bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Cataract as a Key to Recognition of Myotonic Dystrophy Type 1
Authors: Voermans Nicol C. , Erasmus Corrie E. , Ockeloen Charlotte W. , Van Engelen Baziel G. , Eggink Catharina A. 
Published: February 2015

Purpose Primary cataract is often the initial manifestation of the adult-onset type of myotonic dystrophy type 1 (DM1), the most common muscular dystrophy in adults. It is caused by a CTG repeat expansion within the DMPK gene, and anticipation may cause earlier onset and more severe symptoms in subsequent generations. Methods We report a family with hereditary cataract, which was initially classified as primary hereditary cataract. After presentation of 2 children with motor development delay and behavioral changes, DM1 was diagnosed. Subsequently, various DM1 features were recognized in older family members. Conclusions This report aims to increase awareness among ophthalmologists of the high prevalence of DM1 among young primary cataract patients. Ophthalmologists can play a significant role in early diagnosis, since cataract frequently is the first occasion that patients seek medical attention. Early recognition is crucial since it enables adequate cardiac follow-up and allows counseling of couples of childbearing age.
Effect of Pupil Dilation on Biometry Measurements with Partial Coherence Interferometry and Its Effect on IOL Power Formula Calculation
Authors: Rodriguez-Raton Alvaro , Jimenez-Alvarez Marianela , Arteche-Limousin Lucia , Mediavilla-Peña Estibaliz , Larrucea-Martinez Iñaki 
Published: February 2015

Purpose To determine if there are any differences between eye parameters measured by the IOLMaster (Carl Zeiss Meditec AG, Jena, Germany) biometer before and after dilating the pupil. The effect of those changes on intraocular lens (IOL) power calculation is also analyzed. Methods A prospective observational study was carried out including 107 right eyes of 107 patients with cataract and no other ocular morbidity. An IOLMaster baseline measurement included axial length (AL), mean keratometry (K), and anterior chamber depth (ACD) (corneal epithelium to lens). A second measurement was taken 45 minutes after instillation of topical tropicamide and phenylephrine. Biometric variation was analyzed and prediction for IOL power based on the Haigis and the Sanders/Retzlaff/Kraff Theoretical (SRK/T) formulas was calculated for both measurements. Results The ACD increased significantly after dilation (+0.12 ± 0.12 mm; p<0.01). The AL and K variation was not significant: +0.00 ± 0.02 mm (p = 0.62) and +0.01 ± 0.22 D (p = 0.57), respectively. Pupil dilation did not affect IOL power calculation based on SRK/T formula either targeting emmetropia (-0.02 ± 0.26, p = 0.30) or the lowest myopic residual refraction (-0.03 ± 0.34, p = 0.30). However, using the Haigis formula significantly changed calculations for emmetropia (0.07 ± 0.34, p = 0.03) and for the lowest myopic refraction (0.10 ± 0.40, p = 0.01). Conclusions Pupil pharmacologic dilation produces a significant increase in ACD when measured by the IOLMaster. This change results in a different IOL power prediction according to the Haigis formula, which calculates the effective lens position taking into account the ACD.
How Can We Prevent Myopia Progression?
Authors: Chassine Thomas , Villain Max , Hamel Christian P. , Daien Vincent 
Published: February 2015

Purpose Myopia has increased worldwide during recent years and is becoming a serious public health problem. In East Asia, the prevalence can reach 80% of the population. The focus for screening and interventions should be on early life during childhood when myopia progression is faster. Methods Review and discussion of the recent literature on potential interventions for preventing the development of myopia or slowing its progression. Results Increased time spent outdoors is a protective factor for myopia progression. Undercorrection increased myopia progression and optimal correction is mandatory. The use of progressive or bifocal lenses (spectacles or contact lenses) may yield a slowing of myopia by limiting eye accommodation. Rigid gas permeable contact lenses were found to have few effects on myopic eye growth. A marked slowing of myopia was observed with orthokeratology by temporarily changing the curvature radius of the cornea. The largest positive effects for slowing myopia progression were observed with atropine eyedrops with an interesting dose effect. The benefit of surgical scleral reinforcement is reserved for severe and progressive myopia. Conclusions In this review, we discuss optical and pharmacologic interventions that can be used in myopia management.
Prostaglandin Analogue–Induced Pigmentation of the Skin of the Nasal Septum and Nasal Alae in a Glaucoma Patient
Authors: Holló Gábor , Kóthy Péter 
Published: February 2015

