bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polycaprolactone Antimony Nanoparticles as Drug Delivery System for Leishmaniasis
Authors: Sousa-Batista Ariane de Jesus , Cerqueira-Coutinho Cristal , do Carmo Fagner Santos , Albernaz Marta de Souza , Santos-Oliveira Ralph 
Published: December 2016

Background:
Leishmaniasis is a neglected disease endemic in tropical and subtropical areas, with an incidence about 1.6 million cases/year. The first-line treatment of this disease is pentavalent antimony, and the second-line are pentamidine and amphotericin B. All the treatments available cause severe side effects and often have difficulty in accessing parasites within infected cells.

Study Question:
This study aimed to determine if the use of nanoparticles loaded with meglumine antimoniate could reach and targeting infected organs with leishmaniasis, reducing the dosage used and promoting less adverse effects.

Study Design:
This study was performed comparing the meglumine nanoparticle in two experimental groups. The first one healthy mice and the second one inducted mice (leishmaniasis).

Measures and Outcomes:
The nanoparticles loaded with meglumine antimoniate (nanoantimony) were prepared by double-emulsion solvent evaporation method and showed a size of about 150–200 nm. BALB/c mice infected or not with Leishmania amazonensis (cutaneous leishmaniasis model) or Leishmania infantum (visceral leishmaniasis model) was used to access the biodistribution of nanoantimony and meglumine antimoniate labeled with technetium-99m.

Results:
The biodistribution profiles showed a preferential targeting of the nanoparticles to the liver, spleen, and lungs. Because these are the main organs infected, the nanoparticle may be used for this purpose. The results for cutaneous leishmaniasis showed a low uptake by the lesion (infected region).

Conclusions:
The results demonstrated the potential use of these nanoparticles to improve the efficacy of meglumine antimoniate in the treatment of visceral leishmaniasis, indicating their potential as an alternative therapeutic strategy for leishmaniasis infections.
Analysis of Immunogenetic Factors in Idiosyncratic Drug‐induced Liver Injury in the Pediatric Population
Authors: Ocete‐Hita Esther , Salmerón‐Fernández MaJ. , Urrutia‐Maldonado Emilia , Muñoz‐de‐Rueda Paloma , Salmerón‐Ruiz María , Martinez‐Padilla MaC. , Ruiz‐Extremera Angela 
Published: December 2016

ABSTRACTObjectives:Idiosyncratic drug‐induced liver injury is a multifactorial complex disease, in which the toxic potential of the drug, together with genetic and acquired factors and deficiencies in adaptive processes, which limit the extent of damage, can determine susceptibility, and make individuals unique in their development of hepatotoxicity. The aim of the present study is to analyse the genetic factors (human leukocyte antigen [HLA], cytokine polymorphisms, and killer cell immunoglobulin‐like receptor [KIR] genotype) of children who experience an episode of drug‐induced liver injury.Patients and Methods:Prospective multicentre case‐control study. The subjects included in the study were 30 paediatric patients—infants and children ages between 0 and 15 years and who presented possible liver disease associated with the intake of medicines, herbal products, drugs, or toxins. As a control group, 62 subjects were selected.Results:Although HLAC0401 and HLADQB0603 may provide a hepatoprotective mechanism in the paediatric population, HLADQA0102 and HLA‐DR*12 are more commonly found in sick children and their presence may be related to liver damage. The KIR inhibitor KIR3DL1 was not present in any child in the control group.Conclusions:Polymorphisms that are low producers of interleukin‐10 occur more frequently in children who have experienced hepatotoxicity.
The Ethical Use of Mobile Health Technology in Clinical Psychiatry
Authors: Torous John , Roberts Laura Weiss 
Published: December 2016

