bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anesthesia teams managing pacemakers and ICDs for the perioperative period: enhanced patient safety and improved workflows
Authors: Feldman Joshua B. , Stone Marc E. 
Published: April 2020

Purpose of review
There have been both technological and philosophical advances over the last decade regarding pacemakers and implanted cardioverter defibrillators (ICDs). Collectively, these devices are currently referred to as cardiac implantable electronic devices (CIEDs). Technological advances include the introduction of leadless pacemakers, subcutaneous defibrillators and cardiac event recorders, enhancements regarding compatibility of CIEDs for MRI scanning, the ability to interrogate devices remotely, and improved programming modes that preserve battery life. Philosophical advances have been mainly in the area of perioperative management of CIED patients.

Recent findings
Current practice recommendations now acknowledge that not every patient requires a formal interrogation of their CIED before and after surgery (as was previously recommended). The response to magnet application is standardized across manufacturer's platforms, and it is known that sources of electromagnetic interference remote from the CIED and its leads do not usually cause any interference with device function.

Summary
Educated anesthesia teams can independently manage the vast majority of CIED patients perioperatively with magnet application alone. Furthermore, this portends enhanced patient safety and improved workflows in the perioperative period.
Breast surgery and peripheral blocks. Is it worth it?
Authors: Schwemmer Ulrich 
Published: April 2020

Purpose of review
The objective of this review is to identify the potential of peripheral nerve blocks established over the last years for perioperative pain management in breast surgery. These new blocks will be discussed with respect to their clinical effect and necessity.

Recent findings
After case reports and cadaver studies for the Pecs block and its variations sufficient clinical data from randomized controlled trial (RCT) and meta-analyses exist now. The modified Pecs block or Pecs II leads to a reduction of postoperative 24-h opioid consumption. The recently invented Erector spine block addresses the intercostal nerves. The benefits in analgesia of this approach were tested in few RCTs and showed superiority to the control group in terms of requested postoperative morphine. Most studies showed low intraoperative opioid doses and no study more than low to moderate postoperative pain scores.

Summary
Taking the pain levels after breast surgery into account, the request of additional nerve blocks has to be pondered against the potential risks and resource requirement. To reduce or avoid intraoperative or postoperative opioids, an ultrasound-guided Pecs II block proves to be the best option for perioperative pain relief.
Potential Neurodevelopmental Effects of Pediatric Intensive Care Sedation and Analgesia: Repetitive Benzodiazepine and Opioid Exposure Alters Expression of Glial and Synaptic Proteins in Juvenile Rats
Authors: Iqbal O’Meara Alia Marie , Miller Ferguson Nikki , Zven Sidney E. , Karam Oliver L. , Meyer Logan C. , Bigbee John W. , Sato-Bigbee Carmen 
Published: April 2020

Objectives:
Sedatives are suspected contributors to neurologic dysfunction in PICU patients, to whom they are administered during sensitive neurodevelopment. Relevant preclinical modeling has largely used comparatively brief anesthesia in infant age-approximate animals, with insufficient study of repetitive combined drug administration during childhood. We hypothesized that childhood neurodevelopment is selectively vulnerable to repeated treatment with benzodiazepine and opioid. We report a preclinical model of combined midazolam and morphine in early childhood age-approximate rats.

Design:
Animal model.

Setting:
Basic science laboratory.

Subjects:
Male and female Long-Evans rats.

Interventions:
Injections of morphine + midazolam were administered twice daily from postnatal days 18–22, tapering on postnatal days 23 and 24. Control groups included saline, morphine, or midazolam. To screen for acute neurodevelopmental effects, brain homogenates were analyzed by western blot for synaptophysin, drebrin, glial fibrillary acidic protein, S100 calcium-binding protein B, ionized calcium-binding adaptor molecule 1, and myelin basic proteins. Data analysis used Kruskal-Wallis with Dunn posttest, with a p value of less than 0.05 significance.

