bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin resistance is associated with elevated transaminases and low aspartate aminotransferase/alanine aminotransferase ratio in young adults with normal weight
Authors: Simental-Mendía Luis E. , Rodríguez-Morán Martha , Gómez-Díaz Rita , Wacher Niels H. , Rodríguez-Hernández Heriberto , Guerrero-Romero Fernando 
Published: December 2016

Objective
The aim of this study is to determine whether insulin resistance is associated with elevation of transaminases levels and aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio in normal-weight healthy young adults.

Participants and methods
Apparently healthy nonpregnant women and men, aged 18–23 years, were enrolled in a cross-sectional study. According to the homeostasis model assessment of insulin resistance, the participants were allocated into groups of patients with (>2.5) and without (≤2.5) insulin resistance. Normal weight was defined by BMI of at least 18.5 and less than 25.0 kg/m2. A multiple logistic regression analysis was carried out to determine the association between insulin resistance and elevated transaminases and AST/ALT ratio of 1 or less.

Results
A total of 1732 young adults were enrolled and allocated into groups with (n=287) and without (n=1445) insulin resistance. The prevalence of insulin resistance was 16.6% in the overall population. The multivariate logistic regression analysis adjusted by age, sex, waist circumference, and BMI indicated that the odds ratio (OR) between insulin resistance and elevated ALT concentrations is 1.65 [95% confidence interval (CI): 1.04–2.62, P=0.03], for AST/ALT ratio lower than 1 OR is 1.69 (95% CI: 1.27–2.26, P<0.001), and for elevated AST levels OR is 1.31 (95% CI: 0.71–2.43, P=0.377).

Conclusion
The results of the present study suggest that insulin resistance is significantly associated with elevated ALT levels and AST/ALT ratio of lower than 1, but not with elevated AST levels.
Preadmission Diuretic Use and Mortality in Patients Hospitalized With Hyponatremia: A Propensity Score–Matched Cohort Study
Authors: Holland-Bill Louise , Christiansen Christian F. , Ulrichsen Sinna P. , Ring Troels , Lunde Jørgensen Jens O. , Sørensen Henrik T. 
Published: December 2016

Background:
Hyponatremia is associated with increased mortality and is frequently induced by diuretic use. It is uncertain whether diuretic use is linked to mortality risk in patients with hyponatremia.

Study Question:
To measure the prognostic impact of diuretic use on 30-day mortality among patients hospitalized with hyponatremia.

Study Design:
Using population-based registries, we identified all patients with a serum sodium measurement <135 mmol/L within 24 hours after acute hospital admission in western Denmark from 2006 to 2012 (cumulative population of 2.2 million). We categorized patients as current diuretic users (new and long-term), former users or nonusers, and followed them until death, migration or up to 30 days which ever came first.

Measures and Outcomes:
Thirty-day cumulative mortality and relative risk with 95% confidence interval (CI) controlled for demographics, previous morbidity, renal function, and co-medications. Calculations were also divided by the diuretic type and were repeated after propensity score matching.

Results:
Thirty-day mortality was 11.4% among current diuretic users (n = 14,635) compared with 6.2% among nonusers, yielding an adjusted relative risk of 1.4 (95% CI, 1.2–1.5). New users were at higher risk (1.7, 95% CI, 1.5–2.0) than long-term users (1.3, 95% CI, 1.2–1.4). In particular, the use of loop diuretics (1.6, 95% CI, 1.4–1.8), potassium-sparing diuretics (1.6, 95% CI, 1.2–2.2), and diuretic polytherapy (1.5, 95% CI, 1.3–1.7) were associated with increased risk, whereas thiazide use was not (1.0, 95% CI, 0.9–1.2). Propensity score–matched analyses confirmed the results.

Conclusions:
Diuretic use except from thiazides, and particularly if newly initiated, is a negative prognostic factor in patients admitted with hyponatremia.
Genotype-guided diagnosis in familial hypercholesterolemia: population burden and cascade screening
Authors: Hopkins Paul N. 
Published: December 2016

Purpose of review
In this review, how genetic testing has provided major new insights regarding the population burden of familial hypercholesterolemia (FH) are reviewed. In addition, the role of genetic testing in cascade screening for FH and an updated MEDPED (Make Early Diagnoses to Prevent Early Death in MEDical PEDigrees) algorithm for the clinical diagnosis of FH are presented.

