bluuebunny/crossref_metadata_2025_split huggingface dataset:
STICKY SILICONE OIL
Authors: Ghoraba Hamouda Hamdi , Zaky Adel Galal , Abd Al Fatah Haithem Mamoun , El Gemai Emad El Din Mohamed , Heikal Mohamed Amin 
Published: November 2016

Objective:
To report and analyze the phenomenon of sticky silicone oil on the retina at the time of its removal.

Background:
Silicone oil has been used for more than 25 years as a long-term retinal tamponade in the surgical management of patients with complex retinal detachments. When a decision to remove silicone oil was made at the end of the tamponade period, the system involved a number of different materials: silicone oil, aqueous solution with or without remnants of perfluorocarbon liquid plus the material of the cannula used to aspirate Silicone oil. This, in effect, may lead to an abnormal adherence of large bubbles of residual silicone oil to the posterior pole of the retina.

Patients and methods:
A retrospective, interventional case study was performed. We consecutively reviewed 796 patients of silicone oil removal (5,000 or 5,500 centistokes) after primary pars plana vitrectomy at one vitreoretinal center operated by a single surgeon (HG). Chart review was performed to identify potential patients or procedural factors that could predispose to sticky silicone oil formation at the macular area.

Results:
Large silicone oil bubbles were sticky to the macula in eight out of 796 silicone oil removal procedures between January 2014 and August 2015. The use of perfluorooctane was related to the occurrence of the phenomenon (P < 0.001).

Conclusion:
The sticky silicone oil bubble at the macular region was not related to internal limiting membrane peeling, epiretinal membrane, viscosity, duration, or brand of silicone oil used, but to the use of perfluorooctane.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF CHORIORETINAL LESIONS DUE TO IDIOPATHIC MULTIFOCAL CHOROIDITIS
Authors: Zahid Sarwar , Chen Kevin C. , Jung Jesse J. , Balaratnasingam Chandrakumar , Ghadiali Quraish , Sorenson John , Rofagha Soraya , Freund K. Bailey , Yannuzzi Lawrence A. 
Published: November 2016

Purpose:
To evaluate the spectrum of macular chorioretinal lesions occurring in idiopathic multifocal choroiditis using optical coherence tomography angiography (OCTA) to evaluate those showing neovascular flow.

Methods:
This was a descriptive, retrospective study of 18 eyes of 14 patients with multifocal choroiditis. Macular lesions were characterized as subretinal pigment epithelium, subretinal, or mixed and evaluated during active and presumed inactive states of multifocal choroiditis. Correlations between structural optical coherence tomography and OCTA were performed. In select cases, correlations between OCTA, fluorescein angiography, and fundus autofluorescence were evaluated. In 5 eyes, quantitative measurements of neovascular lesions were compared at baseline and following intravitreal anti–vascular endothelial growth factor therapy.

Results:
Mean patient age was 48 years (SD: 13.8; 86% women). Optical coherence tomography angiography flow signatures consistent with neovascularization were identified in 83% of eyes, including in 0% of subretinal pigment epithelium, 91% of subretinal, and 100% of mixed lesions. Lesions that did not demonstrate definitive signs of fluorescein angiography leakage were frequently found to have neovascularization using OCTA. There was no change in quantitative measurements of neovascular lesions after anti–vascular endothelial growth factor therapy (all tested variables P > 0.05).

Conclusion:
Optical coherence tomography angiography may be a useful imaging modality for understanding the pathophysiology of multifocal choroiditis and monitoring its clinical course.
GEMCITABINE-INDUCED RETINOPATHY
Authors: Kovach Jaclyn L. 
Published: November 2016

Purpose:
To report a case of Purtscher-like retinopathy associated with gemcitabine.

Methods:
The author reports a 68-year-old woman who presented with a 4-month history of bilateral vision loss. She had a history of diabetes, hypertension, and leiomyosarcoma, diagnosed 5 months before presentation and had completed 5 cycles of combination treatment with gemcitabine and docetaxel. Clinical examination revealed a Purtscher-like retinopathy that improved after gemcitabine cessation without the development of cystoid macular edema or retinal neovascularization.

