bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polypoidal Choroidal Vasculopathy following Photodynamic Therapy for Choroidal Hemangioma
Authors: Tuncer S. , Demirci H. , Shields C.L. , Shields J.A. 
Published: January 2018

Purpose To report a case of circumscribed choroidal hemangioma (CCH) that responded to photodynamic therapy (PDT) but 3 years later developed polypoidal choroidal vasculopathy (PCV) with exudative retinopathy. Methods Case report. Results A 59-year-old woman with a juxtapapillary CCH in her left eye was treated with a single 83-second, 7.5 mm PDT laser spot at 689 nm (50 J/cm2) 15 minutes after the injection of intravenous verteporfin (6 mg/m2). Three years later, the patient presented with photopsia in her left eye. Fundus examination of the left eye showed CCH regressed completely to a flat atrophic scar. There was diffuse macular edema and exudative retinopathy along the inferotemporal vascular arcade. On indocyanine green angiography, there were hyperfluorescent dilated choroidal vessels inferior to the foveola with late staining and leakage consistent with PCV. Hypofluorescence superior and nasal to the optic disc at the site of the treated hemangioma, consistent with choroidal ischemia, was observed. She was treated with 1.25 mg (0.05 cc) intravitreal bevacizumab. After 21 months of follow-up, the exudative retinopathy and macular edema completely regressed. Conclusions PDT is an effective treatment for CCH. Side effects of PDT for CCH are rare but include PCV.
Acute Anticholinergic Syndrome from Atropa Belladonna Mistaken for Blueberries
Authors: Mateo Montoya A. , Mavrakanas N. , Schutz J.S. 
Published: January 2018

Purpose To report the first case in the ophthalmic literature of acute anticholinergic syndrome after ingestion of Atropa belladonna mistaken for blueberries. Methods A 36-year-old woman presented to our ophthalmic emergency department with complaints of blurry vision, lightning flashes, disorientation, loss of balance, agitation, and anxiety for 24 hours. Ophthalmic examination revealed bilateral pupillary dilatation and paresis of accommodation. Additional symptoms of the anticholinergic syndrome were elicited on further questioning. Results Anticholinergic intoxication was suspected and the patient admitted to have eaten six “blueberries” found in the forest the previous day. The patient identified Atropa belladonna as the source of the berries she had eaten when shown photographs of the plant and its fruit. The recommendations of the Swiss Toxicological Information Centre were followed and physostigmine, the antidote for severe poisoning when 10 or more berries are ingested, was not administered. Conclusions Accidental ingestion of Atropa belladonna berries may cause patients to first consult an ophthalmologist. It is important to recognize the anticholinergic syndrome caused by such intoxication in order to make a proper diagnosis, avoid unnecessary testing, and provide expedient appropriate treatment when required.
Clinical Efficacy of a Ginkgo biloba Extract in the Topical Treatment of Allergic Conjunctivitis
Authors: Russo Vincenzo , Stella Andrea , Appezzati Loredana , Barone Antonio , Stagni Edoardo , Roszkowska Anna M. , Noci Nicola Delle 
Published: January 2018

Purpose To investigate the clinical efficacy of a Ginkgo biloba extract associated with hyaluronic acid ophthalmic solution (GB-HA, Trium®, SOOFT, Italy), compared to hyaluronic acid ophthalmic solution (HA) alone, in seasonal allergic conjunctivitis (AC). Methods A total of 60 patients with symptomatic AC were enrolled and randomly assigned to the two treatment regimens. After a washout period of 15 days, the treatment with GB-HA eye-drops or HA ophthalmic solution alone was initiated and continued for 1 month. The clinical symptoms such as conjunctival hyperemia, conjunctival discharge, and chemosis, and subjective signs as itching, photophobia, stinging, and lacrimation, were evaluated before and after the treatment. A 0–4 score was used by an independent clinical observer to quantify the above parameters. Results Patients treated with GB-HA, compared to patients treated with HA alone, showed a significant decrease in the appearance of conjunctival hyperemia, conjunctival discharge, and chemosis. Furthermore, all patients treated with GB-HA showed a significant improvement of subjective symptoms, compared to HA patients. Compared to their baseline values, patients treated with HA alone showed a small but not significant improvement in only some of the clinical and subjective symptoms. Conclusions The results suggest that Ginkgo biloba extract may exert therapeutic activity in the treatment of seasonal allergic conjunctivitis. Hyaluronic acid did not exert any valuable effect on this pathology.
Why do Patients with Improved Visual Acuity Drop out of RGP Contact Lens use? Ten-Year Follow-Up Results in Patients with Scarred Corneas
Authors: Özkan Berna , Elibol Orhan , Yüksel Nurşen , Altintaş Özgül , Karabaş V. Levent , Çağlar Yusuf 
Published: January 2018

