bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Trabeculectomy Augmented With Subconjunctival and Subscleral Ologen Implantation in Primary Advanced Glaucoma
Authors: Angmo Dewang , Wadhwani Meenakshi , Upadhyay Ashish Dutt , Temkar Shreyas , Dada Tanuj 
Published: September 2016

Purpose:
To evaluate the efficacy and safety of trabeculectomy with combined subconjunctival and subscleral ologen implant in eyes with advanced glaucomatous optic neuropathy.

Design:
This is a retrospective, noncomparative case series.

Methods:
Twenty seven eyes of 23 patients with advanced primary glaucoma who underwent fornix-based trabeculectomy with insertion of ologen both subsclerally and subconjunctivally along with low dose Mitomycin-C (0.1 mg/mL×1 min) were evaluated. Data recorded included a complete history, demographic profile, and ophthalmic examination including gonioscopy and visual fields. Any complications or secondary procedures performed after trabeculectomy were recorded. Complete success was defined as intraocular pressure (IOP) ≤15 mm Hg without ocular hypotensive medication and qualified success as IOP≤15 mm Hg with medications.

Results:
The average age of patients was 46.2±14.8 years. There were 17 males and 6 females. Of these, 7 patients were diagnosed with juvenile open-angle glaucoma, 7 patients with primary open-angle glaucoma and 9 patients with primary angle-closure glaucoma and pseudophakia. The average follow-up time was 23.3±5.6 months, with a minimum of at least 12 months. The mean preoperative IOP was 38.3±6.6 mm Hg. Postoperatively, the IOP at 3 months was 12.5±1.9 mm Hg; 6 months was 12.6±3.9 mm Hg; 12 months was 12.3±2.5 mm Hg; and 24 months was 12.5±1.6 mm Hg (n=17); (P<0.0001). Complete success was noted in 92.6% eyes, qualified success in 3.7% eyes, and failure in 3.7% eyes. The preoperative and postoperative best-corrected visual acuity in logarithm of the minimum angle of resolution was 0.3±0.2 and 0.3±0.1 (P=0.31). The average number of ocular hypotensive medications used preoperatively was 4.2±0.5 (median 4) which decreased to 0.07±0.3 (median 0), (P<0.0001) postoperatively.

Conclusions:
Trabeculectomy with low dose Mitomycin-C and with implantation of ologen both subsclerally and subconjunctivally, appears to offer encouraging results in achieving a low target IOP in eyes with advanced primary adult glaucoma.
Differences in Corneal Biomechanics in Nonpenetrating Deep Sclerectomy and Deep Sclerectomy Reconverted into Trabeculectomy
Authors: Casado Alfonso , Cabarga Carmen , Pérez-Sarriegui Ane , Fuentemilla Enrique 
Published: September 2016

Purpose:
To evaluate the differences in intraocular pressure (IOP) and in corneal biomechanics in eyes with uneventful nonpenetrating deep sclerectomy (NPDS) in 1 eye and with intended deep sclerectomy reconverted into trabeculectomy (RIT) in the fellow eye of the same patient.

Participants:
Forty eyes of 20 patients with both types of glaucoma surgery and more than 6 months of follow-up, and 31 eyes of 50 controls.

Methods:
IOP was assessed with Goldmann applanation tonometry (GAT), ocular response analizer (ORA), and dynamic contour tonometer (DCT). Student t test for independent samples and a univariate generalized estimating equations model were used to analyze the results.

Main Outcome Measures:
Overall, no significant differences were found between IOP of NPDS and RIT eyes when measured with 3 tonometers.

Results:
Although NPDS showed lower values of IOP measured with GAT and ORA, RIT presented lower IOP if DCT is the chosen tonometry. Biomechanically, NPDS eyes had higher corneal hysteresis (CH) and corneal resistance factor (CRF). When compared with control patients, eyes that underwent glaucoma surgery had lower IOP using GAT, DCT and ORA (P<0.001, 0.315, and 0.260, respectively), and lower CRF (P<0.001).