Conclusion:
This case highlights the importance of recognizing gemcitabine-induced ischemic retinopathy that can be associated with life-threatening myocardial or renal ischemia.
Respiratory Syncytial Virus in Older Adults
Authors: Talbot H. Keipp , Belongia Edward A. , Walsh Edward E. , Schaffner William 
Published: November 2016

Abstract
Respiratory syncytial virus (RSV) is a common cause of medically significant respiratory tract illnesses in adults 65 years and older. The clinical presentation of RSV is largely indistinguishable from other respiratory infections including influenza, limiting awareness of its burden and impact among health care professionals and the public. Although no specific treatment in adults or licensed vaccine to prevent the disease is currently available, several promising candidate vaccines and treatments are on the horizon. Recognizing and defining the impact of RSV in older adults is important to evaluate the impact of these new prevention and treatment options. Public health and health care professionals need to be aware about RSV so they can advise the general public and older patients about the importance of prevention.
Genetic variant rs3750625 in the 3′UTR of ADRA2A affects stress-dependent acute pain severity after trauma and alters a microRNA-34a regulatory site
Authors: Linnstaedt Sarah D. , Walker Margaret G. , Riker Kyle D. , Nyland Jennifer E. , Hu JunMei , Rossi Catherine , Swor Robert A. , Jones Jeffrey S. , Diatchenko Luda , Bortsov Andrey V. , Peak David A. , McLean Samuel A. 
Published: November 2016

Abstract
α2A adrenergic receptor (α2A-AR) activation has been shown in animal models to play an important role in regulating the balance of acute pain inhibition vs facilitation after both physical and psychological stress. To our knowledge, the influence of genetic variants in the gene encoding α2A-AR, ADRA2A, on acute pain outcomes in humans experiencing traumatic stress has not been assessed. In this study, we tested whether a genetic variant in the 3′UTR of ADRA2A, rs3750625, is associated with acute musculoskeletal pain (MSP) severity following motor vehicle collision (MVC, n = 948) and sexual assault (n = 84), and whether this influence was affected by stress severity. We evaluated rs3750625 because it is located in the seed binding region of miR-34a, a microRNA (miRNA) known to regulate pain and stress responses. In both cohorts, the minor allele at rs3750625 was associated with increased musculoskeletal pain in distressed individuals (stress*rs3750625 P = 0.043 for MVC cohort and P = 0.007 for sexual assault cohort). We further found that (1) miR-34a binds the 3′UTR of ADRA2A, (2) the amount of repression is greater when the minor (risk) allele is present, (3) miR-34a in the IMR-32 adrenergic neuroblastoma cell line affects ADRA2A expression, (4) miR-34a and ADRA2A are expressed in tissues known to play a role in pain and stress, (5) following forced swim stress exposure, rat peripheral nerve tissue expression changes are consistent with miR-34a regulation of ADRA2A. Together, these results suggest that ADRA2A rs3750625 contributes to poststress musculoskeletal pain severity by modulating miR-34a regulation.
Resuscitative endovascular balloon occlusion of the aorta: promise, practice, and progress?
Authors: Perkins Zane B. , Lendrum Robbie A. , Brohi Karim 
Published: November 2016

Purpose of review
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research.

Recent findings
REBOA is a feasible method of achieving temporary aortic occlusion and can be performed rapidly, with a high degree of success, in the emergency setting (including at the scene of injury) by appropriately trained clinicians. The procedure supports central perfusion, controls noncompressible haemorrhage, and may improve survival in certain profoundly shocked patient groups; but is also associated with significant risks, including ischaemic tissue damage and procedural complications. Evolutions of this strategy are being explored, with promising proof-of-concept studies in the fields of partial aortic occlusion and the combination of REBOA with extracorporeal support.

Summary
Noncompressible torso haemorrhage is the leading cause of preventable trauma deaths. The majority of these deaths occur soon after injury, often before any opportunity for definitive haemorrhage control. For a meaningful reduction in trauma mortality, novel methods of rapid haemorrhage control are required.
Survey on Clinical Practice of Primary Prophylaxis in Portal Hypertension in Children
Authors: Jeanniard‐Malet Odile , Duché Mathieu , Fabre Alexandre 
Published: November 2016

