bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical Ripasudil for the Treatment of Segmental Corneal Edema: A Case Series
Authors: Tseng Michael , Feder Robert 
Published: April 2023

Purpose:
Ripasudil, a rho-kinase inhibitor, has gained popularity as an adjunctive therapy after Descemet stripping only to hasten visual recovery. Ripasudil has been shown to increase corneal endothelial cell proliferation and intercellular adhesion, and decrease endothelial cell apoptosis. We present 4 cases in which persistent corneal edema after various anterior segment surgeries was successfully treated with topical ripasudil, and 1 case in which corneal edema did not improve with use of ripasudil.

Methods:
Retrospective chart review revealed 5 patients treated with topical ripasudil for persistent corneal edema that failed to improve with conventional, nonsurgical treatments.

Results:
In each case, the patient had symptomatic, persistent, focal corneal edema which followed a surgical procedure in the anterior segment. The various etiologies of corneal edema included graft failure after Descemet stripping endothelial keratoplasty, a failed penetrating keratoplasty, and 3 cases of pseudophakic corneal edema. These patients experienced improved vision and partial or complete resolution of corneal edema after 2 to 4 weeks of topical ripasudil administered 4 times daily. One patient with pseudophakic bullous keratopathy had edema that initially improved on topical ripasudil, but after cessation of the medication, developed progressive corneal edema and required endothelial keratoplasty.

Conclusions:
In patients with focal corneal edema resulting from surgical trauma to the endothelium who failed to clear over time with conservative measures, topical ripasudil was shown to be an effective treatment option that in most cases improved vision and helped reduce the need for endothelial transplantation.
The role of eye banking with cell-based therapies
Authors: Tran Lillian T. , Li Jennifer Y. 
Published: April 2023

Purpose of review
Cell-based therapies are an exciting new frontier in managing corneal diseases. The introduction of these novel therapies may provide new alternatives to corneal transplantation and decrease the dependence on donor corneal tissue. These changes have the potential to significantly impact eye banking in the future.

Recent findings
The current article reviews current research involving cell-based therapy for treating corneal disorders, including cultivated limbal stem cell transplantation, limbal mesenchymal stem cells for stromal regeneration, and the use of human-cultivated endothelial cells. We will look at barriers to the development and implementation of these therapies.

Summary
As corneal surgery expands to include cell-based therapies; eye banks will need to redefine their role to support the everchanging landscape of corneal surgery and the decreased demand for corneal donor tissue.
Duloxetine for rehabilitation after total knee arthroplasty: a systematic review and meta-analysis
Authors: Yang Jia-Man , Wang Yi , Li Jun-Yi , Li Cong-Cong , Wang Zhen-Tao , Shen Zhen , Ou Liang , Chen Ze-Hua 
Published: April 2023

Objective:
The aim was to evaluate the efficacy and safety of duloxetine for postoperative recovery after total knee arthroplasty.

Methods:
The following electronic databases were searched for eligible trials: PubMed, EMBASE, Web of Science, Cochrane Library, VIP, Wanfang Data, and China National Knowledge Infrastructure (CNKI). The search was performed from the inception dates to 10 August 2022. Data extraction and quality assessment were performed by two independent reviewers. Standard mean differences or mean differences with 95% CIs for pooled data were calculated. The primary outcomes were pain, physical function, and analgesic consumption. Secondary outcomes included range of motion (ROM) of the knee, depression, and mental health.

Results:
This meta-analysis included 11 studies, reporting on a total of 1019 patients. Results of analyses indicated that duloxetine showed a statistically significant reduction in pain at rest at 3 days, 1 week, 2, and 6 weeks and pain on movement at 5 days, 1 week, 2, 4, 6, and 8 weeks. However, there was no statistical significance in pain at rest and on movement at 24 h, 12 weeks, 6 months, and 12 months. Additionally, duloxetine had a significant improvement in physical function, ROM of the knee at 6 weeks, and emotional function (depression and mental health). Moreover, the cumulative opioid consumption at 24 h in the duloxetine groups was lower than in the control groups. But there was no statistical significance for the cumulative opioid consumption over 7 days between the duloxetine groups and controls.

