bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dry Eye Assessment in Patients With Vitamin D Deficiency
Authors: Demirci Goktug , Karaman Erdur Sevil , Ozsutcu Mustafa , Eliacik Mustafa , Olmuscelik Oktay , Aydin Rukiye , Kocabora Mehmet Selim 
Published: September 2016

Objectives:
The aim of this study was to evaluate tear film function in patients with vitamin D deficiency.

Methods:
In a single center, 60 eyes of 30 patients with vitamin D deficiency (group 1), and 60 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear break-up time (TBUT), scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity.

Results:
Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309±9 mOsm/L, 35.78±21.44 and 1.3±0.9, respectively) compared with group 2 (295±10 mOsm/L, 18.69±17.21 and 0.4±0.8, respectively) (P<0.001 for all). Schirmer I test and TBUT results in group 1 (8.5±3.7 mm and 8.7±0.6 sec, respectively) were significantly lower compared with group 2 (16.6±2.4 and 18.1±0.5, respectively) (P<0.001 for all).

Conclusions:
This study demonstrates that vitamin D deficiency is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitamin D deficiency may be prone to dry eye.
The Application of Liquid Nitrogen Spray Cryotherapy in Treatment of Bronchial Stenosis
Authors: Janke Kelly J. , Abbas Abbas El-Sayed , Ambur Vishnu , Yu Daohai 
Published: September 2016

Objective Spray cryotherapy (SCT), the application of liquid nitrogen in a noncontact form, has been demonstrated to have efficacy in treating various types of pathologic lesions of the airway when used as an adjunct with bronchoscopy. The purpose of the study was to evaluate the results of the use of bronchoscopic SCT on the airway in a single institution. Methods We performed a retrospective review of data collected on all patients who underwent SCT to re-establish or improve airway patency in an 11-month period. Patients were classified based on the nature of their disease into benign or malignant. Demographic data, change in luminal patency, and clinical outcomes were recorded. The percent of stenosis was divided into grades according to the following classification: 1, ≤25%; 2,26% to 50%; 3,51% to 75%; and 4, ≥76%. We defined successful completion of treatment as obtaining a final patency of grade 1. Results Twenty-two patients met inclusion criteria, with 45.5% (10 patients) having benign stenosis and 54.5% (12 patients) malignant. At initial bronchoscopic evaluation, the median grade of stenosis was 4 for malignant disease and 3.5 for benign disease. The median final post-treatment grade of stenosis was 2 for malignant disease and 1 for benign. The median improvement in grade of stenosis after treatment was 2 for both malignant and benign causes (Wilcoxon test, P = 0.92). Final patency of grade 1 was achieved in 42% of malignant stenosis and 80% of benign. Overall, 86.4% of patients had an improvement in grade of stenosis after treatment. The rate of morbidity was 4.5% (1/22) of all patients. Conclusions The median change in grade after treatment was 2 grades of improvement for both the benign and malignant groups. These results provide evidence that the use of SCT is equally efficacious for both types of stenosis with an expectation of overall improvement in luminal patency, offering a safe and effective method of achieving airway patency in a minimally invasive fashion. This study contributes to the small but growing body of literature supporting the use of SCT in benign and malignant disease.
Gastrointestinal Polyposis in Cowden Syndrome
Authors: Shaco-Levy Ruthy , Jasperson Kory W. , Martin Katie , Samadder N.J. , Burt Randall W. , Ying Jian , Bronner Mary P. 
Published: September 2016

Goals:
To further characterize the gastrointestinal manifestations of Cowden syndrome in clinically well-annotated patients to improve the diagnosis of this syndrome.

Background:
The gastrointestinal manifestations of Cowden Syndrome, an important heritable and multiorgan cancer syndrome, are not well defined. Proper diagnosis is essential for effective cancer surveillance and prevention in these patients.

Study:
Cowden patients with gastrointestinal polyps were selected for medical record and pathologic slide review.

