bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis
Authors: Strigård Karin , Clay Leonard , Stark Birgit , Gunnarsson Ulf 
Published: May 2016

Background:
The aim of this study was to define the indicators predicting improved abdominal wall function after surgical repair of abdominal rectus diastasis (ARD). Preoperative subjective assessment quantified by the validated Ventral Hernia Pain Questionnaire (VHPQ) was related to relative postoperative functional improvement in abdominal muscle strength.

Methods:
Fifty-seven patients undergoing surgery for ARD completed the VHPQ before surgery. Preoperative pain assessment results were compared with the relative improvement in muscle strength measured with the BioDex system 4.

Results:
There was a correlation between the relative improvement in muscle strength measured by the BioDex System 4 for flexion at 30 degrees (P = 0.046) and 60 degrees per second (P = 0.004) and the preoperative question, “Do you find it painful to sit for more than 30 minutes?” There was also a correlation between BioDex improvement for flexion at 30 degrees (P = 0.022) and for isometric work load (P = 0.038) and the preoperative question, “Has abdominal pain limited your ability to perform sports activities?” The VHPQ responses also formed a pattern with a fairly good correlation between other BioDex modalities (with the exception of extension at 60 degrees per second) and the response to the question regarding complaints when performing sports. Postoperative visual analog scale ratings of abdominal wall stability correlated to the questions regarding complaints when sitting (P = 0.040) and standing (P = 0.047). No other correlation was seen.

Conclusion:
VHPQ ratings concerning pain while being seated for more than 30 minutes and pain limiting the ability to perform sports are promising indicators in the identification of patients likely to benefit from surgical correction of their ARD.
Improving Antimicrobial Regimens for the Treatment of Breast Tissue Expander-Related Infections
Authors: Viola George M. , Baumann Donald P. , Mohan Kriti , Selber Jesse , Garvey Patrick , Reece Gregory , Raad Issam I. , Rolston Kenneth V. , Crosby Melissa A. 
Published: May 2016

Background:
Infectious complications in tissue expander (TE) breast reconstruction can be devastating and costly. Therefore, to optimize care, we examined patient’s demographics, microbiology of TE infections, and the efficacy of empiric antimicrobial regimens and thereafter generated an algorithm for the treatment of these complex infections.

Methods:
We retrospectively reviewed all patients who underwent TE breast reconstruction between 2003 and 2012 and analyzed those patients who developed a “definite” device-related infection leading to TE explantation and had a positive intraoperative culture.

Results:
A total of 3,082 patients underwent immediate breast reconstruction with TE. Of these, 378 patients (12.3%) developed an infection, 189 (6.1%) eventually proceed with explantation, and 118 (3.8%) had a positive intraoperative culture. Gram-positive organisms caused 73% of infections, and Gram-negative organisms caused 27% of infections. Narrow-spectrum empiric antimicrobials with predominantly Gram-positive coverage were deemed appropriate in only 62% of cases, and those with Gram-negative coverage were appropriate in 46%. Broad-spectrum antimicrobials were used in 47% of cases, mainly recommended by infectious disease specialists, and were considered appropriate in >90% of the occasions.

Conclusions:
Current empiric antibiotic regimens do not cover the vast spectrum of organisms causing TE infections. To increase the salvage rate of an infected TE, at the first sign of infection, in addition to benefiting with an infectious diseases consultation, empiric coverage with broad-spectrum antibiotics active against biofilm-embedded organisms should be administered.
The Vermilionectomy and the Subsequent Lower Lip Reconstruction Were Introduced by Victor von Bruns and not by von Langenbeck or von Esmarch as Reported Previously
Authors: Roldán J. Camilo , Teschke Marcus , Feinendegen Dominik L. 
Published: May 2016

Summary:
Vermilionectomy is an established procedure for the management of precancerous lesions of the lip and is often performed simultaneously with a lower lip resection for the treatment of a malignancy. The literature suggests that Dieffenbach or von Langenbeck or von Esmarch was the first to introduce this procedure. A systematic review of the German literature from the 19th century revealed that it was von Bruns who performed the vermilionectomy for the management of lip malignancies for the first time.
Vermilion Reconstruction with Genital Mucosa
Authors: Müller-Richter Urs D.A. , Weyandt Gerhard H. , Woeckel Achim , Kübler Alexander C. 
Published: May 2016

