bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Features of Sarcopenia in Patients With Lumbar Spinal Stenosis
Authors: Matsuo Sachika , Kawakami Mamoru , Minetama Masakazu , Nakagawa Masafumi , Teraguchi Masatoshi , Kagotani Ryohei , Mera Yoshimasa , Yamamoto Yoshio , Sakon Nana , Nakatani Tomohiro , Sumiya Tadashi , Nakagawa Yukihiro 
Published: March 2020

Study Design.
Cross-sectional design.

Objective.
To investigate the prevalence of sarcopenia and identify factors associated with sarcopenia in patients with lumbar spinal stenosis (LSS).

Summary of Background Data.
Patients with LSS have a higher prevalence of sarcopenia compared with healthy older adults. However, the clinical features of sarcopenia in patients with LSS are poorly understood and the factors affecting sarcopenia in patients with LSS remain unclear.

Methods.
Patients diagnosed with LSS based on clinical examination and magnetic resonance imaging findings, and referred to physical therapy, were enrolled. Muscle mass was measured using bioelectrical impedance using InBody S10. We collected a numerical rating scale (NRS) for back pain, the 36-Item Short-Form Survey (SF-36), the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), bone mineral density (BMD), and radiographic measurements of spinal alignment. Sarcopenia was defined according to the Asian Working Group for Sarcopenia guidelines and patients were classified into sarcopenia or nonsarcopenia groups.

Results.
A total of 178 patients were enrolled: 35 in the sarcopenia group and 143 in the nonsarcopenia group. The prevalence of sarcopenia was 19.7%. The average percent of slip (% slip) among patients in the sarcopenia group was significantly higher compared with those in the nonsarcopenia group (P < 0.05). Body mass index (BMI), BMD, physical function as assessed by the SF-36, and gait disturbance as assessed by the JOABPEQ were significantly lower in the sarcopenia group compared with those in the nonsarcopenia group (P < 0.05). A trend was observed toward between-group differences in back pain on the NRS (P < 0.1). In the logistic regression analysis, significant associations were seen between sarcopenia and % slip (odds ratio 1.15, 95% CI 1.01–1.30).

Conclusion.
Patients with LSS and sarcopenia have a higher degree of slippage and lower BMI, BMD, and physical function, and reported more severe low back pain, compared with those without sarcopenia.

Level of Evidence: 4
Management of ventricular arrhythmias in patients with LVAD
Authors: Maradey Joan A. , Singleton Matthew J. , O’Neill Thomas J. , Bhave Prashant D. 
Published: March 2020

Purpose of review
Left ventricular assist devices (LVADs) have extended the life expectancy of patients with heart failure. The hemodynamic support afforded by LVADs in this population has also resulted in patients having prolonged ventricular arrhythmias. The purpose of this article is to review the mechanisms of ventricular arrhythmias in LVADs and the available management strategies.

Recent findings
Recent evidence suggests that prolonged ventricular arrhythmias may result in increased mortality in patients with LVADs.

Summary
Successful management of ventricular arrhythmias in patients with LVAD requires interdisciplinary collaboration between electrophysiology and heart failure specialists. Medical management, including changes to LVAD changes, heart failure medication management, and antiarrhythmics constitute the initial treatment for ventricular arrhythmias. Surgical or endocardial ablation are reasonable options if VAs are refractory.
Blood pressure-related hypoalgesia: a systematic review and meta-analysis
Authors: Makovac Elena , Porciello Giuseppina , Palomba Daniela , Basile Barbara , Ottaviani Cristina 
Published: March 2020

Objective:
Spontaneous or experimentally induced high blood pressure (BP) is associated with reduced pain perception, known as BP-related hypoalgesia. Despite its clinical implications, such as the interference with early detection of myocardial infarction in ‘at risk’ groups, the size of the association between high BP and pain has not yet been quantified. Moreover, the distinct association between high BP and physiological or psychological components of pain has not yet been considered so far. The aim of this study was to overcome this gap by performing separate meta-analyses on nociceptive response versus quantifiable perceptual measures of pain in relation to high BP.