Purpose To evaluate the long-term results of rigid gas permeable (RGP) contact lenses and to investigate the reasons for patient dissatisfaction with this therapy. Methods Records of 17 patients (20 eyes) who started using RGP contact lenses for correction of irregular astigmatism due to scarred corneas between 1995 and 1996 were evaluated retrospectively. Best-corrected visual acuities with or without RGP contact lenses were noted. The mean duration of contact lens use, reasons for discontinuation of therapy, and treatment methods preferred over contact lens use were evaluated. Results The irregular astigmatisms were induced by herpetic keratitis (3 eyes), corneal trauma (5 eyes), and previous corneal infections (12 eyes). All of the patients had increase in visual acuity with RGP contact lenses (p=0.000). At the end of the follow-up it was found that only one patient was still using RGP contact lenses (5%). The mean duration for contact lens use was 21.42±4.53 SE months (2–72 months). The reasons for dropping out contact lenses were intervening surgical procedures (57.8%), loss of patient motivation (26.3%), recurrent punctate epitheliopathy (10.5%), and herpes simplex keratitis reactivation (5.2%). Conclusions RGP contact lens use is a successful method of increasing visual acuity in scarred corneas. However, patients with good visual acuity in the fellow eye find it hard to remain motivated for RGP contact lens use in the unhealthy eye. Furthermore, patients prefer permanent treatment methods even though these methods would result in decreased visual acuity.
Incidence of Hyperemia Associated with Bimatoprost Treatment in Naïve Subjects and in Subjects Previously Treated with Latanoprost
Authors: Kurtz Shimon , Mann Oran 
Published: January 2018

Purpose Bimatoprost is a potent hypotensive drug used in the treatment of glaucoma or ocular hypertension with lower target intraocular pressure (IOP) than latanoprost. Its most disturbing side effect is conjunctival hyperemia. The authors compared the extent of conjunctival hyperemia in patients receiving bimatoprost as initial therapy with that in patients whose treatment with latanoprost was replaced by bimatoprost. Methods One group of consecutive patients with newly diagnosed bilateral primary open-angle glaucoma (POAG) was treated with once daily bimatoprost 0.03% ophthalmic solution as initial therapy. Treatment in another group of patients who had been on latanoprost treatment for at least 3 months was replaced by bimatoprost 0.03%. Conjunctival hyperemia was assessed by a single masked observer using a five-point grading scale. Results The mean ± SD baseline hyperemia scores were 0.4±0.3 and 0.70±0.3 for the firstline and replacement groups, respectively. Following 3 weeks of treatment, the mean post-treatment conjunctival hyperemia scores were 2.3±1 and 1.1±0.5, respectively. IOP of 25.2±9.8 mmHg and 18.95±2.1 mmHg dropped to 18.79±2.13 mmHg and 18.23±1.95 mmHg, respectively, following bimatoprost therapy. The differences in baseline levels of hyperemia for each group were not statistically significant (p=0.478). Changes in hyperemia scores from baseline were highly significant (p<0.001) only in first-line therapy patients (p=0.02 for the replacement group). Conclusions The above findings suggest that patients already on prostaglandin therapy may be less likely to experience an increase in conjunctival hyperemia induced by bimatoprost.
Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Patients with Uncontrolled Open-Angle Glaucoma
Authors: Russo Vincenzo , Barone Antonio , Cosma Annesa , Stella Andrea , Noci Nicola Delle 
Published: January 2018

Purpose To compare the efficacy of selective laser trabeculoplasty (SLT) to argon laser trabeculoplasty (ALT) as treatment and retreatment to lower intraocular pressure (IOP) in patients with uncontrolled open-angle glaucoma (OAG) on maximally tolerated medication therapy with a follow-up of 12 months. Methods A total of 120 eyes of 120 patients with uncontrolled OAG were enrolled in the study. Group A included patients with IOP >22 mmHg on maximal medical therapy. A total of 43 eyes underwent SLT treatment and 41 eyes underwent ALT treatment. At the end of the follow-up IOP was <18 mmHg. Group B included patients with IOP >20 mmHg at 3 months follow-up after SLT or ALT treatment. These patients were retreated randomly, 18 with SLT and 18 with ALT. Results In Group A at the end of the follow-up there was no statistically significant difference in IOP lowering between SLT (6.01 mmHg) and ALT (6.12) (p=0.794). In Group B at the end of the follow-up patients undergoing SLT presented IOP lowering statistically significant to ALT treatment (6.24 mmHg and 4.65 mmHg, respectively, p<0.01). Discussion SLT is effective as treatment for patients with OAG and appears to be equivalent to ALT in IOP lowering at 12 months only in patients without a prior treatment. In case of retreatment SLT appears to be better than ALT in IOP lowering.
Rifabutin Corneal Deposits in a Patient with Acquired Immunodeficiency Syndrome: In Vivo Confocal Microscopy Investigation
Authors: Mazzotta Cosimo , Traversi Claudio , Nuti Elisabetta , Sparano Maria Caterina , Caporossi Aldo 
Published: January 2018