Conclusions:
Eyes with NPDS tended to have higher values of CH and CRF and lower IOP than RIT eyes, as measured with 3 of 4 tonometry methods; these differences did not reach statistical significance.
Capillary Dropout at the Retinal Nerve Fiber Layer Defect in Glaucoma: An Optical Coherence Tomography Angiography Study
Authors: Ichiyama Yusuke , Minamikawa Takayuki , Niwa Yuichi , Ohji Masahito 
Published: September 2016

Purpose:
To investigate the microvasculature changes of retinal nerve fiber layer (RNFL) defects in glaucoma.

Design:
The study design is a case report.

Patients and Methods:
Four glaucomatous eyes were included in this observational cross-sectional study. The microvasculature changes of RNFL defects were examined using optical coherence tomography (OCT) angiography.

Results:
Three eyes had apparent wedge-shaped capillary dropout on OCT angiography. In the fourth eye, detection of wedge-shaped capillary loss was difficult because of overall capillary drop out due to advanced glaucoma. Capillary dropout detection by OCT angiography was correlated with visual field loss and RNFL defect detection by regular OCT. Compared with regular OCT used to obtain retinal thickness maps, OCT angiography is often better at visualizing the borders of lesions in the RNFL.

Conclusions:
OCT angiography can detect capillary dropout in RNFL defects in glaucomatous eyes, and therefore could be a useful glaucoma examination tool.
Effect of Nocturnal Intermittent Peritoneal Dialysis on Intraocular Pressure and Anterior Segment Optical Coherence Tomography Parameters
Authors: Chong Ka Lung , Samsudin Amir , Keng Tee Chau , Kamalden Tengku Ain , Ramli Norlina 
Published: September 2016

Purpose:
To evaluate the effect of nocturnal intermittent peritoneal dialysis (NIPD) on intraocular pressure (IOP) and anterior segment optical coherence tomography (ASOCT) parameters. Systemic changes associated with NIPD were also analyzed.

Methods:
Observational study. Nonglaucomatous patients on NIPD underwent systemic and ocular assessment including mean arterial pressure (MAP), body weight, serum osmolarity, visual acuity, IOP measurement, and ASOCT within 2 hours both before and after NIPD. The Zhongshan Angle Assessment Program (ZAAP) was used to measure ASOCT parameters including anterior chamber depth, anterior chamber width, anterior chamber area, anterior chamber volume, lens vault, angle opening distance, trabecular-iris space area, and angle recess area. T tests and Pearson correlation tests were performed with P<0.05 considered statistically significant.

Results:
A total of 46 eyes from 46 patients were included in the analysis. There were statistically significant reductions in IOP (−1.8±0.6 mm Hg, P=0.003), MAP (−11.9±3.1 mm Hg, P<0.001), body weight (−0.7±2.8 kg, P<0.001), and serum osmolarity (−3.4±2.0 mOsm/L, P=0.002) after NIPD. All the ASOCT parameters did not have any statistically significant changes after NIPD. There were no statistically significant correlations between the changes in IOP, MAP, body weight, and serum osmolarity (all P>0.05).

Conclusions:
NIPD results in reductions in IOP, MAP, body weight, and serum osmolarity in nonglaucomatous patients.
Increased spatial dimensions of repetitive heat and cold stimuli in older women
Authors: Naugle Kelly M. , Cruz-Almeida Yenisel , Fillingim Roger B. , Staud Roland , Riley Joseph L. 
Published: September 2016

Abstract
Protocols of temporal summation (TS) of pain typically involve the delivery of brief repetitive noxious pulses of a constant intensity while measuring the perceived intensity of pain after each pulse. The size percept of noxious repetitive stimulation has been poorly characterized. Furthermore, no studies have investigated age differences in TS of cold pain. The current study examined TS of pain intensity and the perceived size of the painful area during repetitive noxious heat and cold pulses in healthy younger (n = 104) and older adults (n = 40). Trials of 10 brief repetitive noxious heat or cold pulses were delivered to the upper extremities. Participants rated the perceived size of the painful area or intensity of pain after each pulse. The magnitude of change for the size percept and intensity for pain were calculated for each trial. The results indicated that older adults experienced greater TS of the size percept of cold stimuli compared with younger adults. Additionally, older women experienced greater TS of the size percept of heat stimuli compared with older men and all younger participants. No overall age or sex differences were found in the TS of pain intensity for cold or heat trials. These results suggest dysfunctional modulation of the spatial percept of the painful stimuli by older adults, and in particular older women, during repetitive noxious thermal pulses.
Withdrawal-associated injury site pain (WISP): a descriptive case series of an opioid cessation phenomenon
Authors: Rieb Launette Marie , Norman Wendy V. , Martin Ruth Elwood , Berkowitz Jonathan , Wood Evan , McNeil Ryan , Milloy M.-J. 
Published: September 2016

