bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Metformin Use During Hospitalization and Mortality in Critically Ill Adults With Type 2 Diabetes Mellitus and Sepsis*
Authors: Gómez Hernando , Del Rio-Pertuz Gaspar , Priyanka Priyanka , Manrique-Caballero Carlos L. , Chang Chung-Chou H. , Wang Shu , Liu Qing , Zuckerbraun Brian S. , Murugan Raghavan , Angus Derek C. , Kellum John A. 
Published: February 2022

OBJECTIVES:
Whether metformin exposure is associated with improved outcomes in patients with type 2 diabetes mellitus and sepsis.

DESIGN:
Retrospective cohort study.

SETTING:
Patients admitted to ICUs in 16 hospitals in Pennsylvania from October 2008 to December 2014.

PATIENTS:
Adult critical ill patients with type 2 diabetes mellitus and sepsis.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We conducted a retrospective cohort study to compare 90-day mortality in diabetic patients with sepsis with and without exposure to metformin during hospitalization. Data were obtained from the electronic health record of a large healthcare system in Pennsylvania from October 2008 to December 2014, on patients admitted to the ICU at any of the 16 hospitals within the system. The primary outcome was mortality at 90 days. The absolute and adjusted odds ratio (OR) with 95% CI were calculated in a propensity score-matched cohort. Among 14,847 patients with type 2 diabetes mellitus and sepsis, 682 patients (4.6%) were exposed to metformin during hospitalization and 14,165 (95.4%) were not. Within a total of 2,691 patients subjected to propensity score-matching at a 1:4 ratio, exposure to metformin (n = 599) was associated with decreased 90-day mortality (71/599, 11.9% vs 475/2,092, 22.7%; OR, 0.46; 95% CI, 0.35–0.60), reduced severe acute kidney injury (50% vs 57%; OR, 0.75; 95% CI, 0.62–0.90), less Major Adverse Kidney Events at 1 year (OR, 0.27; 95% CI, 0.22–0.68), and increased renal recovery (95% vs 86%; OR, 6.43; 95% CI, 3.42–12.1).

CONCLUSIONS:
Metformin exposure during hospitalization is associated with a decrease in 90-day mortality in patients with type 2 diabetes mellitus and sepsis.
Combined Poroma and Verruca Plantaris
Authors: Kneiber Diana , Cassarino David S. 
Published: February 2022

Abstract:
A 76-year-old female patient presented with a peculiar new exophytic-appearing, flesh-colored skin lesion on her left hallux. Owing to its atypical appearance, the neoplasm was biopsied. Histologic sections demonstrated numerous thickened, anastomosing cord-like structures composed of bland appearing adnexal keratinocytes attached to the epidermis and extending into the superficial dermis. Nearby areas exhibited papillomatosis, epidermal acanthosis, dense hyperparakeratosis, hypergranulosis, and superficial koilocytes, findings consistent with a verruca plantaris. A p16 stain was positive in many of the superficial epidermal keratinocytes. Human papillomavirus typing by in situ hybridization for the most common low-risk and high-risk types was also performed and was negative for these. We herein present an unusual case of a skin lesion which combines features of a poroma with a verruca plantaris. We further review what is known of the relationship between human papillomavirus and poroid neoplasms.
Descemet Membrane Endothelial Keratoplasty and Goniosynechialysis in Iridocorneal Endothelial Syndrome: Surgical Perspective and Long-Term Outcomes
Authors: Joshi Vineet Pramod , Vaddavalli Pravin Krishna 
Published: February 2022

Purpose:
The purpose of this study was to report the long-term outcomes of Descemet membrane endothelial keratoplasty (DMEK) with goniosynechialysis in eyes with iridocorneal endothelial syndrome with an emphasis on the surgical technique.

Methods:
This was a retrospective series of 5 eyes of 5 patients undergoing a DMEK procedure at a tertiary eye care institute by a single surgeon. Modifications in the standard surgical technique, including the release of peripheral anterior synechiae, peripheral descemetorhexis, the release of adherent membranes, maneuvers in the anterior chamber with or without cataract extraction were logged. Long-term outcomes of the surgery in these patients are reported.

