bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Choroidal Thickness and Corneal Parameters in Diabetic Eyes
Authors: Galgauskas Saulius , Laurinavičiūtė Guoda , Norvydaitė Dovilė , Stech Simona , Ašoklis Rimvydas 
Published: October 2015

Purpose To evaluate the effect of diabetes mellitus (DM) on central corneal thickness (CCT), corneal endothelial parameters (endothelial cell density [ECD], average size [AVE], hexagonality [A6], polymegathism [SD]), and subfoveal choroidal thickness (SFCT), and to determine whether these parameters depend on the duration of DM and hemoglobin A1c (HbA1c) level. Methods A total of 62 patients with type 2 DM and 65 healthy subjects were examined using a noncontact specular microscope, A-scan ultrasound, and spectral-domain optical coherence tomography. The study parameters included medical history, age, eye axial length, CCT, ECD, AVE, A6, SD, and SFCT. The duration of DM and HbA1c level of the 2 latest tests were noted. Results The SFCT (258.0 ± 74.4 µm) and ECD (2721.8 ± 264.1 cells/mm2) were significantly lower, and the CCT (566.7 ± 35.7 µm) higher, in diabetic patients than in the control group (313.1 ± 88.5 µm, 2967.3 ± 220.6 cells/mm2, 550.0 ± 56.4 µm, respectively) (p<0.05). There were no differences in age, sex, or axial length between the diabetic and control groups (p>0.05). Diabetic retinopathy and macular edema did not influence SFCT significantly (p>0.05). No differences in endothelial parameters between groups and no correlations among HbA1c, duration of DM, and any of the examined parameters were found (p>0.05). Conclusions Diabetic patients have thicker corneas, lower ECD, and thinner subfoveal choroid than healthy subjects.
The Clinical Utility of Measuring the Macular Outer Retinal Thickness in Patients with Glaucoma
Authors: Kita Yoshiyuki , Anraku Ayako , Kita Ritsuko , Goldberg Ivan 
Published: October 2015

Purpose Few optical coherence tomography (OCT) studies have investigated outer retinal thickness including the photoreceptor layer in glaucoma. We measured changes in the macular outer retinal thicknesses using OCT in patients with glaucoma with an average follow-up of 2.9 ± 0.8 years. Methods A total of 39 eyes of 39 patients with primary open-angle glaucoma were analyzed. The RTVue-100 was used to measure the macular outer retinal, macular ganglion cell complex, and circumpapillary retinal nerve fiber layer thicknesses, global loss volume, and focal loss volume. Using the paired t test, baseline parameters were compared with those at the last follow-up. Results The average baseline mean deviation value in the Humphrey Field Analyzer was −2.13 dB. The ganglion cell complex thickness significantly decreased over the follow-up period (baseline thickness, 79.66 ± 7.71 μm; final thickness, 76.79 ± 7.39 μm; p<0.001). There were significant differences between baseline and final visit measurements for circumpapillary retinal nerve fiber layer thickness, global loss volume, and focal loss volume (p<0.001, p<0.001, and p = 0.004, respectively). However, there was no significant change in outer retinal thickness (baseline thickness, 167.56 ± 7.26 μm; final thickness, 167.25 ± 7.93 μm; p = 0.540). Conclusions Outer retinal thickness was not altered during the follow-up period. The stability of outer retinal thickness may indicate the reliability of OCT analysis for glaucoma follow-up.
Sudden Occurrence of Roth Spots and Retinal Hemorrhages following Endoscopic Adhesiolysis: An SD-OCT Evaluation
Authors: Dell'Arti Laura , Barteselli Giulio , Pinna Valentina , Invernizzi Alessandro , Mapelli Chiara , Viola Francesco 
Published: October 2015

Purpose To document the occurrence of Roth spots and retinal hemorrhages by spectral-domain optical coherence tomography (SD-OCT) following endoscopic adhesiolysis for failed back surgery syndrome. Methods Case report. Results A 47-year-old patient noted progressive and bilateral visual loss immediately after epidural endoscopy and endoscopic adhesiolysis. Funduscopic examination showed multiple Roth spots and retinal hemorrhages at the posterior pole and the retinal midperiphery in both eyes. Spectral-domain optical coherence tomography demonstrated that Roth spots involved the inner retina, while dot hemorrhages involved the outer retina. Most retinal hemorrhages and Roth spots resolved over 6 weeks, with complete functional recovery in both eyes. However, SD-OCT revealed multiple areas of disruption of the outer retinal layers in the left eye. Conclusions Roth spots and retinal hemorrhages can occur after endoscopic spinal surgery. Although hemorrhages resolve quickly over few weeks, SD-OCT can demonstrate that retinal damage might persist, especially in the outer retina. This finding may explain cases of incomplete recovery of visual function after complicated endoscopic adhesiolysis.
Intravitreal Injection of Recombinant Tissue Plasminogen Activator in Submacular Hemorrhage: Case Series
Authors: Araújo Joana , Sousa Cristina , Faria Pedro Alves , Carneiro Ângela , Rocha-Sousa Amândio , Falcão-Reis Fernando 
Published: October 2015