Abstract
Withdrawal pain can be a barrier to opioid cessation. Yet, little is known about old injury site pain in this context. We conducted an exploratory mixed-methods descriptive case series using a web-based survey and in-person interviews with adults recruited from pain and addiction treatment and research settings. We included individuals who self-reported a past significant injury that was healed and pain-free before the initiation of opioids, which then became temporarily painful upon opioid cessation—a phenomenon we have named withdrawal-associated injury site pain (WISP). Screening identified WISP in 47 people, of whom 34 (72%) completed the descriptive survey, including 21 who completed qualitative interviews. Recalled pain severity scores for WISP were typically high (median: 8/10; interquartile range [IQR]: 2), emotionally and physically aversive, and took approximately 2 weeks to resolve (median: 14; IQR: 24 days). Withdrawal-associated injury site pain intensity was typically slightly less than participants' original injury pain (median: 10/10; IQR: 3), and more painful than other generalized withdrawal symptoms which also lasted approximately 2 weeks (median: 13; IQR: 25 days). Fifteen surveyed participants (44%) reported returning to opioid use because of WISP in the past. Participants developed theories about the etiology of WISP, including that the pain is the brain's way of communicating a desire for opioids. This research represents the first known documentation that previously healed, and pain-free injury sites can temporarily become painful again during opioid withdrawal, an experience which may be a barrier to opioid cessation, and a contributor to opioid reinitiation.
Transient remission of nonalcoholic fatty liver disease decreases the risk of incident type 2 diabetes mellitus in Japanese men
Authors: Fukuda Takuya , Hamaguchi Masahide , Kojima Takao , Mitsuhashi Kazuteru , Hashimoto Yoshitaka , Ohbora Akihiro , Kato Takahiro , Nakamura Naoto , Fukui Michiaki 
Published: September 2016

Introduction
It is unclear how the transient remission of nonalcoholic fatty liver disease (NAFLD) affects incident type 2 diabetes mellitus (T2DM). Here, we sought to determine the effect of the transient remission of NAFLD on incident T2DM in Japanese men.

Materials and methods
We used a population-based health check-up program. The primary outcome was set as incident T2DM. We divided the participants who showed NAFLD at the time of enrollment into three groups according to their clinical course of NAFLD: the Regression group, in which the participants showed a regression of NAFLD and no relapse during the follow-up period; the Transient Remission group, in which participants achieved a transient remission of NAFLD, but had a relapse of NAFLD; and the Persistent group, in which participants showed NAFLD throughout the follow-up. The Never group of participants who did not show NAFLD throughout the follow-up served as a reference.

Results
The incidence rates of T2DM in the Never group, the Regression group, the Transient Remission group, and the Persistent group were 4.7% (62/1306), 9.2% (14/153), 18.0% (25/139), and 35.1% (120/342), respectively. In a multivariate Cox regression analysis with covariates, the adjusted hazard ratios for incident T2DM compared with the Never group were as follows: Regression group: 1.08 [95% confidence interval (CI) 0.53–2.04, P=0.81], Transient Remission group: 2.12 (95% CI 1.22–3.57, P<0.01), and Persistent group: 3.44 (95% CI 2.29–5.21, P<0.001). The adjusted hazard ratio of the Transient Remission group was significantly lower than that of the Persistent group (P<0.05).

