bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTERNAL ASPIRATION UNDER PERFLUOROCARBON LIQUID FOR THE MANAGEMENT OF LARGE MACULAR HOLES
Authors: Ohana Oded , Barak Adiel , Schwartz Shulamit 
Published: January 2017

Purpose:
To report the outcomes of pars plana vitrectomy with internal aspiration under perfluorocarbon liquid for large macular holes (MH).

Methods:
Retrospective consecutive case series of patients with large (>400 µm) MH. All treated were with pars plana vitrectomy, internal limiting membrane peeling, internal fluid aspiration under perfluorocarbon liquid, and gas/oil tamponade. Outcomes included closure rate and visual acuity at 6 months.

Results:
Twenty eyes of 20 patients were included. Mean age of patients was 67.6 ± 7.3 years. Mean MH size was 609.4 ± 154.7 μm. Mean symptoms duration was 9.05 ± 7.3 months. Unfavorable prognostic factors included chronic MHs (≥4 months) in 15 eyes (75%), refractory MH in 6 eyes (30%), and poor initial visual acuity (≤20/200 logarithm of minimal angle of resolution) in 18 eyes (90%). Gas tamponade was used in 18 eyes (90%). Nineteen MHs (95%) had closed after a single operation. Two (10.5%) had Type-II closure. Mean visual acuity improved significantly from 20/330 to 20/140 Snellen acuity (1.22 ± 0.31–0.85 ± 0.35 logarithm of minimal angle of resolution; P < 0.001). Fifteen eyes (75%) had visual acuity improvement of more than 0.2 logarithm of minimal angle of resolution. Thirteen eyes (65%) achieved visual acuity better than 20/200.

Conclusion:
Pars plana vitrectomy combined with internal fluid aspiration under perfluorocarbon liquid is an effective and safe surgical technique for the management of large MH. This innovative technique offers improved closure rates and visual acuity results.
PERIPHERAL RETINOSCHISIS IN INTERMEDIATE UVEITIS
Authors: Pichi Francesco , Srivastava Sunil K. , Nucci Paolo , Baynes Kimberly , Neri Piergiorgio , Lowder Careen Y. 
Published: January 2017

Purpose:
To examine cases of intermediate uveitis complicated by retinoschisis and review the pathogenetic hypothesis.

Methods:
A retrospective chart review of patients with intermediate uveitis. Data were collected at three uveitis referral centers on sex, age, best-corrected visual acuity, degree of vitritis, extent and location of snowbanking, presence of hard exudates, neovascularization, vitreous hemorrhage, and extent and nature of retinal elevations.

Results:
A series of 23 eyes of 20 patients were examined; patient's age ranged from 10 years to 70 years and follow-up period from 8 months to 6 years. Twenty-two eyes had retinoschisis (95.6%), and 1 had retinoschisis associated with serous retinal detachment (4.3%). Extensive inferior pars plana exudates with snowbanking were present in 12 eyes (52.2%), whereas 3 eyes had inferior snowballs over the elevated retina. Neovascularization of the vitreous base accompanied by vitreous hemorrhage occurred in one eye. There was no coexisting macular pathology in 16 eyes, whereas 4 eyes had cystoid macular edema.

Conclusion:
The appearance of peripheral retinoschisis in this series of uncontrolled intermediate uveitis patients seems to be secondary to a complex balance between the persistent fluorescein leakage, a subclinical peripheral ischemia, and the constant low-grade vitreous inflammation that causes vitreous shrinkage and traction. The results of this study suggest that the absence of macroscopic changes in the retina does not preclude ischemic peripheral abnormalities, and the detection of a peripheral retinoschisis in an intermediate uveitis patient with active fluorescein leakage must suggest the need for a more aggressive form of treatment despite the good visual acuity.
Number of Bacteria and Time of Coincubation With Bacteria Required for the Development of Acanthamoeba Keratitis
Authors: Nakagawa Hayate , Hattori Takaaki , Koike Naohito , Ehara Tomoko , Narimatsu Akitomo , Kumakura Shigeto , Matsumoto Tetsuya , Goto Hiroshi 
Published: January 2017

Purpose:
We hypothesized that bacteria may be a factor contributing to the development of Acanthamoeba keratitis (AK). We investigated interactions between Acanthamoeba and Pseudomonas aeruginosa for the development of keratitis in rabbit corneas.