Methods:
PubMed and Web of Knowledge databases were searched for English language studies conducted in humans. Fifty-nine studies were eligible for the analyses. Pooled effect sizes (Hedges’ g) were compared. Random effect models were used. Results show that higher BP is significantly associated with lower nociceptive response (g = 0.38; k = 6) and reduced pain perception, assessed by quantifiable measures (g = 0.48; k = 59).

Results:
The association between BP and pain perception, derived from highly heterogeneous studies, was characterized by significant publication bias. BP assessment, pain assessment, site of pain stimulation, percentage of female participants in the sample, and control for potential confounders were significant moderators.

Conclusion:
Current meta-analytic results confirm the presence of BP-related hypoalgesia and point towards the need for a better understanding of its underlying mechanisms.
Locking Y Lateral Canthopexy as a Treatment for Dry Eye Disease Caused by Eyelid Malposition
Authors: Ortega-Evangelio Leticia , Peris-Martínez Cristina , Marco-Campmany Amelia , Ortega-Serrano Joaquín , Tomás-Torrent Juan M. 
Published: March 2020

Purpose:
The signs and symptoms of dry eye disease (DED) can affect the quality of life of patients. This study analyzes whether locking Y lateral canthopexy improves patients’ quality of life and in what way it does so (based on the ocular surface disease index questionnaire) and DED signs (measured by the fluorescein breakup time, tear osmolarity, Schirmer test, and corneal staining) in patients with DED caused by a eyelid malposition or impaired blink dynamics.

Methods:
This was a case-control study. Forty eyes of 20 patients with DED and lateral canthal disinsertion examined at the University Hospital La Ribera during a 1-year period from November 2016 to November 2017. The 40 eyes were divided into 2 groups: Group 1 eyes that underwent locking Y lateral canthopexy (i.e., a plication of the superficial lateral canthal tendon to the lateral orbital rim periosteum); and group 2 eyes that underwent observational treatment, without surgery. Symptoms and signs in OU were recorded separately at baseline and 1 month after surgery.

Results:
One month after surgery, the ocular surface disease index reduced in group 1 eyes when compared with those of group 2 (p = 0.001), fluorescein breakup time showed an improvement in the operated eyes (group 1) (p < 0.001) and corneal staining was reduced in group 1 after surgery (p = 0.012). The osmolarity results did not change when compared with eyes from group 2 (p < 0.001).

Conclusions:
Locking Y lateral canthopexy is an effective surgical technique for treating patients with evaporative dry eye caused by a lateral canthal tendón disinsertion by restoring proper eyelid closure and improving blinking dynamics. It improves DED signs and symptoms, thereby enhancing the quality of life of patients.
Comparison of visual performance and satisfaction with a bilateral emmetropic vs a bilateral mild myopic target using a spherical monofocal intraocular lens
Authors: Vinciguerra Paolo , Holladay Jack T. , Pagano Luca , Gramigna Marco , Borgia Alfredo , Lanni Vittoria , Legrottaglie Emanuela , Vinciguerra Riccardo 
Published: March 2020

Purpose:To compare the binocular visual outcomes and satisfaction of patients with emmetropia or mild myopia (−0.50 diopters [D]) implanted with a bilateral spherical monofocal IOL.Setting:Ophthalmology Department, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.Design:Prospective nonrandomized study.Methods:This study comprised 2 groups of 30 patients each. Group 1 included patients implanted with bilateral monofocal IOLs with near emmetropic target (plano to −0.25 D). Group 2 included patients with a postoperative bilateral target of −0.50 D. Both groups underwent uncorrected and corrected distance defocus curves postoperatively and subjective questionnaires were used to investigate patient satisfaction postoperatively.Results:The defocus curve showed a significant difference between Group 1 and Group 2 binocular vision (allPvalues <.01 except at −3.00 D wherePvalue = .32) with Group 1 seeing significantly better than Group 2 at +1.00, +0.50, and 0 but significantly worse in all other points of the defocus. In addition, patients of Group 2 at 0 D of defocus curve (infinite) had a visual acuity close to 0 logarithm of the minimum angle of resolution (logMAR) (0.03 ± 0.04). The main outcome of Group 2 defocus curves was that, at defocus point 0 D, even if the mean refraction was −0.67 0.15 × 160, mean uncorrected logMAR visual acuity was 0.0 ± 0.06.Conclusions:Bilateral monofocal IOLs implanted with mild myopic target provided better intermediate visual acuity compared with emmetropia at a minimal cost in terms of uncorrected distance visual acuity.
Placebo hypoalgesia: racial differences
Authors: Okusogu Chika , Wang Yang , Akintola Titilola , Haycock Nathaniel R. , Raghuraman Nandini , Greenspan Joel D. , Phillips Jane , Dorsey Susan G. , Campbell Claudia M. , Colloca Luana 
Published: March 2020