Purpose To establish the real localization of rifabutin-related corneal deposits in a patient with human immunodeficiency virus (HIV) infection by in vivo HRT II confocal microscopy with related clinicopathologic implications. Methods Observational case report. After Siena University Institutional Review Board approval in May 2008 and specific informed consent, a 54-year-old patient with HIV infection under rifabutin treatment for acquired immunodeficiency syndrome–related Mycobacterium avium complex prevention who developed diffuse corneal deposits was examined at the Department of Ophthalmology of Siena University. He underwent a complete clinical eye examination, biomicroscopy, and digital slit lamp photographs, endothelial specular microscopy, ultrasound pachymetry, and confocal microscopy by HRT II system. Results Confocal scans revealed the presence of deep stromal and pre descemetic hyperreflective polymorphous deposits. In vivo confocal examination excluded the presence of rifabutin-related deposits at endothelial level. Conclusions Confocal microscopy enables establishment of the real localization of rifabutin deposits at deep stromal level, providing a better qualitative analysis of all corneal layers compared to biomicroscopic examination, with clinical and physiopathologic implications.
Acute Reversible Charles Bonnet syndrome Precipitated by Sudden Severe Anemia
Authors: Kaeser Pierre-François , Borruat François-Xavier 
Published: January 2018

Purpose To report the sudden onset of reversible Charles Bonnet syndrome precipitated by acute severe anemia. Methods The charts of three patients (Usher syndrome, bilateral macular degeneration, and bilateral retinal vein occlusion) with acute Charles Bonnet syndrome in the setting of severe anemia were reviewed. Results Anemia resulted from bladder surgery, recto-colitis, and severe urinary tract infection. Hemoglobin ranged from 78 to 86 g/L. Decreased visual acuity and formed visual hallucinations (giants, flowers, animals) were present in all three patients. Rapid reversal of Charles Bonnet syndrome and visual acuity improvement followed blood transfusion. Conclusions Acute severe anemia can precipitate Charles Bonnet syndrome, which may be reversible by blood transfusion.
Pattern Reversal Electroretinograms in Patients with Unilateral Idiopathic Full Thickness Macular Holes
Authors: Gündüz K. 
Published: January 2018

Purpose To discover the effect of detachment of the posterior vitreous cortex on pattern electroretinogram (PERG) P50 amplitudes in the uninvolved fellow eyes (FE) of patients with macular holes (MH), and to determine the prognostic value of the PERG in identifying the FE of patients with MH that could be at risk for the development of a MH. Methods PERGs were recorded using 12' and 46' checkboard stimulus reversing at 5 Hz in 18 patients selected from a cohort of 37 patients with unilateral idiopathic full thickness MH, and in age-matched controls (AMC). Contact lens biomicroscopy with a Goldmann contact lens and kinetic B-scan ultrasonography were performed bilaterally in both patients and AMC. Results The P50 amplitudes with checks of 12′ and 46′ were significantly lower in eyes with MH than in the uninvolved FE and AMC. There was a significant reduction in the P50 amplitudes in the FE compared to the AMC with checks of 12′, but there was no significant reduction with checks of 46′. In the FE with posterior vitreous detachment (PVD) (eleven cases), the P50 amplitudes with checks of 12' were greater than in the eyes without PVD. With checks of 46', there was no significant difference in eyes with and without PVD. Conclusions These data suggest that subclinical macular pathology in the FE of MH probably resulting from vitreous traction can be demonstrated by PERG using small check size stimulus.
Automatic Intracranial Segmentation: Is the Clinician Still Needed?
Authors: Meillan Nicolas , Bibault Jean-Emmanuel , Vautier Julien , Daveau-Bergerault Caroline , Kreps Sarah , Tournat Hélène , Durdux Catherine , Giraud Philippe 
Published: January 2018

