bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Circuit Lifetime be a Quality Indicator in Continuous Renal Replacement Therapy in the Critically Ill?
Authors: Kleger Gian-Reto , FäSsler Edith 
Published: January 2018

Purpose Continuous renal replacement therapy (CRRT) is frequently used in critically ill patients with acute renal failure and sepsis. Frequent circuit changes increase nursing workload, blood loss and costs, and also compromise achievement of the filtration rate goal. Circuit downtime is the most important factor that compromises the cumulative filtration goal. Methods We used continuous venovenous hemodiafiltration (Prismaflex®, Gambro, Meyzieu Cedex, France) in our 12-bed medical intensive care unit (ICU). Circuit lifetimes, indication to start CRRT, anticoagulation protocol, reason for circuit change, and location of the vascular access were prospectively documented for 12 months in consecutive patients. Unfractionated heparin was the first choice for anticoagulation. No anticoagulation was used in patients with severe coagulation abnormalities or hepatic failure; regional citrate-based anticoagulation (CBA) was used in patients with recurrent circuit clotting or with bleeding predisposition. Our aim was to assess the suitability of circuit lifetime as a quality indicator, evaluated by survival analysis. Results Median circuit lifetime was significantly longer for CBA (log rank χ2=8.08; p=0.018). This is consistent with the literature. There were no differences in vascular access site, proportion of sepsis, or vasopressor dependency between the three anticoagulation groups. Conclusions In addition to monitoring the complication rate, the evaluation of circuit lifetime using survival analysis stratified by anticoagulation strategy is a simple and feasible means of assessing the quality of CRRT in the ICU.
In Vivo Evaluation of the Effect of Intramedullary Nail Microtopography on the Development of Local Infection in Rabbits
Authors: Moriarty Thomas F. , Campoccia Davide , Nees Stephanie K. , Boure Ludovic P. , Richards Robert G. 
Published: January 2018

Background and Aim Fractures of the tibia and femoral diaphysis are commonly repaired by intramedullary (IM) nails, which are currently composed of either electropolished stainless steel (EPSS) or standard, non-polished titanium-aluminum-niobium (TAN). Once the fracture has fully healed, removal of IM nails is common, but the strong adhesion of bone to standard TAN complicates removal. Polishing the surface of TAN IM nails has been shown to reduce bony adhesion and ease implant removal without compromising fixation. Polished TAN nails are, therefore, expected to have significant clinical benefit in situations where the device is to be removed. The aim of the present study was to determine the effect of polishing TAN IM nails on susceptibility to infection in an animal model. Materials and Methods Solid IM nails (Synthes, Betlach, Switzerland) composed of standard TAN were compared with polished equivalents and also to clinically available EPSS nails. The surface chemical and topographical properties of the materials were assessed by X-ray photon spectroscopy (XPS), white light profilometry, and scanning electron microscopy (SEM). An in vivo infection study was performed using a clinical isolate of Staphylococcus aureus that was characterized with respect to various virulence factors. Results Polishing TAN IM nails caused no significant change to the chemistry of the nails, but the topography of the polished TAN nails was significantly smoother than standard TAN nails. In the infection study, the rank order based on descending infectious dose 50 (ID50) was: standard TAN, polished TAN, and finally EPSS. The ID50 values did not differ greatly between any of the groups. Conclusions Polishing the surface TAN IM nails was not found to influence the susceptibility to infection in our animal model.
Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study
Authors: Chen Cheng , Yan Yan , Gao Xiao , Xiang Shiting , He Qiong , Zeng Guangyu , Liu Shiping , Sha Tingting , Li Ling 
Published: January 2018

Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother–infant pairs in three communities in Hunan, China. Data about participants’ characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant’s birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.
Barriers to Hospice Care in Trauma Patients: The Disparities in End-of-Life Care
Authors: Haines Krista L. , Jung Hee Soo , Zens Tiffany , Turner Scott , Warner-Hillard Charles , Agarwal Suresh 
Published: January 2018