Purpose To report the safety and efficacy of intravitreal recombinant tissue plasminogen activator (rtPA) with gas for managing submacular hemorrhage. Methods Patients with submacular hemorrhage centered in or close to the fovea underwent hemorrhage displacement with intravitreal injection of rtPA (50 μg/0.05 mL) followed by gas injection (0.3 mL SF6). Anatomic and visual outcomes are described. Results Exudative age-related macular degeneration (AMD) (n = 4) and blunt trauma (n = 2) were the etiologies of submacular hemorrhage in this sample. Intravitreal injection of rtPA decreased the extent of submacular hemorrhage in all eyes, with complete hemorrhage displacement in 2 and partial displacement in 4. Visual acuity remained stable (n = 4) or improved (n = 2) after the procedure. Improvements in anatomic and visual outcomes were less evident in exudative AMD cases, which also had longer hemorrhage duration. Recurrence occurred only in 1 eye. No evident rtPA-associated retinal toxicity was observed. Conclusions Untreated submacular hemorrhage has poor visual prognosis. Our results suggest that rtPA injection is a minimally invasive, simple, inexpensive procedure with few related complications. Cost-benefit of this injection seems acceptable.
Receiver Operating Characteristic Curve to Predict Anti-VEGF Resistance in Retinal Vein Occlusions and Efficacy of Ozurdex
Authors: Wolfe Jeremy D. , Shah Ankoor R. , Yonekawa Yoshihiro , Faran Abdulrahman Al , Franklin Michael S. , Abbey Ashkan M. , Capone Antonio 
Published: October 2015

Purpose Current treatment paradigms for macular edema associated with retinal vein occlusions (RVO) often involve initial treatment with anti-vascular endothelial growth factor (VEGF) agents, then switching to intravitreal dexamethasone implant (IDI; Ozurdex, Allergan, Parsippany, NJ) for poor responders. However, many patients undergo multiple injections prior to being declared a nonresponder. We devised a method for prediction of poor anti-VEGF response after one injection, and show that these patients subsequently respond well to IDI. Methods This study is a retrospective consecutive interventional case series of patients with RVO receiving anti-VEGF agents that were switched to IDI. Patients were categorized as nonresponders to anti-VEGF agents (edema did not improve) or responders (edema improved, but switched to IDI for longer treatment duration). Receiver operating characteristics (ROC) curve analysis was used to determine cutoffs of reduction in central retinal thickness (CRT) to predict poor response to anti-VEGF treatment. Results Twenty-three patients met inclusion criteria. There were 14 nonresponders and 9 responders. The ROC curve analysis found that the maximal sensitivity and specificity in correctly identifying responders to anti-VEGF therapy was those with >25% reduction in CRT 1 month after 1 anti-VEGF treatment (sensitivity 0.89, specificity 0.79, area under the curve 0.93). After IDI placement, anti-VEGF nonresponders showed significant improvement in visual acuity (VA) (p = 0.02) and CRT (p = 0.01). Conclusions In patients with macular edema secondary to RVOs, a reduction in CRT by ≤25%, 1 month after 1 anti-VEGF injection, is predictive of poor response to anti-VEGF treatment. These patients may benefit from earlier conversion to IDI treatment, which in our study, resulted in improved VA and CRT.
Metal Ion Levels in Ceramic-on-Ceramic THR with Modular Necks: Analysis of Cobalt and Chromium Serum Levels in 30 Healthy Hip Patients
Authors: Somers Jan F.A. 
Published: October 2015