Summary:
Functional and aesthetical reconstruction, especially of the upper lip after ablative tumor surgery, can be very challenging. The skin of the lip might be sufficiently reconstructed by transpositional flaps from the nasolabial or facial area. Large defects of the lip mucosa, including the vestibule, are even more challenging due to the fact that flaps from the inner lining of the oral cavity often lead to functional impairments. We present a case of multiple vermilion and skin resections of the upper lip. At the last step, we had to resect even the whole vermilion mucosa, including parts of the oral mucosa of the vestibule, leaving a bare orbicularis oris muscle. To reconstruct the mucosal layer, we used a mucosal graft from the labia minora and placed it on the compromised lip and the former transpositional flaps for the reconstructed skin of the upper lip with very good functional and aesthetic results.
CHRONICALLY PROGRESSIVE SARCOID GRANULOMA IN AN ASYMPTOMATIC PATIENT
Authors: Stefater James A. , Gragoudas Evangelos S. 
Published: May 2016

Purpose:
To report 18 years of follow-up of a patient with atypical ocular sarcoidosis.

Methods:
The patient was observed in clinic and with photography for over 18 years.

Results:
One patient with a history of dermal melanoma and atypical ocular sarcoidosis.

Discussion:
Several features presented in this case are exceedingly atypical including lack of any intraocular inflammation over 18 years of yearly observation, the preservation of excellent vision despite the choroidal disease, and lack of systemic symptoms. This case suggests a disconnect between ocular sarcoidosis and intraocular inflammation, and supports clinical observation as a prudent method in patients with extensive choroidal disease and good vision.
EPIRETINAL MEMBRANE FORMATION AFTER INTRAVITREAL AUTOLOGOUS STEM CELL IMPLANTATION IN A RETINITIS PIGMENTOSA PATIENT
Authors: Kim Ju Young , You Yong Sung , Kim Soon Hyun , Kwon Oh Woong 
Published: May 2016

Methods:
A retrospective case report of a retinitis pigmentosa patient who underwent vitrectomy for epiretinal membrane after intravitreal autologous stem cell implantation.

Results:
A 71-year-old female RP patient came to our clinic for ophthalmic evaluation after intravitreal autologous stem cell injection. Four months ago, she underwent intravitreal autologous stem cell injection for both eyes at another hospital. New thick epiretinal membrane (ERM) with extensive macular pucker was found on her left eye. She underwent pars plana vitrectomy and membranectomy. After biopsy, many CD34-positive stem cells were detected in ERM specimen.

Conclusion:
This is the first report of ERM formation following intravitreal autologous stem cells injection. CD34-positive stem cells were detected in a human eye at 4 months after injection. Further studies are needed to determine how stem cells caused ERM and how long they would stay in the eye.
A SECOND CASE OF BILATERAL RHEGMATOGENOUS RETINAL DETACHMENTS REPAIRED WITH SIMULTANEOUS BILATERAL PNEUMATIC RETINOPEXY
Authors: Rubin Uriel , De Jager Cornelis , Zakour Moayed , Gonder J. Thomas 
Published: May 2016

Background/Purpose:
To present a case of a patient with simultaneous bilateral retinal detachments treated successfully with bilateral pneumatic retinopexy.

Study design:
Case report.

Results:
This is a case of an otherwise healthy 49-year-old woman with no remarkable ocular history that presented with simultaneous phakic superior bilateral rhegmatogenous retinal detachments. Treatment on the day of presentation included laser retinopexy of the inferior lattice degeneration in the left eye and bilateral intravitreal injection of 0.4 cc of 100% C3F8 gas preceded by topical anesthesia. After 48 hours, both retinas were completely reattached, and bilateral laser retinopexy was performed to the superior tears.

Discussion:
After a review of the literature, the authors could find only two reported cases of simultaneous bilateral retinal detachments treated successfully with pneumatic retinopexy. This is not only a cost-effective procedure but also allows treatment when there is no immediate operating room availability or a when a quick referral for surgery is not possible.
Tear Function and Ocular Surface Alterations After Accelerated Corneal Collagen Cross-Linking in Progressive Keratoconus
Authors: Kalkan Akçay Emine , Kilicarslan Aydan , Uysal Betul Seher , Hondur Gozde , Kosekahya Pinar , Altinkaynak Hasan , Cagil Nurullah 
Published: May 2016

Objective:
To investigate the alterations in the ocular surface and tear film parameters 3 months after accelerated corneal collagen cross-linking (A-CXL) in progressive keratoconus (KC) patients.