Measurements and Main Results:
Morphine + midazolam and morphine animals gained less weight than saline or midazolam (p ≤ 0.01). Compared with saline, morphine + midazolam expressed significantly higher drebrin levels (p = 0.01), with numerically but not statistically decreased glial fibrillary acidic protein. Similarly, morphine animals exhibited less glial fibrillary acidic protein and more S100 calcium-binding protein B and synaptophysin. Midazolam animals expressed significantly more S100 calcium-binding protein B (p < 0.001) and 17–18.5 kDa myelin basic protein splicing isoform (p = 0.01), with numerically increased synaptophysin, ionized calcium-binding adaptor molecule 1, and 21.5 kDa myelin basic protein, and decreased glial fibrillary acidic protein.

Conclusions:
Analysis of brain tissue in this novel rodent model of repetitive morphine and midazolam administration showed effects on synaptic, astrocytic, microglial, and myelin proteins. These findings warrant further investigation because they may have implications for critically ill children requiring sedation and analgesia.
Gallbladder disease, cholecystectomy, and pancreatic cancer risk in the International Pancreatic Cancer Case-Control Consortium (PanC4)
Authors: Rosato Valentina , Negri Eva , Bosetti Cristina , Malats Núria , Gomez-Rubio Paulina , Consortium PanGenEU , Maisonneuve Patrick , Miller Anthony B. , Bueno-de-Mesquita H. Bas , Baghurst Peter A. , Zatonski Witold , Petersen Gloria M. , Scelo Ghislaine , Holcatova Ivana , Fabianova Eleonora , Serraino Diego , Olson Sara H. , Vioque Jesús , Lagiou Pagona , Duell Eric J. , Boffetta Paolo , La Vecchia Carlo 
Published: April 2020

Background
The association among gallbladder disease, cholecystectomy, and pancreatic cancer is unclear. Moreover, time interval between gallbladder disease or cholecystectomy and pancreatic cancer diagnosis is not considered in most previous studies.

Aim
To quantify the association among gallbladder disease, cholecystectomy, and pancreatic cancer, considering time since first diagnosis of gallbladder disease or cholecystectomy.

Methods
We used data from nine case-control studies within the Pancreatic Cancer Case-Control Consortium, including 5760 cases of adenocarcinoma of the exocrine pancreas and 8437 controls. We estimated pooled odds ratios and the corresponding 95% confidence intervals by estimating study-specific odds ratios through multivariable unconditional logistic regression models, and then pooling the obtained estimates using fixed-effects models.

Results
Compared with patients with no history of gallbladder disease, the pooled odds ratio of pancreatic cancer was 1.69 (95% confidence interval, 1.51–1.88) for patients reporting a history of gallbladder disease. The odds ratio was 4.90 (95% confidence interval, 3.45–6.97) for gallbladder disease diagnosed <2 years before pancreatic cancer diagnosis and 1.11 (95% confidence interval, 0.96–1.29) when ≥2 years elapsed. The pooled odds ratio was 1.64 (95% confidence interval, 1.43–1.89) for patients who underwent cholecystectomy, as compared to those without cholecystectomy. The odds ratio was 7.00 (95% confidence interval, 4.13–11.86) for a surgery <2 years before pancreatic cancer diagnosis and 1.28 (95% confidence interval, 1.08–1.53) for a surgery ≥2 years before.

Conclusions
There appears to be no long-term effect of gallbladder disease on pancreatic cancer risk, and at most a modest one for cholecystectomy. The strong short-term association can be explained by diagnostic bias and reverse causation.
Characterizing Urban-Rural Differences in Colon Cancer Outcomes
Authors: Bosma Nicholas A. , Tilley Derek , Batra Atul , Cheung Winson Y. 
Published: April 2020

Objective:
We aimed to explore possible drivers for urban-rural disparities in colon cancer outcomes in a single-payer health care system where all patients had access to universal health care coverage.

Methods:
Patients diagnosed with stage II/III colon cancer between 2004 and 2015 in Alberta, Canada were reviewed. On the basis of postal code, patients were categorized as living in urban, rural, or suburban areas based on travel distance to the cancer center. Kaplan-Meier methods and Cox regression models assessed the associations among the area of residence, receipt of treatment, and overall survival (OS).