Purpose To present a case of topical prostaglandin analogue–induced skin pigmentation in a location previously never reported, with a differential diagnostic significance. Case report An 83-year-old man successfully treated for primary open-angle glaucoma of both eyes with the bimatoprost/timolol fixed combination for 6 years reported increased pigmentation of the skin of the nasal septum and alae. According to his report, the darkened skin area was not present when he was a young or middle-aged man. The patient had noted periocular pigmentation and deepening of the upper lid sulcus on both sides, which developed during the years of his bimatoprost/timolol treatment. Dermatology consultation excluded any nevus, malignancy, or other pathology as a cause of the pigmentation. The otorhinolaryngology consultation failed to identify any pathologic condition in the nasal cavity, but described mild chronic senile rhinitis. Conclusions The acquired pigmentation of the skin of the nasal septum and alae in our patient represents a new form of cutaneous pigmentation induced by topical prostaglandin analogue therapy, which may have differential diagnostic significance in clinical practice. We speculate that the senile rhinitis of the patient increased the exposure of the nasal skin to the prostaglandin analogue solution drained via the nasolacrimal duct, and could therefore play a role in the development of skin pigmentation in this location.
Effect of Steep Meridian Clear Corneal Incisions in Phacoemulsification
Authors: Song Wenjun , Chen Xiaoyong , Wang Wei 
Published: February 2015

Purpose To evaluate the torque and flattening effect of steep meridian clear corneal incisions on cornea in phacoemulsification when posterior cornea surface measurements were considered. Methods Thirty-six eyes underwent cataract surgery with steep meridian clear corneal incisions. Before surgery and at 1 month and 3 months after surgery, corneal topography was measured with a rotating Scheimpflug camera. Both preoperative and postoperative corneal astigmatism were calculated in 2 ways: total corneal astigmatism and keratometric astigmatism. Polar analysis was used to evaluate the flattening and torque effect of steep meridian incisions on corneal astigmatism. Results Total corneal astigmatism changed significantly after 3 months (p = 0.005) and univariate analysis revealed a significant change 0.25D ± 0.36 D in astigmatic polar value AKP(+45) of total corneal astigmatism (p = 0.047). A decrease in AKP(+0) was observed in both keratometric and total astigmatism at 1 and 3 months, although the decreases were not statistically significant (p = 0.394, p = 0.442, p = 0.602, p = 0.503, respectively). Conclusions Steep meridian incision performed on the preoperative steeper meridian of keratometric astigmatism may cause a significant torsional effect on total corneal astigmatism as well as reducing the astigmatism along the meridian.
Delayed Suprachoroidal Hemorrhage following Nd:YAG Laser Goniopuncture: A Case Report
Authors: Rabiolo Alessandro , Bettin Paolo , Fiori Marina , Ciampi Carlo , Di Matteo Federico , Bandello Francesco M. 
Published: February 2015

Purpose To report a delayed suprachoroidal hemorrhage following Nd:YAG laser goniopuncture (LGP) in an eye with a previous deep sclerectomy. Methods Case report. Results A 75-year-old woman with advanced primary open-angle glaucoma underwent LGP due to unsatisfactory intraocular pressure (IOP) in her left eye, 1 month after undergoing deep sclerectomy in the same eye. Delayed suprachoroidal hemorrhage occurred the day after LGP execution. Conclusions Nd:YAG laser goniopuncture is often performed to enhance IOP control following deep sclerectomy. Although LGP is usually effective and safe, severe complications, such as delayed suprachoroidal hemorrhage, may occur after its execution.
Lesion of Gluteal Nerves and Muscles in Total Hip Arthroplasty through 3 Surgical Approaches. An Electromyographically Controlled Study
Authors: Chomiak Jiří , Huráček Jiří , Dvořák Jiří , Dungl Pavel , Kubeš Radovan , Schwarz Ondřej , Munzinger Urs 
Published: February 2015