ABSTRACTPrimary prophylaxis in portal hypertension in children is controversial, because there are few studies documenting its efficacy on the risk of bleeding. Twenty‐eight centres out of the 38 we contacted returned a completed questionnaire about their clinical practices. More than 75% of the centres use endoscopy to screen patients diagnosed with portal cavernoma, biliary atresia, cystic fibrosis, and other fibrotic chronic liver diseases with suspected portal hypertension. In cases of grade 2 varices with red marks and grade 3 varices >90% of centres perform sclerotherapy or endoscopic variceal ligation. Noncardioselective beta‐blockers were used by approximately 20% of centres. In conclusion, despite the absence of scientific recommendations there is a tacit consensus concerning the need to screen children with clinical signs of portal hypertension, and to provide primary prophylaxis in cases of endoscopic patterns of high‐risk varices.
Cessation of Smoking and Alcohol Addiction Following Thalamic Hemorrhage
Authors: Najeeb Fatima , Silver Brian , Khan Muhib 
Published: November 2016

Introduction:
We describe a case of thalamic intracerebral hemorrhage leading to cessation of smoking.

Case Report:
A 53-year-old female presented to the emergency department with right-sided weakness and dysarthria. Initial systolic blood pressure was 220 mm Hg. Computed tomography scan showed a left thalamic hemorrhage with associated edema and hemorrhage extending into the left lateral and third ventricle. She recovered uneventfully and was discharged to inpatient rehabilitation and eventually transitioned home. Three months later in the clinic, she reported that following the stroke, she abruptly stopped smoking without any smoking cessation aid. She reported that she had no craving for cigarettes. She also developed an aversion to drinking alcohol.

Discussion:
Cessation of smoking following a thalamic intracerebral hemorrhage is not reported earlier. This observation suggests that the thalamus may play a role in nicotine and alcohol addiction. Further studies are needed to elucidate the possible involvement of the thalamic circuits in addiction pathways and as a potential target for modulation.
Pontine Warning Syndrome
Authors: Enriquez-Marulanda Alejandro , Amaya-Gonzalez Pablo , Orozco Jorge L. 
Published: November 2016

Introduction:
Crescendo transient ischemic attacks or “Stroke Warning Syndromes” consist of stereotyped frequent short-lasting episodes of focal neurological deficits. This is explained by intermittent hypoperfusion of the vascular territory of terminal arteries with insufficient collateral flow, presenting a high risk for subsequent infarction. Pontine warning syndrome (PWS) is a subtype of this atypical presentation of stroke/transient ischemic attack and is considered a challenge for diagnosis.

Case Report:
We describe 2 cases of patients with PWS who were admitted to our institution. They presented acute neurological deficits that fluctuated during the course of their hospitalization; interestingly, this neurological worsening and improvement was associated with blood pressure fluctuations. In both cases, brain magnetic resonance imaging revealed an ischemic lesion in the paramedian pons due to basilar artery branch disease. No outstanding infectious or metabolic factors contributed to neurological worsening/fluctuations. These patients received standard medical care without IV-thrombolysis because of the presence of contraindications for IV tissue plasminogen activator. Permissive hypertension was promoted to achieve adequate perfusion during hospitalization. At discharge and follow-up, the patients showed partial resolution from their stroke symptoms.

Conclusions:
PWS is a diagnostic and management challenge for the clinician. Because of its low incidence, this syndrome has been underestimated and understudied. There is, currently, no standard treatment for this condition; however, it is paramount, during treatment, that hypotension/hypoperfusion be avoided, with the goal being asymptomatic normotension to permissive hypertension. The probable mechanism of disease is hypoperfusion due to basilar artery branch disease and perhaps cerebral vascular dysregulation in the affected area.
Severe Relapse After Cessation of Immunosuppressive Therapy in a Patient With Neuromyelitis Optica Spectrum Disorder
Authors: Hyun Jae-Won , Kim Gayoung , Kim Yeseul , Jeong In Hye , Kim Su-Hyun , Kim Ho Jin 
Published: November 2016

Introduction:
The optimal duration of immunosuppressive therapy (IT) for neuromyelitis optica spectrum disorder (NMOSD) has not been established. Here, we report a case of severe relapse after early cessation of IT.

Case Report:
A 32-year-old woman presented with a 2-week history of intractable vomiting and hiccups followed by quadriplegia with respiratory insufficiency. Spinal cord MRI showed longitudinally extensive transverse myelitis (LETM) and aquaporin-4-immunoglobulin-G (AQP4-IgG) was positive. She was diagnosed with NMOSD and IT was initiated. She did not experience any clinical attacks during 42 months of IT and her AQP4-IgG status was negative. IT was discontinued on her own decision; 36 months later, the patient experienced a severe LETM relapse with paraplegia, and her AQP4-IgG status reverted to positive.

