bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of renovascular hypertension
Authors: Textor Stephen C. 
Published: August 2020

Purpose of review
Renovascular occlusive disease remains a common cause of resistant and rapidly progressive hypertension. The present review summarizes current practice regarding management of renovascular hypertension (RVH).

Recent findings
Current data using blood oxygen level dependent MR emphasize the tolerance of the kidney to moderate reductions in blood flow and the efficacy of antihypertensive drug therapy for many individuals. Prospective trials have failed to identify benefits of revascularization for moderate disease, either regarding blood pressure or renal function. Antihypertensive drug therapy including renin-angiotensin system blockade is central to management of RVH. Recent and ongoing observational studies report important improvements after revascularization regarding blood pressure, management of refractory or ‘flash’ pulmonary edema, and survival in specific ‘high risk’ clinical populations not included in randomized trials. Research directions underscore the role of adjunctive measures, including mitochondrial protection, therapeutic angiogenesis, and cell-based regenerative repair to protect kidney function in RVH.

Summary
Clinicians should recognize the potential for disease progression to threaten renal function with severe and prolonged renal ischemia. Improved patient selection for true resistant hypertension with RVH and ‘high-risk’ clinical manifestations is critical to identify those likely to benefit from renal revascularization.
Adverse events beyond 1 year after percutaneous coronary intervention
Authors: Madhavan Mahesh V. , Stone Gregg W. 
Published: August 2020

Purpose of review
To provide a summary and critical appraisal of recent literature pertaining to very late adverse events (>1 year) after revascularization with percutaneous coronary intervention (PCI) with coronary stents.

Recent findings
Recent studies, including an individual patient-level pooled analysis of randomized trials and network meta-analysis have demonstrated that all coronary stents, including contemporary drug-eluting stents (DES), are associated with an ongoing risk of major adverse cardiovascular events related to the stented region beyond the first year after stent implantation, with rates ranging from 2 to 3% per year for at least 4 years. Patients also remain at additional risk for events originating outside the stented segments because of progressive de novo atherosclerotic disease.

Summary
Despite improvements in the management of coronary artery disease, patients remain at risk for very late adverse cardiovascular events both arising from the stented regions and other untreated segments of the coronary tree. Further advancements focused on primary prevention, stent design and procedural technique, and secondary prevention will be crucial to reducing rates of very late events and improving symptoms and prognosis of patients after PCI.
Surgical Treatment for SWS Glaucoma: Experience From a Tertiary Referral Pediatric Hospital
Authors: Karaconji Tanya , Ting Eugene R. , Zagora Sophia L. , Ardern-Holmes Simone , Jamieson Robyn V. , Grigg John R. 
Published: August 2020

Precis:
Glaucoma associated with Sturge-Weber syndrome (SWS) often requires surgical intervention. Our study shows that trabeculectomy is efficacious in treating this condition.

Purpose:
The purpose of this study was to describe the surgical outcomes of glaucoma associated with SWS in children presenting to the tertiary Paediatric Ophthalmology Department at The Children’s Hospital at Westmead.

Materials and Methods:
A retrospective study of patients with SWS referred to the Department of Ophthalmology at The Children’s Hospital at Westmead between 2003 and 2016 with at least 2 years of follow-up were identified, and information was collected from the clinical notes of all subjects.

Results:
A total of 27 patients with SWS were evaluated for glaucoma in which 8 were excluded due to inadequate follow-up. In total, 19 patients with SWS were included in this study in which glaucoma was diagnosed in 15 patients and 19 eyes, of which 13 eyes required glaucoma surgery. A total of 21 surgical procedures were performed with a median follow-up of 85 months. A primary trabeculotomy was performed in 5 eyes of which 4 required re-do trabeculotomy, and 3 of these eyes underwent a Baerveldt tube (BVT) shunt as a third procedure. One eye with a primary trabeculotomy underwent a BVT as a secondary procedure. A BVT was inserted in a total of 6 eyes in which it was a primary procedure in 2 eyes. Of the 6 eyes undergoing a BVT insertion, 5 achieved success (2 complete and 3 qualified), and 1 failed. One case underwent intraluminal stent removal. Six eyes underwent a primary trabeculectomy and needed no further surgical intervention. In the trabeculectomy group, 4 eyes achieved complete success and 2 eyes achieved qualified success.