Results:
Of 19 total patients, genetic testing revealed pathogenic PTEN mutations in 12. Pan-colonic (11-patients, 58%) and pan-gastrointestinal (8-patients, 42%) polyp distributions were common. Inflammatory (juvenile) polyps were the most common of the hamartomatous polyp (18 patients, 95%), along with expansive lymphoid follicle polyps (12 patients, 63%), ganglioneuromatous polyps (10 patients, 53%), and intramucosal lipomas (5 patients, 26%). The findings of 2 or more hamartomatous polyp types per patient emerged as a newly described and highly prevalent (79%) feature of Cowden syndrome. Ganglioneuromatous polyps, rare in the general population, and intramucosal lipomas, which may be unique to Cowden syndrome, should both prompt further evaluation. Colonic adenomas and adenocarcinomas were common; 10 patients (53%) had single and 3 (16%) had ≥3 adenomas, whereas 2 (11%) had colonic adenocarcinoma, strengthening the emerging association of colorectal cancer with Cowden syndrome.

Conclusions:
The clinical phenotypes and gastrointestinal manifestations in Cowden syndrome are quite variable but this series adds the following new considerations for this syndromic diagnosis: multiple gastrointestinal hamartomas, especially 2 or more hamartoma types, and any intramucosal lipomas or ganglioneuromas. These features should warrant consideration of Cowden syndrome.
A Real-World Evaluation of Repeat Paracentesis-guided Management of Spontaneous Bacterial Peritonitis
Authors: Goel Aparna , Biewald Mollie , Huprikar Shirish , Schiano Thomas , Im Gene Y. 
Published: September 2016

Background:
Spontaneous bacterial peritonitis (SBP) is a common infection in cirrhosis associated with high mortality. More than 20% of patients with SBP do not respond to initial antibiotics. Guidelines differ in recommendations to repeat paracentesis (retap) to confirm antibiotic efficacy. We aim to evaluate the effect of retap-guided management of SBP on antibiotic escalation and 30-day transplant-free survival.

Materials and Methods:
Retrospective cohort study of cirrhotic patients with SBP admitted to a single transplant center from 2010 to 2014. Patients were divided into 2 groups: retap-guided management versus no retap. Prevalence of initial antibiotic treatment failure, defined as <25% decrease in ascitic polymorphonuclear cells, and factors associated with treatment failure, antibiotic escalation and 30-day transplant-free survival were evaluated.

Results:
Out of 210 patients, 146 (age 58, 74% male, mean model for end-stage liver disease score, 25) had retap and treatment failure was noted in 28 (22%). Gram-positive bacteria accounted for 44% of all positive cultures and third-generation cepahalosporin resistance was noted in 23%. Thirty-day transplant-free survival was 72% and 62% in retap and control groups, respectively (P=0.07). Treatment failure independently doubled the 30-day mortality rate (hazard ratio: 2.15, 1.03 to 4.50, P=0.04). After adjusting for age, model for end-stage liver disease and nosocomial infection, retap-guided management was not associated with improved survival (P=0.34).

Conclusions:
The prevalence of initial treatment failure is high (22%) in patients with SBP and doubles the 30-day mortality risk, supporting recommendations to retap all patients with SBP.
The Comparison of Effectiveness of Various Potential Predictors of Response to Treatment With SSRIs in Patients With Depressive Disorder
Authors: Bares Martin , Novak Tomas , Brunovsky Martin , Kopecek Miloslav , Höschl Cyril 
Published: September 2016

Abstract
The substantial non-response rate in depressive patients indicates a continuing need to identify predictors of treatment outcome. The aim of this 6-week, open-label study was (1) to compare the efficacy of a priori defined predictors: ≥20% reduction in MADRS score at week 1, ≥20% reduction in MADRS score at week 2 (RM ≥ 20% W2), decrease of cordance (RC), and increase of serum and plasma level of brain-derived neurotrophic factor at week 1; and (2) to assess whether their combination yields higher efficacy in the prediction of response to selective serotonin re-uptake inhibitors (SSRIs) than when used singly. Twenty-one patients (55%) achieved a response to SSRIs. The RM ≥20% W2 (areas under curve—AUC = 0.83) showed better predictive efficacy compared to all other predictors with the exception of RC. The identified combined model (RM ≥ 20% W2 + RC), which predicted response with an 84% accuracy (AUC = 0.92), may be a useful tool in the prediction of response to SSRIs.
Are Children or Adolescents More at Risk for Posttraumatic Stress Reactions Following Exposure to Violence?
Authors: Neugebauer Richard , Forde Allana , Fodor Kinga E. , Fisher Prudence W. , Turner J. Blake , Stehling-Ariza Tasha , Yamabe Saori 
Published: September 2016

