bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distress in Persons with HIV and AIDS
Authors: Cohen Mary Ann , Dickerman Anna L. , Goforth Harold W. 
Published: June 2017

Abstract
Persons with HIV have multifactorial and multidimensional sources of distress. Distress has a profoundly negative impact on persons with HIV and their loved ones. While the term distress is more acceptable to patients and does not carry with it the stigma of a specific psychiatric diagnostic disorder, the anguish and suffering associated are still painful. This chapter explores the sources for distress utilizing a comprehensive biopsychosocial approach and presents ways to recognize distress. Related tools in assessing HIV-related distress include the Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), and HIV Symptom Distress Scale (SDS). An overview of the symptoms and illnesses associated with distress include biological, psychological, and social aspects including HIV stigma. Evidence-based approaches to alleviate distress in persons with HIV/AIDS are also presented in the chapter.
Integrative Treatments
Authors: Gore-Felton Cheryl , McGlynn Lawrence , Kreutzberg Andrei , Spiegel David 
Published: June 2017

Abstract
Many individuals seek relief from symptoms associated with HIV infection through the use of integrative medicine. Symptoms include neuropsychiatric problems such as anxiety, depression, cognitive dysfunction, and headaches, as well as somatic disorders related to viral infection and immunodysregulation, such as fatigue, diarrhea, and cardiovascular problems. As antiretroviral treatments have become increasingly effective, symptom management with minimal side effects has become more important. A variety of integrative treatments, including botanicals, vitamins, minerals, probiotics, and herbs, have been utilized, and mind–body approaches such as mindfulness, hypnosis, and movement therapy have been found to reduce symptoms and improve quality of life. This chapter examines widely used integrative medicine approaches to alleviating distressing HIV-related symptoms. Implications for clinical practice are discussed. Integrative approaches emphasize self-management of symptoms and are widely sought after and accepted, even by patients who resist other forms of medical treatment.
Psychopharmacological Treatment Issues in HIV/AIDS Psychiatry
Authors: Cozza Kelly L. , Wynn Gary H. , Wortmann Glenn W. , Williams Scott G. , Rein Rita 
Published: June 2017

Abstract
Attention to pharmacokinetics and pharmacodynamics and an understanding of intended effects, side effects, toxicities, and drug interactions are imperative when treating persons with HIV/AIDS. This chapter includes an essential review of drug interaction principles and an overview of current antiretroviral treatment (ART) and known side effects, toxicities, and drug interactions, in text and table format. The chapter concludes with a presentation of psychotropic-antiretroviral treatment issues. Most psychotropics are effective in the treatment of persons with HIV, but some, particularly the pan-inducing antiepileptics, are best avoided or at least should be very carefully monitored. Recognizing the potential for drug–drug interactions allows for more careful monitoring and for consideration of alternative treatments or precautions. Being a pharmacologically knowledgeable multidisciplinary team member can reduce morbidity and mortality in patients. An understanding of antiretroviral therapy and psychopharmacological treatment issues prevents morbidity, supports adherence to medications, and improves quality of life for persons with HIV.
Hepatitis C and HIV Co-Infection
Authors: Price Jennifer Cohen , Amin Priyanka , Douaihy Antoine 
Published: June 2017

Abstract
Chronic infection with hepatitis C virus (HCV) is a leading cause of end-stage liver disease and is the most common indication for liver transplantation in the United States. Because of shared risk factors, individuals living with HIV infection are disproportionately affected by HCV. Moreover, co-infection with HIV accelerates the natural history of chronic HCV infection, increasing the risk of cirrhosis, hepatocellular carcinoma, hepatic decompensation, and death. Highly effective medications such as direct-acting antivirals (DAA) to cure HCV are now available and have the potential to profoundly improve the health of HIV-HCV-co-infected individuals. However, addressing the many gaps in the HCV care cascade is necessary to fully achieve the benefits of these drugs. This chapter reviews the natural history of HIV-HCV co-infection, the psychiatric comorbidities associated with HCV infection, the evolution of HCV treatment, and the barriers to care that HIV-HCV-co-infected individuals continue to face.
Endocrine Comorbidities in Persons with HIV
Authors: Soffer Jocelyn , Goforth Harold W. 
Published: June 2017