Conclusions:
In conclusion, duloxetine might reduce pain mainly over a time span of 3 days–8 weeks and lower cumulative opioid consumption within 24 h. In addition, it improved physical function, ROM of the knee with a time span of 1–6 weeks and emotional function (depression and mental health).
Evolving trends in inpatient paediatric dermatology
Authors: Pineider Juliana , Oza Vikash S. , Cipriano Sarah D. 
Published: April 2023

Purpose of review
This review provides updates in the evaluation and management of key dermatologic diseases encountered in the hospitalized child.

Recent findings
Our understanding of dermatologic disorders in children continues to evolve. Staphylococcal scalded skin syndrome (SSSS) is a potentially severe blistering disorder typically seen in children under the age of 4 with an incidence that is increasing in the United States. Recent research has highlighted that the majority of cases are due to methicillin-sensitive Staphylococcus aureus (MSSA) and most patients can be adequately managed with beta-lactams. Toxic epidermal necrolysis (TEN) is one of the most feared dermatologic disorders. Currently, there is a lack of consensus on the most efficacious first-line systemic therapy. Etanercept is increasingly being used based on studies showing a shorter time to re-epithelization and decreased mortality. Lastly, the COVID-19 pandemic introduced the novel inflammatory condition multisystem inflammatory syndrome in children (MIS-C) in which approximately three out of four children present with a mucocutaneous eruption. Early recognition of the dermatologic features of MIS-C is important in potentially establishing a diagnosis and differentiating it from the many other causes of childhood fever and rash.

Summary
There are no clear universal treatment guidelines for these rare diagnoses, and therefore, clinicians must remain informed of the latest findings in diagnosis and therapeutics.
Cardiac toxic effect of radiation therapy in patients receiving adjuvant trastuzumab treatment, as examined by LVEF of echocardiography: an experimental research
Authors: Khandoozi Reza , Gelvardi Mohsen S. , Khoshbin Khoshnazar Alireza 
Published: April 2023

Background:
Radiation in breast cancer patients may result in cardiovascular disease affecting the pericardium, myocardium, and cardiac valves.

Objective:
This study aimed to evaluate the cardiotoxic consequences of radiotherapy in breast cancer patients who underwent adjuvant trastuzumab treatment by echocardiographic left ventricular ejection fraction (LVEF) measurement.

Methods:
In this retrospective study patients treated with postoperative breast irradiation with adjuvant trastuzumab were examined in terms of LVEF. Eithy five patients with age of 31–76 referred to the radiotherapy department of 5 Azar Hospital of Gorgan, Iran between years 2013 and 2020 were analyzed. Patients were divided into two left sided and right sided breast groups. Patients are routinely assessed every 3 months by echocardiocraphgy. LVEF values was measured at intervals of 3, 6, and 12 months after treatment onset.

Result:
On the left side, the average of LVEF immediately decreased after treatment, compared to before treatment (∆ LVEF= 0.021), which shows the impact of trastuzumab. The LVEF average 3 months after treatment onset showed a significant decrease (∆ LVEF= 0.043) indicating a synergistic effect of trastuzumab and radiotherapy. LVEF average 6 months and 1 year after treatment onset showed a decrease but not significant (∆ LVEF= 0.009 and 0.013, respectively).In the right breast LVEF average immediately 3 months after treatment showed a significant decrease (∆ LVEF= 0.011 and 0.057, respectively). Nevertheless, LVEF average does not show a significant decrease after 6 months and 1 year after treatment in the right side group (∆ LVEF= 0.0002 and 0.018, respectively).

Conclusion:
Our results showed LVEF changes within one year following treatment in left sided breast cancer was more than right side , but the difference was not significant ,which may be due to the short period of our study based on the protocol of our department. More changes in the left side must be due to placing of the heart in the path of radiation. The study showed that LVEF may be an indicative measure for assessing radiation and adjuvant treatment effects on cardiac function.
Impact of Phlebotomy Volume Knowledge on Provider Laboratory Ordering and Transfusion Practices in the Pediatric Cardiac ICU
Authors: LaCroix Gary A. , Danford David A. , Marshall Amanda M. 
Published: April 2023

Objectives:
Phlebotomy can account for significant blood loss in post-surgical pediatric cardiac patients. We investigated the effectiveness of a phlebotomy volume display in the electronic medical record (EMR) to decrease laboratory sampling and blood transfusions. Cost analysis was performed.