Purpose Three surgical approaches in total hip arthroplasty (THA) were compared concerning: 1) clinical and radiological results; 2) innervation of the tensor fasciae latae and gluteal muscles; 3) clinical outcome of the nerve lesions; 4) sensitivity of the EMG analysis. Methods A total of 70 patients aged 39-79 years were evaluated clinically and electromyographically before and 3-9 months after THA in 2 centres using the anterolateral approach in 22, transgluteal approach in 33 and posterior approach in 15 patients, respectively. Results 1) Hip flexion, external rotation and Trendelenburg lurch were reduced and the centre of the rotation was higher after the anterolateral approach. 2) The inferior branch of the superior gluteal nerve of the tensor fasciae latae muscle was mostly damaged in the anterolateral approach (73% of lesions), whereas innervations of gluteus medius (9% of lesions) and maximus muscles (no lesion) were preserved. The transgluteal approach most often caused a partially denervated gluteus medius (81.8%) and the tensor fasciae latae (48%) and the gluteus maximus muscle only in 29%, respectively. After the posterior approach, partial denervation in the gluteus medius and maximus muscles were noted in 53.3% and 71.4%, respectively, whereas in the tensor fasciae latae muscle in only 14%. 3) The power of the abductors was not significantly reduced in partially denervated muscles. 4) The EMG examination is not sensitive enough to determine the relevant power of hip abductors. Conclusions Despite some disadvantages associated with the anterolateral approach, the transgluteal and posterior approaches are often connected with a partial lesion of the gluteus medius and maximus muscles. In all approaches, clinical sequelae are not significant in primary THA.
First Successful Combination of ECMO with Cytokine Removal Therapy in Cardiogenic Septic Shock: A Case Report
Authors: Bruenger Frank , Kizner Lukasz , Weile Jan , Morshuis Michael , Gummert Jan F. 
Published: February 2015

Purpose A new hemoadsorption device intended as adjunctive treatment for patients with elevated cytokine levels in the setting of SIRS and sepsis has shown promising results. We report on the beneficial application of the device in a patient with cardiogenic septic shock receiving combined extracorporeal life support with rECMO, LVAD, and CVVH despite his highly septic condition. Methods A 39-year-old patient presented with fulminant ARDS and cardiogenic septic shock. A veno-arterial ECMO was implanted for circulatory support. During the course of illness, the patient developed acute renal failure in addition to his chronic renal insufficiency, making initiation of CVVH necessary. Due to a complete cardiac arrest in both ventricles, a left ventricular assist device (LVAD) in combination with right ECMO (rECMO) was implanted despite manifest septic conditions. In the post-operative course IL-6 levels and vasopressor dosages increased drastically. A CytoSorb hemoadsorption device was therefore installed in the CVVH circuit and 3 sessions were run during the following 4 days. Results During CytoSorb treatment, inflammatory markers IL-6, procalcitonin, and C-reactive protein decreased concomitant with significantly reduced vasopressor support. No adverse device-related side effects were documented during or after the treatment sessions. Conclusions This is the first clinical case report of a highly septic patient treated with the combined use of LVAD, rECMO, CVVH, and CytoSorb. The combination was practical, technically feasible, and beneficial for the patient. This combination represents a reasonable approach to improve survival in patients with multiple organ dysfunction necessitating several organ supportive techniques.
Preferred Haemodialysis Vascular Access for Diabetic Chronic Kidney Disease Patients: A Systematic Literature Review
Authors: Coentrão Luís , Van Biesen Wim , Nistor Inout , Tordoir Jan , Gallieni Maurizio , Marti Monros Anna , Bolignano Davide 
Published: February 2015

Background Vascular access problems are one of the main concerns in the diabetic end-stage kidney disease (ESKD) population. However, the optimal strategy for the establishment of vascular access in this population remains to be solved. We performed a systematic review in order to clarify the most advisable approach of vascular access planning in diabetic patients with ESKD. Methods MEDLINE, EMBASE and CENTRAL databases were searched for English-language articles without time restriction through focused, high-sensitive search strategies. We included all studies providing outcome data on diabetics starting chronic haemodialysis treatment on the basis of the type of primary placed vascular access. Results A total of 13 studies comprising over 2,800 participants with diabetes were reviewed in detail and included in the review. We found that diabetic patients using a dialysis catheter apparently experience a higher risk of death and infection compared with patients who successfully achieved and maintained an arteriovenous fistula as dialysis access. The comparison between the use of a graft or an autogenous fistula as dialysis access generated conflicting results. Primary patency rates appeared to be lower in diabetics versus non-diabetics. Conclusions Our study suggests that diabetic ESKD patients with dialysis catheters incur a higher risk of death in comparison to those who achieve an arteriovenous access. It is however unclear whether this is caused by residual selection bias or by a true advantage of native vascular access.
Volume Blood Flow, Static Pressure Ratio and Venous Conductance in Native Arterio-venous Fistulae: Three Surveillance Methods Compared
Authors: King David H. , Paulson William D. , Al-Qaisi Mo , Taylor Michael G. , Panayiotopoulos Yiannis , Abeygunarsekara Sumith , Chan Anthony , Ali Galil , Chemla Eric S. 
Published: February 2015

