associated With Streptococcus dysgalactiae Subspecies equisimilis in Children
Authors: Kakuya Fujio , Kinebuchi Takahiro , Okubo Hitoshi , Matsuo Kumihiro , Kuroda Mami , Fujiyasu Hiroaki 
Published: December 2017

Background and Objectives:
The importance of Streptococcus dysgalactiae subsp. equisimilis (SDSE) in causing sporadic pharyngitis in children remains controversial. The aims of this study were (1) to report the incidence and (2) to compare the epidemiologic and clinical features of patients with SDSE to those with Streptococcus pyogenes (SP).

Methods:
A prospective study was conducted on acute pharyngitis associated with SDSE in children over a 2-year period. SDSE was identified using a phenotypic method, M protein gene (emm) analysis and matrix-assisted laser desorption ionization–time of flight mass spectrometry. Patients with positive SDSE or SP cultures received cephalosporins for 5 days and were followed up. The emm genotyping and specific virulence genes analyses were performed.

Results:
From 3416 throat cultures, 67 isolates (2.0%) were identified as SDSE and 515 (15.1%) were identified as SP. The mean age of patients with SDSE (8.3 years) was older than those with SP (6.6 years; P < 0.01). There was minimal seasonal variation in the isolation rates of SDSE. The febrile patients’ rates, gender distribution, cervical lymph node adenopathy rates, hospitalization rates, eradication and failure rates and the nonsuppurative sequelae between patients with SDSE and SP were similar. All SDSE isolates possessed important virulence genes. The emm genotyping of SDSE showed high strain diversity.

Conclusions:
The incidence of acute pharyngitis associated with accurately identified SDSE was 2/15 of that with SP. Epidemiologic and clinical features of acute pharyngitis associated with SDSE are indistinguishable from those with SP, with the exception of age and seasonal variation.