Methods:
Twenty-six patients (33 eyes total) with progressive KC were enrolled in this study. All patients were subjected to ophthalmic surface examination, such as OSDI (ocular surface disease index) scoring, the osmolarity tear test, Schirmer test, tear film breakup time (TBUT) analysis, rose bengal (RB) and fluorescein (Fl) ocular surface staining, and conjunctival impression cytology (IC) analysis, respectively. These tests were performed at baseline and 3 months after A-CXL. Nelson's grading system was used to evaluate the cell morphology and goblet cell density.

Results:
No statistically significant differences in the levels of tear osmolarity, TBUT, Schirmer test, OSDI scoring, and Fl and RB staining between pretreatment and 3 months postoperatively were observed (all P values >0.05). A statistically significant increase in superior (P=0.005) and temporal (P=0.006) IC grading was seen at the postoperative third month compared to pretreatment.

Conclusions:
Only metaplastic changes and a reduction in the density of the goblet cells were seen in conjunctival IC, which is probably because of the toxicity of ultraviolet-A 3 months after A-CXL. However, these results do not lead to deterioration in TBUT. In this study, A-CXL has no adverse effect on ocular surface and tear function, which are important for visual quality.
Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations
Authors: Edwards Robert R. , Dworkin Robert H. , Turk Dennis C. , Angst Martin S. , Dionne Raymond , Freeman Roy , Hansson Per , Haroutounian Simon , Arendt-Nielsen Lars , Attal Nadine , Baron Ralf , Brell Joanna , Bujanover Shay , Burke Laurie B. , Carr Daniel , Chappell Amy S. , Cowan Penney , Etropolski Mila , Fillingim Roger B. , Gewandter Jennifer S. , Katz Nathaniel P. , Kopecky Ernest A. , Markman John D. , Nomikos George , Porter Linda , Rappaport Bob A. , Rice Andrew S.C. , Scavone Joseph M. , Scholz Joachim , Simon Lee S. , Smith Shannon M. , Tobias Jeffrey , Tockarshewsky Tina , Veasley Christine , Versavel Mark , Wasan Ajay D. , Wen Warren , Yarnitsky David 
Published: May 2016

AbstractThere is tremendous interpatient variability in the response to analgesic therapy (even for efficacious treatments), which can be the source of great frustration in clinical practice. This has led to calls for “precision medicine” or personalized pain therapeutics (ie, empirically based algorithms that determine the optimal treatments, or treatment combinations, for individual patients) that would presumably improve both the clinical care of patients with pain and the success rates for putative analgesic drugs in phase 2 and 3 clinical trials. However, before implementing this approach, the characteristics of individual patients or subgroups of patients that increase or decrease the response to a specific treatment need to be identified. The challenge is to identify the measurable phenotypic characteristics of patients that are most predictive of individual variation in analgesic treatment outcomes, and the measurement tools that are best suited to evaluate these characteristics. In this article, we present evidence on the most promising of these phenotypic characteristics for use in future research, including psychosocial factors, symptom characteristics, sleep patterns, responses to noxious stimulation, endogenous pain-modulatory processes, and response to pharmacologic challenge. We provide evidence-based recommendations for core phenotyping domains and recommend measures of each domain.
Increased fronto-hippocampal connectivity in the Prrxl1 knockout mouse model of congenital hypoalgesia
Authors: Monteiro Clara , Cardoso-Cruz Helder , Matos Mariana , Dourado Margarida , Lima Deolinda , Galhardo Vasco 
Published: May 2016

Abstract
Despite the large number of studies addressing how prolonged painful stimulation affects brain functioning, there are only a handful of studies aimed at uncovering if persistent conditions of reduced pain perception would also result in brain plasticity. Permanent hypoalgesia induced by neonatal injection of capsaicin or carrageenan has already been shown to affect learning and memory and to induce alterations in brain gene expression. In this study, we used the Prrxl1

−/−
model of congenital mild hypoalgesia to conduct a detailed study of the neurophysiological and behavioral consequences of reduced pain experience. Prrxl1 knockout animals are characterized by selective depletion of small diameter primary afferents and abnormal development of the superficial dorsal laminae of the spinal cord, resulting in diminished pain perception but normal tactile and motor behaviour. Behavioral testing of Prrxl1

−/−
mice revealed that these animals have reduced anxiety levels, enhanced memory performance, and improved fear extinction. Neurophysiological recordings from awake behaving Prrxl1

−/−
mice show enhanced altered fronto-hippocampal connectivity in the theta- and gamma-bands. Importantly, although inflammatory pain by Complete Freund Adjuvant injection caused a decrease in fronto-hippocampal connectivity in the wild-type animals, Prrxl1