Design:
This is a prospective interrupted time series quality improvement study. Cross-sectional surveys were administered to medical personnel pre- and post-intervention.

Setting:
The study was conducted in a 19-bed cardiac ICU (CICU) at a Children’s hospital.

Patients:
One hundred nine post-surgical pediatric cardiac patients weighing 10 kg or less with an ICU stay of 30 days or less were included.

Interventions:
We implemented a phlebotomy volume display in the intake and output section of the EMR along with a calculated maximal phlebotomy volume display based on 3% of patient total blood volume as a reference.

Measurements and Main Results:
Providers poorly estimated phlebotomy volume regardless of role, practice setting, or years in practice. Only 12% of providers reported the availability of laboratory sampling volume. After implementation of the phlebotomy display, there was a reduction in mean laboratories drawn per patient per day from 9.5 to 2.5 (p = 0.005) and single electrolytes draw per patient over the CICU stay from 6.1 to 1.6 (p = 0.016). After implementation of the reference display, mean phlebotomy volume per patient over the CICU stay decreased from 30.9 to 14.4 mL (p = 0.038). Blood transfusion volume did not decrease. CICU length of stay, intubation time, number of reintubations, and infections rates did not increase. Nearly all CICU personnel supported the use of the display. The financial cost of laboratory studies per patient has a downward trend and decreased for hemoglobin studies and electrolytes per patient after the intervention.

Conclusions:
Providers may not readily have access to phlebotomy volume requirements for laboratories, and most estimate phlebotomy volumes inaccurately. A well-designed phlebotomy display in the EMR can reduce laboratory sampling and associated costs in the pediatric CICU without an increase in adverse patient outcomes.
18F-FDG PET–Positive Large Pelvic Granuloma Mimicking Malignant Bladder Tumor
Authors: Altintas Taslicay Ceylan , Cam Isa , Civriz Aziz Hakki , Kara Onder , Demir Hakan 
Published: April 2023

Abstract
An 88-year-old man was admitted to our hospital with a recurrent lower urinary tract infection. He had a history of open prostatectomy for benign prostatic hyperplasia 15 years ago and smoking. A mass arising within a bladder diverticula was suspected on the left lateral wall of the bladder on ultrasonography. Although no mass was observed in the bladder lumen on the cystoscopy, abdominal CT detected a left-sided pelvic soft tissue mass. A hypermetabolic mass was detected on 18F-FDG PET/CT performed because of suspicion of malignancy, and it was excised. Granuloma secondary to chronic vasitis was diagnosed histopathologically.
Functional Magnetic Resonance Spectroscopy of Lactate in Alzheimer Disease: A Comprehensive Review of Alzheimer Disease Pathology and the Role of Lactate
Authors: Shirbandi Kiarash , Rikhtegar Reza , Khalafi Mohammad , Mirza Aghazadeh Attari Mohammad , Rahmani Farzaneh , Javanmardi Pouya , Iraji Sajjad , Babaei Aghdam Zahra , Rezaei Rashnoudi Amir Mohammad 
Published: April 2023

Abstract
Functional 1H magnetic resonance spectroscopy (fMRS) is a derivative of dynamic MRS imaging. This modality links physiologic metabolic responses with available activity and measures absolute or relative concentrations of various metabolites. According to clinical evidence, the mitochondrial glycolysis pathway is disrupted in many nervous system disorders, especially Alzheimer disease, resulting in the activation of anaerobic glycolysis and an increased rate of lactate production. Our study evaluates fMRS with J-editing as a cutting-edge technique to detect lactate in Alzheimer disease. In this modality, functional activation is highlighted by signal subtractions of lipids and macromolecules, which yields a much higher signal-to-noise ratio and enables better detection of trace levels of lactate compared with other modalities. However, until now, clinical evidence is not conclusive regarding the widespread use of this diagnostic method. The complex machinery of cellular and noncellular modulators in lactate metabolism has obscured the potential roles fMRS imaging can have in dementia diagnosis. Recent developments in MRI imaging such as the advent of 7 Tesla machines and new image reconstruction methods, coupled with a renewed interest in the molecular and cellular basis of Alzheimer disease, have reinvigorated the drive to establish new clinical options for the early detection of Alzheimer disease. Based on the latter, lactate has the potential to be investigated as a novel diagnostic and prognostic marker for Alzheimer disease.
CT Volumetry Can Be Used for Monitoring Liver Function Recovery in Auxiliary Partial Orthotopic Liver Transplantation
Authors: Kirchner Antoine , Ronot Maxime , Durand Francois , Dondero Federica , Lesurtel Mickael , Francoz Claire , Roux Olivier , Lebtahi Rachida , Vilgrain Valérie , Dioguardi Burgio Marco 
Published: April 2023