Results:
Five DMEK procedures were performed in 5 eyes of 5 patients. The average age of the patients was 48.2 ± 10.8 years, and the donor was 55.2 ± 3.2 years with a mean endothelial cell density (ECD) of 2784.6 ± 231 cells/mm2. After a mean follow-up period of 29.6 months (24–41 mo), all the 5 grafts remained clear; the mean BCVA at the last follow-up was 0.18 ± 0.17 logarithm of the minimum angle of resolution with a mean ECD of 1086.2 ± 338 cells/mm2 with a 61.1% reduction in ECD. intra ocular pressure was normal in all the cases. None of the patients had graft detachments that required rebubbling, and all eyes had a clear graft at the last follow-up.

Conclusions:
DMEK can be performed successfully in a case with iridocorneal endothelial syndrome with good visual outcomes with modifications to the surgical technique, including peripheral anterior synechiae release and minimizing surgical manipulation.
Prevalence and Impact of Cornea Guttata in the Graft After Penetrating Keratoplasty in Germany
Authors: Schönit Silvana , Maamri Amine , Zemova Elena , Munteanu Cristian , Safi Tarek , Daas Loay , Seitz Berthold 
Published: February 2022

Purpose:
The aim of this study was to analyze the prevalence and severity of corneal guttata (CG) in grafts after penetrating keratoplasty (PKP) and to determine its clinical significance.

Methods:
This retrospective study included 1758 PKP performed in 1522 patients. In total, 6662 postoperative endothelial images revealed the prevalence and severity of CG (divided into categories G0 without CG and G1-G3 with increasing severity). Origin of the graft, postoperative corneal thickness, visual acuity, pleomorphism, polymegethism, and endothelial cell density (ECD) were analyzed.

Results:
CG was detected in 14.9% of the grafts within 9 months after PKP, most of them were low-grade G1 (13.6%). Grafts from Homburg/Saar showed significantly less CG cases compared with other eye banks (P = 0.034). The mean corrected distance visual acuity (logMAR) did not differ between G1 (0.45 ± 0.31) and G0 (0.46 ± 0.31). The mean ECD was lower in G1 compared with G0 (P < 0.001). The mean corneal thickness was higher in G3 (597 ± 101 μm) compared with G0 (541 ± 65 μm) (P < 0.001). Pleomorphism and polymegethism were correlated with CG (P < 0.001). A progression of CG severity was detected in 13.5% of the cases during a follow-up time of 25.0 ± 19.9 months.

Conclusions:
Our study suggested that CG are transplanted in 14.9% of PKP, most of which are low-grade CG not affecting the visual acuity but already leading to an increase in corneal thickness, loss of ECD, and alteration of endothelial cell morphology. In 13.5% of the cases, a progression was demonstrated in the postoperative course.
Low-Level Light Therapy Versus Intense Pulsed Light for the Treatment of Meibomian Gland Dysfunction: Preliminary Results From a Prospective Randomized Comparative Study
Authors: Giannaccare Giuseppe , Pellegrini Marco , Carnovale Scalzo Giovanna , Borselli Massimiliano , Ceravolo Domenico , Scorcia Vincenzo 
Published: February 2022

Purpose:
The purpose of this study was to evaluate and compare the safety and efficacy of low-level light therapy (LLLT) and intense pulsed light (IPL) for the treatment of meibomian gland dysfunction (MGD).

Methods:
Forty eyes of 40 patients with MGD were randomized to receive either LLLT or IPL. Four weekly sessions of LLLT (MY MASK-E, Espansione Marketing S.p.A., Bologna, Italy) and IPL (Eye-light device, Espansione Marketing S.p.A., Bologna, Italy) were performed. The following parameters were evaluated before and 2 weeks after the last session for each treatment: Standard Patient Evaluation of Eye Dryness questionnaire, noninvasive break-up time, tear meniscus height, redness score, meiboscore, and meibomian gland loss.

Results:
All patients completed regularly all the scheduled sessions, and no adverse events were reported in any of the groups. The Standard Patient Evaluation of Eye Dryness score significantly decreased after both LLLT and IPL (P < 0.001) although the improvement was significantly greater in the LLLT compared with the IPL group (−9.9 ± 3.2 vs. −6.75 ± 4.5; P = 0.014). Patients in the LLLT group showed a significantly higher increase in tear meniscus height compared with those in the IPL group (0.06 ± 0.10 mm vs. −0.01 ± 0.014; P = 0.040). In both groups, the noninvasive break-up time, redness score, meiboscore, and meibomian gland loss did not vary significantly after treatment (all P > 0.05).

