bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived Toddler Sleep Problems, Co-sleeping, and Maternal Sleep and Mental Health
Authors: Covington Lauren B. , Armstrong Bridget , Black Maureen M. 
Published: December 2017

ABSTRACT:

Objective:
Childhood sleep problems are associated with insufficient parental sleep and adverse maternal mental health symptoms, which may be exacerbated when mothers/toddlers co-sleep (i.e., bed/room sharing). This study examines maternal sleep duration as a mechanism linking perceived toddler sleep problems with maternal mental health and examines whether these associations vary by co-sleeping, in addition to exploring alternative models.

Methods:
Low-income mothers of toddlers (n = 280) (age 12–32 months) recruited from Women, Infants, and Children and pediatric clinics provided demographic information and completed questionnaires on their toddler's sleep and their own sleep duration and mental health symptoms (depressive symptoms, anxiety, and stress). Indirect and conditional indirect models were conducted to examine the relation between perceived toddler sleep problems and maternal mental health.

Results:
Perceived toddler sleep problems were associated with an average decrease of 51 minutes in maternal sleep when co-sleeping (mean = 6.1 h). Maternal sleep duration mediated the relation between perceived toddler sleep problems and maternal symptoms of depression, anxiety, and stress for co-sleeping mothers. Maternal sleep duration did not mediate relations between maternal mental health symptoms and perceived toddler sleep problems.

Conclusion:
This study provides a conceptual model by which parent and child sleep is related to parental mental health. Practitioners might consider alternatives to co-sleeping when discussing sleep arrangements with parents. Future studies should replicate results longitudinally and examine whether reducing co-sleeping improves maternal sleep duration and reduces perceptions of toddler sleep problems.
Use and Nondisclosure of Complementary Health Approaches Among US Children with Developmental Disabilities
Authors: Lindly Olivia , Thorburn Sheryl , Zuckerman Katharine 
Published: December 2017

ABSTRACT:

Objectives:
Many US children use complementary health approaches (CHAs), including some modalities that may be ineffective, unsafe, and/or costly. Yet, little is known about the prevalence and correlates of CHA use among children with developmental disabilities (DDs), as well as parent nondisclosure of CHAs used for children with DDs to health care providers. We, therefore, aimed to profile the use and nondisclosure of CHAs among US children with DDs.

Methods:
We analyzed data from the 2012 National Health Interview Survey, which included the most recent Child Complementary and Alternative Medicine Supplement. The study sample was comprised of 2141 children with DDs aged 4 to 17 years.

Results:
Nearly one-quarter (23%) of US children with DDs used CHAs. Among those with a personal health provider, 42% of parents did not disclose some or all CHAs used to the child's provider. The adjusted odds ratios of using CHAs were greater among those with female sex, higher household income, residences not in the South, difficulty accessing care, or comorbid conditions. CHA was most commonly used because “it is natural.” Nondisclosure was associated with female sex, older age, having no functional limitations, less conventional services use, and use of fewer CHAs. The most common reason for nondisclosure was that the child's provider did not ask.

Conclusion:
Complementary health approach use is prevalent among US children with DDs, and nondisclosure is likely among those who use CHAs. Future intervention targeting education and communication about CHAs for parents of children with DDs and their health care providers may promote disclosure.
The Cellular Response of Keloids and Hypertrophic Scars to Botulinum Toxin A: A Comprehensive Literature Review
Authors: Austin Evan , Koo Eugene , Jagdeo Jared 
Published: December 2017

BACKGROUND
Keloids and hypertrophic scars are conditions of pathologic scarring characterized by fibroblast hyperproliferation and excess collagen deposition. These conditions significantly impact patients by causing psychosocial, functional, and aesthetic distress. Current treatment modalities have limitations. Clinical evidence indicates that botulinum toxin A (BoNT-A) may prevent and treat keloids and hypertrophic scars.

OBJECTIVE
To examine investigated cellular pathways involved in BoNT-A therapeutic modulation of keloids and hypertrophic scars.

METHODS
The authors searched PubMed, Embase, and Web of Science for basic science articles related to botulinum toxin therapy, scarring, fibroblasts, keloids, and hypertrophic scars.

RESULTS
Eleven basic science articles involving keloids and hypertrophic scars were reviewed.