Introduction: Stereotactic hypofractionated radiotherapy is an effective treatment for brain metastases in oligometastatic patients. Its planning is however time-consuming because of the number of organs at risk to be manually segmented. This study evaluates 2 automated segmentation commercial software. Methods: Patients were scanned in the treatment position. The computed tomography scan was registered on a magnetic resonance imaging and volumes were manually segmented by a clinician. Then 2 automated segmentations were performed (with iPlan and Smart Segmentation). RT STRUCT files were compared with Aquilab’s Artistruct segment comparison module. We selected common segmented volume ratio as the main judging criterion. Secondary criteria were Dice-Sørensen coefficients, overlap ratio, and additional segmented volume. Results: Twenty consecutive patients were included. Agreement between manual and automated contouring was poor. Common segmented volumes ranged from 7.71% to 82.54%, Dice-Sørensen coefficient ranged from 0.0745 to 0.8398, overlap ratio ranged from 0.0414 to 0.7275, and additional segmented volume ranged from 9.80% to 92.25%. Each software outperformed the other on some organs while performing worse on others. Conclusion: No software seemed clearly better than the other. Common segmented volumes were much too low for routine use in stereotactic hypofractionated brain radiotherapy. Manual editing is still needed.
The Role of Big Endothelin-1 in Colorectal Cancer
Authors: Arun C. , Swift B. , Porter K.E. , West K.P. , London N.J.M. , Hemingway D.M. 
Published: January 2018

Introduction Changes in liver blood flow caused by an unknown splanchnic vasoconstrictor have been noted in colorectal cancer patients with liver metastases. This prospective study was performed to assess whether plasma levels of big endothelin-1 (big ET-1) were raised in patients with colorectal cancer. Methods Plasma samples from peripheral vein of patients who underwent surgery for primary colorectal cancer (n=60) and those with known colorectal liver metastases (n=45) for a period of 15 months were taken prior to treatment and compared to age- and sex-matched controls (n=20). Plasma samples were analysed by using a single-step sandwich enzyme immunoassay. Immunohistochemistry and in situ hybridisation were also performed on tumour sections to investigate the expression of ET-1 by cancer cells. Results The median (range) plasma concentration of big ET-1 in controls was 2.1 pg/mL (1.2–13.4 pg/mL). The median (range) plasma concentration of big ET-1 in colorectal cancer patients with no overt hepatic metastases was 3.8 pg/mL (1.2–15.8 pg/mL), p=0.002, and the median (range) plasma concentration of big ET-1 in colorectal cancer patients with hepatic metastases was 5.2 pg/mL (1.7–30 pg/mL), p=0.0001; both were significantly elevated compared to the control group. A significant difference in immunostaining for big ET-1 was noted between paired normal colonic mucosa (median score-1) and tumour sections (median score-3), p=0.01. Conclusion This study has demonstrated elevated concentrations of big ET-1 in colorectal cancer patients, especially in those with hepatic metastases. Upregulation of ET activity in colorectal cancer could be inferred by the increased immunostaining of big ET-1 in cancer cells. Therefore, plasma big ET-1 levels should be evaluated as a potential tumour marker for the identification of hepatic metastases at an earlier stage.
The Integrated Oncology Program of the Italian Ministry of Health
Authors: Paradiso Angelo , Mangia Anita , Orlando Claudio , Verderio Paolo , Belfiglio Maurizio , Marchetti Antonio , Bertario Lucio , Chiappetta Gennaro , Gion Massimo , Tonini Gian Paolo , Podo Franca , Vocaturo Amina , Silvestrini Rosella 
Published: January 2018

In 2007, an Italian cancer research group proposed a specific concerted action aimed at the “analytical and clinical validation of new biomarkers for early diagnosis: Network, resources, methodology, quality control, and data analysis.” The proposal united 37 national operative units involved in different biomarker studies and it created a strong coordinative body with the necessary expertise in methodologies, statistical analysis, quality control, and biological resources to perform ad hoc validation studies for new biomarkers of early cancer diagnosis. The action, financed by the Italian Ministry of Health within the Integrated Oncology Program (PIO) coordinated by NCI-Istituto Tumori Bari, started in 2007 and activated 7 projects, each of which focused on disease-specific biomarker studies. Overall, the 37 participating units proposed studies on 50 biomarkers, including analytical and clinical validation procedures. Clusters of units were specifically involved in research of early-detection biomarkers for cancers of the lung, digestive tract, prostate/bladder, and nervous system, as well as female cancers. Furthermore, a cluster involved in biomarkers for bioimaging and infection-related cancers was created. The first investigators' meeting, “Analytical and clinical validation of new biomarkers for early diagnosis,” was held on 9 September 2008 in Bari. During this meeting, methodological aspects, scientific programs and preliminary results were presented and discussed.
Interferon gamma, an important marker of response to immune checkpoint blockade in non-small cell lung cancer and melanoma patients
Authors: Karachaliou Niki , Gonzalez-Cao Maria , Crespo Guillermo , Drozdowskyj Ana , Aldeguer Erika , Gimenez-Capitan Ana , Teixido Cristina , Molina-Vila Miguel Angel , Viteri Santiago , De Los Llanos Gil Maria , Algarra Salvador Martin , Perez-Ruiz Elisabeth , Marquez-Rodas Ivan , Rodriguez-Abreu Delvys , Blanco Remedios , Puertolas Teresa , Royo Maria Angeles , Rosell Rafael 
Published: January 2018