Purpose Dialysis venous pressure monitoring has been widely recommended as a surveillance method but has not been shown to improve access outcomes in randomised controlled trials. The method has been impaired by the need to either turn off the blood pump or to derive the static venous pressure from the venous pressure measured with the dialysis pump running. We have developed a unique algorithm which converts Doppler-shifted spectral information derived from unsealed pulsatile blood flow waveforms into an estimate of mean blood pressure (MBP) at the point of ultrasound insonation. Methods We have devised the unique expression shown here: MBP = MAP/(1 + Pff/Vff) where MAP is the mean arterial pressure, Pff = (systolic – diastolic)/MAP measured on the contralateral arm and Vff = spectral maximum – minimum/mean. Venous conductance (VC) can be measured by combining this pressure data with Duplex ultrasound blood flow data. A new device BlueDop™ has been used to illustrate the potential clinical value of non-invasive static pressure ratio (SPRn) in a monitoring role. Duplex and BlueDop™ technology were tested in an arterio-venous fistula (AVF) study in which VC, Q and SPRn were compared. Thresholds used for detection of ≥60% venous stenosis were VC <10 mL min−1 mm Hg−1, Q <500 mL min−1, SPRn >0.56. Results The following accuracy was achieved: VC = 96%, Q = 92%, SPRn = 76% with similar accuracy in predicting premature thrombosis. Conclusions A new algorithm has been described and its in vivo accuracy in estimating mean ‘pressure from flow’ has been confirmed. Two new variables and a new dedicated instrument BlueDop™ have been demonstrated in clinical use.
Complications of Peripherally Inserted Central Catheters in Adults with Cystic Fibrosis or Bronchiectasis
Authors: Dupont Christian , Gouya Hervé , Panzo Rozy , Hubert Dominique , Correas Jean-Michel , Agrario Line , Chapron Jeanne , Honoré Isabelle , Kanaan Reem , Legmann Paul , Dusser Daniel , Vignaux Olivier , Burgel Pierre-Régis 
Published: February 2015

Background Peripherally inserted central catheters (PICCs) are increasingly used in patients with cystic fibrosis (CF) or with non-CF bronchiectasis, but little data exist on catheter-related complications in this setting. Methods Prospective follow-up of consecutive PICCs inserted for intravenous (IV) antibiotics in adults with CF or with non-CF bronchiectasis at Cochin Hospital (Paris, France). Results Between March 2009 and December 2011, 182 PICCs were prescribed in 117 adults (67 CF and 50 non-CF patients). Ultrasound-guided placement of catheter was successful in 174/182 (95.6%) procedures; no insertion complication occurred. The mean ± SD catheter dwell time was 15 ± 9 days. No catheter-associated bloodstream infection occurred; main complications were symptomatic upper limb deep vein thrombosis (2%), catheter obstruction (18%) and persistent pain after catheter insertion (18%). Patients' satisfaction was high and PICC could be used to perform antibiotic courses in most patients. Conclusions PICCs were generally safe for performing IV antibiotic courses in patients with CF or non-CF bronchiectasis, but prolonged pain and/or catheter obstruction occurred in approximately 20% of cases.
Securement Methods for Peripheral Venous Catheters to Prevent Failure: A Randomised Controlled Pilot Trial
Authors: Marsh Nicole , Webster Joan , Flynn Julie , Mihala Gabor , Hewer Barbara , Fraser John , Rickard Claire M. 
Published: February 2015