Results:
Of 6163 patients identified, there were 3691, 1779, and 693 from urban, rural, and suburban areas, respectively. There was a larger proportion of younger patients (P=0.033) and left-sided colon cancers (P=0.042) in urban areas. Urban patients experienced shorter times from diagnosis to surgery (P<0.001), but longer delays from surgery to adjuvant chemotherapy (P=0.001). A significant difference in outcomes was identified among urban, rural, and suburban populations where median OS were 104, 94, and 83 months, respectively (P<0.001). In multivariate analysis, the location of residence continued to predict for worse OS in suburban (hazard ratio=1.60, 95% confidence interval: 1.24-2.07, P<0.001) and rural areas (hazard ratio=1.24, 95% confidence interval: 1.02-1.50, P=0.042), when compared with urban areas.

Conclusions:
In this population-based study, urban-rural differences in colon cancer survival persist, even in settings with universal health care coverage. These findings may be partly driven by a younger population with more left-sided colon cancers as well as expedited surgical intervention in urban populations, but these factors do not fully explain the disparities.
Clear Cell Sarcoma With Cutaneous Presentation in a 4-Year-Old Boy
Authors: Westover Clinton , Bacchi Carlos , Gru Alejandro A. 
Published: April 2020

Abstract:
We report a case of a 4-year-old Brazilian boy, who presented with an erythematous and painful nodule involving the skin of his left arm. Immunohistochemistry was performed for S100, SOX10, CD34, desmin, SMA, HMB-45, CD1a, and CD163, and fluorescence in situ hybridization for EWSR1 gene rearrangement using a break-apart probe was completed. Immunohistochemistry showed bland spindle cells with “floret-like” appearance simulating a giant cell fibroblastoma; tumor cells were positive for S100 and SOX10; neoplastic cells were negative for CD34, desmin, SMA, HMB-45, CD1a, and CD163; and fluorescence in situ hybridization showed an EWSR1 gene rearrangement. We report the youngest known case of cutaneous involvement of clear cell carcinoma at the age of 4.
Comparison of conventional and fibreoptic-guided advance of left-sided double-lumen tube during endobronchial intubation
Authors: Park Jin-Woo , Jo Ji H. , Park Jin H. , Bae Yu K. , Park Seong-Joo , Cho Sung-Woo , Han Sung-Hee , Kim Jin-Hee 
Published: April 2020

BACKGROUND
Postoperative sore throat and airway injuries are relatively common after double-lumen tube (DLT) intubation.

OBJECTIVE
The current study aimed to evaluate the effects of fibreoptic-guided advance of DLT on postoperative sore throat and airway injuries associated with intubation.

DESIGN
A randomised controlled study.

SETTING
Tertiary hospital, Seongnam, Korea, from January 2018 to January 2019.

PATIENTS
One hundred twenty three patients undergoing one-lung ventilation with a left-side DLT were randomised into two groups: 62 in the conventional group and 61 in the fibreoptic-guided group.

INTERVENTION
After entering the glottis, the DLT was rotated left 90° and advanced blindly into the left main bronchus in the conventional group. In the fibreoptic-guided group, DLT was advanced into the main bronchus under the guide of fibreoptic bronchoscope, which had been passed through the bronchial lumen and inserted into the left main bronchus.

MAIN OUTCOME MEASURES
The primary outcome was postoperative sore throat at 24 h after operation. The airway injuries were also examined using a bronchoscope during extubation.

RESULTS
At postoperative 24 h, the fibreoptic-guided group showed lower pain score (P = 0.001) and lower incidence (risk ratio [95% CI]: 0.2 [0.1 to 0.5], P < 0.001) of sore throat, compared with the conventional group. Moreover, tracheal injury was more severe in the conventional group than in the fibreoptic group (P = 0.003). Vocal cord injuries also occurred less frequently in the fibreoptic-guided group (risk ratio [95% CI]: 0.4 [0.2 to 1.0], P = 0.036).

CONCLUSION
The fibreoptic-guided advancement seems to reduce irritation to the airway, leading less postoperative complications.

TRIAL REGISTRATION
ClinicalTrials.gov, registration number: NCT03368599.
Coexistence of metabolic syndrome and osteopenia associated with social inequalities and unhealthy lifestyle among postmenopausal women in South Korea: the 2008 to 2011 Korea National Health and Nutritional Examination Survey (KNHANES)
Authors: Lee Hansongyi , Kim Jieun , Lim Hyunjung 
Published: April 2020

Abstract

Objective:
The prevalence of metabolic syndrome (MetS) and osteoporosis (OP) among postmenopausal women has been rapidly increasing. We examined the associations between socioeconomic status-related factors, unhealthy lifestyle, and the coexistence of MetS and osteopenia or OP.