Recent findings
For the first time, recent application of genetic testing for FH in large populations has provided firm estimates of the prevalence of FH (at least one in 220) in the USA. High associated risks of coronary artery disease make FH the most common genetic cause of premature coronary artery disease.

Summary
Genetic testing has yielded accurate, new estimates of the population burden of FH. The potential benefits of early diagnosis of FH on a population-wide level have not yet begun to be realized.
Surviving Depression
Authors: Miranda Jeanne , Bromley Elizabeth , Izquierdo Adriana , Jones Felica , Wells Kenneth 
Published: December 2016

AbstractDepression is persistent and recurrent across ethnic groups. Few narrative analyses of long-term outcomes for ethnically diverse adults with depression exist. We combined 9 years of quantitative data, qualitative interviews at 10 years, clinician ratings of outcomes, and a community discussion group with the objective of describing long-term recovery and survival of diverse primary care patients after an episode of depression. Nearly half of participants were found to be depressed at some time over a 10-year period, and most cases across ethnic groups were judged to need further treatment. The ethnically diverse community members that analyzed the transcripts emphasized assets that participants showed in surviving multiple life stresses. Different sex and ethnic/racial groups had different characteristics of engaging in care, with Latino women in particular raising concerns about care engagement, coping with stress, and long-term outcomes.
Understanding the Impairment Associated With Depressive Symptoms
Authors: Hanson Bjorn , Young Michael A. 
Published: December 2016

Abstract
Relatively little theory or research has addressed the mediating processes through which depressive symptoms lead to impairment. To conceptualize the nature of impairment in depression, we conducted semistructured interviews of 18 psychiatric patients experiencing depressive symptoms about how their depressive symptoms create impairment. Interviews were audio recorded and transcribed, and thematic analysis methods were used to identify content areas and themes. Three content areas were identified: domains of impairment (types of behavior that are impaired), experience of impairment (nature and severity of impairment), and pathways to impairment (processes connecting symptoms to impairment). Pathways included direct connections between symptom and impairment, as well as indirect pathways mediated by other symptoms and by cognitive responses to symptoms. Patients' examples of the impairment phenomena are presented. In addition, patterns of association were observed between particular pathways and symptom type (vegetative versus cognitive/affective). Increased understanding of clients' explanations for impairment may improve clinical intervention and assessments.
Urgent Bypass Surgery Following Failed Endovascular Treatment in Acute Symptomatic Stroke Patient With MCA Occlusion
Authors: Lee Chang Yeob , Kim Chang Hyun , Lee Chang-Young , Sohn Sung-Il , Hong Jeong-Ho 
Published: December 2016

Introduction:
Although the benefits of extracranial-intracranial bypass surgery remain controversial, there is some surgical rationale for the augmentation of cerebral blood flow in cases of acute ischemic stroke with hemodynamic instability.

Case Report:
We report a case of a 62-year-old woman who suddenly developed right hemiplegia and global aphasia. Initial magnetic resonance imaging and magnetic resonance angiography revealed a small acute ischemic lesion in left parietal lobe with occlusion at the left middle cerebral artery. We performed an endovascular thrombectomy, which failed. Her neurological deficits remained unchanged. On the basis of immediate postendovascular magnetic resonance perfusion, diffusion-weighted imaging (DWI), and neurological examination, an obvious clinical-DWI and a DWI–perfusion-weighted imaging mismatch were detected. We decided to perform emergency superficial temporal artery to middle cerebral artery bypass to prevent further progression of cerebral ischemia. On a 3-month follow-up, neurological deficits remained minimal motor aphasia and dysarthria.

Conclusions:
Following failed endovascular treatment in patients with acute symptoms attributed to major cerebral artery occlusion, we recommend immediate multimodal neuroimaging. If there are clinical-DWI and DWI–perfusion-weighted imaging mismatch indications, surgical revascularization could be considered as the next salvageable strategy.
Transient Sensory Recovery in Stroke Patients After Pulsed Radiofrequency Electrical Stimulation on Dorsal Root Ganglia
Authors: Apiliogullari Seza , Gezer Ilknur A. , Levendoglu Funda 
Published: December 2016

Introduction:
The integrity of the somatosensory system is important for motor recovery and neuroplasticity after strokes. Peripheral stimulation or central stimulation in patients with central nervous system lesions can be an effective modality in improving function and in facilitating neuroplasticity.