Background.
Scintigraphy with a 99mTC-trimethyl-Br-IDA tracer (TBIDA) is used to monitor liver function regeneration after auxiliary partial orthotopic liver transplantation (APOLT) for acute liver failure (ALF). As computed tomography (CT) is also regularly performed during patient follow-up, CT volumetry could be used as an alternative to monitor native liver recovery after APOLT for ALF.

Methods.
This was a retrospective cohort study of all patients who underwent APOLT (October 2006–July 2019). Collected data included liver graft and native liver CT volumetry measurements (expressed as fractions), TBIDA scintigraphy results, and biological and clinical data including immunosuppression therapy after APOLT. Four follow-up time points were defined (baseline, discontinuation of mycophenolate mofetil, beginning of tacrolimus reduction, and tacrolimus discontinuation) for analysis.

Results.
Twenty-four patients (7 men; median age 28.5 y old) were included. The main etiologies of ALF were acetaminophen intoxication (n = 12), hepatitis B virus (n = 5), and amanita phalloides intoxication (n = 3). The median native liver function fractions on scintigraphy at baseline, at discontinuation of mycophenolate mofetil, at tacrolimus reduction, and at tacrolimus discontinuation were 22.0% (interquartile range 14.0–30.8), 30.5% (21.5–49.0), 32.0% (28.0–62.0), and 93.0% (77.0–100.0), respectively. The corresponding median native liver volume fractions on CT were 12.8% (10.4–17.3), 20.5% (14.2–27.3), 24.7% (21.3–48.4), and 77.9% (62.5–96.9), respectively. Volume and function were strongly correlated (r = 0.918; 95% confidence interval, 0.878–0.945; P < 0.01). Median time-to-immunosuppression discontinuation was 25.0 (17.0–35.0) mo. Estimated time-to-immunosuppression discontinuation was shorter in patients with acetaminophen-induced ALF (22 versus 35 mo; P = 0.035).

Conclusions.
In patients who receive APOLT for ALF, CT-based liver volumetry closely parallels native liver function recovery evaluated on TBIDA scintigraphy.
Assessment of ChatGPT in the preclinical management of ophthalmological emergencies – an analysis of ten fictional case vignettes
Authors: Knebel Dominik , Priglinger Siegfried , Scherer Nicolas , Siedlecki Jakob , Schworm Benedikt 
Published: April 2023

AbstractBackground/AimsThe artificial intelligence (AI) based platform ChatGPT (Chat Generative Pre-Trained Transformer, OpenAI LP, San Francisco, CA, USA) has gained an impressing popularity over the past months. Its performance on case vignettes of general medical (non-ophthalmological) emergencies has priorly been assessed with very encouraging results. The purpose of this study is to assess the performance of ChatGPT on ophthalmological emergency case vignettes in terms of the main outcome measures triage accuracy, appropriateness of recommended preclinical measures and overall potential to inflict harm to the user/patient.MethodsWe wrote ten short, fictional case vignettes describing different acute ophthalmological symptoms. Each vignette was entered into ChatGPT five times with the same wording and following a standardized interaction pathway. The answers were analysed in a standardised manner.ResultsWe observed a triage accuracy of 87.2%. Most answers contained only appropriate recommendations for preclinical measures. However, an overall potential to inflict harm to users/patients was present in 32% of answers.ConclusionChatGPT should not be used as a stand-alone primary source of information about acute ophthalmological symptoms. As AI continues to evolve, its safety and efficacy in the preclinical management of ophthalmological emergencies has to be reassessed regularly.
Bushfire-smoke trigger hospital admissions with cerebrovascular diseases: evidence from 2019-20 bushfire in Australia
Authors: Hasnain Md Golam , Garcia-Esperon Carlos , Tomari Yumi , Walker Rhonda , Saluja Tarunpreet , Rahman Md Mijanur , Boyle Andrew , Levi Christopher R , Naidu Ravi , Filippelli Gabriel , Spratt Neil J 
Published: April 2023