Methods:
One thousand nine hundred ninety-one postmenopausal women aged 45 to 65 years were used to select a representative sample of the civilian, noninstitutionalized South Korean population from the 2008 to 2011 Korea National Health and Nutrition Examination Survey data. Women were grouped as neither MetS nor OP (normal), MetS, OP, and both MetS and OP (MetS + OP). Socioeconomic status (education, household income, place of residence, employment status), health-related behaviors (physical activity, alcohol consumption, smoking), and diet-related factors (intake of nutrients and food groups, eating habits, food insecurity) were obtained. Logistic regression models were used to examine the odds ratio (OR) and 95% confidence interval (CI).

Results:
The prevalence of MetS + OP was 32.5%. The average number of MetS risk factors in MetS + OP was 3.5, higher than that of normal and OP groups (P < 0.001). Bone mineral density at all sites was significantly lower in MetS + OP than normal and MetS groups (P < 0.001). Also, calcium, phosphorus, vitamin A, riboflavin, and niacin levels were lowest in the MetS + OP group compared with the three other groups (P < 0.05). After controlling for covariates, low-income and low-education women were more likely to have MetS + OP (OR 1.97, 95% CI 1.04-3.72); high-income and high-education group was 70% less likely to have MetS + OP (OR 0.30, 95% CI 0.10-0.86) compared with the middle-income and middle-education group.

Conclusions:
Social inequalities might be powerful contributors in Korean postmenopausal women with coexistence of MetS and OP. Therefore, social and political perspective approaches are required in this population for prevention and treatment of MetS and OP. Future studies should explore to find controllable factors and thereby improve health status in postmenopausal women.
Leadership Quality and Risk of Long-term Sickness Absence Among 53,157 Employees of the Danish Workforce
Authors: Sørensen Jeppe Karl , Framke Elisabeth , Clausen Thomas , Garde Anne Helene , Johnsen Nina Føns , Kristiansen Jesper , Madsen Ida E.H. , Nordentoft Mads , Rugulies Reiner 
Published: April 2020

Objective:
To examine whether low leadership quality predicts long-term sickness absence (LTSA) in Denmark.

Methods:
Using Cox models, we estimated the association between exposure to low leadership quality and onset of register based LTSA (more than or equal to 6 weeks) during 12-months follow-up among 53,157 employees without previous LTSA.

Results:
During 51,155 person-years, we identified 2270 cases of LTSA. Low leadership quality predicted LTSA with a dose–respone pattern after adjustment for confounders. The hazard ratio (HR) of LTSA in the lowest compared with the highest quartile of leadership quality was 1.61 (95% CI: 1.43 to 1.82). Further, change from high to low leadership quality over time predicted risk of LTSA (HR = 1.42, 95% CI: 1.02 to 1.97) compared with persistent high leadership quality.

Conclusions:
Exposure to low leadership quality is a risk factor of LTSA in the Danish workforce.
P16/Ki-67 Immunostaining in the Triage of Postmenopausal Women With Low-Grade Cytology Results
Authors: Dovnik Andraž , Repše Fokter Alenka 
Published: April 2020

Objective
The interpretation of postmenopausal smears and the gynecological treatment of these patients can often be difficult. The objective of this study was to assess the performance of p16/Ki-67 dual-stained cytology as a triage of atypical squamous cells of undetermined significance and low-grade intraepithelial lesion cytology results in postmenopausal women.

Methods
All consecutive atypical squamous cells of undetermined significance and low-grade intraepithelial lesion smears in 1-year period were collected and p16/Ki-67 immunostaining was performed retrospectively. The results were compared with histology results or long-term cytology follow-up in cases with no biopsy.

Results
The sensitivity of p16/Ki-67 immunostaining for the detection of cervical intraepithelial neoplasia (CIN) 2 and CIN 3 was 57.1% and 85.0%, respectively. The specificity for the detection of CIN 2 was 94.3% and CIN 3 92.4%. Negative predictive values for the detection of CIN 2 and CIN 3 were 96.3% and 99.6%, respectively.

