bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Surgical Outcome After Ahmed Valve Implantation for Patients With and Without Fluocinolone Intravitreal Implant (Retisert)
Authors: Hennein Lauren , Hou Jing , Stewart Jay M. , Lowry Eugene A. , Jiang Zhengxuan , Enanoria Wayne T.A. , Han Ying 
Published: August 2016

Purpose:
To determine whether long-term, slow-release exposure to corticosteroids with Retisert promotes better surgical outcomes after Ahmed valve implantation.

Patients:
This comparative retrospective cohort study included 17 study eyes (10 patients) with uncontrolled uveitis requiring Retisert and Ahmed implantation, and 55 control eyes (51 patients) with other types of medically uncontrolled glaucoma that only received Ahmed.

Materials and Methods:
Main outcome measures were intraocular pressure (IOP), glaucoma eye drops per day, best-corrected visual acuity, early complications, and late complications at 1, 3, 6, and 12 months. Linear mixed effects models were used to model IOP, glaucoma drops per day, and visual acuity at 1 year after surgery.

Results:
At 1 year, the study eyes had a mean IOP of 12.24, which was lower than that for control eyes at 15.17 (P=0.04). At 1 year, the average number of glaucoma eye drops used per day for study eyes was 1.4, which was lower than that for control eyes at 2.3 (P=0.03). At 1 year, there were no statistically significant differences in change in visual acuity, early complications, and late complications between study and control eyes.

Conclusions:
Patients who received a Retisert implantation had lower IOP and used fewer glaucoma eye drops compared with control eyes at 1-year post-Ahmed valve surgery. This study suggests that long-term, slow-release corticosteroid medication from Retisert (fluocinolone acetonide) may improve the surgical outcome for patients with an Ahmed valve implantation and/or Retisert helps control uveitis in patients with uveitic glaucoma receiving Ahmed valves.
Ahmed Versus Baerveldt Glaucoma Drainage Implantation in Patients With Markedly Elevated Intraocular Pressure (≥30 mm Hg)
Authors: Resende Arthur F. , Moster Marlene R. , Patel Neal S. , Lee Daniel , Dhami Hermandeep , Pro Michael J. , Waisbourd Michael 
Published: August 2016

Purpose:
Glaucoma patients with markedly elevated intraocular pressure (IOP) are at risk for developing severe hypotony-related complications. The goal of this study was to compare the surgical outcomes of the Ahmed Glaucoma Valve (AGV) and the Baerveldt Glaucoma Implant (BGI) in this patient population.

Methods:
Patients with preoperative IOP≥30 mm Hg were included. Outcome measures were: (1) surgical failure (IOP>21 mm Hg or <30% reduction from baseline or IOP≤5 mm Hg on 2 consecutive follow-up visits after 3 mo, or additional glaucoma surgery, or loss of light perception) and (2) surgical complications.

Results:
A total of 75 patients were included: 37 in the AGV group and 38 in the BGI group. The mean±SD follow-up was 2.3±1.6 years for the AGV group and 2.4±1.7 years for the BGI group (P=0.643). Mean preoperative IOP was 38.7±6.5 mm Hg for the AGV group and 40.8±7.6 mm Hg for the BGI group. At the last follow-up, 10 (27.0%) patients failed in the AGV group compared with 6 (15.8%) patients in the BGI group (P=0.379). The BGI group had higher rate of flat or shallow anterior chamber (n=4, 10%) compared with the AGV group (n=0, 0%) (P=0.043).

Conclusions:
Failure rates of AGV and BGI in patients with IOP≥30 mm Hg were comparable. There were more early hypotony-related complications in the BGI group; however, none were vision threatening. Both glaucoma drainage implants were effective in treating patients with uncontrolled glaucoma in an emergency setting.
Trabeculotomy in the Treatment of Pediatric Uveitic Glaucoma
Authors: Wang Qianqian , Wang Jing , Fortin Eric , Hamel Patrick 
Published: August 2016

Purpose:
To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glaucoma (UG).

Materials and Methods:
We retrospectively reviewed all cases that underwent trabeculotomy for pediatric UG at our center between 2008 and 2014. Up to 2 trabeculotomies per eye were performed in patients with medically controlled uveitis. Surgical success was defined as final intraocular pressure <22 mm Hg and ≥6 mm Hg after 1 or 2 trabeculotomies, with or without medications. Kaplan-Meier survival analyses were done.