Background Modular necks in total hip replacement (THR) can be a source of metal ion release. There are no data to date on the level of cobalt and chromium ions in the serum of patients with a cobalt-chrome stem and a titanium modular neck. Methods Serum ion levels were measured in healthy volunteers with a well-functioning ceramic-on-ceramic THR. Results Average cobalt in serum was 1.21 µg/l for unilateral THR and 2.2 µg/l for bilateral THR. No patient had cobalt levels higher than 2.4 µg/l. No patient had measurable chromium levels. There were no differences in cobalt levels for hips with short necks versus hips with long necks. Conclusions The hybrid THR Profemur® Xm – Procotyl® L with a titanium modular neck on a cobalt-chrome stem design shows no signs of abnormal toxic ion levels (cobalt or chromium) in a randomly selected group of well-functioning hip patients.
Patients’ Perception of Leg Length Discrepancy Post Total Hip Arthroplasty
Authors: Sykes Alice , Hill Janet , Orr John , Humphreys Patricia , Rooney Aidan , Morrow Esther , Beverland David 
Published: October 2015

Perception of a leg length discrepancy post total hip arthroplasty (THA) is one of the most common sources of patient dissatisfaction and can have a direct influence on the considered success of the operation. This research examined postoperative perception of imposed limb discrepancies in a group of THA patients compared to a group of participants with no previous hip surgery. Two subgroups of THA patients were involved: those who did not perceive a difference in limb length following THA and those that did. Discrepancies were imposed in 2.5 mm increments. For discrepancies ≥5 mm, a significant number of participants were aware of a difference (74%). There was no significant difference in perception of imposed discrepancies between THA patients and participants with no previous hip surgery. THA patients who perceived a difference in their limb lengths postoperatively had significantly worse pain and oxford scores when compared to THA patients who perceived their limb lengths to be equal. Knowing the boundaries between LLDs that go undetected and those that patients are aware of could guide surgeons when evaluating the balance between correct soft tissue tension and the resulting unequal leg length. From these findings, discrepancies >5 mm are likely to be perceived. Whether this perception would lead directly to a negative outcome score and patient dissatisfaction is more complex to project and likely to be patient specific. Intraoperative methods to aid the controlled positioning of implanted components could help maintain and restore leg length to within an acceptable amount that patients cannot perceive.
Late Complications and Long-Term Outcomes following Aseptic Revision of a Hip Arthroplasty Performed for Oncological Resection
Authors: Houdek Matthew T. , Wagner Eric R. , Wilke Benjamin K. , Wyles Cody C. , Taunton Michael J. , Sim Franklin H. 
Published: October 2015

Purpose In order to achieve an oncological margin during limb salvage surgery for tumours around the hip, part or the entire hip joint is frequently sacrificed. Hip arthroplasty restores a functional extremity and achieves limb salvage. Currently there is a paucity of data concerning the late complications, long-term survival, and the risks of re-revision following aseptic revision of a total hip arthroplasty (THA) performed following an oncological resection. Methods We identified 78 patients who underwent aseptic revision of a THA which was performed for an oncological process involving the hip from 1972 to 2006. All patients had a minimum 5 years of follow-up with a mean of 13 years. Outcomes were compared to 1,378 patients undergoing aseptic revision of a THA that was performed for a diagnosis of osteoarthritis. Results The mean 5-, 10-, 15-, and 20-year re-revision-free survival for an oncologic process of the hip was 100%, 85%, 69%, and 57%. Within this cohort, younger patients were at an increased risk of revision surgery. There was no difference in survivorship of the revision implant at any of the aforementioned time points between the oncologic and osteoarthritis cohorts. Patients with an oncologic diagnosis had a higher rate of dislocations, component wear, and loosening compared to the osteoarthritis group. Conclusion Late complications following revision surgery of THA performed for an oncologic resection are common. The results of this study provide information for counselling patients on implant survivorship and complications following aseptic revision THA after index surgery for an oncologic indication.
Vulvar Necrosis after Surgical Treatment of Femoral Neck Fracture: A Case Report and Investigation of the Mechanism of Injury
Authors: Chantalat Elodie , Debonnecaze Guillaume , Cavaignac Etienne , Chaynes Patrick , Vidal Fabien 
Published: October 2015

We report the case of a young patient, presenting with total bilateral vulvar necrosis after reduction of a femoral neck fracture. This report describes the management of this complication, its mechanism of injury and the associated means of prevention. We present an investigation of the vulvar vasculature in order to understand the mechanism of injury. The study of the vulvar vasculature rejects the anatomical hypothesis of selective damage to the internal and external arteries. Instead, it suggests intraoperative impingement of the terminal blood vessels caused by compression against the perineal post prompting discussion on the use of moulded countertraction posts during orthopaedic surgery.
Dual Mobility Cups: An Effective Prosthesis in Revision Total Hip Arthroplasties for Preventing Dislocations
Authors: Jauregui Julio J. , Pierce Todd P. , Elmallah Randa K. , Cherian Jeffrey J. , Delanois Ronald E. , Mont Michael A. 
Published: October 2015