Abstract
No large-cohort studies that examine potential racial effects on placebo hypoalgesic effects exist. To fill this void, we studied placebo effects in healthy and chronic pain participants self-identified as either African American/black (AA/black) or white. We enrolled 372 study participants, 186 with a diagnosis of temporomandibular disorder (TMD) and 186 race-, sex-, and age-matched healthy participants to participate in a placebo experiment. Using a well-established paradigm of classical conditioning with verbal suggestions, each individual pain sensitivity was measured to calibrate the temperatures for high- and low-pain stimuli in the conditioning protocol. These 2 temperatures were then paired with a red and green screen, respectively, and participants were told that the analgesic intervention would activate during the green screens to reduce pain. Participants then rated the painfulness of each stimulus on a visual analog scale ranging from 0 to 100. Racial influences were tested on conditioning strength, reinforced expectations, and placebo hypoalgesia. We found that white participants reported greater conditioning effects, reinforced relief expectations, and placebo effects when compared with their AA/black counterparts. Racial effects on placebo were observed in TMD, although negligible, short-lasting, and mediated by conditioning strength. Secondary analyses on the effect of experimenter-participant race and sex concordance indicated that same experimenter-participant race induced greater placebo hypoalgesia in TMDs while different sex induced greater placebo hypoalgesia in healthy participants. This is the first and largest study to analyze racial effects on placebo hypoalgesia and has implications for both clinical research and treatment outcomes.
Liver metastases from pancreatic ductal adenocarcinoma: is there a place for surgery in the modern era?
Authors: Imai Katsunori , Margonis Georgios A. , Wang Jaeyun , Wolfgang Christopher L. , Baba Hideo , Weiss Matthew J. 
Published: March 2020

Abstract
Pancreatic ductal adenocarcinoma (PDAC) represents one of the most aggressive malignancies, and the majority of patients with PDAC present with metastatic disease, mainly in the liver, at the time of diagnosis. Surgical resection is the only treatment that can offer prolonged survival and possible cure. However, the indications for surgery for patients with PDAC metastases remain extremely limited to highly selected patients with localized disease, and metastatic disease is generally regarded as a contraindication to surgery. Recently, however, the advent of more effective chemotherapy has changed the treatment strategy for metastatic PDAC. In fact, cases in which resection of synchronous or metachronous PDAC liver metastases lead to prolonged survival in highly selected patients have been reported. In this review, we provide current data regarding survival outcomes after surgery, and discuss the role of surgical resection and selection criteria for patients with PDAC liver metastases in the modern era.
Fat Grafting Improves Fibrosis and Scarring in Vulvar Lichen Sclerosus: Results From a Prospective Cohort Study
Authors: Almadori Aurora , Hansen Esther , Boyle Deborah , Zenner Nicole , Swale Victoria , Reid Wendy , Maclane Allan , Butler Peter E.M. 
Published: March 2020

Objective
The aim of the study was to evaluate the effect of lipotransfer in women presenting with fibrosis and scarring due to lichen sclerosus.

Materials and Methods
This prospective cohort study included 33 women attending the vulvar clinic of a public hospital. Patients received one lipotransfer treatment. Validated measures were used prospectively to assess the sexual function (Female Sexual Function Index, Female Sexual Distress Scale); symptoms (visual analog scale for itching, burning, soreness), pain (Pain Anxiety Symptoms Scale 20); psychological status and quality of life (Hospital Anxiety and Depression Scale, Relationship Assessment Scale, Wound Management Questionnaire Revised); physician-based disease signs (Vulvar Architecture Severity Scale). Data were analyzed using paired t test with nonparametric Wilcoxon matched-pairs signed rank test and unpaired t test with nonparametric Mann-Whitney test (Prism6 Software).