Case Report:
We present 2 hemiplegic cases with sensory motor deficit and the result of the pulsed radiofrequency (PRF) electrical stimulation to the dorsal root ganglia. After PRF electrical stimulation, significant improvement was achieved in the examination of patients with superficial and deep sensation. However, during the follow-up visits were observed that the effect of PRF electrical stimulation disappeared.

Conclusions:
We believe that these preliminary results could be used in the development of future prospective cohort studies and randomized controlled trials that focus on the effect of PRF electrical stimulation on dorsal root ganglia to treat sensory deficits in poststroke patients.
Movement Disorders Induced by the “Atypical” Antipsychotic Aripiprazole
Authors: Selfani Karim , Soland Valérie L. , Chouinard Sylvain , Huot Philippe 
Published: December 2016

Objectives:
Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect.

Methods:
Patients referred to the André-Barbeau Movement Disorder clinic treated with aripiprazole were enrolled in this study. Their charts were retrospectively reviewed and data regarding past psychiatric history, past antipsychotic medication, duration of aripiprazole treatment, daily dose of aripiprazole administered, and resulting movement disorders were collected.

Results:
We report 14 cases of parkinsonism, tardive dyskinesia and akathisia induced by aripiprazole. Some of these, mostly the parkinsonian phenotype, abated spontaneously following drug discontinuation, whereas others, mostly related to tardive phenomena, persisted after aripiprazole was discontinued, and required treatment.

Conclusions:
This case-series adds to the existing literature that suggests that movement disorders may arise following treatment with aripiprazole. Clinicians should be aware of this potential side effect when prescribing aripiprazole to patients.
Spontaneous Spinal Subdural Hematoma
Authors: de Beer Marlijn H. , Eysink Smeets Marjolein M. , Koppen Hille 
Published: December 2016

Objective:
Spinal subdural hematomas (SSDHs) are rare. Causes are (1) posttraumatic, (2) iatrogenic (following surgery or lumbar puncture), (3) spontaneous including underlying malformations or coagulation deficits. With a systematic review of literature we want to shed light on the last group: symptomatology, etiology, treatment and outcome will we discussed.

Methods:
Systematic review of literature on PubMed for cases of acute nontraumatic noniatrogenic SSDHs in adults (≥18 y of age). A total of 122 cases were reviewed including 2 cases from our hospital.

Results:
There was a slight preponderance of female patients with spontaneous SSDHs and the mean age was 60 years. Spontaneous SSDHs were mostly located in the thoracic region (40%). Motor symptoms were most frequent (89%), followed by pain. Sensory deficits were present in 64%, of which 81% had a sensory level. In 6% radiculating pain, without any focal neurological deficits, was the presenting symptom. SSDHs were mainly caused by a coagulopathy (48%), predominantly due to the use of coumarins (34%). Other causes were underlying (vascular) malformations and vasculitis. Forty-three percent the SSDHs was idiopathic. 72% of patients underwent a decompressive laminectomy. 59% had a favorable outcome and 34% had a poor outcome.

Conclusions:
Spontaneous SSDHs were predominantly located in the thoracic spine, presenting with paraparesis/paraplegia, sensory level and pain. Over 40% was caused by a coagulation defect, most frequently due to coumarins. Six percent of patients presented with radiculating pain without any focal neurological deficits.
Development of a Keratoconus-Specific Questionnaire Using Rasch Analysis
Authors: Khadka Jyoti , Schoneveld Paul G. , Pesudovs Konrad 
Published: December 2016

ABSTRACT

Purpose
To develop and validate a keratoconus-specific quality of life (QoL) questionnaire: the Keratoconus Outcomes Research Questionnaire (KORQ).

Methods
The study was carried out in three phases. Phase I: content identifications: items were identified based on an extensive literature review, open-ended patient mail survey, and expert consultations. Each item was scored on a visual analog scale (VAS). Phase II: pilot testing using Rasch analysis. Phase III: testing psychometric properties of the final version of the KORQ.