Purpose Postoperative dislocation is one of the most common complications following total hip arthroplasty (THA), and dual mobility articulations have been designed to provide greater hip stability. However, there are few studies that have assessed outcomes of these designs in revision THAs. Our purpose was to evaluate differences in dislocation rates, aseptic survivorship, and patient outcomes between dual mobility articulations and conventional arthroplasties in the revision setting. Methods Patients who underwent revision THA with dual mobility articulations (n = 60) were matched (1:2) to patients who had conventional single articulation prostheses (n = 120). They were matched for body mass index, age, gender, and Paprosky acetabular defect classification, and were followed up for a mean of 30 months (range, 18 to 52 months). The outcomes were evaluated preoperatively and at final follow-up using Harris Hip Scores, the University of California Los Angeles activity scale, and the Short Form-36 questionnaires. Results The dual mobility group had lower dislocation (1.7% (1 out of 60) versus 5.8% (7 out of 120)) and aseptic loosening rates (1.7% (1 out of 60) versus 4.2% (5 out of 120)) compared to the control group. There were no significant differences in functional outcomes, activity level, or overall physical and mental health status between the 2 cohorts. Conclusions When used in the revision setting, dual mobility bearings had fewer dislocations. We believe that these designs may lead to clinically significant improvements in complications while also improving patient reported and functional outcomes, but larger cohort studies are necessary for evaluation.
Slipped Capital Femoral Epiphysis: Long-Term Outcome and Remodelling after in Situ Fixation
Authors: Reinhardt Max , Stauner Kerstin , Schuh Alexander , Steger Wolfgang , Schraml Annemarie 
Published: October 2015

Purpose In primary treatment of slipped capital femoral epiphysis (SCFE) in situ fixation reliably prevents slip progression. The aim of this study was to examine the long-term outcome of SCFE-patients treated by transfixation with Kirschner wires with a special focus on the remodelling process of the hips under this fixation method. Methods 30 patients with stable SCFE (mean initial slip angle: 29°, mean follow-up: 10 years), who were treated with bilateral transfixation by Kirschner wires, were recruited for this study. At most recent follow-up patients were clinically and radiologically (X-ray and MRI) examined. Medical records were reviewed for previous follow-up time points. Results Range of motion: At most recent follow-up the mean range of motion was: extension/flexion: 0/0/121, abduction/adduction: 44/0/31, external rotation/internal rotation: 39/0/24. Nearly all dimensions of motion significantly improved during the postoperative course. Head-shaft angle: We saw a significant reduction of the mean head-shaft angle from 29° preoperatively to 11° at most recent follow-up (p<0.0001). Harris Hip Score (HHS): 24 patients had an excellent, 3 a good, 2 a fair and 1 a poor outcome defined by HHS. Remodelling: At most recent follow-up 25 patients achieved complete remodelling. The remodelling process took place especially during the first postoperative year. Angle alpha: The mean angle alpha of the affected hips at most recent follow-up was 62°. Conclusions Transfixation with Kirschner wires leads to very good clinical, functional and radiologic results with a low complication rate. Furthermore the femoral head-neck junction retains enough plasticity for an active remodelling process.
Hip Arthroscopy in Osteoarthritis: A Systematic Review of the Literature
Authors: Piuzzi Nicolas S. , Slullitel Pablo A.I. , Bertona Agustin , Oñativia Ignacio J. , Albergo Ignacio , Zanotti Gerardo , Buttaro Martin A. , Piccaluga Francisco , Comba Fernando M. 
Published: October 2015