Abstract
The rapid rise of mobile health technologies, such as smartphone apps and wearable sensors, presents psychiatry with new tools of potential value in caring for patients. Novel diagnostic and therapeutic applications of these technologies have been developed in private industry and utilized in mental health, although these methods do not yet constitute standard of care. In this article, we provide an ethical perspective on the practical use of this novel modality by psychiatrists. We propose that in the present context of limited scientific research and regulatory oversight, mobile technologies should serve to enhance the psychiatrist-patient relationship, rather than replace it, to minimize potential clinical and ethical harm to vulnerable patients. We analyze areas of possible ethical tension between clinical practice and the consumer-driven mobile industry, and develop a decision-tree model for implementing ethical safeguards in practice, focused on managing risk to the therapeutic relationship, informed consent, confidentiality, and mutual alignment of treatment goals and expectations.
Autoimmune Encephalitides: A Broadening Field of Treatable Conditions
Authors: Kalman Bernadette 
Published: December 2016

Background:
Neurology has been continuously transforming by the refinement of molecular diagnostics and the development of disease-modifying treatments. The discovery of new antibody markers has elucidated the pathogenesis, provided the means of diagnostics, and offered cure or treatment for several immune-mediated neurological and neuropsychiatric disorders. The identification of pathogenic and marker autoantibodies has also facilitated defining the associated phenotypic spectra and the overlap among the phenotypes linked to individual immune markers.

Review Summary:
This survey presents the list of currently known autoimmune encephalitis entities along with the associated marker autoantibodies, highlights the phenotypic and immune pathogenic relationships, calls attention to the recently described rare syndromes, discusses the biological significance of the autoantibodies and targeted molecules, points out the potential postinfectious origin of immune pathogenesis in several of the disorders, and directs the readers to the latest diagnostic guidelines as well as to the generally used treatment approaches.

Conclusions and Future Directions:
Owing to the successful and usually combined use of various methods to detect serum and cerebrospinal fluid autoantibodies on rodent brain sections, in primary neuronal cell culture, in immune precipitation, and cell-based assays, or in other antigen-specific immune assays (Western blot, enzyme-linked immunosorbent assay, and radioimmune assay), the subgroup of antibody marker-negative autoimmune encephalopathy syndromes is contracting, whereas the numbers of entities within the overall group are expanding. Recognition of the correct diagnosis is becoming increasingly rewarding not only for neurologists, but also for pediatric neurologists and psychiatrists.
Fatal Morvan Syndrome Associated With Myasthenia Gravis
Authors: Nagappa Madhu , Mahadevan Anita , Sinha Sanjib , Bindu Parayil S. , Mathuranath Pavagada S. , Bineesh Cheminikara , Bharath Rose D. , Taly Arun B. 
Published: December 2016

Introduction:
Morvan syndrome is a rare and complex autoimmune disorder affecting multiple sites of neuraxis.

Case Report:
We present fulminant Morvan syndrome, developing on a background of chronic myasthenia gravis. A 54-year-old gentleman presented with fluctuating ophthalmoplegia and proximal muscles weakness of 7 years duration that remitted with pyridostigmine and prednisolone. He developed insomnia of 2 months duration, worsening of myasthenic symptoms and respiratory distress, dysautonomia, encephalopathy, and peripheral nerve hyperexcitability. Antibodies against contactin-associated protein (CASPR) 2 were detected in serum. Computed tomography of thorax showed a thymic mass. He received intravenous methyl prednisolone and plasmapheresis. Antibodies against CASPR and thymic lesion reduced with immunotherapy. However, he developed persistent hypotension and expired after 11 weeks of hospital stay.

Conclusions:
Clinical clues for diagnosis of Morvan syndrome and therapeutic changes faced by the treating team are highlighted in this report. Increased awareness and prompt testing for CASPR2 antibody is warranted so that early immunotherapy can be initiated.
Accommodation and Phoria in Children Wearing Multifocal Contact Lenses
Authors: Gong Celia R. , Troilo David , Richdale Kathryn 
Published: December 2016

ABSTRACT

Purpose
To determine the effect of multifocal contact lenses on accommodation and phoria in children.

Methods
This was a prospective, non-dispensing, randomized, crossover, single-visit study. Myopic children with normal accommodation and binocularity and no history of myopia control treatment were enrolled and fitted with CooperVision Biofinity single vision (SV) and multifocal (MF, +2.50D center distance add) contact lenses. Accommodative responses (photorefraction) and phorias (modified Thorington) were measured at four distances (>3 m, 100 cm, 40 cm, 25 cm). Secondary measures included high- and low-contrast logMAR acuity, accommodative amplitude, and facility. Differences between contact lens designs were analyzed using repeated measures regression and paired t-tests.