Abstract
A wide range of endocrine abnormalities commonly accompany and complicate HIV infection, many of which have implications for psychiatrists and other mental health professionals working with this population. Such abnormalities include adrenal insufficiency, hypercortisolism, hyperthyroidism, hypothyroidism, hypogonadism, decreased bone mineral density, and bone disease. Endocrinopathies are great mimickers of psychiatric disorders, manifesting in some cases as disturbances of mood, sleep, appetite, thought process, energy level, or general sense of well-being. Understanding the intricate and complex relationships between immunological, endocrinological, and psychological systems is important to improve recognition and treatment of reversible endocrinopathies, diminish suffering, and enhance quality of life and longevity in persons with HIV and AIDS. This chapter will present an overview of HIV-associated changes in the function of the hypothalamic–pituitary axes, adrenal glands, thyroid gland, gonads, and bone and mineral metabolism, and consider the psychosocial implications of such endocrinopathies.
Overview of HIV-Associated Multimorbidities
Authors: Pereira Luis F. , Bradley Mark , Goforth Harold W. , Alfonso César A. , Lux Joseph Z. , Martínez Esteban , Mullen Michael P. 
Published: June 2017

Abstract
With the advent of effective antiretroviral therapy, persons with access to and engagement in HIV medical care and antiretroviral therapy can live longer and remain healthy with what has become a chronic manageable illness. Despite advances in medical care, without access to HIV medical care and antiretroviral therapy or with access but without viral suppression, persons with HIV still experience opportunistic infections and cancers. This chapter reviews the HIV-associated multimorbidities, including pulmonary manifestations, ophthalmological complications, dermatological manifestations, gastrointestinal and hematological illnesses, as well as HIV-associated malignancies. The proposed mechanisms through which HIV may contribute to premature aging are also discussed.
Health Services and Policy Issues in AIDS Psychiatry
Authors: Walkup James T. , Crystal Stephen 
Published: June 2017

Abstract
Health services research is a practically focused discipline drawing on the social and behavioral sciences and concerned with the organization, financing, and delivery of services. Investigators studying HIV services examine how well healthcare and other systems meet needs, eliminate disparities, integrate services, eliminate barriers, and provide care to socially marginal and stigmatized individuals, such as injection drug users and people who are incarcerated. These issues have been important from the earliest days of the HIV epidemic and have taken on increased significance as efficacious treatments have been developed and, more recently, changes in the financing of care have reduced the number of uninsured. This chapter this focuses primarily on research in the United States with a review of recent work on financing, service fragmentation, and difficulties integrating different sectors of care, as well as problems related to the functioning of medicine in a complex, stratified society. Also addressed are certain general features of the Affordable Care Act that are relevant to HIV care and psychiatry.
Recurrent Patellar Instability: Implications of Preoperative Patellar Crepitation on the Status of the Patellofemoral Articular Cartilage
Authors: Luhmann Scott J. , Smith June C. , Schootman Mario , Prasad Nandan 
Published: June 2017

Background:
The purpose of the study was to quantify the frequency, severity, and location of patellofemoral (PF) articular cartilage changes recurrent patellar instability treated surgically in patients with preoperative clinical patellar crepitation.

Methods:
A single-surgeon database was queried for all knees with recurrent patellar instability between 3/2000 and 6/2012 (n=214). Only knees which underwent knee arthroscopy during the surgical treatment were included (n=148). PF articular cartilage condition was assessed arthroscopically.

Results:
There were 148 knees in 130 patients (mean age, 16 y), which met inclusion criteria. There were 93 females and 37 males. Diagnoses were dislocations [122 (82.4%)] and subluxations (26). Preoperatively 28 knees (18.9%) had PF crepitation. Statistical analysis demonstrated preoperative PF crepitation was correlated with medial patellar facet lesions (P=0.0022) and were 3.6 times more likely to have medial patellar facet lesions. Crepitation was correlated with the higher outerbridge (OB) patellar grades (P<0.0001) and larger patellar lesion size (P=0.0021). At arthroscopy 89 knees (60.5%) had patellar articular cartilage damage with a mean OB grade of 1.3 (0 to 4) and mean size of 93.2 mm2 (0 to 750). The femoral articular cartilage was identified in 29 knees (19.7%) with a mean OB grade of 0.44 (0 to 4).