Conclusions:
Both LLLT and IPL were safe and effective in improving ocular discomfort symptoms in patients with MGD; however, the former determined a greater improvement in symptoms and an improvement of tear volume.
KeraKlear Artificial Cornea Implantation Assisted by Femtosecond Laser in Eyes With Aniridia
Authors: de Farias Charles Costa , Bezerra Fernanda Machado , Lamazales Luiz Luciano , Nosé Walton , Pereira Gomes José Álvaro 
Published: February 2022

Purpose:
The purpose of this study was to evaluate the feasibility of treating aniridia-associated keratopathy with a nonpenetrating artificial cornea in 2 patients with corneal blindness secondary to aniridia.

Methods:
This was a prospective, nonrandomized, interventional study of 2 consecutive patients with corneal blindness caused by aniridia. Ophthalmological examination was performed before the nonpenetrating keratoprosthesis surgery and then repeated 1, 7, 15, 30, 90, and 180 days and subsequently every 90 days thereafter. Optical coherence tomography was performed 90 days postsurgery to assess the position of the implant.

Results:
Visual acuity improved significantly after the KeraKlear surgery. Postoperative findings included periprosthetic corneal thinning, neovascularization, and retroprosthetic opacity.

Conclusions:
KeraKlear nonpenetrating artificial corneas represent a promising alternative to keratolimbal allografts and Boston keratoprosthesis for the treatment of aniridia-associated keratopathy.
Neurotrophic Keratopathy After Herpes Zoster Ophthalmicus
Authors: Meyer Jay J. , Liu Kevin , McGhee Charles N. J. , Danesh-Meyer Helen V. , Niederer Rachael L. 
Published: February 2022

Purpose:
The aim of this study was to describe risk factors for neurotrophic keratopathy (NK) after herpes zoster ophthalmicus (HZO).

Methods:
This study was a retrospective review of all patients seen at the Auckland District Health Board with HZO from 2006 through 2016. Cox proportional hazards analysis was performed to examine time to development of neurotrophic keratitis.

Results:
Eight hundred sixty-nine patients were included in the study with a median follow-up of 6.3 years (5504.4 patient-years). The median age was 65.5 years (interquartile range 52.9–75.4), and 456 subjects (52.5%) were male. NK developed in 58 patients (6.7%), with the highest hazard 1 to 2 years after onset of HZO. On univariate analysis, age, White ethnicity, best-corrected visual acuity (BCVA) at presentation, intraocular pressure, corneal involvement, uveitis, and number of recurrences were associated with increased risk of NK. On multivariate analysis, the following factors were significant: age (hazard ratio [HR] = 1.03; P = 0.021), White ethnicity (HR = 3.18; P = 0.015), BCVA (HR = 1.81; P = 0.026), uveitis (HR = 3.77; P = 0.001), and recurrence (HR = 1.34; P < 0.001). Vision loss (BCVA ≤6/15) was more frequent in subjects with NK (65.5% vs. 16.3%, P < 0.001).

Conclusions:
NK is a relatively common and serious complication of HZO and occurs more frequently in older White individuals, those with poor visual acuity at presentation, and those with uveitis. Vision loss occurs in approximately two-thirds of patients.
Transmastoid Repair of Otogenic Encephaloceles in Patients With Canal Wall Down Mastoidectomy
Authors: Patel Tirth R. , Roy Alexa S. , Piracha Ali Z. , Michaelides Elias , Wiet R. Mark 
Published: February 2022

Objective:
Description of a series of cases in which otogenic encephaloceles in patients requiring canal wall down (CWD) mastoidectomies were repaired via a transmastoid approach.

Study Design:
Case series.

Setting:
Tertiary-care hospital.

Patients:
Eleven cases of otogenic encephaloceles in patients requiring CWD mastoidectomy for chronic ear disease.

Interventions:
Surgical repair of an otogenic encephalocele using a transmastoid approach.

Main Outcome Measures:
Success of repair, number and size of defects, materials used for repair, complications encountered in surgery, pure tone average air-bone gap (PTA-ABG).

Results:
Eleven cases were identified. Two of these patients had a prior CWD cavity while the remainder received CWD mastoidectomy simultaneously with encephalocele repair. None of the patients required revision of encephalocele repair. Mean preoperative PTA-ABG was 30 dB and mean postoperative PTA-ABG was 28 dB (p = 0.66).

