bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Picture of Severe Systemic Capillary-Leak Syndrome Episodes Requiring ICU Admission
Authors: Pineton de Chambrun Marc , Luyt Charles-Edouard , Beloncle François , Gousseff Marie , Mauhin Wladimir , Argaud Laurent , Ledochowski Stanislas , Moreau Anne-Sophie , Sonneville Romain , Verdière Bruno , Merceron Sybille , Zappella Nathalie , Landais Mickael , Contou Damien , Demoule Alexandre , Paulus Sylvie , Souweine Bertrand , Lecomte Bernard , Vieillard-Baron Antoine , Terzi Nicolas , Azoulay Elie , Friolet Raymond , Puidupin Marc , Devaquet Jérôme , Mazou Jean-Marc , Fedun Yannick , Mira Jean-Paul , Raphalen Jean-Herlé , Combes Alain , Amoura Zahir 
Published: June 2017

Objective:
Systemic capillary-leak syndrome is a very rare cause of recurrent hypovolemic shock. Few data are available on its clinical manifestations, laboratory findings, and outcomes of those patients requiring ICU admission. This study was undertaken to describe the clinical pictures and ICU management of severe systemic capillary-leak syndrome episodes.

Design, Setting, Patients:
This multicenter retrospective analysis concerned patients entered in the European Clarkson’s disease (EurêClark) Registry and admitted to ICUs between May 1992 and February 2016.

Measurements and Main Results:
Fifty-nine attacks occurring in 37 patients (male-to-female sex ratio, 1.05; mean ± sd age, 51 ± 11.4 yr) were included. Among 34 patients (91.9%) with monoclonal immunoglobulin G gammopathy, 20 (58.8%) had kappa light chains. ICU-admission hemoglobin and proteinemia were respectively median (interquartile range) 20.2 g/dL (17.9–22 g/dL) and 50 g/L (36.5–58.5 g/L). IV immunoglobulins were infused (IV immunoglobulin) during 15 episodes (25.4%). A compartment syndrome developed during 12 episodes (20.3%). Eleven (18.6%) in-ICU deaths occurred. Bivariable analyses (the 37 patients’ last episodes) retained Sequential Organ-Failure Assessment score greater than 10 (odds ratio, 12.9 [95% CI, 1.2–140]; p = 0.04) and cumulated fluid-therapy volume greater than 10.7 L (odds ratio, 16.8 [1.6–180]; p = 0.02) as independent predictors of hospital mortality.

Conclusions:
We described the largest cohort of severe systemic capillary-leak syndrome flares requiring ICU admission. High-volume fluid therapy was independently associated with poorer outcomes. IV immunoglobulin use was not associated with improved survival; hence, their use should be considered prudently and needs further evaluation in future studies.
Comparison of Efficacy of Difluprednate 0.05% and Loteprednol Gel 0.5% After Cataract Surgery
Authors: Abessi Bryan , Brooksby Lauren , Schultze Robert L. 
Published: June 2017

Purpose:
To compare the outcomes and complications of topical difluprednate 0.05% and loteprednol gel 0.5% after routine cataract surgery.

Methods:
Subjects received either difluprednate emulsion 0.05% (n=30 eyes) or loteprednol gel 0.5% (n=30 eyes) after routine cataract surgery. Topical steroid drops were initiated 3 days before cataract surgery and continued for 2 weeks postoperatively. Anterior chamber (AC) cell grade, corneal edema, corneal pachymetry, visual acuity, ocular surface quality (Oxford scale), and intraocular pressure (IOP) were evaluated at 1 day, 1 week, and 1 month postoperatively.

Results:
Patients treated with difluprednate or loteprednol had statistically similar resolution of their AC cell grade and corneal edema at 1 day, 1 week, and 1 month postoperatively (P>0.05 at each study visit). Difluprednate-treated and loteprednol-treated eyes achieved a mean best-corrected visual acuity of at least 20/25 by 1 week postoperatively (0.055 and 0.061 logarithm of the minimum angle of resolution, respectively; P=0.82). The nasal ocular surface quality at 1 week had improved in loteprednol-treated eyes compared with difluprednate-treated eyes (1.0 vs. 1.9 Oxford score, respectively; P<0.001), but similar at all other visits. There was no statistical difference between IOP levels between both treatment groups (P>0.05). In the difluprednate-treated group, one patient developed rebound inflammation and two patients developed cystoid macular edema at their 1-month postoperative visit.