Introduction: End-of-life and palliative care are important aspects of trauma care and are not well defined. This analysis evaluates the racial and socioeconomic disparities in terms of utilization of hospice services for critically ill trauma patients. Methods: Trauma patients ≥15 years old from 2012 to 2015 were queried from the National Trauma Databank. Chi-square and multivariate logistic regression analyses for disposition to hospice were performed after controlling for age, gender, comorbidities, injury severity, insurance, race, and ethnicity. Negative binomial regression analysis with margins for length of stay (LOS) was calculated for all patients discharged to hospice. Results: Chi-square analysis of 2 966 444 patient’s transition to hospice found patients with cardiac disease, bleeding and psychiatric disorders, chemotherapy, cancer, diabetes, cirrhosis, respiratory disease, renal failure, cirrhosis, and cerebrovascular accident (CVA) affected transfer ( P < .0001). Logistic regression analysis after controlling for covariates showed uninsured patients were discharged to hospice significantly less than insured patients (odds ratio [OR]: 0.71; P < .0001). Asian, African American, and Hispanic patients all received less hospice care than Caucasian patients (OR: 0.65, 0.60, 0.73; P < .0001). Negative binomial regression analysis with margins for LOS showed Medicare patients were transferred to hospice 1.2 days sooner than insured patients while uninsured patients remained in the hospital 1.6 days longer ( P < .001). When compare to Caucasians, African Americans patients stayed 3.7 days longer in the hospital and Hispanics 2.4 days longer prior to transfer to hospice ( P < .0001). In all patients with polytrauma, African Americans stayed 4.9 days longer and Hispanics 2.3 days longer as compared to Caucasians ( P < .0001). Conclusions: Race and ethnicity are independent predictors of a trauma patient’s transition to hospice care and significantly affect LOS. Our data demonstrate prominent racial and socioeconomic disparities exist, with uninsured and minority patients being less likely to receive hospice services and having a delay in transition to hospice care when compared to their insured Caucasian counterparts.
Differences in the Tensor Veli Palatini Between Adults With and Without Cleft Palate Using High-Resolution 3-Dimensional Magnetic Resonance Imaging
Authors: George Thomas N. , Kotlarek Katelyn J. , Kuehn David P. , Sutton Bradley P. , Perry Jamie L. 
Published: January 2018

Objective: To investigate the dimensions of the tensor veli palatini (TVP) muscle in adults with and without cleft palate. Design: Prospective study. Participants: There were a total of 14 adult participants, 8 noncleft and 6 with cleft palate. Methods: Analysis and comparison of the TVP muscle and surrounding structures was completed using 3D MRI data and Amira 5.5 Visualization Modeling software. TVP muscle volume, hamular process distance, mucosal thickness, TVP muscle length, and TVP muscle diameter were used for comparison between participant groups based upon previous research methods. Results: Mann-Whitney U tests revealed a significantly smaller ( U < .001, P = .002) TVP muscle volume in the cleft palate group (median = 536.22 mm3) compared to individuals in the non–cleft palate group (median = 895.19 mm3). The TVP muscle was also significantly shorter ( U = 1.00, P = .003) in the cleft palate group (median = 18.04 mm) versus the non–cleft palate (median = 21.18 mm). No significant differences were noted for the other measured parameters. Conclusion: Significant differences in the TVP muscle volume and length among the noncleft participants found in this study may insights into the reported increased incidence of otitis media with effusion (OME) seen in the cleft population. Results from this study contribute to our understanding of the underlying anatomic differences among individuals with cleft palate.
Feline primary erythrocytosis: a multicentre case series of 18 cats
Authors: Darcy Hannah , Simpson Katherine , Gajanayake Isuru , Seth Mayank , McGrotty Yvonne , Szladovits Balazs , Glanemann Barbara 
Published: January 2018