DISCUSSION
BoNT-A may reduce skin fibrosis by decreasing fibroblast proliferation, modulating the activity of transforming growth factor-β, and reducing transcription and expression of profibrotic cytokines in keloid-derived and hypertrophic scar–derived dermal fibroblasts. BoNT-A may modulate collagen deposition, but there is a paucity of evidence regarding specific mechanisms of action.

CONCLUSION
Overall, BoNT-A has the potential to prevent or treat pathologic scars in patients with a known personal or family history of keloids and hypertrophic scars, which may improve patient psychosocial distress and reduce clinic visits and health care costs. Variability in keloid and hypertrophic scar response to BoNT-A may be due to interexperiment differences in dosing, tissue donors, and assay sensitivity.
Platelet-Rich Plasma Versus Tretinoin in Treatment of Striae Distensae: A Comparative Study
Authors: Gamil Hend D. , Ibrahim Samia A. , Ebrahim Howyda M. , Albalat Waleed 
Published: December 2017

BACKGROUND
Striae distensae (SD) are dermal scars associated with atrophy of the epidermis.

OBJECTIVE
To evaluate the effect and safety of intralesional injection of platelet-rich plasma (PRP) versus topical tretinoin 0.05% in treatment of SD.

METHODS
Thirty patients (27 females and 3 males) had bilateral striae distensae were enrolled in this study. In every patient, half of the selected striae were treated with PRP intralesional injection. The other half was treated by topical tretinoin. Skin biopsies were taken from both sides before and after the treatment. Digital photographs were taken at the baseline and at the end of follow-up period. Clinical improvement was evaluated by 2 blind dermatologists in addition to the patient's satisfaction rating.

RESULTS
There was statistically significant improvement in the SD treated with PRP and topical tretinoin cream. The improvement was more in the SD treated with PRP injections (p = .015). Patient's satisfaction showed that the improvement was more in the PRP-treated side (p = .003). Collagen and elastic fibers in the dermis were increased in all biopsies after treatment.

CONCLUSION
PRP injection and topical tretinoin are safe for the treatment of SD, but PRP is more effective and it gives better therapeutic response than tretinoin.
Evaluating Perceived Naturalness of Facial Expression After Fillers to the Nasolabial Folds and Lower Face With Standardized Video and Photography
Authors: Philipp-Dormston Wolfgang G. , Wong Cindy , Schuster Bernd , Larsson Markus K. , Podda Maurizio 
Published: December 2017

BACKGROUND
Hyaluronic acid (HA) fillers are commonly used in treating facial wrinkles and folds but have not been studied with standardized methodology to include assessment of standard facial expressions.

OBJECTIVE
To assess perceived naturalness of facial expression after treatment with 2 HA fillers manufactured with XpresHAn Technology (also known as Optimal Balance Technology).

MATERIALS AND METHODS
Treatment was directed to the nasolabial folds (NLFs) and at least 1 additional lower face wrinkle or fold. Maintenance of naturalness, attractiveness, and age at 1 month after optimal treatment were assessed using video recordings and photographs capturing different facial animations. Global aesthetic improvement, subjects' satisfaction, and safety were also evaluated.

RESULTS
The treatment was well tolerated. Naturalness of facial expression in motion was determined to be at least maintained in 95% of subjects. Attractiveness was enhanced in 89% of subjects and 79% of subjects were considered to look younger. Most subjects assessed their aesthetic appearance as improved and were satisfied with their treatment.

CONCLUSION
Naturalness and attractiveness can be assessed using video recordings and photographs capturing different facial animations. XpresHAn Technology HA filler treatments create natural-looking results with high subject satisfaction.
Novel Stereoscopic Optical System for Objectively Measuring Above-Surface Scar Volume—First-Time Quantification of Responses to Various Treatment Modalities
Authors: Salameh Fares , Koren Amir , Sprecher Eli , Artzi Ofir 
Published: December 2017

BACKGROUND
Current approaches use subjective semiquantitative or cumbersome objective methodologies to assess physical characteristics of hypertrophic and keloid scars.

OBJECTIVE
This pilot study aimed to evaluate the accuracy and feasibility of a new stereoscopic optical and high-resolution 3-dimensional imaging system, for objectively measuring changes in above-surface scar volume after various interventions.

