bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypertension impairs hypoxia-induced angiogenesis in men
Authors: Garcia Vinicius P. , Rocha Helena N.M. , Rocha Marcos P. , Mattos João D. , Campos Monique O. , Mansur Daniel E. , Secher Niels H. , Nóbrega Antonio C.L. , Fernandes Igor A. , Rocha Natália G. 
Published: March 2020

Objective:
The inability of the organism to appropriately respond to hypoxia results in abnormal cell metabolism and function. Hypoxia-induced angiogenesis seems to be suppressed in experimental models of hypertension; however, this hypothesis has not been tested in humans. We examined changes in endothelial biomarkers and vascular chemoattraction/angiogenic capacity in response to isocapnic hypoxia in hypertensive men.

Methods:
Twelve normotensive (38 ± 10 years) and nine hypertensive men (45 ± 11 years) were exposed to 5-min trials of normoxia (21% O2) and isocapnic hypoxia (10% O2). During the last minute of each trial, venous blood was drawn. Endothelial progenitor cells (EPCs; CD45dim/CD34+/VEGFR2+), endothelial microvesicles (apoptotic EMVs, CD42b−/CD31+/AnnexinV+; endothelial activation, CD62E+/CD144+), nitrite, vascular endothelial growth factor (VEGF), and stromal cell-derived factor 1 (SDF-1) were measured.

Results:
During normoxia, EPCs, nitrite, endothelial activation, and SDF-1 were similar between groups, whereas VEGF was lower (P = 0.02) and apoptotic EMVs tended to increase (P = 0.07) in hypertensive men. During isocapnic hypoxia, endothelial activation increased in both groups (normotensive, P = 0.007 vs. normoxia; hypertensive, P = 0.006 vs. normoxia), whereas EMVs were higher only in the hypertensive group (P = 0.03 vs. normotensive). EPCs (P = 0.01 vs. normoxia; P = 0.03 vs. hypertensive men), NO (P = 0.01 vs. normoxia; P = 0.04 vs. hypertensive), and VEGF (P = 0.02 vs. normoxia; P = 0.0005 vs. hypertensive) increased only in normotensive individuals in response to isocapnic hypoxia. SDF-1 did not change in either group.

Conclusion:
These results suggest that hypertension-induced impairment in angiogenesis in response to isocapnic hypoxia is related to disrupted NO bioavailability, VEGF chemotactic signaling, and EPC mobilization.
The α1D-adrenoreceptor antagonist BMY 7378 reverses cardiac hypertrophy in spontaneously hypertensive rats
Authors: Rodríguez Jessica E. , Saucedo-Campos Alberto D. , Vega Ana V. , Ramírez-Hernández Diana , Martínez-Aguilar Luisa , Jiménez-Flores J. Rafael , Andrade-Jorge Erik , Estrada-Soto Samuel E. , Villalobos-Molina Rafael , Touyz Rhian M. , Gallardo-Ortíz Itzell A. 
Published: March 2020

Objective:
The α1D-adrenoreceptor (α1D-AR) is involved in angiotensin II-induced vascular remodeling and hypertension. Whether α1D-AR plays a role in hypertension-associated cardiac hypertrophy is unclear. Here we investigated effects of BMY 7378, a selective α1D-AR antagonist, on cardiac status in aged spontaneously hypertensive rats (SHR).

Methods:
Male SHR were studied during the phase of developing hypertension (5 and 10 weeks old) and once hypertension was established (20 and 30 weeks old) to assess the evolution of cardiac hypertrophy. Age-matched WKY rats were studied as controls. Thirty-week-old SHR were treated for 4 weeks with BMY 7378 (10 mg/kg per day, o.a.), or captopril (angiotensin-converting enzyme inhibitor, 40 mg/kg per day, o.a.) (as a positive control). Blood pressure and cardiac function were measured in vivo, cardiac hypertrophy by histology, and α1D-AR protein expression by immunofluorescence.

Results:
By 30 weeks of age, SHR exhibited significant hypertension and cardiac hypertrophy. BMY 7378 and captopril decreased blood pressure and improved hemodynamic parameters and cardiac function in treated SHR vs. untreated SHR (P < 0.05). Histology showed increased cardiomyocyte size, fibrosis, and left ventricular hypertrophy in SHR hearts. BMY 7378 ameliorated fibrosis and cardiac hypertrophy, but had no effect on cardiomyocyte size in SHR. Effects of BMY 7378 were associated with increased α1D-AR protein expression in SHR.