Conclusions:
Glaucoma affects a significant proportion of patients with SWS and is associated with the presence of an ipsilateral port-wine stain in most cases. In our study, trabeculectomy was the most efficacious procedure for controlling intraocular pressure and reducing the burden of ongoing treatment in SWS-associated glaucoma.
Opioid Use After Orbital, Eyelid, or Lacrimal Surgery
Authors: Vu Priscilla Q. , Yu Jeffrey J. , Charlson Emily S. , Grob Seanna R. , Kshirsagar Rijul S. , Tao Jeremiah P. 
Published: August 2020

Purpose:
Opioids may be indicated to mitigate pain after oculofacial surgery. The opioid crisis prompted attention to how these medications are dispensed and disposed. This study aims to characterize opioid usage and handling of patients undergoing oculofacial plastic surgery.

Methods:
Eighty-nine adult patients were surveyed on their opioid usage after undergoing orbital, lacrimal, or eyelid (including esthetic) surgery at a tertiary oculofacial plastic surgery practice. Each patient was prescribed 10 tablets of hydrocodone/acetaminophen 5 mg/325 mg; one tablet taken orally as needed every 6 hours for pain not relieved by acetaminophen. Subset analysis was performed for type of surgery, age, and gender.

Results:
Patients consumed an average of 3 ± 0.4 tablets. In the subsets, the averages were 2.1 ± 0.5 (n = 38) tablets after eyelid surgery, 1.6 ± 0.6 (n = 24) after lacrimal surgery, and 5.6 ± 0.9 (n = 27) after orbital surgery. Greater opioid usage was observed after orbital versus eyelid surgery (p = 0.0007) and orbital versus lacrimal surgery (p = 0.0005) but not eyelid versus lacrimal surgery (p = 0.8604). Forty-six patients (51.7%) used no opioids. Over half (57.3%; n = 51) filled their prescription. Thirty-three patients (37.1%) had unused medications, of which 21 patients did not properly dispose of their medications. The mean age of patients who used opioids was less than the mean age of those who needed no opioids (p = 0.024). There were no gender differences in opioid usage use versus not (p = 0.62).

Conclusions:
Opioid needs after oculofacial plastic surgeries, especially eyelid and lacrimal, were minimal in this cohort. For most patients, the prescription exceeded needs. Younger age but not gender was associated with opioid use versus not. Most did not properly discard these medications. Quality improvement in both the dispensing and disposal of opioids in oculofacial surgical practice may be warranted.
Anophthalmic Ptosis and the Effects of Enucleation on Upper Eyelid Function
Authors: Custer Philip L. , Maamari Robi N. , Huecker Julia B. , Gordon Mae O. 
Published: August 2020

Purpose:
To describe the incidence of anophthalmic ptosis, identify clinical factors associated with its development, and evaluate the effects of enucleation on eyelid mechanics.

Methods:
In this observational cohort study, measurements and photographs were reviewed in 139 patients who underwent enucleation between 2007 and 2016. Patient demographics, pre- and postoperative eyelid measurements, and exophthalmometry were used to assess the incidence of ptosis and effects of surgery on eyelid function.

Results:
Preoperative ptosis was common and more often present in patients with enophthalmos (p = 0.0305) or reactive blepharospasm (p < 0.0001). The incidence of new-onset ptosis and improvement of preexisting ptosis following enucleation were similar (40%). Surgical repair was performed in 7% of patients with ptosis. Contralateral levator function declined with age and was positively correlated with exophthalmometry (p < 0.0001). Anophthalmic levator function was greater with increased anterior projection of the implant (p < 0.0001) and prosthesis (p < 0.0001). Patients with larger implants had improved levator function, with (p = 0.0065) and without (p = 0.0007) the prosthesis. Superior sulcus deepening was associated with decreased levator activity, but not margin-reflex distance.