METHODS
Feasibility and accuracy were assessed by monitoring the above-surface scar volume of 5 scars in 2 patients for 5 successive months. Above-surface scar volume and Vancouver Scar Scale scores and the investigator and patient volume improvement assessment scores were assessed before and 12 weeks after last intervention.

RESULTS
Scar volume measured by the imaging system correlated significantly with the gold standard (actual weight). The greatest volume reduction followed a combination of cryotherapy and intralesional triamcinolone acetonide and 5-fluorouracil injections in Patient 1 and a combination of pulse dye laser and intralesional triamcinolone acetonide injections in Patient 2.

CONCLUSION
The new stereoscopic optical system is a valid, accurate, and practical objective method for assessing scar volume and for monitoring treatment response. It is more sensitive and accurate than semiquantitative objective scales. Further studies with a higher number of patients and scars are required to increase the measurement validity of the system.
Palliative care in gynecologic oncology
Authors: Karlin Daniel , Phung Peter , Pietras Christopher 
Published: December 2017

Purpose of review
Patients with gynecologic malignancies face many difficult issues in the course of their diseases, ranging from physical symptoms to advance care planning in light of a poor prognosis. This review examines the evidence supporting integration of palliative care early in the course of disease and symptom management, and provides a framework for difficult conversations.

Recent findings
Palliative care has been demonstrated to improve quality of life and promote survival if integrated early in the course of disease. An evidence-based approach should guide symptom management, such as pain and nausea. Advance care planning and goals of care discussions are enhanced by a framework guiding discussion and the incorporation of empathetic responses.

Summary
Palliative care is a diverse multidisciplinary field that can provide significant benefit for patients with gynecologic malignancies.
Alternative facts and morcellation
Authors: Olive David L. 
Published: December 2017

Purpose of review
Since the recent black-box warning regarding the use of electromechanical morcellation, there has been a hesitancy to utilize the product and even to perform other types of morcellation by gynecologists. Unfortunately, this Food and Drug Administration action and the continued public criticisms of this procedure are grounded in poor data and faulty reasoning. To truly perform informed consent to patients considering procedures involving morcellation, a thorough review of the facts, not alternative facts, must be communicated.

Recent findings
Misrepresentation of the ethics surrounding this procedure, the role of informed consent and the risks and benefits as determined by evidence-based medicine have led to confusion and poor public policy. Today's evidence suggests that the procedure is indeed ethical when full disclosure of the risks and benefits is presented via informed consent. Risks of the procedure have been exaggerated significantly, and little attention has been paid to the risks of denying morcellation procedures to patients. Attempts to condemn gynecologists as acting contrary to established surgical principles do not coincide with facts.

Summary
Morcellation is a controversial technique which undoubtedly has a role as well as limitations. To appropriately determine if the procedure is indicated and acceptable to the patient, full disclosure of the best available evidence is necessary.
SEVERE IMMUNE-MEDIATED THROMBOCYTOPENIA AFTER INTRAVITREAL BEVACIZUMAB INJECTION
Authors: Li Tianyi , Witteman Derek T. , Weber Eric D. , Alexander Warren L. , Schaber John D. 
Published: December 2017

Purpose:
To report a case of severe immune-mediated thrombocytopenia after intravitreal bevacizumab administration.

Methods:
A 77-year-old man with right-sided macular degeneration received intravitreal bevacizumab. After his third treatment dose, he was hospitalized for symptomatic thrombocytopenia (platelet count of 3 k/μL) and underwent testing to determine the etiology.

Results:
Initial platelet counts on admission were 3 k/μL, down from 238 k/μL 3 months before. A peripheral smear, coagulation studies, and an abdominal CT were unremarkable. A bone marrow biopsy revealed hypercellular marrow with megakaryocytic hyperplasia. Serum antiplatelet antibody testing identified antibodies against glycoprotein IV and human leukocyte antigens. A total of 13 units of platelets were administered and resulted in no significant response. Treatment with rituximab, romiplostim, and human leukocyte antigen–matched platelets resulted in slow recovery and normalization of platelet counts.