Background Hip arthroscopy treatment in patients with osteoarthritis is controversial. Hypothesis/Purpose To systematically review the clinical outcome of patients with hip osteoarthritis (OA) treated with arthroscopy and what proportion of these patients subsequently underwent total hip arthroplasty (THA). Study design Systematic review. Methods PubMed, Cochrane library and LILACS were searched from January 1990 through December 2013 for eligible studies. The methodological quality of the collected data (applied to each study) was performed with a modified version of the Coleman methodology score (mCMS). Results 11 studies were included in this review. Most of the studies included reported clinical improvements. The overall conversion rate to THA ranged from 9.5% to 50%. Mean time between arthroscopy and THA was 13.5 months. Conclusions The quality of studies is low. We have found inconclusive evidence to make categorical indications for hip arthroscopy in the treatment of OA, although we have found that there is some postoperative clinical outcome improvement of pain and function in a short-term evaluation. Increasingly worse outcomes were seen as the severity of OA increased.
Emergency Percutaneous, Bicaval Double-Lumen, ECMO Cannulation in Neonates and Infants: Insights from Three Consecutive Cases
Authors: Moscatelli Andrea , Buratti Silvia , Gregoretti Cesare , Lampugnani Elisabetta , Salvati Pietro , Marasini Maurizio , Ribera Elena , Fulcheri Ezio , Tuo Pietro 
Published: October 2015

Background Veno-venous extracorporeal membrane oxygenation (ECMO) is probably the preferable configuration to assist children with respiratory failure who do not respond to maximized conventional therapies. The single-vessel, double-lumen approach through the internal jugular vein is extremely advantageous, especially in infants, where femoral access presents limitations related to the small dimensions of the veins. In case of emergencies, ECMO might need to be started at the bedside, without the availability of fluoroscopic guidance. To our knowledge, a completely percutaneous approach has not been reported before in children younger than 1 year and weighing less than 5 kg. Methods We describe 3 cases of emergency bedside, percutaneous, bicaval double-lumen cannulation under real-time transthoracic ultrasound control in 2 neonates and 1 infant. Results In our experience, this approach proved to be safe, effective and time saving, while minimizing bleeding from the cannula insertion site. Cannulation times, from decision making to the beginning of ECMO flow, were 30, 28, 25 minutes respectively, from patient 1 to 3. We do not report any cannula-related injury to vessels and heart structures. Conclusions Our preliminary data suggest that, with the described precautions, percutaneous, echo-guided, bicaval double-lumen cannulation in neonates and infants could be effective and free from major complications. Further evaluation should be warranted in the neonatal population.
Effect of Air-Abrasion Regimens and Fine Diamond Bur Grinding on Flexural Strength, Weibull Modulus and Phase Transformation of Zirconium Dioxide
Authors: Michida Silvia Masae de Araújo , Kimpara Estevão Tomomitsu , dos Santos Claudinei , Souza Rodrigo Othavio Assunção , Bottino Marco Antonio , Özcan Mutlu 
Published: October 2015

Purpose This study evaluated the effect of air abrasion and polishing regimens on the flexural strength of yttrium stabilized polycrystalline tetragonal zirconia (Y-TZP). Methods From Y-TZP blocks (InCeram 2000 YZ Cubes; Vita Zahnfabrik, Bad Säckingen, Germany) 120 bars (25 mm × 4 mm × 1.2 mm) were obtained according to ISO 6872:2008 and randomly divided into 4 groups: Group C: (control) without surface treatment (n = 30); Group APA: Air abrasion with aluminum oxide (44 µm) (n = 30); Group SC: Silica-coating (CoJet, 30 µm) (n = 30); Group FD: Fine diamond bur (n = 30). Subsequently, all specimens were subjected to 4-point bending test (in distilled water at 37°C) in a universal testing machine (EMIC DL 1000; São José dos Pinhais, Paraná, Brazil); cross-head speed: 0.5 mm/min). The characteristic strength (σ0) of each specimen was obtained from the flexural strength test and evaluated using Weibull analysis. X-ray diffraction analysis was utilized to quantity the monoclinic phase. The surface topography of specimens was analyzed using 3D optical profilometer and scanning electron microscopy (SEM) after surface conditioning methods. The flexural strength data (σ4p) were statistically analyzed by 1-way ANOVA, Tukey test (α = 0.05) and Weibull (m = modulus, σ0 = characteristic strength) were calculated. Results The mean ± standard deviations (MPa) of the groups were as follows: C: 1196.2 ± 284.2a; APA: 1369.7 ± 272.3a; SC: 1207.1 ± 229.7a and FD: 874.4 ± 365.4b. The values (m) and (σ0) were as follows: C: 4.5 and 1308.12; APA: 5.9 and 1477.88; SC: 6.0 and 1300.28; and FD: 2.6 and 985.901, respectively. Conclusions Air particle abrasion with neither silica nor alumina showed significant difference compared to the control group but grinding with fine diamond bur impaired the flexural strength of the zirconia tested.