Results
The mean (SD) follow-up was 12.9 (3.5) months. Sexual function improved after treatment (p < .001), as well as the distress associated with sexuality (p < .0001). A significant improvement was reported in itching (p < .001), burning (p < .05), soreness (p < .001), and pain (p < .0001). Patients reported a significant improvement in romantic relationship (p < .05), anxiety (p < .0001), and depression (p < .0001). Improvement was not significant in the self-care associated with self-disgust assessment (p = .42). The clinical physician-based score showed an overall improvement in all the treated areas to lesser or greater extent.

Conclusions
The use of fat grafting in lichen sclerosus is promising. Further studies are required to rule out a potential placebo effect and to better understand the underlying molecular mechanism of action.
Features of the Vaginal and Vestibular Microbioma in Patients With Vestibulodynia: A Case-Control Study
Authors: Murina Filippo , Caimi Camilla , Di Pierro Francesco , Di Francesco Stefania , Cetin Irene 
Published: March 2020

Objective
Our objective was to determine the role of vaginal and/or vestibular microbiota disturbance as an associated factor of symptom characteristic of provoked vestibulodynia (PVD).

Study Design
In an observational case-control study, the bacterial microbiomes in the vagina and vestibule from 20 women with PVD and 18 healthy controls were compared using a 16S rRNA gene-based molecular analysis. Clinical data were recorded through a 0- to 10-point visual analog scale related to dyspareunia and vulvovaginal pain/burning.

Results
Comparative assessment of the bacterial taxa (cutoff ≥15%) revealed 105 genera in the vaginal samples of PVD patients and 113 genera in the vestibular samples. Similarly, 120 genera were detected in the vaginal samples and 151 in the vestibular samples of the control group. Bacterial complexity was higher in the vestibular samples than in vaginal samples in both groups, without statistically significant differences. The following 3 dominant taxonomic units were found: Lactobacillus, Gardnerella, and Atopobium in PVD patients and Lactobacillus, Gardnerella, and Bifidobacterium in the control group. Lactobacillus gasseri was dominant only in women with PVD, showing a significant correlation with burning/pain intensity and dyspareunia severity (0.255 and 0.357, respectively, p < .001).

Conclusions
Our data suggest that bacterial communities in vaginal discharge are an important contributor to the vestibular microbiota. Lactobacillus gasseri may be an element of vulnerability toward the development of vaginal dysbiosis. We can postulate its association as a potential etiologic organism in some individuals, either by itself or in some combination with other trigger factors.
Adult Vulvar Lichen Sclerosus: Can Experts Agree on the Assessment of Disease Severity?
Authors: Sheinis Michal , Green Nicole , Vieira-Baptista Pedro , Carriero Carmine , Fischer Gayle , Leclair Catherine , Madnani Nina , Moyal-Barracco Micheline , Selk Amanda 
Published: March 2020

Objective
The objective of this study was to test the severity rating of the signs and architectural changes for interrater reliability among world experts via analysis of lichen sclerosus (LS) photographs.

Methods
A recent Delphi consensus exercise established a list of symptoms, signs, and architectural changes, which experts feel are important to include in a severity scale. Photographs of vulvar LS were manually extracted from patient charts and 50 photographs with a range of severity of signs and architectural changes were chosen. Lichen sclerosus experts were invited to take part in the study and 3 dermatologists and 3 gynecologists were selected for their expertise and geographic variety. Raters assessed the photographs for multiple signs and architectural changes as well as an overall impression of disease severity on a 4-point Likert scale. Intraclass correlation coefficients were calculated.

Results
The intraclass correlation coefficients were very poor for individual signs and architectural changes as well as for overall disease severity when analyzed for all 6 raters as well as when analyzed with dermatologists' and gynecologists' responses grouped separately. There were no statistically significant correlations found.