Conclusion:
The case presented shows apparent severe immune-mediated thrombocytopenia after intravitreal bevacizumab administration.
Eyelid Changes Related to Meibomian Gland Dysfunction in Early Middle-Aged Patients Using Topical Glaucoma Medications
Authors: Kim Ji Hong , Shin Yong Un , Seong Mincheol , Cho Hee Yoon , Kang Min Ho 
Published: December 2017

Purpose:
To investigate the relationship between topical glaucoma medications and meibomian gland dysfunction (MGD) in early middle-aged patients with glaucoma.

Methods:
In this cross-sectional study, 50 patients with glaucoma younger than 50 years who had used topical glaucoma medications for more than 6 months and 40 normal controls of similar age were included. Patients in each group were graded for MGD (0–4) using slit-lamp microscopy. Tear film breakup time (BUT), ocular surface staining, and Marx line scores were also evaluated. Differences between both groups were analyzed statistically.

Results:
The prevalence of MGD was 82% in the group using topical glaucoma medications and 52.5% in the control group. The average period of topical glaucoma medication use was 27.4 months. There were significant differences in the breakup time and Marx line score according to the presence of MGD. Although the duration of topical glaucoma medication use and the severity of MGD did not show a significant correlation, the degree of MGD and the Marx line score were significantly correlated.

Conclusions:
Glaucoma eye drops may be one factor affecting the eyelid changes associated with MGD. The Marx line score may be used as an index to evaluate MGD in patients with glaucoma.
Epidemiology of Persistent Dry Eye-Like Symptoms After Cataract Surgery
Authors: Iglesias Eugenia , Sajnani Ravin , Levitt Roy C. , Sarantopoulos Constantine D. , Galor Anat 
Published: December 2017

Purpose:
To evaluate the frequency and risk factors for persistent postsurgical pain (PPP) after cataract surgery, defined as mild or greater dry eye (DE)-like symptoms 6 months after surgery.

Methods:
This single-center study included 86 individuals who underwent cataract surgery between June and October 2016 and had DE symptom information available 6 months after surgery. Patients were divided into 2 groups: controls were defined as those without DE symptoms 6 months after surgery (defined by a Dry Eye Questionnaire 5 (DEQ5) score <6), cases were defined as those with mild or greater DE-like symptoms 6 months after surgery (DEQ5 ≥6).

Results:
Mean age of the study population was 71 ± 8.6 years; 95% (n = 82) were men. DE-like symptoms were reported in 32% (n = 27) of individuals 6 months after cataract surgery; 10% (n = 8) reported severe symptoms (DEQ5 ≥12). Patients with DE-like symptoms after cataract extraction also had higher ocular pain scores and specific ocular complaints (ocular burning, sensitivity to wind and light) compared with controls with no symptoms. A diagnosis of nonocular pain increased the risk of DE-like symptoms after cataract surgery (odds ratio 4.4, 95% confidence interval 1.58–12.1, P = 0.005).

Conclusions:
Mild or greater PPP occurred in approximately 1/3 of individuals after cataract surgery. Prevalence of severe PPP is in line with that of refractive surgery, dental implants, and genitourinary procedures.
Psychiatric Disorders, Antiretroviral Medication Adherence and Viremia in a Cohort of Perinatally HIV-Infected Adolescents and Young Adults
Authors: Bucek Amelia , Leu Cheng-Shiun , Benson Stephanie , Warne Patricia , Abrams Elaine J. , Elkington Katherine S. , Dolezal Curtis , Wiznia Andrew , Mellins Claude Ann 
Published: December 2017

Background:
Perinatally HIV-infected (PHIV+) adolescents and young adults (AYA) are at risk for suboptimal antiretroviral therapy (ART) adherence and mental health and substance use problems that, in HIV-infected adults, predict nonadherence. Studies on the relationship between psychiatric and substance use disorders (SUD) and adherence among PHIV+ AYA are limited, but may be important for informing evidence-based interventions to promote adherence.

Methods:
Data were analyzed from 3 annual follow-up interviews (FU2–FU4, N = 179) in a longitudinal study of PHIV+ AYA. Psychiatric disorders (anxiety, disruptive behavior, mood and SUD) were assessed with the Diagnostic Interview Schedule for Children. Adherence was self-reported missed ART doses within the past week. Viral load (VL) results were abstracted from medical charts. Multiple logistic regression analyzed cross-sectional associations between psychiatric disorders and (1) missed ART dose and (2) VL > 1000 copies/mL. Multiple linear regression assessed associations between psychiatric disorders and proportion of VL values >1000 copies/mL over time.