Results
Phase I identified 44 items across 3 different content areas: activity limitation (26), symptoms (20), and convenience (8). The 44-item KORQ was self-administered to 158 people with keratoconus. The 44-item KORQ was multidimensional. Unidimensionality was restored by separating items across three content areas (subscales) as identified in phase I. The activity limitation and symptoms subscales demonstrated adequate measurement precision, but convenience (precision, 1.01) did not. Hence, the convenience subscale was discarded. Rasch analysis revealed that the VAS was disordered. The ordering of the VAS was restored by collapsing categories into 4. An iterative Rasch analysis guided item-removal resulted into a 29-item KORQ (18-item activity limitation and 11-item symptoms). The VAS was replaced by a discrete 4-option labeled categorical rating scale, and it was self-administered by 169 people with keratoconus. Both the subscales demonstrated good psychometric properties. The KORQ scores strongly correlated with visual acuity and contrast sensitivity demonstrating its construct validity.

Conclusions
The 29-item KORQ was a psychometrically robust and valid instrument to assess the impact of keratoconus on activity limitation and symptoms.
Association of Body Length with Ocular Parameters in Mice
Authors: Chakraborty Ranjay , Park Han na , Tan Christopher C. , Weiss Paul , Prunty Megan C. , Pardue Machelle T. 
Published: December 2016

ABSTRACTPurposeTo determine the association between changes in body length with ocular refraction, corneal radii, axial length, and lens thickness in two different mouse strains.MethodsBody length, ocular refraction, corneal radii, axial length, and lens thickness were measured for two inbred mouse strains: 129S1/SvJ (n= 7) and C57BL/6 J (n= 10) from 4 to 12 weeks of age. Body length, from tip of nose to base of tail, was obtained using a digital camera. Biometric parameters, corneal radii, and refractions were measured using spectral-domain optical coherence tomography, automated keratometry, and infrared photorefraction, respectively. A mixed-model ANOVA was performed to examine the changes in ocular parameters as a function of body length and strain in mice controlling for age, gender, and weight over time.ResultsC57BL/6J mice had significantly longer body length (average body length at 10 weeks, 8.60 ± 0.06 cm) compared to 129S1/SvJ mice (8.31 ± 0.05 cm) during development (P< .001). C57BL/6J mice had significantly hyperopic refractions compared to 129S1/SvJ mice across age (mean refraction at 10 weeks, 129S1/SvJ: +0.99 ± 0.44D vs. C57BL/6J: +6.24 ± 0.38D,P< .001). Corneal radius of curvature, axial length, and lens thickness (except 10 weeks lens thickness) were similar between the two strains throughout the measurement. In the mixed-model ANOVA, changes in body length showed an independent and significant association with the changes in refraction (P= .002) and corneal radii (P= .016) for each mouse strain. No significant association was found between the changes in axial length (P= .925) or lens thickness (P= .973) as a function of body length and strain.ConclusionsChanges in body length are significantly associated with the changes in ocular refraction and corneal radii in different mouse strains. Future studies are needed to determine if the association between body length and ocular refraction are related to changes in corneal curvature in mice.
Effect of Accommodation on Peripheral Eye Lengths of Emmetropes and Myopes
Authors: Aldossari Hussain , Suheimat Marwan , Atchison David A. , Schmid Katrina L. 
Published: December 2016

ABSTRACT

Purpose
To investigate the effect of accommodation on central and peripheral axial lengths in young adult emmetropes and myopes.

Methods
On-axis and peripheral axial lengths were measured with the Haag-Streit Lenstar in 83 young adult participants for 0D and 6D accommodation demands. A Badal system was used to both correct refractive errors and induce accommodation. Participants were emmetropes (n = 29, mean spherical equivalent refraction +0.35 ± 0.35D), low myopes (32, −1.38 ± 0.73D), and higher myopes (22, −4.30 ± 0.73D). Ages were similar for all groups (22 ± 2 years). Pupils were dilated with 2.5% phenylephrine to allow a large field of measurement while maintaining active accommodation. Axial lengths were measured in 5° steps to ±30° across the horizontal visual field.

Results
With accommodation, axial length increased for all refractive groups at all positions, but with lessening effect away from fixation. Axial length changes were greater for higher myopes than for emmetropes on-axis (higher myopes 41 ± 14 μm, emmetropes 30 ± 12 μm, P = .005), for higher myopes than for low myopes at 30° nasal (P = .03), and for the higher myopes than for the other groups at 20° nasal (P < .05). There were significant correlations between myopia and changes in axial length at all positions, with the highest correlation on-axis (R
2 = 0.30, P < .001).