Conclusion:
This case suggests that clinicians should exercise caution before discontinuing effective IT in patients with NMOSD.
Dehydration Status is Associated With More Severe Hemispatial Neglect After Stroke
Authors: Bahouth Mona N. , Bahrainwala Zainab , Hillis Argye E. , Gottesman Rebecca F. 
Published: November 2016

Background:
Many stroke patients are clinically dehydrated at the time of hospital presentation, which could lead to an increase in blood viscosity and alteration in cerebral perfusion. Impaired cerebral perfusion can cause hemispheric dysfunction, which can be rapidly quantified with bedside tests of hemispatial neglect. We hypothesized that hospitalized patients with laboratory markers consistent with dehydration or a volume contracted state (VCS) would have more severe cerebral dysfunction defined by greater degree of neglect.

Methods:
Subjects were a consecutive series of right-handed patients with acute right hemispheric stroke admitted within the Johns Hopkins Health System. All participants had clinical syndrome and magnetic resonance imaging consistent with acute infarction. The primary definition of a VCS was a urea/creatinine ratio >15, with secondary definition including urine specific gravity over 1.010. Acute infarct volume was measured on magnetic resonance imaging. Neglect was evaluated using a standardized battery of bedside tests.

Results:
Of 201 patients meeting inclusion criteria, 131/201 (65%) had elevated BUN/creatinine ratios at admission. Approximately 61% (122/201) had some degree of neglect. Elevated BUN/creatinine ratio was associated with an increased odds of severe neglect in unadjusted models (OR=4.1; 95% CI, 1.2, 14.4), with loss of significance in adjusted models (OR=4.43; 95% CI, 0.99, 19.8) after adjustment for age, infarct volume, sex, and NIHSS score.

Conclusions:
Our data suggest that patients who are in a VCS at the time of stroke may have more frequent and severe neglect, with attenuation of results after adjustment for factors related to stroke size and age. If proven clinically relevant, a formalized rehydration strategy based on objective lab markers may represent an opportunity for improvement in outcome with low-cost, broadly available treatment for acute stroke patients.
Chemotherapy-associated Posterior Reversible Encephalopathy Syndrome
Authors: How Joan , Blattner Margaret , Fowler Susan , Wang-Gillam Andrea , Schindler Suzanne E. 
Published: November 2016

Introduction:There are increasing reports of posterior reversible encephalopathy syndrome (PRES) associated with the use of chemotherapeutic agents. Recognition of PRES is crucial given its reversibility with appropriate supportive management. We report a patient presenting with PRES after treatment with Rituximab, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone (R-CHOP) and intrathecal methotrexate. We also perform a systematic review of the literature on chemotherapy-associated PRES.Case Report:A 72-year-old man with recently diagnosed diffuse large B-cell lymphoma became unresponsive 4 days after initiation of R-CHOP and intrathecal methotrexate. Brain magnetic resonance imaging showed interval development of occipital and temporal fluid attenuation inversion recovery hyperintensities consistent with PRES. The patient’s blood pressure was aggressively controlled and he received 5 days of high-dose methylprednisone. He subsequently regained consciousness and his mental status gradually improved. Repeat magnetic resonance imaging showed interval resolution of the bilateral fluid attenuation inversion recovery hyperintensities.Review Summary:We performed a systematic review of the literature and included a total of 70 unique cases involving chemotherapy-associated PRES. Platinum-containing drugs, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone/R-CHOP regimens, and gemcitabine were the agents most commonly used in patients who developed suspected chemo-associated PRES. Median onset of symptoms occurred 8 days after chemotherapy. Hypertension was the most commonly reported risk factor associated with the development of chemotherapy-associated PRES. In most cases, PRES improved with supportive management alone within 2 weeks.Conclusions:Chemotherapy-associated PRES is an increasingly encountered syndrome. Both neurologists and non-neurologists should be familiar with the most commonly implicated agents, symptoms, risk factors, and clinical course of chemotherapy-associated PRES, given its favorable prognosis with appropriate management.
Histopathology of Subcapsular Cataract in a Patient with Atopic Dermatitis
Authors: Shu Daisy Yao , Ong Keith , Lovicu Frank J. 
Published: November 2016

ABSTRACT

Purpose
To report the histopathological features of anterior subcapsular cataract associated with atopic dermatitis.