Methods:

Acanthamoeba castellanii (ATCC50492) and P. aeruginosa (PAO-1) were used. Two densities of P. aeruginosa (high, 1 × 108/mL; low, 3 × 105/mL) and 2 durations of coincubation (long, 6 h; short, 2 h) of Acanthamoeba with 1 × 108/mL of P. aeruginosa were tested. Acanthamoeba alone or Acanthamoeba coincubated with P. aeruginosa was inoculated into rabbit corneas. After inoculation, levofloxacin (LVFX) eye drops were administered. The clinical score of the cornea was evaluated after inoculation.

Results:

Acanthamoeba alone did not produce keratitis during a 5-day observation period. Rabbit corneas inoculated with Acanthamoeba coincubated with low-density P. aeruginosa followed by topical LVFX were clear with few infiltrates. Corneas inoculated with Acanthamoeba coincubated with high-density P. aeruginosa followed by LVFX treatment developed severe keratitis, and clinical scores were significantly higher compared with high-density P. aeruginosa alone followed by LVFX treatment (scores 7, 9.6, 8.5 vs. 3, 3.5, 3.25 on days 1–3, all P < 0.01). The long (6 h) coincubation time of Acanthamoeba with high-density P. aeruginosa resulted in more severe keratitis compared with short (2 h) coincubation (scores, 9.7, 12.7, 12.1, 9.8, 8.7 vs. 7, 9.6, 8.5, 6.9, 5.6 on days 1–5, all P < 0.01).

Conclusions:
These results suggest that the presence of bacteria is essential and a critical number of bacteria is required for the development of AK. The time of coexistence with bacteria may be an important determinant of the severity of AK.
Periocular Amyloidosis Manifesting as Pseudopemphigoid Treated With Mitomycin C
Authors: Vahdani Kaveh , Thaller Vladimir T. , Albanese Giorgio , Dean Andrew F. 
Published: January 2017

Purpose:
To describe an unusual cicatrizing manifestation of periocular amyloid and the utility of adjuvant antimetabolite therapy.

Methods:
This is a case report of a 49-year old woman with progressive bilateral upper lid ptosis, who was found to have bilateral inferior forniceal masses with thickening of the conjunctiva. Conjunctival and eyelid biopsies showed evidence of amyloid deposition. Systemic evaluation did not reveal any evidence of systemic amyloidosis. Her blepharoptosis continued to deteriorate, and she underwent bilateral sequential upper lid ptosis correction surgery and debulking procedures. Subsequently, she developed severe and progressive cicatricial conjunctivitis with extensive symblepharon formation in all 4 fornices and restriction of ocular motility, simulating a clinical picture of ocular mucous membrane pemphigoid.

Results:
She was treated surgically by division of symblepharon augmented with application of topical mitomycin C intraoperatively. This has been partially successful in freeing up differential movement between her lid and her eye and consequently improving eye protection and lubrication.

Conclusions:
Pseudopemphigoid represents a rare manifestation of periocular amyloid. Risks and benefits of surgical procedures in this context need to be carefully weighed to minimize the risk of secondary complications. Topical mitomycin C may be considered as a relatively safe adjunct in managing the cicatricial component of the disease.
Pathogenesis of abdominal pain in bowel obstruction: role of mechanical stress-induced upregulation of nerve growth factor in gut smooth muscle cells
Authors: Lin You-Min , Fu Yu , Winston John , Radhakrishnan Ravi , Sarna Sushil K. , Huang Li-Yen M. , Shi Xuan-Zheng 
Published: January 2017