Conclusions
Dual p16/Ki-67 immunostaining is a useful additional method in postmenopausal patients with low-grade cytology. Considering the high specificity and negative predictive value in our study, we believe that it could be helpful in avoiding unnecessary referrals to colposcopy and thus reduce the cost of the program.
Measurement of the Pediatric and Adult Osseous External Auditory Canal: Implications for Transcanal Endoscopic Ear Surgery
Authors: Ito Tsukasa , Kubota Toshinori , Furukawa Takatoshi , Kakehata Seiji 
Published: April 2020

Objective:
To develop a method for measuring the diameter of the osseous external auditory canal (OEAC) in pediatric and adult patients.

Study Design:
Retrospective analysis of imaging data from patients with a cholesteatoma who underwent transcanal endoscopic ear surgery (TEES) to remove the cholesteatoma by analyzing preoperative sagittal cone beam computed tomography (CBCT) images using ImageJ.

Methods:
Pediatric and adult patients were included who underwent TEES for a cholesteatoma between December 2011 and March 2015 and had available preoperative CBCT scans. Sagittal CT imaging data were analyzed by ImageJ to measure the maximum and minimum Feret diameters along the OEAC. The output data were then analyzed to determine the smallest maximum and smallest minimum Feret diameters for each patient.

Results:
Fifty-one patients ranging in age from 3 to 83 years old were included in this study. The smallest maximum Feret diameter ranged from 6.5 to 10.1 mm (mean: 8.0 mm) for pediatric patients (<16 years of age) and 6.9 to 15.0 mm (mean: 8.9 mm) for adult patients, while the smallest minimum Feret diameter ranged from 3.6 to 5.9 mm (mean: 5.1 mm) for pediatric patients and 3.4 to 6.4 mm (mean: 5.4 mm) for adult patients. Moreover, the smallest maximum Feret diameters of children were significantly smaller than those of adults.

Conclusion:
We have developed a novel method for measuring the diameter along the OEAC and determining its narrowest site. This method can be incorporated into the preoperative evaluation of patients who are candidates for TEES.
100 Years on: Politzer's Greatest Historical Legacy
Authors: Mudry Albert , Young John Riddington 
Published: April 2020

Objective:
To mark the centenary of Adam Politzer's death by investigating and celebrating the legacy he left to otology. Politzer is arguably one of the greatest otologists of the last 200 years and his textbook on otological history is undoubtedly the seminal work on the subject. The aim of this paper is twofold. Not only do the authors hope to find out if he is still remembered by otolaryngologists, but also what has been the greatest legacy which he has bequeathed to them.

Methodology:
Extensive review of available academic literature mentioning the name Politzer.

Results:
Politzer's celebrated tome, History of Otology was not only the first comprehensive book on the subject, but it has stood the test of time and still remains unsurpassed as the “Gold Standard” reference work.

Conclusion:
The considered opinion of the authors (both otolaryngologists and academic historians) is that the name of Politzer certainly lives on and that this book is probably his most enduring legacy to posterity. It can justifiably be said that Adam Politzer was the first otologist to prove the concept that the past is the key of the present, which opens the future.
Apolipoprotein C-II: the re-emergence of a forgotten factor
Authors: Wolska Anna , Reimund Mart , Remaley Alan T. 
Published: April 2020

Purpose of review
Apolipoprotein C-II (apoC-II) is a critical cofactor for the activation of lipoprotein lipase (LPL), a plasma enzyme that hydrolyzes triglycerides (TG) on TG-rich lipoproteins (TRL). Although apoC-II was first discovered nearly 50 years ago, there is renewed interest in it because of the recent efforts to develop new drugs for the treatment of hypertriglyceridemia (HTG). The main topic of this review will be the development of apoC-II mimetic peptides as a possible new therapy for cardiovascular disease.

Recent findings
We first describe the biochemistry of apoC-II and its role in TRL metabolism. We then review the clinical findings of HTG, particularly those related to apoC-II deficiency, and how TG metabolism relates to the development of atherosclerosis. We next summarize the current efforts to develop new drugs for HTG. Finally, we describe recent efforts to make small synthetic apoC-II mimetic peptides for activation of LPL and how these peptides unexpectedly have other mechanisms of action mostly related to the antagonism of the TG-raising effects of apoC-III.

Summary
The role of apoC-II in TG metabolism is reviewed, as well as recent efforts to develop apoC-II mimetic peptides into a novel therapy for HTG.