AbstractBackgroundExposure to ambient air pollution is strongly associated with increased cerebrovascular diseases. The 2019–20 bushfire season in Australia burnt 5.4 million hectares of land in New South Wales alone, with smoke so severe it affected cities in Argentina, 11,000 km away. We aimed to determine the effects of i) short-term air pollution triggered by bushfires and ii) high smoke days in increasing the daily number of hospital admissions with cerebrovascular diseases.MethodsHospitalisation data were accessed from the admitted patient dataset from seven local Government areas of Hunter New England Local Health District. The bushfire period was defined from 1 October 2019 to 10 February 2020, and a similar period from 2018-19 as the control. High bushfire smoke days were days when the average daily concentration of particulate matter was higher than the 95thpercentile of the control period. Poisson regression models and fixed effect meta-analysis were used to analyse the data.ResultsIn total, 275 patients with cerebrovascular admissions were identified, with 147 (53.5%) during the bushfire (2019-20) and 128 (46.5%) in the control period (2018-19). There was no significant increase in daily cerebrovascular disease (Incidence Rate Ratio, IRR: 1.04; 95% CI: 0.98-1.05; p-value: 0.73) or ischemic stroke (IRR: 1.18; 95% CI: 0.87-1.59; p-value: 0.28) admissions over the entire bushfire period. However, the high bushfire smoke days were associated with increased ischaemic stroke-related hospital admissions with a lag of 0-1 days (IRR: 1.28; 95% CI: 1.01-1.62; I2=18.9%). In addition, during the bushfire period, particulate matter, both PM10and PM2.5(defined as particulates that have an effective aerodynamic diameter of 10 microns, and 2.5 microns, respectively), were also associated with increased ischaemic stroke admissions with a lag of 0 to 3 days.ConclusionThe results suggested an association between particulate matter and high smoke days with increased hospital admissions due to cerebrovascular diseases during the recent Australian bushfire season.
Developing a context-relevant psychosocial stimulation intervention to promote cognitive development of children with severe acute malnutrition in Mwanza, Tanzania
Authors: Jensen C. L. , Sanga E. , Kitt H. , PrayGod G. , Kunzi H. , Setebe T. , Filteau S. , Webster J. , Gladstone M. , Olsen M. F. 
Published: April 2023

AbstractMore than 250 million children will not meet their developmental potential due to poverty and malnutrition. Psychosocial stimulation (PS) has shown promising effects for improving development in children exposed to severe acute malnutrition (SAM) but programs are rarely implemented. In this study, we used qualitative methods to inform the development of a PS programme to be integrated with SAM treatment in Mwanza, Tanzania. We conducted in-depth interviews with seven caregivers of children recently treated for SAM and nine professionals in early child development. We used thematic content analysis and group feedback sessions and organised our results within the Nurturing Care Framework. Common barriers to stimulate child development included financial and food insecurity, competing time demands, low awareness about importance of responsive caregiving and stimulating environment, poor father involvement, and gender inequality. Caregivers and professionals suggested that community-based support after SAM treatment and counselling on PS would be helpful, e.g. how to create homemade toys and stimulate through involvement in everyday chores. Based on the findings of this study we developed a context-relevant PS programme. Some issues identified were structural highlighting the need for programmes to be linked with broader supportive initiatives.Key findingsFinancial insecurity, competing time constraints, lack of awareness and poor father involvement are all barriers highlighted by families with children who have severe acute malnutrition (SAM) as negatively impacting their ability to promote nurturing care and child development.Despite knowledge of the importance of good health and adequate nutrition as important contributors to child development, caregivers of children with SAM did not always have the resources to support this.Caregivers interviewed were less familiar with the importance of responsive caregiving and opportunities for early learning as ways to support children’s development.A context-relevant programme to support psychosocial development among young children treated for SAM should include clear linkages with community-based support after discharge, but also approaches to promote involvement of fathers in childcare, and counselling of caregivers on low-cost strategies to improve nutrition and development.Other supporting social welfare initiatives in the community are needed to address the broader structural issues identified in this study.