Abstract
Abdominal pain is one of the major symptoms in bowel obstruction (BO); its cellular mechanisms remain incompletely understood. We tested the hypothesis that mechanical stress in obstruction upregulates expression of nociception mediator nerve growth factor (NGF) in gut smooth muscle cells (SMCs), and NGF sensitizes primary sensory nerve to contribute to pain in BO. Partial colon obstruction was induced with a silicon band implanted in the distal bowel of Sprague-Dawley rats. Colon-projecting sensory neurons in the dorsal root ganglia (T13 to L2) were identified for patch-clamp and gene expression studies. Referred visceral sensitivity was assessed by measuring withdrawal response to stimulation by von Frey filaments in the lower abdomen. Membrane excitability of colon-projecting dorsal root ganglia neurons was significantly enhanced, and the withdrawal response to von Frey filament stimulation markedly increased in BO rats. The expression of NGF mRNA and protein was increased in a time-dependent manner (day 1-day 7) in colonic SMC but not in mucosa/submucosa of the obstructed colon. Mechanical stretch in vitro caused robust NGF mRNA and protein expression in colonic SMC. Treatment with anti-NGF antibody attenuated colon neuron hyperexcitability and referred hypersensitivity in BO rats. Obstruction led to significant increases of tetrodotoxin-resistant Na+ currents and mRNA expression of Nav1.8 but not Nav1.6 and Nav1.7 in colon neurons; these changes were abolished by anti-NGF treatment. In conclusion, mechanical stress-induced upregulation of NGF in colon SMC underlies the visceral hypersensitivity in BO through increased gene expression and activity of tetrodotoxin-resistant Na+ channels in sensory neurons.
Continuous noninvasive monitoring in the neonatal ICU
Authors: Sahni Rakesh 
Published: January 2017

Purpose of review
Standard hemodynamic monitoring such as heart rate and systemic blood pressure may only provide a crude estimation of organ perfusion during neonatal intensive care. Pulse oximetry monitoring allows for continuous noninvasive monitoring of hemoglobin oxygenation and thus provides estimation of end-organ oxygenation. This review aims to provide an overview of pulse oximetry and discuss its current and potential clinical use during neonatal intensive care.

Recent findings
Technological advances in continuous assessment of dynamic changes in systemic oxygenation with pulse oximetry during transition to extrauterine life and beyond provide additional details about physiological interactions among the key hemodynamic factors regulating systemic blood flow distribution along with the subtle changes that are frequently transient and undetectable with standard monitoring.

Summary
Noninvasive real-time continuous systemic oxygen monitoring has the potential to serve as biomarkers for early-organ dysfunction, to predict adverse short-term and long-term outcomes in critically ill neonates, and to optimize outcomes. Further studies are needed to establish values predicting adverse outcomes and to validate targeted interventions to normalize abnormal values to improve outcomes.
Klf10 Gene, a Secondary Modifier and a Pharmacogenomic Biomarker of Hydroxyurea Treatment Among Patients With Hemoglobinopathies
Authors: Elalfy Mohsen S. , El Sherif Nayera H.K. , Kamal Tarek M. , Aly Nihal H. 
Published: January 2017

Background:
The klf10 gene could indirectly modify γ-globin chain production and hence the level of fetal hemoglobin (HbF) ameliorating the phenotype of β-hemoglobinopathies and the response to hydroxycarbamide (hydroxyurea [HU]) therapy. In this study, we aimed to evaluate the frequency of different genotypes for the klf10 gene in β-thalassemia major (B-TM), β-thalassemia intermedia (B-TI), and sickle cell disease (SCD) patients by polymerase chain reaction and to assess its relation to disease phenotypes and HU response.

Methods:
This cross-sectional study included 75 patients: 50 B-TM, 12 SCD, and 13 B-TI patients (on stable HU dose). The relation of the klf10 gene polymorphism (TIEG, TIEG1, EGRα) (rs3191333: c*0.141C>T) to phenotype was studied through baseline mean corpuscular volume, HbF, and transfusion history, whereas evaluation of response to HU therapy was carried out clinically and laboratory.

Results:
The frequency of the mutant klf10 genotype (TT) and that of the mutant allele (T) was significantly higher among B-TM patients compared with those with B-TI and SCD patients. Only homozygous SCD patients for the wild-type allele within the klf10 gene had a significantly lower transfusion frequency. The percentage of HU responders and nonresponders between different klf10 polymorphic genotypes among B-TI or SCD patients was comparable.

Conclusions:
Although the klf10 gene does not play a standalone role as an HbF modifier, our data support its importance in ameliorating phenotype among β-hemoglobinopathies.
Vision Problems and Reduced Reading Outcomes in Queensland Schoolchildren
Authors: Hopkins Shelley , Sampson Geoff P. , Hendicott Peter L. , Wood Joanne M. 
Published: January 2017