Conclusion:
Our data indicate that pharmacological antagonism of α1D-AR reduces blood pressure and associated cardiac hypertrophy in aged SHR. These findings suggest that the α1D-AR plays a pathophysiological role in the development of hypertension and cardiac target organ damage in SHR.
IS VAGINAL DELIVERY HARMFUL TO PATIENTS WITH PSEUDOXANTHOMA ELASTICUM?
Authors: Risseeuw Sara , Yildirim Hilin , Spiering Wilko , Imhof Saskia M. , van Leeuwen Redmer , Ossewaarde-van Norel Jeannette 
Published: March 2020

Background/Purpose:
To investigate the effect of a vaginal delivery (VD) on retinal pathology in patients with pseudoxanthoma elasticum.

Methods:
Retrospective case series. All 14 consecutive women with pseudoxanthoma elasticum who visited the ophthalmology department during pregnancy and after delivery between 2010 and 2018 were included. Prepartum and postpartum imaging consisted of color imaging, near-infrared imaging, and optical coherence tomography and was assessed on occurrence of (sub)retinal hemorrhages and change in angioid streaks.

Results:
Fourteen patients (15 deliveries) were included, of whom 11 patients (79%) had a VD and three patients (21%) a secondary caesarian section. Data of three patients with VD (four deliveries) could not be assessed for (sub)retinal hemorrhage within 10 weeks postpartum. The median age at delivery was 31 years (IQR 29–37). One patient with VD (9%) had a choroidal neovascularization and was treated with anti-VEGF injections before assisted delivery. All patients had angioid streaks in the central 5,500 µm of the posterior pole of both eyes. After delivery, no patient in the VD or caesarian section group presented with progression of angioid streaks or (sub)retinal hemorrhage.

Conclusion:
Pushing during the expulsion phase of VD seems safe in pseudoxanthoma elasticum patients without active choroidal neovascularization, and the presence of angioid streaks alone should not be an indication for elective caesarian section.
Transcribed ultraconserved noncoding RNA uc.153 is a new player in neuropathic pain
Authors: Zhang Chenjing , Peng Yunan , Wang Yin , Xu Hongjiao , Zhou Xuelong 
Published: March 2020

Abstract
Transcribed ultraconserved regions are a novel class of long noncoding RNAs and are completely conserved in humans, rats, and mice. Transcribed ultraconserved regions have been implicated in diverse biological processes; however, very little is currently known about their role in pain modulation. Here, we found that the level of the spinal transcribed ultraconserved region uc.153 was significantly increased in a mouse model of sciatic nerve chronic constriction injury (CCI)-induced chronic neuropathic pain. The knockdown of spinal uc.153 prevented and reversed chronic constriction injury–induced pain behaviours and spinal neuronal sensitization. By contrast, the overexpression of spinal uc.153 produced pain behaviours and neuronal sensitization in naive mice. Moreover, we found that uc.153 participates in the regulation of neuropathic pain by negatively modulating the processing of pre-miR-182-5p. Collectively, our findings reveal an important role for uc.153 in pain modulation and provide a novel drug target for neuropathic pain therapy.
Exercise Interventions in Cardio-Oncology Populations
Authors: Wang Hsiao-Lan , Cousin Lakeshia , Fradley Michael G. , Donovan Kristine A. , Smith Barbara , Szalacha Laura , Lavoie Smith Ellen M. , Buck Harleah G. 
Published: March 2020

Background
Cardiac toxicity in patients with cancer results from treatment-related damage to the cardiovascular system by chemotherapy, targeted agents, or thoracic radiation. Cardio-oncology patients with co-occurring cancer and cardiovascular disease frequently experience fatigue. Exercise is recommended in clinical guidelines to manage fatigue during or after cancer treatment.

Purpose
The purpose of this article is to conduct a scoping review of the exercise randomized clinical trials in cardio-oncology patients, focusing on the components and effects of exercise interventions on patient cardiovascular and fatigue outcomes.

Methods
A scoping review methodological framework was deemed appropriate and used. Key words for search included “cancer,” “oncology,” “cardio-oncology,” “heart failure,” “physical activity,” and “exercise.” Search involved systematic searches of large databases (PubMed, MEDLINE, Cochrane Review, and CINAHL) and hand searches of reference lists, key journals, webpages, and experts in the field using snowballing techniques.

Results
There were 12 randomized clinical trials included in this review. Study characteristics, accordance of exercise protocols with recommendations, specific exercise training components, and cardiovascular and fatigue outcomes were mapped.