Conclusions:
PF articular damage was present in 63% of knees, which were surgically treated for patellar instability. The patella was involved in 61% (mean, 129 mm2) and femoral trochlea in 20% (mean 166 mm2) of knees. Knee with preoperative PF crepitation (20% of cohort) more commonly had medial patellar facet lesions with higher OB grades, and larger patellar lesion size than knees without preoperative crepitation. Because of the high frequency of patellar (83%) and femoral (36%) articular damage documented at the time of surgical reconstruction, visualization of the PF joint is recommended when knees have preoperative PF crepitation.

Level of Evidence:
Level IV.
Transcranial Motor Evoked Potential Alarm Criteria to Predict Foot Drop Injury During Lumbosacral Surgery
Authors: Tamkus Arvydas , Rice Kent S. , Hoffman Gregory 
Published: June 2017

Study Design.
A retrospective cohort analysis.

Objective.
This study aims to investigate whether waveform alterations in transcranial motor evoked potentials (TCMEPs) can reliably predict postoperative foot drop.

Summary of Background Data.
Nerve injury leading to foot drop is a potential complication of lumbosacral surgery. Very limited data exist on the use of intraoperative TCMEPs to identify iatrogenic foot drop.

Methods.
We retrospectively reviewed neuromonitoring data from 130 consecutive spine surgeries with instrumentation involving L4-S1. TCMEP waveform analysis included amplitude (A), area under the curve (AUC), latency (L), and duration (D). Patient outcomes were correlated with neuromonitoring results. Intraoperative alert criteria were established on the basis of observed intraoperative changes.

Results.
Three patients developed severe foot drop with a muscle weakness functional grade ranging from 0/5 to 3/5. Two patients developed a mild foot drop with functional grade 4/5. Twenty-three patients had preoperative weakness in an L5 distribution. One-hundred two patients who had neither preoperative nor postoperative neurological complications served as a control group. Amplitude significantly decreased in patients with a severe postoperative deficit (P = 0.005) as did AUC and duration (P < 0.05). Intraoperative alert criteria defined as a >65% decrease in AUC resulted in a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100%, 91.4%, 12%, and 100%, respectively. When defining an alert criteria as a >50% decrease in amplitude, sensitivity, specificity, PPV, and NPV were 100%, 87.9%, 8.8%, and 100%, respectively.

Conclusion.
Reduction of TCMEP waveform associated with postoperative severe foot drop can be detected during lumbar surgery. Other waveform parameters such as AUC may predict foot drop better than the amplitude. Additional examinations in larger samples of foot drops are needed to validate these alert threshold findings.

Level of Evidence: 4
Three-Dimensional Topography of the Supratrochlear Nerve With Reference to the Lacrimal Caruncle, and Its Danger Zone in Asians
Authors: Gil Young-Chun , Lee Shin-Hyo , Shin Kang-Jae , Song Wu-Chul , Koh Ki-Seok , Shin Hyun Jin 
Published: June 2017

BACKGROUND
The supratrochlear nerve (STN) is relatively superficial and therefore vulnerable to iatrogenic injury.

OBJECTIVE
To elucidate the course of STN with reference to the lacrimal caruncle, with the aim of preventing nerve injury during surgery in the forehead region.

MATERIALS AND METHODS
Thirty-four hemifaces from 18 Korean cadavers were dissected. The vertical line through the apex of lacrimal caruncle and the horizontal line through the supraorbital margin were used as horizontal and vertical reference lines, respectively. The course of STN in the frontal view and the point at which it pierced the overlaying musculature were examined.

RESULTS
After exiting the corrugator muscle cushion, the STN enters the subcutaneous plane by piercing the frontalis muscle. These piercing points occurred at mean horizontal and vertical distances relative to the medial branch of the STN of 9.2 and 9.6 mm, respectively; the corresponding distances for the lateral branch of the STN were 1.1 and 15.3 mm, respectively.