Abstract
Whether children or adolescents exhibit higher levels of posttraumatic stress symptoms (PTSS) in response to violence is an unresolved research question. We examine this issue in UNICEF’s 1995 National Trauma Survey (NTS) of 8–19-year-olds (n = 942) who survived the Rwandan Genocide and lived and attended schools in the community. PTSS were assessed with a symptom checklist based on DSM-IV indexed using an overall score comprising the sum of scores on all items and mean item scores of each of five distinct factors identified in a factor analysis within this sample. Eighty percent of the sample had witnessed massacres; 25%, rape/sexual mutilation. The overall symptom score among children was significantly (p < 0.05) lower than among adolescents. Among the five separate factors, this direct association of age with symptom levels held for two: re-experiencing (p < 0.001) and dysphoric arousal (p < 0.05), but not for the remaining three: avoidance, numbing, and anxious arousal. This discordance in factorial response to violence may help explain prevailing inconsistencies in the age-PTSS association reported to date.
Theory of Mind in Euthymic Bipolar Patients and First-Degree Relatives
Authors: Santos Josep Manel , Pousa Esther , Soto Estel , Comes Anna , Roura Pere , Arrufat Francesc X. , Obiols Jordi E. 
Published: September 2016

Abstract
The present study analyzed the capacity for mentalization of patients with bipolar disorder (BD) and their first-degree relatives (FDR) and examined the implications of clinical variables and cognitive deficits. The study recruited 31 patients with type I BD, 18 FDR, and 31 paired healthy controls. Their capacity for mentalization was explored by means of first- and second-order false-belief tasks, the hinting task, and the Movie for the Assessment of Social Cognition (MASC). Patients and FDR were found to have a theory of mind (ToM) deficit when they were evaluated with the MASC, which was also related to a worse neurocognitive performance and to being a patient or FDR. The evidence of ToM deficits in FDRs supports the hypothesis that these deficits could be an independent trait marker for cognitive deficit. Further research is needed on FDR of patients with BD, using sensitive ToM assessment instruments such as the MASC.
Short-Term Health-Related Quality of Life of Critically Ill Children Following Daily Sedation Interruption*
Authors: Vet Nienke J. , de Wildt Saskia N. , Verlaat Carin W. M. , Mooij Miriam G. , Tibboel Dick , de Hoog Matthijs , Buysse Corinne M. P. 
Published: September 2016

Objective:
Our earlier pediatric daily sedation interruption trial showed that daily sedation interruption in addition to protocolized sedation in critically ill children does not reduce duration of mechanical ventilation, length of stay, or amounts of sedative drugs administered when compared with protocolized sedation only, but undersedation was more frequent in the daily sedation interruption + protocolized sedation group. We now report the preplanned analysis comparing short-term health-related quality of life and posttraumatic stress symptoms between the two groups.

Design:
Preplanned prospective part of a randomized controlled trial.

Setting:
Two tertiary medical-surgical PICUs in the Netherlands.

Patients:
Critically ill children requiring mechanical ventilation.

Interventions:
None.

Measurements and Main Results:
Eight weeks after a child’s discharge from the PICU, health-related quality of life was assessed with the validated Child Health Questionnaire and, only for children above 4 years old, posttraumatic stress was assessed with the Dutch Children’s Responses to Trauma Inventory. Additionally, health-related quality of life of all study patients was compared with Dutch normative data. Of the 113 patients from two participating centers in the original study, 96 patients were eligible for follow-up and 64 patients were included (response rate, 67%). No difference was found with respect to health-related quality of life between the two study groups. None of the eight children more than 4 years old showed posttraumatic stress symptoms.

Conclusions:
Daily sedation interruption in addition to protocolized sedation for critically ill children did not seem to have an effect on short-term health-related quality of life. Also in view of the earlier found absence of effect on clinical outcome, we cannot recommend the use of daily sedation interruption + protocolized sedation.
Validation of Accelerometer Cut-Points in Children With Cerebral Palsy Aged 4 to 5 Years
Authors: Keawutan Piyapa , Bell Kristie L. , Oftedal Stina , Davies Peter S. W. , Boyd Roslyn N. 
Published: September 2016

Purpose:
To derive and validate triaxial accelerometer cut-points in children with cerebral palsy (CP) and compare these with previously established cut-points in children with typical development.