Conclusions
Recommendations for addressing the gaps included focusing on non–breast-cancer patients with cardiac toxicity risks, developing precision-based prescriptions based on various medical and physiological characteristics, and adding fatigue symptom experience as an outcome variable.
Nurses' Perspectives of Factors That Influence Therapeutic Relationships in Secure Inpatient Forensic Hospitals
Authors: Stevenson Claire , Taylor James 
Published: March 2020

Background
The therapeutic relationship is synonymous with mental health nursing and fundamental to the provision of nursing care, regardless of the setting in which care is provided. This literature review examines, from a nursing perspective, factors influencing the formation and maintenance of therapeutic relationships in forensic mental health settings.

Methods
A systematic search of the literature, using a range of electronic databases, focusing on nurse–patient therapeutic relationships in forensic settings was conducted. Articles were Critical Appraisal Skills Programme quality appraised, followed by a meta-aggregative thematic approach to data analysis and synthesis to identify themes and, finally, a production of an “action” policy statement.

Findings and Implication for Practice
Eight articles met the criteria for review inclusion. Nine themes were identified; seven were categorized as internal/interpersonal factors, and two were categorized as external/environmental factors (with some themes interconnected). Synthesis of findings resulted in the production of a policy statement encouraging forensic mental health nurses to be aware of intrapersonal influences on therapeutic relationships and the need to provide a safe and supportive clinical environment for these relationships to form.
Comparison of Outcomes Between the National Surgical Quality Improvement Program and an Emergency General Surgery Registry
Authors: DesPain Robert W. , Parker William J. , Kindvall Angela T. , Learn Peter A. , Elster Eric A. , Jessie Elliot M. , Rodriguez Carlos J. , Bradley Matthew J. 
Published: March 2020

ABSTRACT

Background:
The National Surgical Quality Improvement Program (NSQIP) has become a prevalent tool for quality improvement. At our tertiary military hospital, NSQIP collects 20% of eligible cases. We implemented an emergency general surgery (EGS) registry to prospectively review all EGS cases. We compared our EGS registry with NSQIP, hypothesizing that NSQIP sampling under-represents EGS outcomes.

Methods:
A formal EGS Process Improvement Program was implemented in 2016. From 2016 to 2018, the four most common operations were laparoscopic appendectomy, laparoscopic cholecystectomy, surgery for small bowel obstruction, and nonelective hernia repair. Outcomes were compared between the EGS registry and NSQIP abstracted cases.

Results:
In 2016, the EGS registry identified 11/112 (9.8%) patients with a complication. National Surgical Quality Improvement Program abstracted 16% of EGS cases with 16.7% (3/18) of patients having a complication. In 2017, the EGS registry identified 10/87 (11.5%) cases with complications. National Surgical Quality Improvement Program abstracted 23% of EGS with zero complications. In 2018, the EGS registry identified 9.5% of 74 cases with complications. National Surgical Quality Improvement Program abstracted 15% of EGS cases with zero complications.

Conclusions:
National Surgical Quality Improvement Program did not capture many important EGS outcomes. In 2 of 3 years, NSQIP did not identify a single complication for EGS. National Surgical Quality Improvement Program alone may be insufficient to target EGS improvements.
The association between homocysteine and ischemic stroke subtypes in Chinese
Authors: Zhang Tao , Jiang Yuan , Zhang Shuhua , Tie Tingting , Cheng Yan , Su Xiaoming , Man Zhu , Hou Jing , Sun Li , Tian Meiyuan , Zhang Yaogang , Li Jianhua , Ma Yanyan 
Published: March 2020

Abstract

Background:
The findings on the association between elevated plasma homocysteine levels and the risk of the trial of org 10172 in acute stroke treatment (TOAST) of ischemic stroke have been inconsistent in Chinese. So far, there is no meta-analysis about the association between Hcy and the TOAST subtypes of ischemic stroke in Chinese. This study; therefore, aimed to evaluate whether elevated homocysteine levels are associated with the TOAST subtypes of ischemic stroke using a meta-analysis.

Materials and methods:
A systematic search of electronic databases were conducted for studies reporting homocysteine levels in ischemic stroke and the TOAST of ischemic stroke to April 18, 2018. The data were extracted after the application of inclusion and exclusion criteria. All the data were analyzed using Stata software version 9.0 (Stata Corp LP, College Station, TX). The standardized mean difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables.