Conclusion
Transient remission of NAFLD significantly decreased the risk of developing T2DM.
The role of capsule endoscopy in the diagnosis and treatment of obscure gastrointestinal bleeding in older individuals
Authors: Li Lan , Chen Chunxiao , Li Youming , Zhang Bingling 
Published: September 2016

Background/aim
Capsule endoscopy (CE) is currently recommended as the first-line diagnostic modality for the investigation of obscure gastrointestinal bleeding (OGIB). This study aimed to evaluate the diagnostic efficacy of CE and to determine the subsequent impacts on the treatment of the OGIB episode in older individuals.

Methods
Eight hundred and fifty-three patients who underwent CE for the indication of OGIB were investigated in a single center between January 2004 and December 2015. Patients were divided into two groups: those 65 years of age and older and those younger than 65 years of age.

Results
There were no significant differences between older patients and younger patients with respect to the CE completion rate. The diagnostic yield was significantly higher in older patients than in younger patients (55.1 vs. 46.6%, P=0.021). Vascular lesions were the main cause of bleeding in the elderly, whereas ulcerated/erosive lesions were found most frequently in younger patients. Furthermore, 56.0% of older patients with positive CE results had relevant changes in their management plans and received specific treatment on the basis of CE findings.

Conclusion
Our study confirmed the important role of CE in the diagnosis of OGIB and its huge impact on decision making in the management plan for older patients.
Pancreaticoduodenectomy for nonampullary duodenal lesions: indications and results
Authors: Shamali Awad , McCrudden Raymond , Bhandari Pradeep , Shek Fanny , Barnett Emily , Bateman Adrian , Abu Hilal Mohammed 
Published: September 2016

Background
Pancreaticoduodenectomy (PD) is a complex procedure, associated with a definite risk of mortality and 30–50% risk of complications. For nonampullary duodenal lesions, PD can carry a higher morbidity as they are more commonly associated with a soft pancreas and narrow-calibre main pancreatic ducts. It is therefore paramount that the risks and benefits of surgery are considered carefully in this group of patients. A preoperative histological diagnosis for duodenal lesions is normally achieved by endoscopic biopsy. In this study, we aim to assess the outcome of PD in patients with nonampullary duodenal lesions and correlate the preoperative endoscopic histology work-up with the definitive postoperative pathology.

Materials and methods
We reviewed a prospectively collected PD database from January 2007 to December 2013. Demographic and clinical data were included. Preoperative endoscopic histology was compared with final specimen histology to assess concordance.

Results
Forty patients (55% women, mean age 69.4 years, range 45–83 years) underwent PD for duodenal lesions over a 7-year time period. The most common presenting symptom was epigastric pain (32.5%), followed by anaemia (20%). Overall, the complication rate was 55%, with the most frequent adverse event being pancreatic fistula in 13/40 (32.5%). The perioperative mortality was 2/40 (5%). Duodenal adenocarcinoma (65%) was the most common postoperative histological diagnosis. The mean tumour size was 36 mm (range 5–103 mm) and a median of 13 nodes were harvested. The median length of stay was 15 days (range 7–66 days). Overall, 12/40 patients (30%) had a preoperative diagnosis of high-grade dysplasia. The postoperative specimen in this subgroup of patients was reviewed carefully and only 3/12 (25%) patients had high-grade dysplasia in the resection specimen. In the remaining patients, 3/12 (25%) had adenocarcinoma in the resection specimen and 6/12 patients (50%) had low-grade dysplasia.

Conclusion
PD carries a high mortality and morbidity, especially for duodenal lesions. We recommend a careful endoscopic review after the index case with a high-definition optical evaluation of duodenal lesions. This, in addition to an experienced histological assessment of the index biopsy material, forms an essential prerequisite in aiding the multidisciplinary team in the decision-making process with respect to triage of these lesions to conservative management, surveillance, endoscopic resection or finally surgical resection.
Virtual Laboratory and Imaging: an online simulation tool to enhance hospital disaster preparedness training experience
Authors: Carenzo Luca , Ragozzino Francesco , Colombo Davide , Barra Federico Lorenzo , Della Corte Francesco , Ingrassia Pier Luigi 
Published: September 2016

Objective
Hospitals play a pivotal role as basic healthcare providers during mass casualty incidents (MCIs). Radiological studies and emergency laboratory test are of high importance for the management of hospital patients. However, it is known that during these events, they can generate significant bottlenecks. Appropriate request of such tests is of utmost importance to not generate delays in the patient flow. The aim of this paper is to describe a software designed to increase the realism of hospital-based MCI training through a realistic reproduction of radiology and laboratory departments.