Case series summary A retrospective multicentre case series of feline primary erythrocytosis (PE) was evaluated. The aim was to gain better understanding of disease presentation and progression to guide management and prognostication. Case records were assessed for evidence of increased packed cell volume (PCV; >48%), sufficient investigation to rule out relative and secondary erythrocytosis, and follow-up data for at least 12 months or until death. Eighteen cats were included in the case series. No significant trends in signalment were noted. Seizures and mentation changes were the most common presenting signs (both n = 10). Median PCV was 70% (median total protein concentration of 76 g/l) with no other consistent haematological changes. Sixteen cats survived to discharge. Phlebotomy was performed initially in 15/16 surviving animals and performed after discharge in 10/16. Hydroxyurea was the most common adjunctive therapy, used in 10/16 cats. Of the 16 patients surviving to discharge, 14 patients were still alive at the conclusion of the study (survival time >17 months post-discharge), with the two non-survivors having lived for 5 years or more after diagnosis. PCV, when stabilised, did not correlate with resolution of clinical signs. Relevance and novel information In contrast to perceptions, feline PE was generally well managed via a combination of phlebotomy and medical therapy, with evidence of prolonged survival times. The use of hydroxyurea enabled cessation or repeat phlebotomies.
Intravenous rocuronium 0.3 mg/kg improves the conditions for tracheal intubation in cats: a randomized, placebo-controlled trial
Authors: Sakai Daniel M , Zornow Kailee Anne , Campoy Luis , Cable Christina , Appel Leslie D , Putnam Holly J , Martin-Flores Manuel 
Published: January 2018

Objectives We evaluated the use of rocuronium 0.3 mg/kg intravenously (IV) to facilitate tracheal intubation in cats anesthetized for elective ovariohysterectomy. Methods Thirty female cats were randomly allocated to receive rocuronium 0.3 mg/kg IV or an equal volume of normal saline, following induction of anesthesia with ketamine and midazolam. Thirty seconds after induction, a single investigator, unaware of treatment allocation, attempted tracheal intubation. The number of attempts and the time to complete intubation were measured. Intubating conditions were assessed as acceptable or unacceptable based on a composite score consisting of five different components. Duration of apnea after induction was measured and cases of hemoglobin desaturation (SpO2 <90%) were identified. Results Intubation was completed faster (rocuronium 12 s [range 8–75 s]; saline 60 s [range 9–120 s]) and with fewer attempts (rocuronium 1 [range 1–2]; saline 2 [range 1–3], both P = 0.006) in cats receiving rocuronium. Unacceptable intubating conditions on the first attempt occurred in 3/15 cats with rocuronium and in 10/15 with saline ( P = 0.01). Apnea lasted 4 ± 1.6 mins with rocuronium and 2.3 ± 0.5 mins with saline ( P = 0.0007). No cases of desaturation were observed. Conclusions and relevance Rocuronium 0.3 mg/kg IV improves intubating conditions compared with saline, and reduces the time and number of attempts to intubate with only a short period of apnea in cats.
Distance Alternate-Letter Suppression Test for Objective Assessment of Sensorial Status in Intermittent Exotropia
Authors: Yildirim C. , Altinsoy H.I. 
Published: January 2018

Purpose To investigate the value of distance alternate-letter suppression testing in the objective assessment of fusional control of intermittent exotropia. Methods A total of 71 consecutive patients with intermittent exotropia (study group) and 112 normal subjects (control group) underwent a series of measurements including distance alternate-letter suppression testing, Worth 4 Dot test at distance and near, and distance and near stereo acuity tests to see whether sensorial behavior differed in the study and control groups. The distance alternate-letter suppression test and distance stereo acuity tests were performed using the Mentor B-VAT II-SG Video Acuity Tester and Binocular Vision Testing System. The TNO test was used to measure near stereo acuity. Results Seventeen patients with intermittent exotropia (24%) presented suppression with the distance alternate-letter suppression test, but none of the normal subjects (p<0.001, X2 test). Only, three patients (4%) showed suppression on the Worth 4 Dot test at distance, and all had fusion on the Worth 4 Dot test near. Patients with intermittent exotropia had significantly diminished distance stereo acuity compared to normal subjects (p<0.001). Normal subiects and patients had good near stereo acuity (p>0.05). Patients with intermittent exotropia who had fusion with the distance alternate-letter suppression test had significantly better distance stereo acuity than patients who had suppression (p<0.001). Conclusionsg Distance alternate-letter suppression testing and distance stereo acuity tests may be useful as objective measures for assessing sensory loss in patients with intermittent exotropia.
Congenital Lacrimal Fistula
Authors: Uǧurbaş S.H. , Zilelioǧlu G. 
Published: January 2018