Results:
At FU2, 53% of PHIV+ AYA had any psychiatric disorder, 35% missed an ART dose in the past week and 47% had a VL > 1000 copies/mL. At FU2, behavioral disorders were associated with missed dose (P = 0.009) and VL > 1000 (P = 0.019), and mood disorders were associated with missed dose (P = 0.041). At FU4, behavioral disorders were associated with missed dose (P = 0.009). Behavioral disorders (P = 0.041), SUD (P = 0.016) and any disorder (P = 0.008) at FU2 were associated with higher proportion of VLs >1000 across FU2–FU4.

Conclusions:
Addressing psychiatric disorder and SUD among PHIV+ AYA may improve ART adherence outcomes in this population. Targeted interventions should be developed and tested.
Population Pharmacokinetics of Lopinavir in Severely Malnourished HIV-infected Children and the Effect on Treatment Outcomes
Authors: Archary Moherndran , Mcllleron Helen , Bobat Raziya , Russa Phillip La , Sibaya Thobekile , Wiesner Lubbe , Hennig Stefanie 
Published: December 2017

Background:
In developing countries, malnutrition remains a common clinical syndrome at antiretroviral treatment (ART) initiation. Physiologic changes because of malnutrition and during nutritional recovery could affect the pharmacokinetics of antiretroviral drugs.

Methods:
HIV-infected children admitted with severe acute malnutrition were randomized to early or delayed initiation of lopinavir (LPV)/ritonavir, abacavir and lamivudine using World Health Organization weight band dosage charts. LPV concentrations were measured on day 1 and day 14. Thereafter, patients were followed-up to week 48. The population pharmacokinetics of LPV was described using NONMEM v7.3. Covariates were screened to assess their influence on the pharmacokinetics of LPV, and the relationship between pharmacokinetic variability and treatment outcomes were assessed.

Results:
Five hundred and two LPV concentrations were collected from 62 pediatric patients 0.1–3.9 years of age (median: 0.9 years). Rifampin-based antituberculosis treatment and “super-boosted” LPV/ritonavir were prescribed in 20 patients. LPV disposition was well described by a one-compartment model with first-order elimination. Neither randomization to early or delayed ART, tuberculosis comedications nor anthropometrical measurements explained the pharmcokinetic variability. Allometrically scaled fat-free mass influenced apparent clearance (CL/F) and volume of distribution (V
d/F). Pharmacokinetic exposure did not correlate with virologic outcomes or death at 12 or 48 weeks.

Conclusions:
LPV pharmacokinetics was influenced by fat-free mass and not by timing of ART initiation or tuberculosis comedication in severely malnourished HIV-infected children. LPV pharmacokinetics was found to be highly variable and bioavailability greatly reduced, resulting in a high CL estimate in this population. The role of LPV dose adjustment should be further evaluated in severely malnourished children initiating ART.
Hearing Loss in Pediatric Patients With Cerebral Palsy
Authors: Weir Forest W. , Hatch Jonathan L. , McRackan Theodore R. , Wallace Sarah A. , Meyer Ted A. 
Published: December 2017

Objective:
This study evaluates the prevalence, type, and severity of hearing impairment in children with cerebral palsy (CP) and to analyze audiologic and otologic outcomes in these patients.

Study Design:
Retrospective analysis of the AudGen Database.

Setting:
Tertiary academic referral center.

Patients:
Pediatric patients in AudGen Database with a diagnosis of cerebral palsy. Appropriate audiologic, otologic, and demographic data were recorded.
Nine hundred forty patients met inclusion criteria. Hearing loss (HL) was defined as greater than 15 dB HL at any threshold by pure tone or greater than 20 dB HL by soundfield audiometry. Other available otologic and medical conditions were documented.

Results:
Of 940 patients, 367 (39%) had hearing loss. Of the 1,629 individual ears with HL, 782 (48%) had conductive, 63 (4%) had sensorineural, 410 (25%) had mixed, and 374 (23%) had unspecified hearing loss. Patients with mixed type 1 hearing loss had significantly worse PTAs.

Interpretation:
Hearing loss in CP has a large degree of sensorineural loss, with a predisposition to be bilateral. The severity of hearing loss was correlated with the degree of the motor and neurologic disability in these patients.