Conclusions
During accommodation, eye length increased out to at least ±30° visual angle in young adult myopes and emmetropes. The increase was significantly greater for higher myopes than for the other groups at some positions. At all positions, there were significant correlations between myopia and accommodation-induced changes in axial length.
Oxygen Tension Beneath Scleral Lenses of Different Clearances
Authors: Giasson Claude J. , Morency Jeanne , Melillo Marc , Michaud Langis 
Published: December 2016

ABSTRACT

Purpose
To evaluate the relative partial pressure in oxygen (pO2) at the corneal surface under Boston XO2 scleral lenses (SL) fitted with targeted clearances of 200 and 400 μm (SL200 and SL400).

Methods
During this prospective study, the right eyes of eight normal subjects were fitted with SL200 and SL400. Clearance, validated after 5 minutes of wear with an optical coherence tomograph, was used with lens thicknesses to calculate transmissibility and estimate pO2. Corneal pO2s were measured with an oxygen electrode after 5 minutes of (1) corneal exposure to calibrating gases with various pO2 or of (2) SL wear. Decays in pO2 were modeled to an exponential. Linear regression between exponent k of these decays and calibrating gas pO2s allowed for the calculation of corneal pO2 under SL. Differences between pO2s beneath SL200 and SL400 were tested with a mixed ANOVA.

Results
The estimated transmissibility based on thicknesses and clearances (239.7 ± 34.7; 434.5 ± 33.2 μm) predicted a corneal pO2 of 8.52 ± 0.51 and 6.37 ± 0.28% for SL200 and SL400. These values were close to measured pO2: 9.07 ± 0.86 and 6.19 ± 0.87% (mean ± SEM) (P < .05) for SL200 and SL400, respectively. Both pO2 measurements fall short of the theoretical values needed to prevent hypoxia during lens wear (9.9% and above).

Conclusions
As shown in vivo for the first time, an 18-mm scleral lens fitted with a 400-μm clearance reduces the oxygen tension available to the cornea by 30% compared to a similar lens fitted with a 200-μm clearance after 5 minutes of wear.
Clinical Features in Children with Posterior Polymorphous Corneal Dystrophy
Authors: Ahn Ye Jin , Choi Soon Il , Yum Hae Ri , Shin Sun Young , Park Shin Hae 
Published: December 2016

ABSTRACT

Purpose
To describe clinical features in children diagnosed with posterior polymorphous corneal dystrophy (PPCD) in their first or second decade of life.

Methods
A retrospective study was performed with the medical records of seven unrelated Korean pediatric patients who were diagnosed with PPCD and were followed up for a minimum of 3 years. Thorough ocular examinations were performed, including best-corrected visual acuity, intraocular pressure, refractive and keratometric measurements, slit-lamp biomicroscopy, and specular microscopy at all visits.

Results
Slit-lamp examinations revealed vesicular lesions in one patient and horizontally parallel band-like endothelial lesions in six patients. Unilateral corneal involvement was displayed in 4 patients, yielding 10 eyes with deep corneal features characteristic of PPCD. Other corneal, iris, or fundus pathologic findings were not detected in all cases. Among four children who were examined in their visual development (approximately under 8 years of age), two cases demonstrated unilateral amblyopia at initial examination and exhibited improved visual acuity after refractive correction and occlusion therapy. Astigmatism more than 1.5D, which is generally considered amblyogenic, was found in 8 among 10 PPCD-affected eyes. A final visual acuity of more than 20/32 was achieved with appropriate refractive correction in all PPCD-affected eyes. There was a negative correlation between the corneal astigmatism and the mean endothelial cell density (ECD) (r = −0.655, P = .011). Initial specular microscopic examinations revealed reduced ECD (1733.0 ± 543.9 cells/mm2) composed of enlarged cells (average cell area, 624.8 ± 182.1 μm2/cell) in PPCD-affected eyes, compared with those in PPCD-unaffected eyes from our study subjects (P < .001 and P = .005, respectively). A statistically significant percent loss in ECD from initial to 3 years was noted in the PPCD-affected eyes (P = .03).

Conclusions
The awareness and treatment of refractive error are important, especially in children with early-onset PPCD during the reversible period of amblyopia. Long-term monitoring of corneal endothelium is required in pediatric patients with early-onset PPCD based on a significant endothelial loss over 3 years in PPCD-affected eyes.