ABSTRACTPurposeTo assess the relationship between vision and reading outcomes in Indigenous and non-Indigenous schoolchildren to determine whether vision problems are associated with lower reading outcomes in these populations.MethodsVision testing and reading assessments were performed on 508 Indigenous and non-Indigenous schoolchildren in Queensland, Australia divided into two age groups: Grades 1 and 2 (6–7 years of age) and Grades 6 and 7 (12–13 years of age). Vision parameters measured included cycloplegic refraction, near point of convergence, heterophoria, fusional vergence range, rapid automatized naming, and visual motor integration. The following vision conditions were then classified based on the vision findings: uncorrected hyperopia, convergence insufficiency, reduced rapid automatized naming, and delayed visual motor integration. Reading accuracy and reading comprehension were measured with the Neale reading test. The effect of uncorrected hyperopia, convergence insufficiency, reduced rapid automatized naming, and delayed visual motor integration on reading accuracy and reading comprehension were investigated with ANCOVAs.ResultsThe ANCOVAs explained a significant proportion of variance in both reading accuracy and reading comprehension scores in both age groups, with 40% of the variation in reading accuracy and 33% of the variation in reading comprehension explained in the younger age group, and 27% and 10% of the variation in reading accuracy and reading comprehension, respectively, in the older age group. The vision parameters of visual motor integration and rapid automatized naming were significant predictors in all ANCOVAs (P< .01). The direction of the relationship was such that reduced reading results were explained by reduced visual motor integration and rapid automatized naming results.ConclusionsBoth reduced rapid automatized naming and visual motor integration were associated with poorer reading outcomes in Indigenous and non-Indigenous children. This is an important finding given the recent emphasis placed on Indigenous children’s reading skills and the fact that reduced rapid automatized naming and visual motor integration skills are more common in this group.
Functional Characteristics of Health Coalitions in Local Public Health Systems: Exploring the Function of County Health Councils in Tennessee
Authors: Barnes Priscilla , Erwin Paul , Moonesinghe Ramal , Brooks Ashley , Carlton Erik L. , Behringer Bruce 
Published: January 2017

Context:
Partnerships are emerging as critically important vehicles for addressing health in local communities. Coalitions involving local health departments can be viewed as the embodiment of a local public health system. Although it is known that these networks are heavily involved in assessment and community planning activities, limited studies have evaluated whether health coalitions are functioning at an optimal capacity.

Objective:
This study assesses the extent to which health coalitions met or exceeded expectations for building functional capacity within their respective networks.

Design:
An evaluative framework was developed focusing on 8 functional characteristics of coalitions previously identified by Erwin and Mills. Twenty-nine indicators were identified that served as “proxy” measures of functional capacity within health coalitions.

Setting and Participants:
Ninety-three County Health Councils (CoHCs) in Tennessee.

Main Outcome Measure(s):
Diverse member representation; formal rules, roles, and procedures; open, frequent interpersonal communication; task-focused climate; council leadership; resources; active member participation; and external linkages were assessed to determine the level of functionality of CoHCs. Scores across all CoHCs were analyzed using descriptive statistics such as frequency distributions, measures of central tendency, and measures of variability. Data were analyzed using SAS 9.3.

Results:
Of 68 CoHCs (73% response rate), the total mean score for the level of functional characteristics was 30.5 (median = 30.5; SD = 6.3; range, 18-44). Of the 8 functional characteristics, CoHCs met or exceeded all indicators associated with council leadership, tasked-focused climate, and external linkages. Lowest scores were for having a written communications plan, written priorities or goals, and opportunities for training.

Conclusion:
This study advances the research on health coalitions by establishing a process for quantifying the functionality of health coalitions. Future studies will be conducted to examine the association between health coalition functional capacity, local health departments' community health assessment and planning efforts, and changes in community health status.
Resident-Driven Quality Improvement Project in Perioperative Hand Hygiene
Authors: Pimentel Marc Philip T. , Feng Aiden Yuzhe , Piszcz Regina , Urman Richard D. , Lekowski Robert W. , Nascimben Luigino 
Published: January 2017

Objectives
The goal of the project was to improve hand hygiene compliance in the perioperative setting while involving anesthesia residents in quality improvement. To achieve this goal, we facilitated direct trainee participation on patient safety and quality improvement initiatives. The result was a project for perioperative hand hygiene improvement conceived and led by anesthesiology residents.

Methods
Anesthesiology residents contributed project ideas and participated in problem-based learning discussions to develop several interventions for improving perioperative hand hygiene compliance. Interventions included electronic and laminated posters, reminder cards, monthly aggregated performance feedback, and a simulation-based hand hygiene workshop. Monthly hand hygiene compliance data were gathered during unannounced observations for a 29-month period. Run chart analysis and χ2 test were used to determine the impact of these interventions on compliance rates.