Results:
Thirteen studies comprising 3114 participants (2243 patients and 871controls) met the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that the ischemic stroke group had significantly higher levels of homocysteine than controls (SMD = 1.15, 95% CI = 0.85–1.45, P < .05). The subgroup analyses suggested that the groups of patients with large-artery atherosclerosis, small-vessel occlusion, cardioembolism, stroke of other determined etiology and stroke of undetermined etiology had significantly higher levels of homocysteine compared to those in the control group (large-artery atherosclerosis: SMD = 2.12, 95% CI = 1.40–2.84, P < .05; small-vessel occlusion: SMD = 1.10, 95% CI = 0.72–1.48, P < .05; CE: SMD = 1.17, 95% CI = 0.64–1.71, P < .05; stroke of other determined etiology: SMD = 0.88, 95% CI = 0.53–1.24, P < .05; stroke of undetermined etiology: SMD = 1.50, 95% CI = 0.66–2.33, P < .05, respectively).

Conclusion:
This meta-analysis found that ischemic stroke patients and the TOAST of ischemic stroke patients in Chinese had significantly higher homocysteine levels than the controls, suggesting that serum homocysteine levels may be a risk factor for ischemic stroke and the TOAST subtypes of ischemic stroke in Chinese.
Clinical outcomes and cost-effectiveness of massage chair therapy versus basic physiotherapy in lower back pain patients
Authors: Kim Seung-Kook , Min Aran , Jeon Chuljin , Kim Taeyun , Cho Soohyun , Lee Su-Chan , Lee Choon-Key 
Published: March 2020

Abstract

Introduction:
Low back pain is a chronic recurrent symptom, which can lower the patient's quality of life. With technological development of automated home massage systems, now offers a promising alternative to physiotherapy. However, thus far, the effectiveness of such methods has not been evaluated. We aimed to compare the efficacy and cost-effectiveness of a massage chair with those of conventional physiotherapy for the treatment.

Methods:
This was a randomized controlled trial with a two-group parallel design. Following randomization and allocation, 56 participants were enrolled to receive either physiotherapy (n = 25) or mechanical massage using the massage chair (n = 31). Pain severity was measured using a visual analog scale (VAS) and satisfaction assessed with the McGill Pain Questionnaire (MPQ). Quality of life modification was analyzed using the Functional Rating Index (FRI). Cost-effectiveness was analyzed by comparing the sum of physiotherapy fees and monthly rental fees for chair massage.

Results:
Physiotherapy and massage chair were both effective for pain control as assessed with the VAS (P < .001), satisfaction as assessed by MPQ (P < .001) and life quality improvement as assessed by FRI (P < .001) in both groups. Both VAS and FRI scores were significantly higher for physiotherapy than for massage chair (P = .03 and P = .03, respectively). There was no significant difference in MPQ between the two groups. Massage chair therapy was more cost-effective than physiotherapy, at only 60.17% of the physiotherapy cost (P < .001).

Conclusions:
The home massage chair system was cost-effective, but pain control and disability improved more with physiotherapy. However, our results showed that the massage chair is a promising treatment for pain control and quality of life modification, but efficacy is still superior in physiotherapy and the chair is not a replacement for physiotherapy.

Trial registration:
Clinical Research Information Service, KCT0003157. Retrospectively registered August 2, 2018.
Efficacy of extracorporeal shockwave therapy in the treatment of postherpetic neuralgia
Authors: Lee Sung Hyun , Ryu Kyoung-Ho , Kim Pyoung On , Lee Hyo-Won , Cho Eun-Ah , Ahn Jin-Hee , Youn Inyoung , Yang Kyung Seung 
Published: March 2020

Abstract
Established conventional treatments for postherpetic neuralgia (PHN) and postherpetic itch (PHI) are difficult and often disappointing. In this study, the authors investigated the effect and mechanisms of extracorporeal shockwave therapy (ESWT) on pain and itch associated with PHN and PHI.
Thirteen patients, 50 to 80 years of age, with symptoms associated with PHN or PHI (duration of persistent pain >3 months) and complaints of pain or itch rated >4 on a numerical rating scale (NRS), were included. ESWT was administered using a shockwave device (Piezo Shockwave2, Richard Wolf GmbH, Knittlingen, Germany) to skin areas affected by pain or itch. An energy flux density of 0.09 to 0.16 mJ/mm2 at a frequency of 5 Hz and 2000 impulses was administered at 3-day intervals for 6 sessions. The NRS, 5D-Itch Scale, and Patients Global Impression of Change (PGIC) scale were used to evaluate the efficacy of ESWT.
NRS scores of pain and itch and 5D-Itch Scale scores decreased significantly compared with before treatment and at the end of the treatment sessions (P < .0001, P = .001, P = .0002, respectively). There was a statistically significant difference between PGIC scores, which were checked every 2 sessions (P < .0001).
ESWT is a noninvasive modality that significantly reduced PHN-associated pain and itch.
Acupuncture combined with tamsulosin hydrochloride sustained-release capsule in the treatment of chronic prostatitis/chronic pelvic pain syndrome
Authors: Wang Ji-Sheng , Yang Jie , Deng Sheng , Yu Xu-Dong , Bao Bing-hao , Liu Rui-Jia , Li Hai-Song 
Published: March 2020

Abstract

Background:
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urinary system disease in men. As part of traditional Traditional Chinese medicine, acupuncture has been widely used in clinical practice. In order to evaluate the exact effect of acupuncture on the clinical efficacy of CP/CPPS, this experiment uses randomized controlled experiments.