Conclusions:
The anti-inflammatory effect, visual recovery, and IOP of patients using topical difluprednate or loteprednol gel after cataract surgery are equivalent. There may be an additional short-term benefit of loteprednol gel in protecting the ocular surface after cataract surgery.
Central Connections of the Lacrimal Functional Unit
Authors: Willshire Catherine , Buckley Roger J. , Bron Anthony J. 
Published: June 2017

Purpose:
To study the contribution of each eye to the reflex tear response, after unilateral and bilateral topical anesthesia.

Method:
A closed-eye, modified Schirmer test was performed bilaterally in 8 normal subjects, in a controlled environment chamber set to 23°C, 45% relative humidity, and 0.08 m/s airflow. Eye drops were instilled into each eye 10 minutes before the Schirmer test. Experiments were as follows: 1) bilateral saline (control), 2) unilateral anesthesia (ipsilateral anesthetic; contralateral saline), and 3) bilateral anesthesia.

Results:
There was no difference in between-eye wetting lengths in the saline control eyes (P = 0.394) or the bilaterally anesthetized eyes (P = 0.171). The wetting length was reduced in both eyes after bilateral anesthesia compared with saline controls (P = 0.001; P ≤ 0.0005). After unilateral anesthesia, the wetting length was reduced in the anesthetized eye compared with its saline control by 51.4% (P ≤ 0.0005) and compared with its fellow, unanesthetized eye (P = 0.005). The fellow eye value was also reduced compared with its saline control (P = 0.06).

Conclusions:
The wetting length was reduced by topical anesthesia, when instilled bilaterally and ipsilaterally. The latter response implies an ipsilateral, reflex sensory drive to lacrimal secretion. In the unanesthetized fellow eye, the reduction compared with its saline control was not quite significant. This implies a relative lack of central, sensory, reflex cross-innervation, although the possibility cannot entirely be ruled out. These results are relevant to the possibility of reflex lacrimal compensation from a normal fellow eye, in cases of unilateral corneal anesthesia.
Influence of Refractive Status on the Higher-Order Aberration Pattern After Small Incision Lenticule Extraction Surgery
Authors: Li Liuyang , Cheng George P. M. , Ng Alex L. K. , Chan Tommy C. Y. , Jhanji Vishal , Wang Yan 
Published: June 2017

Purpose:
To study the effect of myopia on the pattern change in higher-order aberrations after small incision lenticule extraction.

Methods:
Sixty eyes of 60 patients were included: low myopia (≤−3.00 D), moderate myopia (−3.00 D to −6.00 D), and high myopia (≥−6.00 D). Total higher-order aberrations (tHOA), vertical coma (

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), horizontal coma (

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), and spherical aberration (

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) were measured preoperatively and at postoperative 3 months.

Results:
At the end of 3 months, tHOA changed significantly compared with the preoperative values (P < 0.05), except for

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and

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in the low myopia group. The change in

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,

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, and

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in the moderate group (−0.299, −0.175, and 0.108 μm) was 2.020, 4.861, and 4.696 times higher than the low group (−0.148, −0.036, 0.023 μm) (P = 0.002, 0.001, 0.001), respectively. The value in the high group (−0.331, −0.192, 0.154 μm) was 1.107, 1.097 (P = 0.478, 0.665), and 1.426 times (P = 0.047) higher than the moderate group. The degree of myopia was positively correlated with Δ

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(r = 0.447; P < 0.001) and Δ

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(r = 0.496; P < 0.001), and negatively correlated with ΔtHOA (r = −0.363, P = 0.004) and Δ

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(r = −0.599; P < 0.001).