Results
A total of 16 subjects, aged 10 to 15 years, completed the study. There was a small decrease in high (SV: −0.08, MF: +0.01) and low illumination (SV: −0.03, MF: +0.08) (both P < .01) visual acuity, and contrast sensitivity (SV: 2.0, MF: 1.9 log units, P = .015) with multifocals. Subjects were more exophoric at 40 cm (SV: −0.41, MF: −2.06 Δ) and 25 cm (SV: −0.83, MF: −4.30 Δ) (both P < .01). With multifocals, subjects had decreased accommodative responses at distance (SV: −0.04; MF: −0.37D, P = .02), 100 cm (SV: +0.37; MF: −0.35D, P < .01), 40 cm (SV: +1.82; MF: +0.62D, P < .01), and 25 cm (SV: +3.38; MF: +1.75D, P < .01). There were no significant differences in accommodative amplitude (P = .66) or facility (P = .54).

Conclusions
Children wearing multifocal contact lenses exhibited reduced accommodative responses and more exophoria at increasingly higher accommodative demands than with single vision contact lenses. This suggests that children may be relaxing their accommodation and using the positive addition or increased depth of focus from added spherical aberration of the multifocals. Further studies are needed to evaluate other lens designs, different amounts of positive addition and aberrations, and long-term adaptation to lenses.
Penicillin-Induced Fulminant Myocarditis
Authors: Ben Khelil Mehdi , Chkirbene Youssef , Mlika Mona , Haouet Slim , Hamdoun Moncef 
Published: December 2016

Abstract
Drug-induced eosinophilic myocarditis is uncommon with few cases reported in the literature. It is a rare but potentially life-threatening disease.
We report the case of an 11-year-old girl without medical history who developed an acute malaise and chills, followed by severe shortness of breath and a cardiopulmonary arrest 1 hour after an intramuscular injection of penicillin.
At autopsy, we observed in the external examination nonspecific asphyxia signs, an injection mark, and the absence of traumatic signs. The organs examination showed a heart with a normal shape and a transmural, diffuse, tannish discoloration of the myocardium. The lungs were severely congested with a diffuse edema. Histological examination of the ventricular walls and septum revealed suggestive signs of eosinophilic myocarditis. Immunohistochemical analysis for the phenotypic characterization of the inflammatory cells revealed the positivity of the CD3 antibody without any stain for CD20.
The diagnosis of fulminant myocarditis with an eosinophilic infiltrate was established as the cause of death. The manner of death was stated as natural.
The Importance of Patient Satisfaction: A Blessing, a Curse, or Simply Irrelevant?
Authors: Cohen Justin B. , Myckatyn Terence M. , Brandt Keith 
Published: December 2016

Summary:
New regulations require that physician performance must be evaluated and graded in both objective and subjective ways. This represents a novel factor in American health care delivery driven by the reality that the United States spends more than any other nation on health care yet still lags behind in key outcome measures. Patient satisfaction has been established as a core component of physician rankings and reimbursement. In fact, it already has acted as both a powerful motivator and stressor. Patient feedback has driven hospital administrators’ agendas to improve facilities and provide relative luxuries to inpatients, and individual providers have been tempted to ignore sound medical judgment by relenting to patient requests to increase their satisfaction scores. Unfortunately, there is little high-level evidence to support that patient satisfaction will improve medical outcomes, and there are plenty of contradictory data in smaller studies. Part of the difficulty of these studies may lie in the diversity of patient expectations, which are dependent on the disease process and the inherently subjective and labile nature of people’s responses. Reliable tools are needed that will take into account what constitutes a superior quality of patient care in a more systematic, meaningful, and validated way.
Establishment of an Acquired Lymphedema Model in the Mouse Hindlimb: Technical Refinement and Molecular Characteristics
Authors: Iwasaki Daisuke , Yamamoto Yuhei , Murao Naoki , Oyama Akihiko , Funayama Emi , Furukawa Hiroshi 
Published: December 2016

Background:
The pathophysiology of secondary lymphedema remains poorly understood. This study aimed to establish a consistent mouse hindlimb lymphedema model for further investigation of the mechanism and treatment of lymphedema.