Methods:
Eighty-four children with CP aged 4 to 5 years wore the ActiGraph during a play-based gross motor function measure assessment that was video-taped for direct observation. Receiver operating characteristic and Bland-Altman plots were used for analyses.

Results:
The ActiGraph had good classification accuracy in Gross Motor Function Classification System (GMFCS) levels III and V and fair classification accuracy in GMFCS levels I, II, and IV. These results support the use of the previously established cut-points for sedentary time of 820 counts per minute in children with CP aged 4 to 5 years across all functional abilities.

Conclusions:
The cut-point provides an objective measure of sedentary and active time in children with CP. The cut-point is applicable to group data but not for individual children.
Sporting Activities and Quality of Life in Children With Hemophilia: An Observational Study
Authors: Cuesta-Barriuso Ruben , Torres-Ortuño Ana , Pérez-Alenda Sofía , José Carrasco Juan , Querol Felipe , Nieto-Munuera Joaquín 
Published: September 2016

Introduction:
Sports activities are part of multidisciplinary treatments in people with hemophilia.

Aim:
The objective of this study was to assess the incidence of sports activities in the quality of life as perceived by children with hemophilia.

Methods:
A total of 53 children with hemophilia aged 7 to 13 years and 51 children without hemophilia were evaluated. The perception of quality of life, clinical variables, and the frequency of sports activities were registered. The joint condition of patients with hemophilia was measured with the Spanish version of the Haemophilia Joint Health Score.

Results:
There were no significant differences in the perception of quality of life between children with hemophilia and children without hemophilia. Sports activities in people with hemophilia promoted a greater health satisfaction.

Conclusions:
Sports activity in children with hemophilia is associated with an improved quality of life and joint health. It is also associated with improved psychosocial wellness.
The Effects of Orthopedic Manual Physical Therapy in the Management of Juvenile Idiopathic Arthritis: A Case Report
Authors: Lantz Justin M. , Joshi Shruti , O'Hearn Michael 
Published: September 2016

Purpose:
Juvenile idiopathic arthritis (JIA) is a cause of disability in childhood. Little research exists concerning physical therapy management, and no evidence exists for orthopedic manual physical therapy (OMPT) for JIA. The purpose of this case report is to describe the use of OMPT in combination with therapeutic exercise in the successful treatment of a child with oligoarticular JIA.

Key Points:
A 6-year-old girl with oligoarticular JIA presented with elbow pain and stiffness interfering with function. Treatment consisted of OMPT in combination with therapeutic exercise and a home exercise program.

Conclusions:
Improvements were demonstrated in elbow range of motion, pain, Childhood Health Assessment Questionnaire, Pediatric Outcomes Data Collection Instrument, and the Patient Specific Functional Scale.

Recommendations for Clinical Practice:
Orthopedic manual physical therapy may be considered as a treatment of a child with JIA.

Recommendations:
We provide evidence that OMPT may be considered as a treatment of a child with JIA.
Laparoscopic Treatment of Presinusoidal Schistosomal Portal Hypertension Associated With Postoperative Endoscopic Treatment: Results of a New Approach
Authors: Colaneri Renata P. , Coelho Fabrício F. , de Cleva Roberto , Herman Paulo 
Published: September 2016

Aim:
To propose a laparoscopic treatment for schistosomal portal hypertension.

Methods:
Ten patients with schistosomiasis and portal hypertension, with previous gastrointestinal hemorrhage from esophageal varices rupture, were evaluated. Patients were subjected to a laparoscopic procedure, with ligature of splenic artery and left gastric vein. Upper gastrointestinal endoscopy was performed on the 30th postoperative day, when esophageal varices diameter was measured and band ligature performed. During follow-up, other endoscopic procedures were performed according to endoscopy findings.

Results:
There was no operative mortality. One patient had a postoperative splenic infarction that was conservatively treated. Mean hospitalization time was 5 days. During endoscopy 30 days after surgery, a decrease in variceal diameters was observed in 6 patients. During follow-up (mean 84 mo), after endoscopic therapy 8 patients had eradicated varices, but 4 presented with recurrence. Considering the late postoperative evaluation, all patients had a decrease in variceal diameters. A mean of 3.8 endoscopic banding sessions were performed per patient. Two patients presented bleeding recurrence; one had a minor bleeding episode and the other had 2 episodes of bleeding varices requiring blood transfusion. In both patients, bleeding was controlled with endoscopic therapy. No late mortality was observed.