Conclusions:
The study showed a different pattern of change in ocular aberrations after small incision lenticule extraction in patients with varying degrees of myopia. In patients with low myopia, there was no increase in

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or

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. In high myopia, however,

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increased with the degree of myopia, whereas the rising rate of coma was slowing.
Psychometric Validation of the Mandarin Version Control Attitudes Scale-Revised Questionnaire in Taiwanese Patients With Heart Failure
Authors: Huang Tsuey-Yuan , Hwang Shiow-Li 
Published: June 2017

Background:
Perceived control is an important construct in patients with heart failure (HF) and related to improved health outcomes. There is no reliable and valid instrument available for the measurement of perceived control in Taiwan, limiting the practical application of the construct in research and clinical practice.

Purpose:
The aim of this study was to translate, culturally adapt, and validate the Mandarin version of the Control Attitudes Scale-Revised (Mandarin CAS-R) in Taiwanese patients with HF.

Methods:
The Mandarin CAS-R was developed using a translation/back-translation process and semantic equivalence; importantly, conceptual equivalence was also examined. Reliability was assessed using Cronbach’s α to determine internal consistency, and item homogeneity was assessed using item-total and interitem correlations. Construct validity was examined using exploratory factor analysis and hypothesis testing for known associations.

Results:
Three hundred forty-eight patients with HF were included, and 5-item Mandarin CAS-R was validated in the study. The model performance was acceptable with all factor loadings greater than 0.70, a variance explained of 55.2%, and a Cronbach’s α of .79. The 5-item Mandarin CAS-R was associated with higher levels of self-care maintenance (β = 0.395, P < .001), management (β = 0.219, P < .01), and confidence (β = 0.524, P < .001); perceived social support (β = 0.246, P < .001); and depression (β = −0.125, P < .05).

Conclusions:
This study provided evidence of the reliability and validity of the 5-item Mandarin CAS-R as a measure of perceived control in Taiwanese patients with HF.
Proton pump inhibitor and selective serotonin reuptake inhibitor therapy for the management of noncardiac chest pain
Authors: Viazis Nikos , Katopodi Konstantina , Karamanolis George , Denaxas Konstantinos , Varytimiadis Lazaros , Galanopoulos Michail , Tsoukali Emmanouela , Kamberoglou Dimitirs , Christidou Angeliki , Karamanolis Dimitrios G. , Papatheodoridis George , Mantzaris Gerasimos J. 
Published: June 2017

Introduction
Although gastroesophageal reflux disease is the main cause of noncardiac chest pain (NCCP), proton pump inhibitors (PPIs) benefit a minority of patients. Our prospective study evaluated the effect of PPI and selective serotonin reuptake inhibitors on the different subtypes of NCCP characterized by impedance-pH monitoring.

Methods
All NCCP patients underwent impedance-pH monitoring and on the basis of the results, those with abnormal distal esophageal acid exposure received PPIs twice daily (group A), those with a positive symptom index for chest pain received citalopram 20 mg and PPI once daily (group B), and those with a negative symptom index for chest pain received citalopram 20 mg once daily (group C). Therapy was administered for 12 weeks and treatment success was defined as complete disappearance of chest pain.

Results
From March 2015 to March 2016, 63 patients were included (group A=9, group B=18, group C=36). After 12 weeks of therapy, complete resolution of chest pain was noted in 8/9 (88.9%) group A, 13/18 (72.2%) group B, and 24/36 (66.7%) group C patients.

Conclusion
Combined impedance-pH monitoring identifies different subtypes of NCCP patients who can receive tailored management. Targeted therapy with PPIs and/or citalopram offers complete symptom relief in the great majority of them.
Predicting short-term and long-term mortality of hospitalized Portuguese patients with alcoholic hepatitis
Authors: Fernandes Samuel R. , Marques da Costa Pedro , Vítor Sofia , Carvalho Joana R. , Santos Patrícia , Moura Carlos M. , Cortez-Pinto Helena , Ramalho Fernando , Velosa José 
Published: June 2017