Background: Programmed death-ligand 1 (PD-L1) may be induced by oncogenic signals or can be upregulated via interferon gamma (IFN-γ). We have explored whether the expression of IFNG, the gene encoding IFN-γ, is associated with clinical response to the immune checkpoint blockade in non-small cell lung cancer (NSCLC) and melanoma patients. The role of inflammation-associated transcription factors STAT3, IKBKE, STAT1 and other associated genes has also been examined. Methods: Total RNA from 17 NSCLC and 21 melanoma patients was analyzed by quantitative reverse transcription PCR. STAT3 and Rantes, YAP1 and CXCL5, DNMT1, RIG1 and TET1, EOMES, IFNG, PD-L1 and CTLA4, IKBKE and NFATC1 mRNA were examined. PD-L1 protein expression in tumor and immune cells and stromal infiltration of CD8+ T-cells were also evaluated. Progression-free survival and overall survival were estimated. Results: A total of 17 NSCLC patients received nivolumab and 21 melanoma patients received pembrolizumab. Progression-free survival with nivolumab was significantly longer in NSCLC patients with high versus low IFNG expression (5.1 months versus 2 months, p = 0.0124). Progression-free survival with pembrolizumab was significantly longer in melanoma patients with high versus low IFNG expression (5.0 months versus 1.9 months, p = 0.0099). Significantly longer overall survival was observed for melanoma patients with high versus low IFNG expression (not reached versus 10.2 months p = 0.0183). There was a trend for longer overall survival for NSCLC patients with high versus low IFNG expression. Conclusions: IFN-γ is an important marker for prediction of response to immune checkpoint blockade. Further research is warranted in order to validate whether IFNG is more accurate than PD-L1.
Transatlantic Differences in Management of Carotid Stenosis: BRIDGing the Gap in StrokE Management (BRIDGE) Project
Authors: Balucani Clotilde , Arnedo Vanessa , Weedon Jeremy , Leys Didier , Mas Jean-Louis , Brown Martin , Grotta James C. , Gonzales Nicole R. , Hacke Werner , Brott Thomas , Levine Steven R. 
Published: January 2018

Background and Purpose: Management of carotid stenosis remains controversial despite several trials evaluating carotid endarterectomy (CEA) and carotid angioplasty/stenting (CAS). We compared attitudes in the management of carotid stenosis between selected experts within Europe and North America. Methods: A 3-phase Delphi survey was e-mailed to select stroke experts from Europe (n = 390) and North America (n = 289). Those completing the initial survey were shown all responses after each survey round. Consensus was defined as ≥80% agreement. Results: For phases 1, 2, and 3, response rates were 32%, 62%, and 73%, respectively. Overall, 100 (15%) of 679 participated in all 3 phases, 19% Europeans versus 9% North Americans ( P = .0007). The European group reached consensus in 6 of 15 statements; The North American group reached consensus in 4 of 15. Ninety percentage of Europeans versus 70% of North Americans ( P = .017) stated CEA is superior to CAS for symptomatic carotid stenosis. This difference was not significant in the final model (adjusted odds ratio: 3.72 [95% confidence interval: 0.95-14.5]). Sixty-nine percentage of North Americans agreed there is a stronger indication for CAS over CEA in patients younger than 65 years for symptomatic carotid stenosis, whereas 55% of Europeans ( P = .023) disagreed. For asymptomatic carotid stenosis, when asked how likely they would recommend CAS, 62% North Americans said “sometimes” versus 60% of Europeans said “never” ( P = .06). Conclusion: The majority of North American and European respondents did not consider the 2 procedures equivalent and seemed to indicate that CEA was preferred for the management of carotid stenosis. These findings need to be further explored to help establish evidence-based guidelines.