Results
A total of 1122 hand hygiene observations were made for 29 months. Run chart analysis showed a nonrandom shift and increasing trend during the postintervention period. The baseline hand hygiene rate was 68% (95% CI [65%–72%], n = 661), which increased to 79% post-intervention (95% CI [76%–83%], n = 461, P < 0.01).

Conclusions
Our resident-led hand hygiene program used a multifaceted approach to drive sustained increases in perioperative hand hygiene compliance, while directly engaging house staff in quality improvement initiatives.
Reactive oxygen therapy: a novel therapy in soft tissue infection
Authors: Dryden Matthew 
Published: January 2017

Purpose of review
The global burden of disease in skin and soft tissue lesions is enormous. Many chronic, poorly healing lesions get treated with antibiotics despite the lack of evidence for long-term antibiotics. There is a global antibiotic resistance crisis driven largely by inappropriate use of large volumes of antibiotics. One solution is to reduce the selection pressure on bacteria by reducing the volume of antibiotic use in medicine, agriculture and the environment. There are few novel antimicrobials. One of the only novel agents to reach clinical use is one using reactive oxygen species (ROS), oxygen radicals, as an antimicrobial mechanism.

Recent findings
ROS can be delivered to the site of infection in various formats. ROS is highly antimicrobial against Gram-positive and negative bacteria, viruses and fungi. It also prevents and breaks down biofilm. These functions make ROS highly suitable for chronic inflammatory conditions, where antibiotics are frequently overused and relatively ineffective: chronic wounds, ulcers and burns; but also possibly mucosal infections in the respiratory and urinary tracts and in prosthetic device infection. ROS could also have an important role in infection prevention and antimicrobial stewardship.

Summary
Early clinical data support ROS treatment in skin and soft tissue lesions to reduce bacterial bioburden and biofilm in critical colonization and in preventing surgical site infection, although further trials of ROS in soft tissue infection would be helpful and research in ROS use at other clinical sites might support many novel clinical indications.
Duration of pneumonia therapy and the role of biomarkers
Authors: Kaziani Katerina , Sotiriou Adamantia , Dimopoulos George 
Published: January 2017

Purpose of review
Increasing antimicrobial resistance is a worldwide phenomenon that is threatening public health. Lower respiratory infections are one of the leading causes of morbidity that contribute to antibiotic consumption and thus the emergence of multidrug-resistant microbial strains. The goal of shortening antibiotic regimens’ duration in common bacterial infections has been prioritized by antimicrobial stewardship programs as an action against this problem.

Recent findings
Data coming from randomized controlled trials, meta-analyses, and systematic reviews support the shortening of antimicrobial regimens in community-acquired, hospital-acquired, and ventilator-associated pneumonia. Short schedules have been proven at least as effective as long ones in terms of antimicrobial-free days and clinical cure. Procalcitonin-based algorithms have been validated as well tolerated and cost-effective tools for the duration of pneumonia therapy reduction.

Summary
Shortening the duration of antibiotic regimens in pneumonia seems a reasonable strategy for reducing selective pressure driving antimicrobial resistance and costs provided that clinical cure is guaranteed. Procalcitonin-based protocols have been proven essentially helpful in this direction.

Video abstract

http://links.lww.com/COID/A17
The role of methicillin-resistant Staphylococcus aureus in skin and soft tissue infections
Authors: Bassetti Matteo , Carnelutti Alessia , Righi Elda 
Published: January 2017

Purpose of review
Methicillin-resistant Staphylococcus aureus (MRSA) has become a major public health issue worldwide over the last years. MRSA is frequently implicated in the development of skin and soft tissue infections, leading to significant increases in morbidity, mortality and overall healthcare costs.

Recent findings
In order to face the threat of MRSA, major changes in clinical management of skin and soft tissue infections are required. The identification of populations at risk for the acquisition of infections due to MRSA, together with the improvement of the diagnostic techniques, is paramount. Moreover, a number of new antimicrobials with activity against MRSA have been recently developed and approved for the treatment of skin and soft tissue infections, however, the use of the new drugs in the wide clinical practice remains limited.

Summary
We reviewed the current epidemiology of MRSA in skin and soft tissue infections, with particular focus on implications for clinical management. The potential role of new antibiotic options against MRSA infections is also discussed.