−/−
mice maintained the baseline levels. The onset of inflammatory pain also reverted the differences in forebrain expression of stress- and monoamine-related genes in Prrxl1

−/−
mice. Altogether our results suggest that congenital hypoalgesia may have an effect on brain plasticity that is the inverse of what is usually observed in animal models of chronic pain.
Facilitating Nurses' Engagement in Hospital Quality Improvement: The New Jersey Hospital Association's Implementation of Transforming Care at the Bedside
Authors: Pearson Marjorie L. , Needleman Jack , Beckman Robin , Han Bing 
Published: May 2016

Abstract:
Transforming Care at the Bedside (TCAB) is a program designed by the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement to engage frontline staff in change processes to improve the work environment and patient care on nursing units. Originally designed and piloted in a small number of hospitals, TCAB is being disseminated through large-scale quality improvement (QI) collaboratives facilitated by professional organizations, such the New Jersey Hospital Association's Institute for Quality and Patient Safety (NJHA). This article presents the results of an evaluation of the NJHA dissemination effort. The evaluation team used an observational mixed-method evaluation design and multiple data sources to assess implementation of TCAB by nursing units in these facilities. The results show that most of the participating units successfully implemented the TCAB improvement processes. Nursing teamwork and three nursing-sensitive outcomes improved significantly over the course of TCAB, and TCAB unit managers attributed important improvements to their unit's participation. These findings suggest that TCAB is a viable mechanism for engaging frontline nursing staff in valuable QI activities. Other hospitals interested in furthering the culture and capacity for QI among frontline nursing unit staff should consider a TCAB collaborative for achieving these goals.
Attitudes and Beliefs Regarding the Utility of Robotically Assisted Gynecologic Surgery Among Practicing Gynecologists
Authors: Wright Jason D. , Raglan Greta B. , Schulkin Jay , Fialkow Michael F. 
Published: May 2016

Abstract:
While use of robotic-assisted surgery has increased rapidly, little is known about the attitudes and beliefs of practicing gynecologists regarding the utility of the technology. We surveyed a large sample of gynecologists to examine their attitudes and beliefs about the benefits, utility, and factors driving use of robotic-assisted gynecologic surgery. A 51-item survey was mailed to 600 fellows or junior fellows of the American College of Obstetricians and Gynecologists. The survey included questions on use of robotic surgery, decision-making, and beliefs regarding the technology. Responses were stratified based on whether the respondent used robotic surgery or not. A total of 310 responses were received including 27.8% who used robotic surgery in their practices. Hysterectomy was the most commonly performed procedure. Opinions about the use and effectiveness of robotic procedures varied based on whether an individual was a robot user. Eighty-two percentage of robot users and 21% of nonrobot users believed robotic surgery provided benefits over laparoscopic (p < .0001). Among both groups, the ability to increase access to minimally invasive surgery and marketing were believed to be the greatest drivers of use of robotic surgery. Attitudes and beliefs about the effectiveness of robotic gynecologic surgery are highly variable among clinicians.
Diagnostic performance of T lymphocyte subpopulations in assessment of liver fibrosis stages in hepatitis C virus patients: simple noninvasive score
Authors: Toson El-Shatat A. , Shiha Gamal E. , El-Mezayen Hatem A. , El-Sharkawy Aml M. 
Published: May 2016

Background/aims
Evaluation of liver fibrosis in patients infected with hepatitis C virus is highly useful for the diagnosis of the disease as well as therapeutic decision. Our aim was to develop and validate a simple noninvasive score for liver fibrosis staging in chronic hepatitis C (CHC) patients and compare its performance against three published simple noninvasive indexes.

Materials and methods
CHC patients were divided into two groups: an estimated group (n=70) and a validated group (n=52). Liver fibrosis was tested in biopsies using the Metavair score system. CD4+ and CD8+ count/percentage were assayed by fluorescence-activated cell sorting analysis.

Results
The multivariate discriminant analysis selects a function on the basis of absolute values of five biochemical markers: immune fibrosis index (IFI); score=3.07+3.06×CD4+/CD8++0.02×α-fetoprotein (U/l)−0.07×alanine aminotransferase ratio−0.005×platelet count (109/l)−1.4×albumin (g/dl). The IFI score produced areas under curve of 0.949, 0.947, and 0.806 for differentiation of all patient categories [significant fibrosis (F2–F4), advanced fibrosis (F3–F4), and cirrhosis (F4)].