Purpose Congenital lacrimal fistula is a rare abnormality of the lacrimal system. The patients may be asymptomatic but treatment of those with symptoms such as epiphora and dacryocystitis is still controversial. Methods The clinical findings, methods of surgical treatment and results were evaluated in seven patients (four male, three female) with congenital lacrimal fistula. Three were asymptomatic, types of surgical treatment were fistula excision with dacryocystorhinostomy (DCR) (two cases), fistula excision with conjunctival DCR (one case) and closed fistula excision alone (one case). Results Three of the four patients who underwent surgery had relief of symptoms. The fistula recurred in the case that had undergone fistula excision alone. Conclusions It is difficult to design controlled studies to detect which method is superior for the treatment of lacrimal fistula, considering the small number of cases in the literature. We recommend treating each case according to its own characteristics.
A Randomized, Comparative Study of Fluorometholone 0.2% and Fluorometholone 0.1% Acetate after Photorefractive Keratectomy
Authors: Vetrugno M. , Quaranta G.M. , Maino A. , Cardia L. 
Published: January 2018

Purpose To compare the efficacy and tolerance of fluorometholone 0.1% acetate and fluorometholone 0.2% eyedrops in the postoperative management of photorefractive keratectomy (PRK). Methods A randomised single-blind comparative study was performed on two groups of 30 patients who underwent myopic PRK. The first group was given fluorometholone 0.1% acetate and the second fluorometholone 0.2%. Uncorrected and best corrected visual acuity, haze, IOP and local tolerance were evaluated. Statistical analysis was done using parametric and non-parametric tests. Results Visual acuity did not differ in the two groups; both were homogeneous as far as refractive error and haze were concerned. Three patients (10%) treated with fluorometholone 0.2% and two patients (6.6%) with fluorometholone 0.1% acetate developed ocular hypertension, but this was not statistically significant. Conclusions Fluorometholone 0.1% acetate was effective on inflammation after PRK, with the same efficacy as fluorometholone 0.2%.
Dependence of Wave Front Refraction on Pupil Size Due to the Presence of Higher Order Aberrations
Authors: Iseli H.P. , Bueeler M. , Hafezi F. , Seiler T. , Mrochen M. 
Published: January 2018

Purpose Propagation of light through the optical pathway within the eye can lead to a deformation of the wave front that might affect objective but also subjective refraction depending on pupil size. The aim of this study was to investigate the change in wave front refraction that is calculated on the basis of second order Zernike polynomials when varying the pupil size from 6 mm to 3 mm. The change was correlated with the amount of fourth and sixth order spherical aberration and fourth and sixth order astigmatism. Methods Wave front aberrations were measured in 130 eyes by means of a Tscherning wave front sensor at a pupil size of 6 mm. Wave front aberrations in terms of Zernike coefficients up to sixth order were approximated for 6 mm and 3 mm pupil size. The wave front refraction was calculated based on the second order Zernike coefficients for both pupil diameters. Resulting differences in wave front refraction (sphere or cylinder) due to the change in pupil size were correlated with the initial higher order aberrations determined for the 6.0 mm pupil by means of a linear regression (Spearman rank correlation coefficient). Results The correlation between the change in sphere and cylinder on one hand and the spherical aberration and higher order astigmatism on the other hand was found to be highly significant (p<0.001), with a correlation coefficient of R = 0.96 for sphere and R = 0.85 for cylinder. Conclusions Calculating the wave front refraction on the basis of second order Zernike polynomials is plagued with the influence of the higher order aberration preexisting in the individual eye. This is one reason why this method does not represent precisely enough subjective refraction. Other methods that calculate the refraction based on wave front measurement independent from the pupil size should be established in the ophthalmic community.
The Effect of Hyperopic Laser in Situ Keratomileusis on Refractive Accommodative Esotropia
Authors: Farahi A. , Hashemi H. 
Published: January 2018