Case Report
A 29-year-old man with atopic dermatitis presented with bilateral anterior subcapsular cataract. After routine cataract surgery, the anterior subcapsular cataractous tissue was obtained as an anterior capsulorhexis flap and prepared as a wholemount for histological analysis. The wholemount consisted of a well-demarcated central grayish-white plaque surrounded by transparent capsule, corroborating the slit-lamp biomicroscopic appearance. Higher magnification of the plaque revealed a fibrous and amorphous mass, most likely extracellular matrix owing to the presence of irregularly arranged bundled strands of fibrils, typical of collagen. Lens epithelial cells at the plaque were densely packed and myofibroblast-like and immunoreactive for alpha-smooth muscle actin. In contrast, lens epithelial cells more distant from the plaque retained their regular cuboidal arrangement and regular spacing, and were not labeled for alpha-smooth muscle actin, similar to lens epithelial cells obtained from a non-cataractous case.

Conclusions
The presence of alpha-smooth muscle actin-reactive elongated cells at the plaque suggests that the cuboidal lens epithelial cells making up the anterior subcapsular cataract have transdifferentiated into spindle-shaped myofibroblastic cells that produce and deposit aberrant extracellular matrix. This transdifferentiation process, more commonly known as an epithelial-mesenchymal transition, contributes to a fibrotic response leading to the development of human anterior subcapsular cataract.
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quantum dots as colouring agents of Art Nouveau and contemporary stained glass: a combined transmission electron microscopy and Raman study
Authors: Fornacelli C. , Sciau Ph. , Colomban Ph. 
Published: November 2016

The use of cadmium chalchogenide nanoprecipitates to obtain brightly coloured glasses enormously expanded by the beginning of the twentieth century, when the production of cadmium-based pigments was already well established. Six historical stained glass pieces produced between the late 1920s and modern days have been investigated in order to delineate the average size and the elemental composition of the nanocrystals. As non-invasive conditions are now mandatory when considering objects belonging to cultural heritage, Raman spectroscopy is used to measure the (average) elemental composition of the nanoparticles. Zinc substitution is also detected by the shifting of the Raman peak position. Moreover, a tentative evaluation of size distribution and crystallinity of the nanoparticles has been performed considering those parameters that are mainly influenced by the disorder of the system, such as Raman band width, surface phonons and the ratio between second and first order band intensities. A confirmation of the above-mentioned conclusion is searched by means of transmission electron microscopy (TEM) and local elemental analysis. Raman investigations allowed identifying a different and more pronounced disorder characterizing the oldest glasses, also verified by TEM observations, suggesting a different manufacture.
This article is part of the themed issue ‘Raman spectroscopy in art and archaeology’.
Virtuous colours for Mary. Identification of lapis lazuli, smalt and cochineal in the Andean colonial image of Our Lady of Copacabana (Bolivia)
Authors: Tomasini Eugenia P. , Marte Fernando , Careaga Valeria P. , Landa Carlos Rúa , Siracusano Gabriela , Maier Marta S. 
Published: November 2016

The image of Our Lady of Copacabana, a gilded polychrome sculpture carved in maguey wood in 1583, is one of the most important devotions in the Americas. In former research, we have identified the use of gypsum, Armenian bole, cerussite and atacamite in its polychromy. In this study, a red sample taken from the Virgin's tunic and a blue sample extracted from the cloak have been analysed with the aim to identify both pigments and offer insights into the painting technique. Analysis by micro-Raman spectroscopy complemented with scanning electron microscopy–energy dispersive spectroscopy and high-performance liquid chromatography allowed the identification of carmine lake in the red sample. Analysis by micro-Raman spectroscopy of the surface of the blue sample and its cross section showed the presence of smalt—the blue-glass pigment—over a cerussite layer, bathed by a very thin ultramarine layer—from a probable native origin—following a pictorial tradition that would last even until the eighteenth century. This is the first time that lapis lazuli has been scientifically identified in a Spanish American colonial painted layer.This article is part of the themed issue ‘Raman spectroscopy in art and archaeology’.