Conclusions:
Preoperative ptosis was common, and often related to reactive blepharospasm or enophthalmos. Levator function declined with age, and correlated to greater anterior projection of the implant and prosthesis following enucleation. The surgeon can counsel patients regarding the similar likelihood (40%) of preoperative ptosis improving and new ptosis developing after enucleation. The primary factor the surgeon can modify to improve postoperative eyelid function is to maximize implant size, which is associated with greater levator activity.
Substance use and risk of HIV infection among Men who have Sex with Men in India
Authors: Kumar Pradeep , Aridoss Santhakumar , Mathiyazhakan Malathi , Balasubramanian Ganesh , Jaganathasamy Nagaraj , Natesan Manikandan , V.M. Padmapriya , David Joseph K. , Rajan Shobini , Adhikary Rajatashuvra , Arumugam Elangovan 
Published: August 2020

Abstract
HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances.
Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015.
For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection.
One in 3 MSM (33.88%) in India were substance users, thus exhibiting “multi-risk” (MR) behaviors. Significantly higher HIV prevalence (3.8%, P < .05) was reported among MR-MSM, despite 97.2% of them being aware of HIV. Higher HIV prevalence among MSM exhibiting homosexual behavior for ≤1 year is of specific concern, as this accounts to recent infections and indicates the increased vulnerability of the infection among the new entrants.
Substance-use resulting in high-risk sexual behavior was significantly associated with higher HIV prevalence among MR-MSM. Integrated targeted interventions focusing on safe sex and safe-IDU practices among MR-MSM are required to end the disease transmission.
COVID-19 in hematological malignancy patients
Authors: Chen Can , Weng Qianping , Li Yiwei , Shi Pengfei , Qian Shenxian 
Published: August 2020

Abstract

Background:
COVID-19 is an international outbreak of the respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The diseases themselves, as well as the intensity of chemotherapy, lead to significant immunosuppression, leading hematological malignancy patients susceptible to infections.

Methods:
This protocol will be performed according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and reported follow the Cochrane Collaboration Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases of PubMed, MEDLINE, Google Scholar, Web of science, Cochrane Library, EMBASE, CNKI, CMB, and Wangfang database from the inception to present will be comprehensively and systematically searched without limitations of language, date, and publication status. Observational, retrospective cohort, prospective case-control, cohort studies, cross-sectional studies, or clinical trials will be included. All assessment of study selection, data extraction, and study quality assessment will be independently performed by 2 reviewers. RevMan V.5.3 program and Stata V.12.0 software will be utilized for the methodological quality assessment and statistical analysis.

Results:
The result of this systematic review will provide evidence for clinicians on the management of COVID-19 patients with hematological malignancy.

Conclusion:
This systematic review will help raise awareness and guide management of COVID-19 patients with hematological malignancy, as well as to improve outcomes in this population.

Ethic and dissemination:
The content of this article does not involve moral approval or ethical review because no individual data will be collected.

PROSPERO registration:
CRD42020187493.
Analgesic effect of pulsed electromagnetic fields for mammaplasty
Authors: Zhang Li , Ding Wei , Ji Yu 
Published: August 2020

Abstract

Background:
Pulsed electromagnetic fields shows some potential in alleviating pain after mammaplasty. This systematic review and meta-analysis is conducted to investigate the analgesic efficacy of pulsed electromagnetic fields for pain control after mammaplasty.

Methods:
The databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases are systematically searched for collecting the randomized controlled trials regarding the impact of pulsed electromagnetic fields on pain intensity after mammaplasty.

Results:
This meta-analysis has included 4 randomized controlled trials. Compared with control group after mammaplasty, pulsed electromagnetic fields results in remarkably reduced pain scores on 1 day (MD = −1.34; 95% confidence interval [CI] = −2.23 to −0.45; P = .003) and 3 days (MD = −1.86; 95% CI = −3.23 to −0.49; P = .008), as well as analgesic consumption (Std. MD = −5.64; 95% CI = −7.26 to −4.02; P < .00001).

Conclusions:
Pulsed electromagnetic fields is associated with substantially reduced pain intensity after mammaplasty.
Effect of a critical thinking intervention on stress management among undergraduates of adult education and extramural studies programs
Authors: Okide Charity Chinelo , Eseadi Chiedu , Ezenwaji Ifeyinwa O. , Ede Moses O. , Igbo Rosemary Ogochukwu , Koledoye Uzoamaka Lucynda , Ekwealor Nwakaego Ebele , Osilike Chioma , Okeke Nkechi Mercy , Igwe Ngozi Justina , Nwachukwu Ruphina U. , Ukanga Lambert Peter , Olajide Mulii Falaremi , Onuorah Anthonia Ekanibe , Ujah Patrick , Ejionueme Lambert K. , Abiogu Godwin C. , Eskay Michael , Ugwuanyi Christian S. 
Published: August 2020

Abstract

Objective:
The objective of this study was to examine the effect of a critical thinking intervention (CTI) on stress management among undergraduates of adult education and extramural studies programs.