Methods:
The authors developed a novel postsurgical lymphedema model in the mouse hindlimb by modifying previously described methods. Lymphedema in the hindlimb was created by removing both the inguinal and popliteal lymph nodes together with the surrounding fat pads, followed by silicone splint placement in the inguinal region. Using this modified mouse model, the authors analyzed lymphatic function, histologic changes, and the expression of lymphangiogenic factors including vascular endothelial growth factor C at various time points.

Results:
The splinted lymphedema model showed a significant increase of edema formation in the hindlimb compared with the sham surgery control animals. Indocyanine green lymphography revealed lymphatic drainage impairment shown by dermal backflow and rerouting of lymph flow in the lymphedema model. Histopathologic and immunohistochemical examinations showed a significant increase of skin thickness and abnormally dilated lymphatics in the lymphedema model. The expression of lymphangiogenic factors in lymphedematous tissues of the splinted lymphedema model was significantly increased compared with controls, depending on the degree of lymphedema.

Conclusions:
This splinted lymphedema model closely simulates the volume response, histopathology, and lymphography characteristics of human acquired lymphedema. Given these similarities to human lymphedema, this refinement of a mouse hindlimb model of acquired lymphedema represents a promising platform for the study of lymphatic vascular insufficiency and for the evaluation of new therapeutic modalities.
Anatomy of the Facial Danger Zones: Maximizing Safety during Soft-Tissue Filler Injections
Authors: Scheuer Jack F. , Sieber David A. , Pezeshk Ronnie A. , Campbell Carey F. , Gassman Andrew A. , Rohrich Rod J. 
Published: December 2016

Summary:
With limited downtime and immediate results, facial filler injections are becoming an ever more popular alternative to surgical rejuvenation of the face. The results, and the complications, can be impressive. To maximize safety during injections, the authors have outlined general injection principles followed by pertinent anatomy within six different facial danger zones. Bearing in mind the depth and the location of the vasculature within each zone, practitioners can tailor their injection techniques to prevent vessel injury and avoid cannulation.
The Impact of Subjective Well-being on Mortality: A Meta-Analysis of Longitudinal Studies in the General Population
Authors: Martín-María Natalia , Miret Marta , Caballero Francisco Félix , Rico-Uribe Laura Alejandra , Steptoe Andrew , Chatterji Somnath , Ayuso-Mateos José Luis 
Published: December 2016

ABSTRACT

Objective
The aims of the study were to assess whether subjective well-being is a protective factor for mortality in the general population and to analyze the differential impact of evaluative, experienced, and eudaimonic well-being.

Methods
Systematic review of articles in the PsycINFO, Web of Science, and PubMed databases. Data on the studies' characteristics, quality, and the effects of variables were extracted. A meta-analysis was conducted on the studies included in the systematic review.

Results
A total of 62 articles that investigated mortality in general populations, involving 1,259,949 participants, were found, and added to those considered in a previously published review (n = 14). The meta-analysis showed that subjective well-being was a protective factor for mortality (pooled hazard ratio = 0.920; 95% confidence interval = 0.905–0.934). Although the impact of subjective well-being on survival was significant in both men and women, it was slightly more protective in men. The three aspects of subjective well-being were significant protective factors for mortality. The high level of heterogeneity and the evidences of publication bias may reduce the generalizability of these findings.

Conclusions
Our results suggest that subjective well-being is associated with a decreased risk of mortality. Longitudinal studies examining changing levels of well-being and their relationship to longevity would be required to establish a cause–effect relationship. Establishing such a causal relationship would strengthen the case for policy interventions to improve the population subjective well-being to produce longevity gains combined with optimizing quality of life.
The Detection, Analysis, and Significance of Physician Clustering in Medical Malpractice Lawsuit Payouts
Authors: Oshel Robert E. , Levitt Philip 
Published: December 2016

Objectives
There is evidence that most adverse events result from individual errors and that most malpractice suits with payouts reflect both patient injury and error. Hypothesis: There are outlier physicians with regard to the frequency and total amount of malpractice payouts.