Conclusions
Global experts were unable to agree on any signs, architectural changes, or an overall global impression to assess vulvar LS disease severity based on analysis of vulvar photographs. Standardized descriptions regarding what constitutes mild, moderate, and severe signs and anatomical changes are required before further scale development can occur.
Retrospective 15-Year Review of Anal Cytology Screening in Women at Mayo Clinic Rochester, Minnesota
Authors: Marnach Mary L. , Larish Alyssa M. , Kim Sharon J. , Mara Kristin C. , Henry Michael R. , Chantigian Paula D. M. 
Published: March 2020

Objectives
Anal cytology is a modality for anal cancer screening in high-risk women. In this retrospective study, we review risk factors associated with abnormal anal cytology and unsatisfactory anal cytology rates, and correlate findings of cytology with histological results.

Methods
A retrospective cohort study of anal cytology screening in women at Mayo Clinic in Rochester, Minnesota from 2002 to 2018 was conducted.

Results
Three hundred fifty-seven women had a total of 592 anal cytologies performed. Three hundred seventeen women had screening anal cytology, whereas 40 women had anal cytology for surveillance given a history of anal intraepithelial neoplasia (AIN) or anal cancer. An unsatisfactory anal cytology result was found in 14.7%. Risk factors, type of follow-up, and correlation with histologic specimens were also reviewed. Histologic finding of AIN 2/3 correlated with abnormal anal cytology 84% of the time in this cohort.

Conclusions
High-risk women should be screened on a periodic basis for anal cancer. Anal cytology is one possible modality that can be used. Further insight into AIN progression, regression, recurrence, and outcome after treatment will help direct future screening recommendations.
Testosterone therapy and other treatment modalities for female sexual dysfunction
Authors: Ingram Catherine F. , Payne Kelly S. , Messore Marisa , Scovell Jason M. 
Published: March 2020

Purpose of review
Recently in October 2019 a Global Consensus Position on the use of Testosterone Therapy for Women was published. The use of testosterone and other agents for female sexual dysfunction (FSD) is an important topic for the urologist focusing on sexual health. This review describes the known causes for FSD, and discusses the role of androgens in this disorder, the evidence for using testosterone treatment, and other current and emerging therapies.

Recent findings
A recent meta-analysis, published in The Lancet Diabetes & Endocrinology evaluated a total of 36 randomized control trials spanning 1990–2018 and includes a total of 8480 patients. The primary findings were that testosterone therapy (TTh) increased sexual function including satisfactory sexual event frequency, sexual desire, pleasure, arousal, orgasm, responsiveness, and self-image when compared with either a placebo or drug-control (e.g., estrogen ± progestogen). In addition, TTh reduced sexual concerns and distress in postmenopausal women. Side effects included an increase in weight, acne, and hair growth, but there was no increase in serious adverse events. Importantly, TTh duration was greater than 12 weeks in all randomized control trials included in this meta-analysis.

Summary
TTh is effective to treat FSD in postmenopausal women. More data is required to evaluate the long-term safety data on the effects of TTh on cardiovascular health, breast health, cognitive function, and the musculoskeletal system in women.
Metastasectomy in patients with renal cell carcinoma: when and how?
Authors: Omid Sara , Abufaraj Mohammad , Remzi Mesut 
Published: March 2020

Purpose of reviewThe role of metastasectomy in the management of metastatic renal cell carcinoma (mRCC) remains controversial. The aim of this review is to summarize and evaluate the recent findings about the surgical treatment of patients with mRCC focusing on the literature published in the last 2 years.Recent findingsDespite the lack of randomized controlled trials, the benefit of metastasectomy in term of cancer-specific and overall survival have been demonstrated in large observational studies. Results of ongoing clinical trials evaluating the impact of combination of surgical and systemic therapies are eagerly awaited and may shed the light on a new treatment armamentarium in this subset of patients.SummarySeveral novel systemic agents have emerged and is continuously changing the treatment paradigm in patients with advanced RCC. However, surgical resection of the primary tumor and metastatic deposits represents a definitive cure option in well selected patients.