CONCLUSION
When performing surgery in the medial forehead region, the surgeon must ensure that the dissection plane of forehead tissue is more superficial: superiorly within 1.5 cm from the supraorbital margin and medially within 1.0 cm from the vertical line through the apex of lacrimal caruncle.
Drug-induced metabolic acidosis
Authors: Holt Christopher T. , Hitchings Andrew W. 
Published: June 2017

Summary
Drug causes of metabolic acidosis are numerous and their mechanisms are diverse. Broadly, they can cause metabolic acidosis with either a normal anion gap (e.g. drug-induced renal tubular acidosis) or an elevated anion gap (e.g. drug-induced lactic acidosis or pyroglutamic acidosis). This review describes the drugs that can cause or contribute to metabolic acidosis during therapeutic use, the mechanisms by which this occurs, and how they may be identified in practice.
TIME COURSE OF CHANGES IN METAMORPHOPSIA FOLLOWING INTRAVITREAL RANIBIZUMAB INJECTION FOR BRANCH RETINAL VEIN OCCLUSION
Authors: Sugiura Yoshimi , Okamoto Fumiki , Morikawa Shohei , Okamoto Yoshifumi , Hiraoka Takahiro , Oshika Tetsuro 
Published: June 2017

Purpose:
To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO) and to assess the relationship between retinal microstructure and metamorphopsia.

Methods:
Subjects were 39 eyes of 39 patients with branch retinal vein occlusion. The severity of metamorphopsia was quantified using the M-CHARTS before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT) and status of the external limiting membrane (ELM) and ellipsoid zone (EZ). The association between retinal microstructure and metamorphopsia was analyzed in 24 eyes with treatment-naïve branch retinal vein occlusion.

Results:
Intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity (BCVA) and central retinal thickness (P < 0.0001, P < 0.0001, respectively), but metamorphopsia did not improve by treatment. Posttreatment metamorphopsia scores showed a significant correlation with duration of symptoms (P < 0.05) and pretreatment metamorphopsia scores (P < 0.01). Posttreatment metamorphopsia score was significantly worse in patients with disruption of external limiting membrane (P < 0.05).

Conclusions:
In patients with branch retinal vein occlusion, intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity and central retinal thickness, but not metamorphopsia. The severity of posttreatment metamorphopsia was significantly associated with duration of symptoms, degree of pretreatment metamorphopsia, and posttreatment integrity of external limiting membrane.
MULTIPLE EVANESCENT WHITE DOT SYNDROME WITH SUBRETINAL DEPOSITS
Authors: Gal-Or Orly , Sorenson John A. , Gattoussi Sarra , Dolz-Marco Rosa , Freund K. Bailey 
Published: June 2017

Purpose:
To describe the multimodal imaging findings of transient subretinal deposits occurring in multiple evanescent white dot syndrome (MEWDS).

Methods:
The multimodal imaging characteristics of transient subretinal deposits occurring in MEWDS were investigated with ultra-widefield color and fundus autofluorescence, cross-sectional and en-face optical coherence tomography (OCT), en face OCT-angiography, and quantitative autofluorescence.

Results:
A 28-year-old woman presented with photopsia and temporal visual field loss in her right eye. Her best-corrected visual acuity was 20/20 in her right eye and 20/25 in her left eye. Funduscopic examination showed characteristic peripapillary hyperautofluorescent white dots of MEWDS corresponding to ellipsoid zone disruption on OCT. These lesions became confluent throughout the posterior fundus over the next 4 weeks. As the patient's symptoms were resolving, a second type of transient hyperautofluorescent lesion was noted which corresponded to hyperreflective subretinal deposits on cross-sectional and en face structural OCT. These subretinal deposits were most evident at 10-week follow-up and had nearly resolved at 14-week follow-up. Quantitative autofluorescence showed that, unlike the acute MEWDS lesions, the hyperautoflurescence of the subretinal deposits persisted after photobleaching. At multiple time points over 14 weeks of follow-up, OCT angiography showed no evidence of retinal or choroidal flow abnormalities.

Conclusion:
Transient subretinal deposits may develop during MEWDS in areas of previous diffuse outer retinal disruption. As these deposits remain hyperautoflurescent on quantitative autofluorescence after photobleaching, they may represent accumulations of debris originating from damaged photoreceptor outer segments.
Further Analysis of the Predictability of Corneal Endothelial Cell Density Estimates When Polymegethism Is Present
Authors: Doughty Michael J. 
Published: June 2017

Purpose:
To assess variability in endothelial cell density (ECD) estimates when polymegethism (variance in cell areas) is present.