Results:
A total of 33 trabeculotomies were performed in 28 eyes of 22 patients. Diagnoses included UG associated with juvenile idiopathic arthritis (68.2%), idiopathic uveitis (22.7%), and pars planitis (9.1%). The average age at surgery was 9.8±3.7 (5 to 17) years. With a mean follow-up of 33.6±18.3 (10 to 78) months, the overall surgical success was 81.8%. The cumulative survival probability after up to 2 trabeculotomies was 0.86 (95% confidence interval, 0.71-0.93) at 12 months and 0.77 (95% confidence interval, 0.60-0.87) at 24 months. Four (11.5%) eyes required a second trabeculotomy to achieve surgical success and 4 (7.7%) required filtrating procedures. Intraocular pressure improved from 31.4±7.6 (18 to 50) mm Hg preoperatively to 15.0±3.6 (8 to 23) mm Hg at final visits, whereas the number of glaucoma medications decreased from 4.2±1.1 (1 to 5) to 0.4±1.0 (0 to 4). Visual acuity and intraocular inflammation remained stable (P>0.05) and there were no major complications.

Conclusions:
Trabeculotomy is a safe and effective surgery for pediatric UG.
Changes in the Choroidal Thickness and Axial Length Upon Mannitol Infusion in Patients With Asymmetric Intraocular Pressure
Authors: Çalişkan Sinan , Uğurbaş Silay C. , Alpay Atilla , Uğurbaş Suat H. 
Published: August 2016

Background/Aims:
To evaluate the changes in the choroidal thickness (CT) and axial length (AL) upon systemic mannitol infusion in glaucoma patients with asymmetric intraocular pressure (IOP).

Materials and Methods:
Forty glaucoma patients with asymmetric IOP, with the IOP of 1 eye ≥40 mm Hg and the fellow eye <25 mm Hg, were administered 150 mL of a 20% mannitol infusion to reduce the IOP. The CT and AL were measured before and an hour after the infusion. The relationship between the IOP reduction and the changes in the CT and AL were investigated.

Results:
The mean decrease in the IOP was −14.23 mm Hg (32.15%) and −4.13 mm Hg (21.40%) in the eyes with higher IOP and their fellow eyes, respectively. The mean changes in the subfoveal CT were 19.28 µm (9.20%; P<0.001) and 2.60 µm (1.93%; P=0.452) in the eyes with higher IOP and their fellow eyes, respectively. The mean changes in the AL were −0.10 µm (0.42%; P<0.001) and −0.33 mm (0.14%; P=0.008) in the eyes with higher IOP and their fellow eyes, respectively. Stepwise analysis revealed that the percent IOP change is the most influential factor on the percent change of the subfoveal CT (P<0.0001; R
2=0.3).

Conclusions:
These results suggest that large IOP changes upon mannitol infusion cause the shortening of the AL in both the eyes and the thickening of the choroid only in the eyes with a higher IOP.
Role of lipoproteins and proprotein convertase subtilisin/kexin type 9 in endotoxin clearance in sepsis
Authors: Walley Keith R. 
Published: August 2016

Purpose of review
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition is a recent high-impact cardiovascular intervention aimed at reducing low-density lipoprotein (LDL) cholesterol levels. Notably, pathogen lipids are also carried in lipoprotein particles and are cleared by hepatocyte LDL receptors. Therefore, the role of PCSK9 in sepsis is reviewed.

Recent findings
Endogenous PCSK9 decreases clearance of LDL cholesterol by decreasing the number of LDL receptors on hepatocytes. Similarly, PCSK9 decreases clearance of pathogen lipids, such as endotoxin, carried in LDL. Pathogen lipids, such as lipopolysaccharide (LPS) from gram-negative organisms or lipoteichoic acid from gram-positive organisms, are carried in high-density lipoprotein, LDL, and very low-density lipoprotein particles. Transfer proteins that handle pathogen lipids (e.g., LPS binding protein) are homologous to transfer proteins that handle cholesterol (e.g., phospholipid transfer protein, cholesterol ester transfer protein). Reduction in PCSK9 function results in increased LPS clearance, a decreased inflammatory response, and improved clinical outcomes in mice. PCSK9 inhibition improves survival in septic mice. Similarly, humans who carry loss-of-function variants of the PCSK9 gene have increased survival in sepsis.