Methods
Using the public use file of the National Practitioner Data Bank (NPDB), we sought the percentage of physicians who lay above several cutoff points with regard to total amounts of payments and number of payments. We looked at the frequency with which outliers were likely to have additional paid claims and to be disciplined by their hospitals and state boards.

Results
Approximately 1.8% of physicians were responsible for half of the $83,368,588,200 reported to the NPDB over 25 years. Within that group, 12.6% had an adverse licensure action reported to the NPDB, and 6.3% had a clinical privileges action reported. Physicians who were in the high dollar payout category and had one malpractice claim payout had a 74.5% chance of another payout, more than twice the rate for all physicians who had a single payout (chi-square, P < 0.0001). The likelihood that that physician would have additional payments increased as the number of previous payments increased. Total dollar payouts per physician better predicted future payouts than numbers of payouts. (For 1, 2, and 3 payouts, the P value was less than 0.0001 for each category.) Limitations: Neither a prospective nor a randomized study was feasible. Sorting by specialty was not done. Malpractice cases are an indirect measure of adverse events.

Conclusions
There is a clustering of payments in medical malpractice cases among a small group of physicians. These findings point up the need to oppose the negative impact of such outlier physicians on the safety of patients.
Antibiotic dosing for multidrug-resistant pathogen pneumonia
Authors: Abdul-Aziz Mohd. H. , Lipman Jeffrey , Roberts Jason A. 
Published: December 2016

Purpose of review
Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens.

Recent findings
Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections. Antibiotic dosing can be guided by plasma drug concentrations, which do not reflect the concentrations at the site of infection. The application of aggressive dosing regimens, in accordance to the antibiotic's pharmacokinetic/pharmacodynamic characteristics, may be required to ensure rapid and effective drug exposure in infected lung tissues.

Summary
Conventional antibiotic dosing increases the likelihood of therapeutic failure in critically ill patients with nosocomial pneumonia. Alternative dosing strategies, which exploit the pharmacokinetic/pharmacodynamic properties of an antibiotic, should be strongly considered to ensure optimal antibiotic exposure and better therapeutic outcomes in these patients.
Does Appearance Matter? Current Issues and Formulation of a Research Agenda for Moulage in Simulation
Authors: Stokes-Parish Jessica B. , Duvivier Robbert , Jolly Brian 
Published: December 2016

Summary StatementThe use of moulage is assumed to add realism and authentic context in simulation. Despite the expense required to utilize moulage effectively, there is little exploration in the literature as to both its necessity and its accuracy of portrayal. We explore engagement, authenticity, and realism theories in the context of moulage and highlight the need for more evidence on moulage in simulation-based education, including suggestions for future research. In particular, we urge the simulation community to move beyond descriptive papers to investigate moulage in terms of justification and clarification.
The Effects of High-Concentration Oxygen on Inflammatory Markers in Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Authors: Schietroma Mario , Colozzi Sara , Pessia Beatrice , Carlei Francesco , Amicucci Gianfranco 
Published: December 2016

Background:
This study assessed effect of administration of high-concentration supplemental perioperative oxygen on systemic inflammatory and immune response in patients undergoing elective laparoscopic cholecystectomy.

Materials and Methods:
One hundred seventy-seven patients were assigned randomly to an oxygen/air mixture with a fraction of inspired oxygen (FiO2) of 30% (n=88) or 80% (n=89). White blood cells, peripheral lymphocytes subpopulation, human leukocyte antigen-DR, neutrophil elastase, interleukin (IL)-1 and IL-6, and C-reactive protein were investigated.

Results:
Significantly higher concentration of neutrophil elastase, IL-1, IL-6 and C-reactive protein was detected postoperatively in the 30% FiO2 group patients in comparison with the 80% FiO2 group (P<0.05). Statistically significant change in human leukocyte antigen-DR expression was recorded postoperatively at 24 hours, as a reduction of this antigen expressed on monocyte surface in patients from 30% FiO2 group.

Conclusions:
This study demonstrated that high-concentration (80%) supplemental perioperative oxygen can lead to a reduction in postoperative inflammatory response and avoid postoperative immunosuppression.