Conclusions:
A single-stage strictly transmastoid approach to otogenic encephalocele repair may be effective in patients with prior CWD mastoid cavities or requiring concurrent CWD mastoidectomy for chronic ear disease and/or cholesteatoma.
Comparative Analysis of Recidivism After Endoscopic and Microscopic-Based Cholesteatoma Resection
Authors: Manzoor Nauman F. , Totten Douglas J. , McLeod Megan E. , Sherry Alexander D. , Perkins Elizabeth L. , Haynes David S. , Rivas Alejandro 
Published: February 2022

Objectives:
1) To analyze outcomes of cholesteatoma resection utilizing postauricular microscopic and endoscopic ear surgery (EES) approaches.
2) To analyze predictors of residual and recurrent cholesteatoma.

Study Design:
Retrospective cohort study.

Setting:
Tertiary referral center.

Patients:
Three hundred seventy-five adult and pediatric patients with cholesteatoma (2012–2017).

Interventions:
Patients underwent surgical resection of cholesteatoma with EES (n = 122) and microscopic (n = 253) approach.

Main Outcome Measures:
Residual cholesteatoma, recurrent cholesteatoma, second-look procedures.

Results:
The endoscopic cohort included significantly more pediatric cases (p = 0.0008). There was no difference in laterality, gender distribution, congenital or acquired cholesteatoma, and revision cases between the cohorts. Out of 122 EES cases, 16 (13%) developed residual disease and 9 (7%) developed recurrent disease. Of 253 microscopic cases 16 (6%) developed residual disease while 11 (4%) developed recurrent disease. Second look procedures were more commonly used in EES cohort (50 vs 18%). Single predictor analysis revealed 12 predictors for residual disease and 5 for recurrent disease. Multivariable model identified pediatric case distribution and higher disease stage to be significant predictors for both residual (p = 0.04, 0.007) and recurrent disease (p = 0.02, 0.01). EES approach was associated with a weak significance for residual disease (p = 0.049) but not recurrent disease (p = 0.34).

Conclusions:
EES approach for cholesteatoma resection seems to perform similarly to microscopic approach with no difference in rates of recurrent disease. However, it is associated with a higher rate of residual disease; this may be a reflection of a greater rate of second look procedures done in this group.
Selection Criteria Optimal for Recovery of Inner Ear Tissues From Deceased Organ Donors
Authors: Aaron Ksenia A. , Hosseini Davood K. , Vaisbuch Yona , Scheibinger Mirko , Grillet Nicolas , Heller Stefan , Wang Tian , Cheng Alan G. 
Published: February 2022

Objective:
To identify optimal conditions for recovering viable inner ear tissues from deceased organ donors.

Setting:
Tertiary recovery hospitals and Donor Network West Organ Recovery Center.

Interventions:
Recovering bilateral inner ear tissues and immunohistological analysis.

Main Outcome Measures:
Immunohistochemical analysis of utricles from human organ donors after brain death (DBD) or donors after cardiac death (DCD).

Results:
Vestibular tissues from 21 organ donors (39 ears) were recovered. Of these, 18 donors (33 utricles) were examined by immunofluorescence. The sensory epithelium was present in seven utricles (two from DBD and five from DCD). Relative to DBD utricles, DCD organs more commonly displayed dense populations of hair cells and supporting cells. Relative to DBD, DCD had significantly shorter postmortem interval time to tissue recovery (<48 h). Compared to donors with no sensory epithelium, donors with intact and viable sensory epithelium (both DCD and DBD) had significantly shorter lag time to resuscitation prior to hospital admission (6.4 ± 9.2 vs 35.6 ± 23.7 min, respectively) as well as a shorter time between pronouncements of death to organ recovery (22.6 ± 30.4 vs 64.8 ± 22.8 h, respectively).

Conclusions:
Organ donors are a novel resource for bilateral inner ear organs. Selecting tissue donors within defined parameters can optimize the quality of recovered inner ear tissues, thereby facilitating future research investigating sensory and nonsensory cells.
Interrupted sleep by ambulatory blood pressure monitoring does not affect blood pressure
Authors: Geng Xue , Li Feng , Mao Zhuofeng , Hu Haijuan , Cui Wei 
Published: February 2022

Background
For the past 20 years, many hypertension guidelines have strongly recommended the practical use of ambulatory blood pressure monitoring (ABPM) to the diagnosis and management of hypertension. However, whether different sleep conditions during ABPM will affect blood pressure (BP) fluctuations and lead to inaccurate measurement results is a concern of clinicians.

Method
This was a prospective cohort study in the real-world setting. The participants were recruited between June 2018 and June 2019 in Hebei Province, China. There are three types of sleep during ABPM: undisturbed sleep, disturbed sleep and severely disturbed sleep. The people were divided into three groups according to their sleep types during ABPM. The primary outcome is 24-h mean BP, circadian rhythm of BP and variation coefficient of 24-h BP. Comparisons between groups are tested by Kruskal–Wallis H test.