Summary
PCSK9 inhibition may be a useful strategy to increase pathogen lipid clearance in the treatment of patients with sepsis.
Results of the FIT-based National Colorectal Cancer Screening Program in Slovenia
Authors: Tepeš Bojan , Bracko Matej , Novak Mlakar Dominika , Stefanovic Milan , Stabuc Borut , Frkovic Grazio Snjezana , Maucec Zakotnik Jozica 
Published: August 2016

Background:
Colorectal cancer (CRC) is one of the most common malignancies in the western world.

Objective:
We aimed to assess the first round of fecal immunochemical test (FIT)-based National CRC screening program (NCSP).

Methods:
In the NCSP conducted in Slovenia, a FIT and colonoscopy for those tested positive was used. The NCSP central unit sent 536,709 invitations to Slovenian residents age 50 to 69 years old between 2009 and 2011. The adherence rate was 56.9% (303,343 participants). FIT was positive in 6.2% (15,310) of the participants (men, 7.8%; women, 5.0%; P<0.01). A total of 13,919 unsedated colonoscopies were performed with the cecal intubation rate of 97.8%.

Results:
The overall adenoma detection rate was 51.3% [95% confidence interval (CI), 50.5%-52.1%] of which 61.0% (95% CI, 59.9%-62.1%) was in men, and 39.1% (95% CI, 37.8%-40.3%) in women (P<0.01). The mean number of adenoma per positive colonoscopy was 1.94 (95% CI, 1.90-1.97). Adenoma, advanced adenoma, or cancer were found in 7732 (55.5%) colonoscopies. A total of 862 (6.2%) CRC cases were found. Only 161 (18.7%) carcinomas were situated in the right colon. A total of 597 (70.2%) patients with cancer were in the early clinical stages (N, negative; 194 22.8%) of all cancers were cured with only endoscopic resection.

Conclusions:
In the NCSP, CRC was found in 6.2% of those participants attending colonoscopy, with 81.3% of carcinomas found in the left colon. A localized clinical stage was found in 70.2% participants. In 22.8% of CRC patients, cancer was cured with endoscopic resection only.
Clinical Features of Chronic Hepatitis B in Treatment-naive Asian Patients With Positive HBeAg and Coexisting Precore and/or Basal Core Promoter Mutations
Authors: Pan Calvin Q. , Dai Erhei , Bhamidimarri Kalyan R. , Zeng Zheng , Yin Paley 
Published: August 2016

Background:
Precore or/and basal core promoter (PC/BCP) mutations are frequently detected in hepatitis B e antigen (HBeAg)-negative patients, but little is known about their clinical significance in HBeAg-positive patients.

Aim:
To characterize and report the clinical features of treatment-naive chronic hepatitis B patients who are HBeAg positive and harbor PC and/or BCP mutations.

Patients and Methods:
Consecutive treatment-naive patients with chronic hepatitis B between 2004 and 2014 were enrolled. Clinical characteristics were compared based on the stratification of HBeAg status and the presence of PC/BCP mutations. In addition, subset analysis in HBeAg-positive cohort was performed to compare clinical features of patients with and without PC/BCP mutations

Results:
Of the 267 patients enrolled from 3 centers, 177 were HBeAg positive and 90 HBeAg negative. When compared with HBeAg-negative patients, HBeAg-positive patients were significantly younger in mean age (37.93 vs. 44.40; P<0.001), had higher levels of median ALT (51 vs. 30.5 U/mL; P<0.001), higher levels of mean HBV DNA (7.50±1.48 vs. 5.10±1.44 log10 copies/mL; P<0.001), and lower frequency of detectable PC/BCP mutations (60.45% vs. 93.33%; P<0.001), but had significantly higher frequency of BCP when mutations were detected (37.85% vs. 22.22%; P=0.013). Among HBeAg-positive patients, when compared with patients with wild type, those with PC/BCP mutations were significantly older (30.63 vs. 42.71; P<0.001), had higher median ALT levels (29.5 vs. 73 U/mL; P<0.001), but there was no significant association with mean HBV DNA levels (7.96 vs. 7.20 log10 copies/mL; P=0.865) or HBV genotype (P=1.000). In the multivariate analysis, only age and ALT were independently associated with PC/BCP mutations in HBeAg-positive patients, but there was no association with HBV genotype or DNA.