BackgroundAlcohol abuse can result in a spectrum of liver injury that ranges from mild fatty infiltration to alcoholic hepatitis (AH), cirrhosis, and hepatocellular carcinoma. The present study aimed to evaluate current scoring systems in predicting short-term and long-term mortality because of AH.Patients and methodsRecords of 170 consecutive patients with AH admitted to a tertiary center between January 2005 and October 2015 were reviewed. Clinical and biochemical parameters were retrieved for the assessment of AH scores for the day of admission (D1) and for the seventh day of hospitalization (D7). Endpoints included admission to the ICU, and 30-day, 90-day, and 1-year mortality.ResultsThe Maddrey discriminant function and the Model of End-Stage Liver Disease (MELD) were modest predictors of the need for ICU admission. In-hospital, 30-day, 90-day, and 1-year mortality were 15.9, 18.2, 21.8, and 30.0%, respectively. There was a numerical, albeit nonsignificant, trend for higher accuracy using D7 scores, especially the MELD, in predicting 30-day and 1-year mortality. Overall, all scores showed high negative predictive values (30 day: 91.2–98.7% and 1 year: 78.8–93.7%), but modest positive predictive values (30 day: 30.6–70.8% and 1 year: 42.1–61.2%). Survival rates were the highest among patients showing a decrease in the MELD, Glasgow Alcoholic Hepatitis Score, and Age, serum Bilirubin, International normalized ratio, and serum Creatinine score over the first week of admission.DiscussionAH scores were comparable in identifying patients at low risk of mortality up to 1 year following admission. Reassessment of the MELD, Glasgow Alcoholic Hepatitis Score, and Age, serum Bilirubin, International normalized ratio, and serum Creatinine score scores after 1 week further improved mortality prediction.
Do toddler’s fractures of the tibia require evaluation and management by an orthopaedic surgeon routinely?
Authors: Adamich John S. , Camp Mark W. 
Published: June 2017

Objective
The majority of uncomplicated toddler fractures of the tibia (toddler’s fractures) do not need an orthopaedic surgeon’s intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system.

Patients and methods
A retrospective analysis of patients who presented for management of toddler’s fractures to The Hospital for Sick Children (SickKids) was performed.

Results
A total of 184 (113 boys, 72 girls) patients, of a mean age of 1.99 (range: 0.2–3.9) years, were included for review. The included patients had attended 2.00±1.0 clinic visits and had had 5.86±2.7 radiographs taken on average. No complications such as cast injuries, nonunion, refracture or subsequent deformity needing assessment or intervention were identified.

Conclusion
Toddler’s fractures do not require routine orthopaedic surgeon assessment, intervention or follow-up. If diagnosed and managed correctly at initial presentation, patients with toddler’s fractures may be discharged safely without the need for further clinician contact. We developed a toddler’s fracture clinical care pathway to reduce unnecessary orthopaedic surgeon referral and clinical and radiographic follow-up, thereby decreasing radiation exposure and costs to families and the healthcare system without risking patient outcomes.
Movement System Diagnosis
Authors: Van Sant Ann F. 
Published: June 2017

Background and Purpose:
This article presents the concept of movement system diagnoses (MSDxs), including an examination of the evolution of the ideas that are shaping the development of MSDxs.

Summary of Key Points:
Ideas leading to development of the need for MSDxs are traced, and an overview of Diagnosis Dialog and points of consensus are provided. Four examples from areas of neurologic and pediatric practice where additional work is needed on movement system diagnosis are highlighted.

Clinical Practice:
The development and use of MSDxs are deemed critical to the future development of practice in pediatric and neurologic physical therapy. The prediction of treatment outcomes through research is dependent on homogeneous groups of patients with similar signs and symptoms of movement system disorders. Only by investigating homogeneous groups with refined MSDxs will it be possible to carefully examine and identify interventions that are appropriate to a specific diagnosis. Further, our ability to identify disordered movements, including inactivity and over-activity that could lead across time to disabling conditions presents a strong argument for establishing movement system diagnoses that forewarn of the risk of disordered movement poses to health. Such movement system diagnoses would guide interventions that deter the development of disabling conditions rooted in disordered movement.
From Disease to Health: Physical Therapy Health Promotion Practices for Secondary Prevention in Adult and Pediatric Neurologic Populations
Authors: Quinn Lori , Morgan Don 
Published: June 2017

Background and Purpose:
Over the last decade there has been a substantial increase in efforts to better understand how targeted physical activity and exercise interventions can be used to minimize secondary consequences arising from neurological damage in both adult and pediatric populations. This article offers an overview of contemporary research that addresses mediators of functional and neuroplastic adaptations associated with physical activity and exercise. We emphasize the important role that physical therapists can play to increase participation and improve well-being in adults and children with neurological disorders. We further highlight potential strategies to foster translation of evidence-based findings for use by clinicians and consumers.