Results
In total 1154 people completed the study. There was no significant difference in 24-h mean BP and circadian rhythm of BP among the three groups. There are statistically significant differences among the three groups in the variation coefficient of 24-h BP for the general population and noninsomnia population. There was no significant difference in mean BP, circadian rhythm of BP and variation coefficient of BP among the three groups for the insomnia people.

Conclusion
Regardless of the insomniac or noninsomniac population, sleep conditions during ABPM do not affect BP value and BP rhythm. For noninsomniac people, the sleep situation during ABPM may affect the BP variation coefficient.
Usefulness of the additional contrast agents to identify offending nerve root in selective nerve root block
Authors: Ko Sangbong , Nam Junho , Lee Jaejun 
Published: February 2022

Abstract
It is hypothesized that if it is confirmed that the pain caused by the injection needle coincides with the lower leg radiating pain(LLRP) that the patient mainly complains of, then the contrast agents may be used less. This study aims to understand if the identification of lancinating identical pain in the procedure could replace the use of contrast agents that causes additional pain provocation using control arm of randomized clinical trial.
This retrospective study included 165 patients who met exclusion criteria from among patients who underwent Selective nerve root block for the treatment of LLRP. With the identical and lancinating pain confirmed in the same site of the patient, consistent with that of the original symptom, the subjects were divided into 2 groups: 1 without contrast injection (Non-Dye [ND] group; 57 patients) and the other with contrast injection (Dye [D] group; 108 patients). The degree of LLRP in the 2 groups was evaluated using visual analog scale (VAS) before injection, 2, 6, and 12 weeks after injection. Functional outcomes were measured using Owestry Disability Index and Rolland-Morris Disability Questionnair, whereas quality of life was measured using Physical component score and Mental component score of Short Form 36 (SF-36) before injection and 3 months after injection.
There was no statistically significant difference in the LLRP severity in both groups at all times and no statistical difference in the degree of VAS improvement relative to the before-injection VAS value between the 2 groups at 2 and 6 weeks after injection (all P > .05). At 12 weeks after injection, there was a statistically significant difference, but they were below Minimum Clinical Important Difference, bearing little clinical implications. There was no statistically significant difference between the 2 groups in Owestry Disability Index, Rolland-Morris Disability Questionnair, SF-36 Physical component score, and SF-36 Mental component score at every interval (all P > .05).
Instead of contrast agent injections that have been used for accurate nerve root identification during Selective Nerve Root Block, the method of merely checking if the needle-induced pain under fluoroscopic imaging is consistent with the LLRP that the patient predominantly experiences shows the same effect in the patient's pain control and functional outcome.
Comparative efficacy of Chinese herbal injections for septic shock
Authors: Huang Peiying , Chen Yan , Liu Qiang , Lei Sisi , Feng Yuchao , Wu Qihua , Zhang Haobo , Chen Bojun , Zeng Zhongyi 
Published: February 2022

AbstractBackground:Septic shock is a life-threatening syndrome. Despite Western medicine guidelines being continually updated on septic shock, the disease still has a high mortality rate. Chinese herbal injections (CHIs) are injections made from effective components of traditional Chinese medicine, which have a potential therapeutic effect on septic shock and are recommended as the adjunctive treatment for septic shock in China. Although pairwise meta-analysis has been published for category-single CHIs about treatment effects of septic shock, there is no meta-analysis comparing more than 3 various types of CHIs used for septic shock.Methods:Chinese and English databases will be retrieved for randomized controlled trials from the establishment of the databases to September 30, 2021. Two reviewers will perform literature searches and data extractions while another 2 reviewers for risk assessments. RevMan V.5.4 software, Stata V.14.0 software, and R V. 4.1.1 software will be applied to perform pairwise meta-analysis and network meta-analysis. We will apply the Cochrane risk of bias tool to assess the risk of bias while the Grades of Recommendation, Assessment, Development, and Evaluation approach will be used to summarize the results of the study. The PRISMA-P guideline was followed for this protocol.Results:The current study will explore the therapeutic effect of CHIs in the treatment of septic shock through pairwise meta-analysis and network meta-analysis.Conclusion:This study will seek out the best-performed CHIs under various indicators for septic shock, providing supporting evidence for clinical selection of CHIs for septic shock.