Conclusions:
PC/BCP mutants were frequent (up to 60%) in treatment-naive HBeAg-positive patients and were associated with distinct clinical characteristics when compared with patients with wild type or HBeAg negative. Future large studies are needed to substantiate the long-term clinical outcomes when PC/BCP mutations are detected in HBeAg-positive patients as it may impact the natural history or treatment response in such patients.
Building a Multidisciplinary Hospital-Based Wound Care Center: Nuts and Bolts
Authors: Kim Paul J. , Attinger Christopher E. , Steinberg John S. , Evans Karen K. , Akbari Cameron , Mitnick Carol Deane Benedict , Johnson-Arbor Kelly K. , Singh Brinder 
Published: August 2016

Background:
A hospital-based wound care center provides an important platform for the multidisciplinary approach to wound care. The colocation of specialists is an ideal working environment for the efficient delivery of quality care of the complex wound through daily communication and shared resources.

Methods:
We describe the critical components necessary in building a hospital-based wound care center. Furthermore, the experience at the authors’ institution in developing the multidisciplinary approach is discussed.

Results:
Readily available ancillary services, specially trained personnel, continuum of care from the outpatient clinic to admission to surgery, and inpatient and outpatient post operative care all contribute to a process that is especially amenable to the care of the complex wound.

Conclusions:
The final goal is to return the patient to the best quality of life achievable given his or her wound or disability. The aim of this study is to present the authors’ experiences and provide insight for others who may want to build this model within their institutions.
Current Concepts in Debridement: Science and Strategies
Authors: Anghel Ersilia L. , DeFazio Michael V. , Barker Jenny C. , Janis Jeffrey E. , Attinger Christopher E. 
Published: August 2016

Background:
The establishment of a healthy wound bed through adequate debridement of infected, senescent, and/or devitalized tissue is central to the progression of normal wound healing. Although a variety of surgical and nonsurgical strategies have been proposed, none have proven completely effective in all settings. This review focuses on the principles and techniques of modern debridement practices employed in the management of complex wounds.

Methods:
A comprehensive review of the PubMed/Medline and Ovid databases was performed to identify basic science and clinical studies using key words most relevant to biofilm, debridement, and wound healing. English language articles that were peer reviewed and that met the standard of evidence-based medicine were included. Level of evidence for various debridement approaches was rated utilizing the American Society of Plastic Surgeons Rating Levels of Evidence and Grading Recommendations.

Results:
The value of both operative and nonoperative debridement techniques, their indications, and limitations are described. With an emphasis placed on surgical debridement, this review highlights technical adjuncts that can be used to optimize wound bed preparation, including preoperative topical staining of the wound, as well as the use of color-guided endpoints to prevent removal of excess healthy tissue. The indications for using temporizing measures for wound control such as negative pressure wound therapy with and without installation are also discussed.

Conclusion:
Optimal management requires a multimodal approach that centers around operative debridement and incorporates the use of adjunctive measures to facilitate the removal of infected tissue, biofilm, and/or senescent cells that impede the progression of normal wound healing.
What Heals Hidradenitis Suppurativa: Surgery, Immunosuppression, or Both?
Authors: Falola Reuben A. , DeFazio Michael V. , Anghel Ersilia L. , Mitnick Carol Deane B. , Attinger Christopher E. , Evans Karen K. 
Published: August 2016

Background:
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that is a significant source of impaired quality-of-life for affected individuals. For patients with refractory disease, radical resection of all involved tissue may offer the only potential option for a cure. However, high rates of recurrence after wide local excision have led investigators to seek alternative therapeutic combinations. We present our experience and a literature review.

Methods:
A comprehensive literature review (1982–2016) was performed on PubMed and Ovid MEDLINE, using key words relevant to HS.

Results:
A total of 1842 publications were identified, and 15 publications were included in this review on: surgical intervention (n = 10), biologic therapy (n = 4), and joint surgical and biologic treatment (n = 1) of HS. The treatment type, level of evidence, and key findings are assessed and discussed.

Conclusions:
Recent trials demonstrating the safety and efficacy of biologic therapy alone in patients with moderate-to-severe HS have spurred questions regarding the potential utility of these agents as adjuncts to more traditional surgical interventions. The results of the literature search advocate a role for radical resection and biologic therapy in the setting of moderate-to-severe disease. Preliminary results from limited case series suggest a potential role for combined management in the setting of advanced, recalcitrant disease.
Modalities to Treat Venous Ulcers: Compression, Surgery, and Bioengineered Tissue
Authors: Gould Lisa J. , Dosi Garima , Couch Kara , Gibbons Gary W. , Howell Raelina S. , Brem Harold , Tomic-Canic Marjana 
Published: August 2016

Background:
Venous leg ulcers (VLUs) represent the most common ulcers of the lower extremity. VLUs are notorious for delayed and prolonged healing with high rates of recurrence. Most patients with VLUs also have significant comorbidities that interfere with primary wound healing. Thus, caring for patients with VLUs requires an interdisciplinary approach that addresses the abnormal venous anatomy and the downstream effects that lead to inflammation, ulceration, and a hostile wound microenvironment.