Purpose To assess the effectiveness of four securement methods to prevent peripheral intravenous catheter (PIVC) failure. Methods A single-centre, four-arm, randomised, controlled, non-blinded, superiority pilot trial was conducted in a tertiary referral hospital in Queensland (Australia), between November 2012 and January 2013. Adult patients, with a PIVC expected to remain in situ for ≥24 hours and admitted to general medical or surgical wards, were randomly allocated to standard polyurethane dressing (control, SPU), tissue adhesive (TA) with an SPU, bordered polyurethane dressing (BPU) or sutureless securement device (SSD) with an SPU, experimental groups. The primary endpoint was PIVC failure, defined as premature device removal before the end of therapy because of pain, blockage, leaking, accidental removal and local or catheter-related bloodstream infection. Results PIVCs were used for an average of 2.6 days across all study groups (n = 85). Catheter failure was lowest in the TA group (3/21, 14%) and highest in the control group (8/21, 38%), with BPU and SSD failure at 5/20 (25%) and 5/23 (22%), respectively. The adjusted hazard ratio of catheter failure was lowest in the TA group (0.50, 95% CI: 0.13-1.98), and then the BPU (0.52, 95% CI: 0.15-1.78) and SSD (0.61, 95% CI: 0.20-1.91) groups. No patient was suspected of a local or catheter-related bloodstream infection. Conclusions Current SPU dressings alone do not prevent many cases of PIVC failure. TA appears promising as an innovative solution, but may not be suitable for all patients. A larger Australian National Health and Medical Research Council (NHMRC)-funded trial has commenced.
Safety and Efficacy of Radiofrequency Wire Recanalization of Chronic Central Venous Occlusions
Authors: Sivananthan Gajan , MacArthur Daniel H. , Daly Kevin P. , Allen David W. , Hakham Salar , Halin Neil J. 
Published: February 2015

Purpose The purpose of this study is to evaluate the safety and efficacy of using a radiofrequency wire (RF) for central venous occlusion (CVO) recanalization after failure using conventional techniques. Materials and methods A retrospective analysis of all central venous recanalization procedures using an RF wire from January 2007 to December 2012 was performed. This comprised 13 consecutive procedures in 12 patients. The electronic medical record and radiologic imaging studies were reviewed to obtain information regarding patient demographics, indication for revascularization, duration of vascular occlusion, procedure outcome, and complications. Results Technical success was achieved in nine of 13 (69%) occluded vessels in nine of 12 (75%) patients. Lengths of successfully crossed lesions (mean 29.8 ± 29.3 mm) were significantly less than those of unsuccessfully crossed lesions (mean 90 ± 73.7 mm), p = 0.039. Of the nine patients with technically successful procedures, three died with patent stents of causes unrelated to the procedure, one had a patent stent at 547 days, two had stent patency of 94 days and 345 days, and three were lost to follow-up. One patient (8.3%) experienced a major complication wherein tracheal perforation by the RF wire contributed to the patient's death. Conclusions RF recanalization is a viable option in patients with central vein occlusion refractory to traditional procedures. However, it does not guarantee successful revascularization and is not without the potential for harm.
Alternative Venous Outflow by Brachial to Jugular Vein Vascular Access for Hemodialysis in the Exhausted Upper Extremities
Authors: Kim Myoung Jo , Yun Sangchul , Song Dan , Cho Sung Woo , Goo Dong Erk , Kim Yong Jae , Choi Dongho 
Published: February 2015

Background A shunt is usually created from the distal arm (wrist) to the proximal arm (axillary loop) as long as no central stenosis has occurred. Creating vascular access in a patient with central vein stenosis could induce venous hypertension in the upper extremities. In such patients, an ipsilateral internal jugular vein (IJV) as an arteriovenous (AV) outflow vein should be the last option for using a particular arm. Methods Thirty-two patients who had AV hemodialysis access via a jugular vein were analyzed retrospectively from 2001 to 2011. All patients had an ipsilateral subclavian or axillary vein stenosis. The preserved IJV and innominate veins were preoperatively confirmed with Doppler echocardiography and contrast venography. Results Mean age of the patients was 57.6 ± 12.3 years, and the mean follow-up period was 43.5 ± 27.4 months. Primary patency was 74%, 54%, 32%, 15% and 5% at 6 months, 1, 2, 3 and 4 years, respectively. Secondary patency was 97%, 93%, 93%, 89%, 79% and 72% at 6 months, 1, 2, 3, 4, and 5 years, respectively. One case of steal syndrome, 2 of seroma, 1 hematoma, 3 swollen arm, 2 infections, 1 pseudoaneurysm, 1 bleeding from puncture site, 8 stenoses and 13 thrombosis cases were noted. Conclusions A brachial-jugular AV graft showed satisfactory results in terms of patency and complication rate. The IJV could be a good outflow vein for an AV fistula if the IJV is preserved in patients with chronic renal failure who have subclavian or axillary vein stenosis or occlusion.