Methods
In this paper, we present a Virtual Laboratory and Imaging system that we designed with the goal of increasing the realism of full-scale mass casualty simulations. The system is able to dynamically manage the speed and load of virtual departments while collecting data on usage and load, and provide data useful for the after-event debriefing. We tested this system in two pilot simulations involving, respectively, 105 and 89 simulated casualties.

Results
The system, by measuring the number of requests and exams’ turnaround time, enabled an objective measurement of the laboratory and radiology workload during simulated MCIs. It was possible to identify bottlenecks and consequently use these data for after-action debriefing.

Conclusion
The tool not only increased the simulation realism by adding the radiology and laboratory departments but also provided valuable data that could be used for educational and organizational purposes.
Fit Minded College Edition Pilot Study: Can a Magazine-Based Discussion Group Improve Physical Activity in Female College Freshmen?
Authors: Pellitteri Katelyn , Huberty Jennifer , Ehlers Diane , Bruening Meg 
Published: September 2016

Objective:
Initial efficacy of a magazine-based discussion group for improving physical activity (PA), self-worth, and eating behaviors in female college freshmen.

Design:
Randomized control trial.

Setting:
A large university in southwestern United States.

Participants:
Thirty-seven female college freshmen were randomized to the intervention (n = 17) and control groups (n = 20) in September 2013.

Intervention:
Participants completed an 8-week magazine-based discussion group program, Fit Minded College Edition, adapted from Fit Minded, a previously tested theory-based intervention. Education on PA, self-worth, and nutrition was provided using excerpts from women's health magazines. Participants also had access to a Web site with supplementary health and wellness material. The control group did not attend meetings or have access to the Web site but received the magazines. Interventions focusing on concepts of self-worth with less focus on weight and appearance may promote long term PA participation and healthy eating behaviors in college women.

Main Outcome Measures:
Self-reported PA, global self-worth, knowledge self-worth, self-efficacy, social support, eating behaviors (ie, fruit/veggie/junk food/sugar-sweetened beverage consumption), satisfaction, and Web site usage.

Results:
Mean age of participants was 18.11 (SD = 0.32) years. Time × Intervention effects were observed for PA minutes per week (Partial η2 = 0.34), knowledge self-worth (Partial η2 = 0.02), and daily sugar-sweetened beverage consumption (Partial η2 = 0.17) (P < .05), with the intervention group reporting greater increases in PA and knowledge self-worth and greater decreases in sugar-sweetened beverage consumption.

Conclusions:
A magazine-based discussion group may provide a promising platform to improve health behaviors in female college freshmen.
A New Method to Directly Observe Tuberculosis Treatment: Skype Observed Therapy, a Patient-Centered Approach
Authors: Buchman Tavora , Cabello Celina 
Published: September 2016

Context:
Tuberculosis (TB) treatment completion is in part determined by patient's adherence to long-term drug regimens. To best ensure compliance, directly observed therapy (DOT) is considered the standard of practice. Nassau County Department of Health TB Control is responsible for providing DOT to patients with TB.

Objective:
Tuberculosis Control sought to use and evaluate Skype Observed Therapy (SOT) as an alternative to DOT for eligible patients.

Design:
The evaluation included analysis of patient's acceptance and adherence to drug regimen using SOT. Tuberculosis Control assessed staff efficiency and cost savings for this program.

Main Outcome Measures:
Percentages of SOT of patients and successful SOT visits, mileage, and travel time savings.

Results:
Twenty percent of the caseload used SOT and 100% of patients who were eligible opted in. Average SOT success was 79%. Total mileage savings and time saved were $9,929.07 and 614 hours.

Conclusions:
Because SOT saves cost and time and is a suitable alternative to DOT for patients, it should be considered as part of new policies and practices in TB control programs.