Conclusion
The IFI score, a novel noninvasive test, can be used easily for the prediction of liver fibrosis stage in CHC patients. Our score was more efficient than aspartate aminotransferase to platelet ratio index, fibrosis index, and fibroQ and more suitable for use in Egyptian hepatitis C virus patients.
A Randomized, Placebo-Controlled Clinical Trial of Efficacy and Safety: Modafinil in the Treatment of Fatigue in Patients With Primary Biliary Cirrhosis
Authors: Silveira Marina G. , Gossard Andrea A. , Stahler Alisha C. , Jorgensen Roberta A. , Petz Janice L. , Ali Ahmad H. , Lindor Keith D. 
Published: May 2016

Background and Aims:
Fatigue is a common symptom of primary biliary cirrhosis (PBC), and is associated with an impaired quality of life.

Study Question:
No studies have assessed the use of modafinil in fatigue related to PBC in a controlled manner.

Study Design, Measures, and Outcomes:
A randomized, double-blind, placebo-controlled study was conducted to determine the safety and efficacy of modafinil for the treatment of fatigue in PBC. Forty patients were randomized to modafinil (n = 20) or placebo (n = 20) for 12 weeks. A verbal report of fatigue for at least 6 months was required for enrollment. Modafinil was administered at 100 mg by mouth once daily; a change by 50 mg every 2 weeks (maximum: 200 mg once daily) was allowed, depending on the subject's response to treatment. The primary outcome was defined as a ≥50% improvement in fatigue severity [quantified by the Fisk Fatigue Impact Scale (FFIS)] after 12 weeks of treatment, compared with baseline values.

Results:
Thirty-three PBC patients completed the study. After 12 weeks of therapy, only 5 patients had a ≥50% reduction in FFIS scores: 3 patients (17.6%) in the modafinil arm and 2 (12.5%) in the placebo arm (P = 1.00). Change in median FFIS score was not statistically different between patients in the 2 treatment groups (P = 0.36). Modafinil was associated with minimal adverse events (headaches, diarrhea, and rash).

Conclusions:
In patients with PBC who have fatigue, treatment with modafinil for 12 weeks was safe and fairly well tolerated; however, it did not result in beneficial effects on fatigue compared with patients treated with placebo (CONSORT Table 1). ClinicalTrials.gov identifier NCT00943176.
Deceleration and Acceleration Capacities in Risk Stratification for Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease
Authors: Buzea Catalin A. , Dan Gheorghe A. , Dan Anca R. , Delcea Caterina , Balea Marius I. , Gologanu Daniela , Popescu Raluca A. , Dobranici Mihaela 
Published: May 2016

Background:
Patients with chronic obstructive pulmonary disease (COPD) have an increased risk for both supraventricular and ventricular arrhythmias. Autonomic dysregulation may be responsible for the development of arrhythmias in these patients, and its analysis could be useful for identifying those at high risk for arrhythmias.

Study Question:
Our purpose is to analyze the role of acceleration capacity (AC) and deceleration capacity (DC), novel markers of the autonomic balance, as potential arrhythmic risk predictors in patients with COPD.

Study Design:
We prospectively included 47 patients diagnosed with COPD, and a control group of 64 age-matched subjects without COPD. AC and DC values were obtained using 24-hour Holter monitoring. The arrhythmias were isolated premature atrial complexes, supraventricular tachycardias, isolated premature ventricular beats (PVC), and combined ventricular arrhythmias consisting in ventricular tachycardias or more than 10 PVC per hour.

Results:
Supraventricular arrhythmias and isolated PVC were more frequent in the COPD group. The DC was significantly lower (3.10 vs. 5.60, P < 0.0001) and AC higher (−4.60 vs. −6.60, P = 0.002) in patients with COPD. DC was identified as a predictor of arrhythmic events with an area under the curve (AUC) for premature atrial complexes >70/d of 0.72 (0.56–0.87, P = 0.013), for supraventricular tachycardias 0.76 (0.62–0.90, P = 0.002), and for combined ventricular arrhythmias 0.69 (0.54–0.82, P = 0.025). AC was predictor only for combined ventricular arrhythmias with an AUC of 0.74 (0.58–0.85, P = 0.002).

Conclusions:
Patients with COPD associate a significant autonomic imbalance and a higher incidence of arrhythmias. DC could be a strong predictor for supraventricular and ventricular arrhythmias in patients with COPD with no clinically apparent cardiac disease. AC could be useful alongside with DC regarding the risk for ventricular arrhythmias, but seems to have lesser value as a predictor for supraventricular arrhythmias.