Methods:
The current literature regarding venous ulcer treatment with an emphasis on compression, surgical options, and use of bioengineered tissue was reviewed. A combination of society guidelines, Cochrane reviews, and over 80 primary articles with high-level evidence were utilized to develop this summary and algorithm for an integrated approach to treating patients with venous ulcers. Details regarding compression modalities and venous diagnostic imaging are presented to help the clinician understand the rationale for using these technologies.

Results:
The comprehensive approach to the patient with chronic venous insufficiency (CVI) includes advances in compression, diagnostics, minimally invasive surgical treatment of venous disease, wound bed preparation, and bioengineered skin and soft tissue substitutes. An algorithm that incorporates early treatment of the ulcer and the venous disease leading to healing with prevention of recurrence is presented.

Conclusions:
Utilizing guidelines that incorporate evidence-based modalities will lead to the highest quality outcomes with the most appropriate resource utilization. A proactive approach to treating venous disease will alleviate suffering and prevent the long-term sequelae of CVI.
Biology and Biomarkers for Wound Healing
Authors: Lindley Linsey E. , Stojadinovic Olivera , Pastar Irena , Tomic-Canic Marjana 
Published: August 2016

Background:As the population grows older, the incidence and prevalence of conditions that lead to a predisposition for poor wound healing also increase. Ultimately, this increase in nonhealing wounds has led to significant morbidity and mortality with subsequent huge economic ramifications. Therefore, understanding specific molecular mechanisms underlying aberrant wound healing is of great importance. It has and will continue to be the leading pathway to the discovery of therapeutic targets, as well as diagnostic molecular biomarkers. Biomarkers may help identify and stratify subsets of nonhealing patients for whom biomarker-guided approaches may aid in healing.Methods:A series of literature searches were performed using Medline, PubMed, Cochrane Library, and Internet searches.Results:Currently, biomarkers are being identified using biomaterials sourced locally from human wounds and/or systemically using high-throughput “omics” modalities (genomic, proteomic, lipidomic, and metabolomic analysis). In this review, we highlight the current status of clinically applicable biomarkers and propose multiple steps in validation and implementation spectrum, including those measured in tissue specimens, for example, β-catenin and c-myc, wound fluid, matrix metalloproteinases and interleukins, swabs, wound microbiota, and serum, for example, procalcitonin and matrix metalloproteinases.Conclusions:Identification of numerous potential biomarkers using different avenues of sample collection and molecular approaches is currently underway. A focus on simplicity and consistent implementation of these biomarkers, as well as an emphasis on efficacious follow-up therapeutics, is necessary for transition of this technology to clinically feasible point-of-care applications.
Current Concepts in Tissue Engineering: Skin and Wound
Authors: Tenenhaus Mayer , Rennekampff Hans-Oliver 
Published: August 2016

Background:
Pure regenerative healing with little to no donor morbidity remains an elusive goal for both surgeon and patient. The ability to engineer and promote the development of like tissue holds so much promise, and efforts in this direction are slowly but steadily advancing.

Methods:
Products selected and reviewed reflect historical precedence and importance and focus on current clinically available products in use. Emerging technologies we anticipate will further expand our therapeutic options are introduced. The topic of tissue engineering is incredibly broad in scope, and as such the authors have focused their review on that of constructs specifically designed for skin and wound healing. A review of pertinent and current clinically related literature is included.

Results:
Products such as biosynthetics, biologics, cellular promoting factors, and commercially available matrices can be routinely found in most modern health care centers. Although to date no complete regenerative or direct identical soft-tissue replacement exists, currently available commercial components have proven beneficial in augmenting and improving some types of wound healing scenarios. Cost, directed specificity, biocompatibility, and bioburden tolerance are just some of the impending challenges to adoption.

Conclusions:
Quality of life and in fact the ability to sustain life is dependent on our most complex and remarkable organ, skin. Although pure regenerative healing and engineered soft-tissue constructs elude us, surgeons and health care providers are slowly gaining comfort and experience with concepts and strategies to improve the healing of wounds.