Purpose To evaluate the efficacy of laser in situ keratomileusis (LASIK) for discarding spectacles and simultaneously correcting ocular alignment in patients with refractive accommodative esotropia. Methods LASIK was performed on 20 eyes of 10 patients (mean age, 24.3 years; range, 11 to 43 years) using a Technolas 217C excimer laser. The target refraction was emmetropia. Visual acuity (uncorrected and best-corrected), refractive error, and ocular alignment were recorded before and after LASIK. Minimum follow-up was 12 months. Results The mean preoperative uncorrected and corrected angle of deviation was 37.1 prism diopters (PD) (range, 17 to 80; standard deviation (SD), 19.8)) and 14.74 PD (range, 0 to 50; SD, 12.9) of esotropia, respectively, which changed to 7.2 PD (range, 0 to 50; SD, 15.78) without correction postoperatively (p=0.005). Of 20 eyes, 15% lost one line of best-corrected visual acuity, 10% gained two lines, and 75% showed no change. Conclusions LASIK could be considered an alternative treatment for patients with refractive accommodative esotropia with intolerance to glasses and contact lenses.
Fluorescein Angiography and Indocyanine Green Angiography for Identifying Occult Choroidal Neovascularization in Age-Related Macular Degeneration
Authors: Pece A , Sannace C. , Menchini U. , Virgili G. , Galli L. , Isola V. , Brancato R. 
Published: January 2018

Purpose To assess whether fluorescein angiography (FA) alone without indocyanine green angiography (ICGA) can identify and localize occult choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). Methods Seventy-nine eyes of 77 consecutive patients with occult CNV were evaluated independently by two skilled physicians at first with FA alone and then with FA combined with ICGA by fundus camera. Results The agreement between FA and ICGA was 73% and 68% for the two physicians (K=0.585 and 0.512, respectively). The first operator correctly identified 20/27 as plaque CNV; six had different sizes and locations. The second operator identified 25/30, with one mistaken for size and location. For focal CNV the first operator identified 34/39, and the second one 23/35. Conclusions Comparing the FA results with ICGA, CNV was correctly identified in about 60% of cases. Therefore, ICGA should be considered an indispensable diagnostic test to identify the presence, the type, and the location of occult CNV.
Homocysteine, Vitamin B12, and Folic Acid in Age-Related Macular Degeneration
Authors: Nowak M. , Świetochowska E. , Wielkoszyński T. , Marek B. , Kos-kudła B. , Szapska B. , Kajdaniuk D. , Głogowska-szelág J. , Siemińska L. , Ostrowska Z. , Kozioł H. , Klimek J. 
Published: January 2018

Purpose Hyperhomocysteinemia is considered an independent risk factor for atherosclerosis and thrombosis. The purpose of this study was to evaluate plasma homocysteine, red blood cell folate, plasma folate, and plasma vitamin B12 concentration in patients with exudative age-related macular degeneration (ARMD). Methods The participants of this study included 30 patients aged 60 to llyears (mean age 66.2±3.6) with exudative ARMD. Plasma homocysteine levels were determined by high performance liquid chromatography (HPLC). Red blood cell folate, plasma folate, and plasma vitamin B12 concentration were determined using a standard kit (Dualcount Solid Phase No Boill radioassay kit for B12/folic acid, DPC Diagnostic, USA) by radioassay method. Results The plasma concentration of Hey (14.88±6.23 μmol/L) in ARMD patients was significantly increased (p<0.0001) compared with the control group (8,.72±3,.34 μmol/L). We found not a significant decrease of the plasma vitamin B12 concentration in the ARMD group (476.88±220.91 pg/mL) compared with the control group (527.08±208.97 pg/mL). Red blood cell folate (158.44±56.30 ng/mL) and plasma folate (6.5±3.4 ng/mL) in ARMD patients were also not significantly decreased when compared with the control group (183.86±59.33 ng/mL and 7.93±5.05 ng/mL). Conclusions Hyperhomocysteinemia might be one of the risk factors for the exudative form of ARMD.