Methods:
Using noncontact specular microscope images of the corneal endothelium, 4 sets of 20 cases were selected, which included 200 cells and had coefficient of variation values of less than 30% (group 1), 31%–40% (group 2), 41%–50% (group 3), and over 50% (group 4). A stepwise analysis was undertaken, 20 cells at a time, of the ECD estimates when using different numbers of cells for the calculations.

Results:
The net differences in ECD estimates when comparing sets of 20 cells with 200 cells were 5.0% ± 3.9%, 8.1% ± 7.3%, 11.3% ± 9.4%, and 14.5% ± 12.4% for groups 1 to 4, respectively. For measures on 100 cells per image, the predicted variances in ECD values were 5.6%, 8.8%, 11.1%, and 13.7% for the 4 groups.

Conclusions:
Higher values of corneal endothelial polymegethism result in predictable increases in the variability (uncertainty) in ECD estimates, thus reducing the “accuracy” of ECD values. There is no obvious utility in assessing more than 100 cells in such endothelia.
Superficial Automated Keratopigmentation for Iris and Pupil Simulation Using Micronized Mineral Pigments and a New Puncturing Device: Experimental Study
Authors: Rodriguez Alejandra E. , Amesty Maria A. , El Bahrawy Mohammed , Rey Severino , Alio del Barrio Jorge , Alio Jorge L. 
Published: June 2017

Purpose:
To study the outcomes and tolerance of micronized mineral pigments for corneal tattooing, using a superficial automated keratopigmentation (SAK) technique in an experimental animal model and a new puncture device to inject the pigments into the corneal stroma.

Methods:
Forty eyes of 40 New Zealand rabbits were included in this study. The animals were divided into groups A and B. Both groups underwent SAK using a new automated keratopigmentation device. Micronized mineral pigments were injected through the epithelium into the corneal stroma to replicate the iris color in 25 eyes (group A), and black color was used to replicate the pupil in 15 eyes (group B). Slit-lamp examination was performed to evaluate the outcome. Histopathological examination was also performed to ascertain the presence of pigment dispersion, inflammation, and/or neovascularization.

Results:
All 40 eyes showed good cosmetic appearance after keratopigmentation. No intraoperative complications were detected. At the first week, mild or moderated conjunctival injection was observed in 13 eyes and transitory corneal epithelial defects were also detected in 27 eyes. Examination was unremarkable 2, 4, and 6 months after surgery. No neovascularization was detected in any case in the histopathology study.

Conclusions:
SAK using a new automated puncture device and micronized mineral pigments achieved good cosmetic outcomes for iris and pupil simulation. This method could be a valid alternative to treat serious cosmetic eye problems that affect the superficial cornea or functional problems, such as photophobia or diplopia secondary to iris defects or trauma.
Regression of Inflamed Pterygia by Frequent High-Dose Intralesional Ziv-Aflibercept
Authors: Mansour Ahmad M. 
Published: June 2017

Purpose:
Intralesional single low-dose vascular endothelial growth factor antagonists have traditionally failed in causing regression of pterygia. The current pilot study investigates the role of high-dose repeated intralesional ziv-aflibercept in causing regression of inflamed or recurring pterygia.

Methods:
This prospective study from January 2015 to April 2017 consisted of using high dose of ziv-aflibercept between 0.1 mL (2.5 mg) and 0.3 mL (7.5 mg), depending on the pterygium size and the degree of inflammation. The injection was deep after tunneling the 30-gauge needle away from the injection site to avoid reflux. Reinjection was done at the first sign of recurrence of inflammation. The main outcome measure was regression of pterygial vessels by central retraction as documented by slit-lamp photography and anterior optical coherence tomography.

Results:
Four subjects, one with bilateral pterygia, were treated. Regression of new vessels and retraction of the leading edge of pterygial vessels occurred in all treated eyes (5 eyes) with dramatic visual gain in 1 eye from counting fingers to 6/9 (20/30). Numbers of injections were 9 (1 eye; 18 mo), 3 (2 eyes; 12 and 18 mo), and 1 (2 eyes; 2.5 and 7 mo).

Conclusions:
Frequent high-dose intralesional ziv-aflibercept can lead to regression and/or retraction of inflamed pterygia in this pilot study.

Clinical Trial Registration:

https://clinicaltrials.gov, NCT02486484.