Conclusions:
Laparoscopic ligature of the splenic artery and the left gastric vein is a promising and less-invasive method for the treatment of schistosomal portal hypertension.
Brain networks stimulation in dementia: insights from functional imaging
Authors: Pievani Michela , Pini Lorenzo , Cappa Stefano F. , Frisoni Giovanni B. 
Published: September 2016

Purpose of review
Noninvasive brain stimulation (NIBS) is increasingly used in the field of dementia as a therapeutic option; however, evidence of clinical efficacy is limited, and the mechanism of action remains unknown. This review summarizes how functional imaging could contribute to the design of targeted and effective NIBS interventions for dementia.

Recent findings
Resting-state functional magnetic resonance imaging (fMRI) has largely contributed to understanding brain dysfunction in dementia by identifying disease-specific networks. Resting-state fMRI might inform on a number of factors critical for the conduction of effective NIBS trials, such as definition of stimulation paradigms and choice of the stimulation target. In addition, fMRI may contribute to the understanding of the mechanisms of action of NIBS, and provide a tool to monitor treatment efficacy.

Summary
Functional imaging is a promising approach for the development of hypothesis-driven, targeted stimulation approaches in the field of dementia.
Leptomeningeal metastases of solid cancer
Authors: Le Rhun Emilie , Galanis Evanthia 
Published: September 2016

Purpose of review
To review recent original data on leptomeningeal metastases in patients with solid cancer.

Recent findings
Lung and breast cancer as well as melanoma remain the most common primaries. Advanced cytological methods and targeted sequencing for candidate tumor-specific mutations may improve the sensitivity of cerebrospinal fluid diagnostics in leptomeningeal metastases. Targeted treatments like epidermal growth factor receptor tyrosine kinase inhibitors for non-small cell lung cancer, anti-human epidermal growth factor receptor-2 treatments for breast cancer or B-rapidly accelerated fibrosarcoma-targeted or immunotherapy for melanoma have an emerging role in the management of this condition.

Summary
Novel diagnostic approaches and the introduction of targeted agents may improve the clinical management of patients with leptomeningeal metastases from solid cancers.
Remote effect of Insecticide-treated nets and the personal protection against malaria mosquito bites
Authors: Moiroux Nicolas , Chandre Fabrice , Hougard Jean-Marc , Corbel Vincent , Pennetier Cédric 
Published: September 2016

AbstractExperimental huts are part of the WHO process for testing and evaluation of Insecticide Treated Nets (ITN) in semi-field conditions. Experimental Hut Trials (EHTs) mostly focus on two main indicators (i.e. mortality and blood feeding reduction) that serve as efficacy criteria to obtain WHO interim recommendation. However, several other outputs that rely on counts of vectors collected in the huts are neglected although they can give useful information about vectors behavior and personal protection provided by ITNs. In particular, EHTs allow to measure the deterrent effect and personal protection of ITNs.To provide a better assessment of ITNs efficacy, we performed a retrospective analysis of the deterrence and the personal protection against malaria transmission for 12 unwashed and 13 washed ITNs evaluated through EHTs conducted in West Africa.A significant deterrent effect was shown for six of the 12 unwashed ITNs tested. When washed 20 times, only three ITNs had significant deterrent effect (Rate Ratios (RR)<1; p<0.05) and three showed an apparent “attractiveness” (RR>1; p<0.01). When compared to the untreated net, all unwashed ITNs showed lower number of blood-fedAnophelesindicating a significant personal protection (RR<1, p<0.05). However, when washed 20 times, three ITNs that were found to be attractive did not significantly reduced human-vector contact (p>0.05).Current WHO efficacy criteria do not sufficiently take into account the deterrence effect of ITNs. Moreover the deterrence variability is rarely discussed in EHT's reports. Our findings highlighted the long range effect (deterrent or attractive) of ITNs that may have significant consequences for personal/community protection against malaria transmission. Indicators measuring the deterrence should be further considered for the evaluation of ITNs.