Summary of Key Points:
Engagement in physical activity can serve as a powerful promoter of health and well-being in adults and youth with neurologic disease, and has the potential to alter the course of disease processes. Physical therapists can play a key role in promoting fitness and wellness by encouraging active living, providing early diagnosis of disease and prescribing targeted activity interventions to improve fitness and participation, and helping individuals overcome personal and environmental barriers to an active lifestyle.

Recommendations for Clinical Practice:
Physical therapists must adopt a model of rehabilitation that emphasizes secondary prevention in adults and youth with neurologic diseases. Physical therapists have a unique role in developing forward-thinking approaches in using innovative health and wellness strategies to promote positive changes in activity and exercise behaviors.
Genetic Variation and Neuroplasticity: Role in Rehabilitation After Stroke
Authors: Stewart Jill Campbell , Cramer Steven C. 
Published: June 2017

Background and Purpose:
In many neurologic diagnoses, significant interindividual variability exists in the outcomes of rehabilitation. One factor that may impact response to rehabilitation interventions is genetic variation. Genetic variation refers to the presence of differences in the DNA sequence among individuals in a population. Genetic polymorphisms are variations that occur relatively commonly and, while not disease-causing, can impact the function of biological systems. The purpose of this article is to describe genetic polymorphisms that may impact neuroplasticity, motor learning, and recovery after stroke.

Summary of Key Points:
Genetic polymorphisms for brain-derived neurotrophic factor (BDNF), dopamine, and apolipoprotein E have been shown to impact neuroplasticity and motor learning. Rehabilitation interventions that rely on the molecular and cellular pathways of these factors may be impacted by the presence of the polymorphism. For example, it has been hypothesized that individuals with the BDNF polymorphism may show a decreased response to neuroplasticity-based interventions, decreased rate of learning, and overall less recovery after stroke. However, research to date has been limited and additional work is needed to fully understand the role of genetic variation in learning and recovery.

Recommendations for Clinical Practice:
Genetic polymorphisms should be considered as possible predictors or covariates in studies that investigate neuroplasticity, motor learning, or motor recovery after stroke. Future predictive models of stroke recovery will likely include a combination of genetic factors and other traditional factors (eg, age, lesion type, corticospinal tract integrity) to determine an individual's expected response to a specific rehabilitation intervention.
Integrating Health Promotion Into Physical Therapy Practice to Improve Brain Health and Prevent Alzheimer Disease
Authors: McGough Ellen , Kirk-Sanchez Neva , Liu-Ambrose Teresa 
Published: June 2017

Background and Purpose:
Alzheimer disease is the most common cause of dementia, and brain pathology appears years before symptoms are evident. Primary prevention through health promotion can incorporate lifestyle improvement across the lifespan. Risk factor assessment and identifying markers of disease might also trigger preventive measures needed for high-risk individuals and groups.

Summary of Key Points:
Many potential risk factors are modifiable through exercise, and may be responsive to early intervention strategies to reduce the downward slope toward disability. Through the use of common clinical tests to identify cognitive and noncognitive functional markers of disease, detection and intervention can occur at earlier stages, including preclinical stages of disease. Physical activity and exercise interventions to address modifiable risk factors and impairments can play a pivotal role in the prevention and delay of functional decline, ultimately reducing the incidence of dementia. This article discusses prevention, prediction, plasticity, and participation in the context of preserving brain health and preventing Alzheimer disease and related dementias in aging adults.

Recommendations for Clinical Practice:
Rehabilitation professionals have opportunities to slow disease progression through research, practice, and education initiatives. From a clinical perspective, interventions that target brain health through lifestyle changes and exercise interventions show promise for preventing stroke and associated neurovascular diseases in addition to dementia. Physical therapists are well positioned to integrate primary health promotion into practice for the prevention of dementia and other neurological conditions in older adults.