Methods/design:
This pragmatic randomized controlled trial will recruit 166 patients who are diagnosed with CP/CPPS. Simple randomization to conventional drug treatment with a 1:1 allocation ratio will be used. Ten 30-minute acupuncture sessions will be provided to patients assigned to the Intervention group. All participants will continue to receive conventional drug treatment. The selection of outcomes will be evaluated by Health's Symptom Score Index (NIH-CPSI) score at week 4.

Discussion:
This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with CP/CPPS.

Trial registration:
ClinicalTrials.gov, ChiCTR1900021132, Registered on 29 January 2019
Unusual clinicopathological presentation of nontraumatic cerebral fat embolism
Authors: Lee Hye Seung , Park Jeong-Jin , Roh Hong Gee , Lim So Dug 
Published: March 2020

Abstract

Rationale:
Fat embolism syndrome (FES) is characterized by the classical triad of cerebral, respiratory, and cutaneous manifestations. In contrast, cerebral fat embolism (CFE), corresponding to incomplete pure type FES, is much rarer and usually follows trauma. CFE typically shows a “starfield” pattern on diffusion-weighted magnetic resonance imaging due to the involvement of multiple small arteries. We report 2 unusual cases of CFE that showed a nontraumatic etiology and the involvement of a single dominant cerebral artery.

Patient concerns:
Case 1 was a 33-year-old woman without a history of trauma who visited the emergency room due to hemiparesis and hemisensory deficits. She was a heavy smoker and had used oral contraceptives for several years. Most importantly, she had 2 experiences of autologous fat grafting 2 months previously. Magnetic resonance angiography (MRA) revealed acute occlusion of the right middle cerebral artery. Case 2 was an 80-year-old man suddenly presented with dizziness, ataxia, and left-sided sensorimotor dysfunction. He had a history of hypertension, untreated atrial fibrillation, and chronic alcoholism. MRA demonstrated the occlusion of the distal basilar artery.

Diagnosis:
Case 1: Microscopic findings demonstrated variable sized fat vacuoles intermixed with moderate amounts of thrombi. Case 2: Histologically, mature adipocytes were intermingled with fibrin, blood cells, and a fragment of entrapped soft tissue resembling the vessel wall.

Intervention:
Case 1 and 2 underwent aspirational thrombectomy guided by transfemoral cerebral angiography.

Outcome:
Case 1 recovered well but Case 2 still suffers from gait ataxia.

Lessons:
CFE can rarely occur in various nontraumatic conditions, with or without evident etiology. Furthermore, it may not show characteristic clinicopathological manifestations. Therefore, careful follow up of those who have undergone procedures that are likely to trigger FES or who have hemodynamic or hypercoagulable risk factors is needed.
Medical Surgical Nurse Self-perceived Competency in Posttraumatic Stress Disorder/Substance Use Disorder Veteran Care in a Non–Veterans Health Administration Setting
Authors: Claus Nancy , Watts Penni , Moss Jacqueline 
Published: March 2020

OBJECTIVE
This study evaluated the self-perceived readiness of medical-surgical nurses in a non–Veterans Health Administration (VHA) facility to care for veterans with posttraumatic stress disorder (PTSD) and substance use disorder (SUD).

BACKGROUND
Nurses caring for veterans with PTSD and SUD at facilities other than the VHA should be equipped with the knowledge, skills, and attitudes to provide care for this population.

METHODS
Nurses evaluated their self-perceived knowledge, skills, attitudes, experiences, and perspectives related to caring for veterans.

RESULTS
Nurses overwhelmingly indicated that they had no knowledge of the “Have you served?” campaign, and fewer than half inquired about military status when assessing patients

CONCLUSION
Nurses caring for veterans in non-VHA facilities do not consistently identify veterans or assess for service-related conditions, including PTSD and SUD. Nurses report low skill levels related to identifying, addressing, and referring patients with service-related conditions.