Method:
A total of 44 undergraduates were randomly sorted into experimental and waitlist control groups. We used the Perceived Stress Scale for data collection at the pre-test, post-test, and follow-up stages. We used unpaired t and paired t-tests to analyze the data collected. SPSS version 22.0 was used for the data analyses (SPSS Inc., Chicago, IL).

Results:
It was shown that the CTI was effective in reducing the mean stress of the participants compared to the control group both in the post-test (t[42] = −22.453, P < .001) and follow-up periods (t[42] = −34.292, P < .001). There were statistically significant changes in the mean stress of participants in the experimental group from the pre-test to post-test phases (t[23] = 26.30, P = .000, r = .08], and from pre-test to follow-up(t[23] = 37.10, P = .000, r = .30). The mean stress of the participants in the experimental group from post-test to follow-up signified the sustained positive influence of the CTI on the mean stress (t[23] = 2.41, P = .000, r = .46) of the undergraduates.

Conclusion:
This study adds to the literature by showing that a CTI is a valuable strategy for stress reduction in a university environment. Given that the CTI demonstrated the ability to reduce stress among undergraduates enrolled in adult education and extramural studies programs, we hope that similar interventions will be adopted to manage and prevent stress among students in other departments and disciplines.
Impaired immune and coagulation systems may be early risk factors for COVID-19 patients
Authors: Qin Zhi-jun , Liu Lei , Sun Qun , Li Xia , Luo Jian-fei , Liu Jia-sheng , Liu Dan 
Published: August 2020

Abstract
The coronavirus disease 2019 (COVID-19) outbreak has become a global health threat and will likely be one of the greatest global challenges in the near future. The battle between clinicians and the COVID-19 outbreak may be a “protracted war.”
The objective of this study was to investigate the risk factors for in-hospital mortality in patients with COVID-19, so as to provide a reference for the early diagnosis and treatment.
This study retrospectively enrolled 118 patients diagnosed with COVID-19, who were admitted to Eastern District of Renmin Hospital of Wuhan University from February 04, 2020 to March 04, 2020. The demographics and laboratory data were collected and compared between survivors and nonsurvivors. The risk factors of in-hospital mortality were explored by univariable and multivariable logistic regression to construct a clinical prediction model, the prediction efficiency of which was verified by receiver-operating characteristic (ROC) curve.
A total of 118 patients (49 males and 69 females) were included in this study; the results revealed that the following factors associated with in-hospital mortality: older age (odds ratio [OR] 1.175, 95% confidence interval [CI] 1.073–1.287, P = .001), neutrophil count greater than 6.3 × 109 cells/L (OR 7.174, (95% CI 2.295–22.432, P = .001), lymphocytopenia (OR 0.069, 95% CI 0.007–0.722, P = .026), prothrombin time >13 seconds (OR 11.869, 95% CI 1.433–98.278, P = .022), d-dimer >1 mg/L (OR 22.811, 95% CI 2.224–233.910, P = .008) and procalcitonin (PCT) >0.1 ng/mL (OR 23.022, 95% CI 3.108–170.532, P = .002). The area under the ROC curve (AUC) of the above indicators for predicting in-hospital mortality were 0.808 (95% CI 0.715–0.901), 0.809 (95% CI 0.710–0.907), 0.811 (95% CI 0.724–0.898), 0.745 (95% CI 0.643–0.847), 0.872 (95% CI 0.804–0.940), 0.881 (95% CI 0.809–0.953), respectively. The AUC of combined diagnosis of these aforementioned factors were 0.992 (95% CI 0.981–1.000).
In conclusion, older age, increased neutrophil count, prothrombin time, d-dimer, PCT, and decreased lymphocyte count at admission were risk factors associated with in-hospital mortality of COVID-19. The prediction model combined of these factors could improve the early identification of mortality risk in COVID-19 patients.
Prediction of nodal staging in breast cancer patients with 1-2 sentinel nodes in the Z0011 era
Authors: Corsi Fabio , Sorrentino Luca , Albasini Sara , Bossi Daniela , Morasso Carlo , Villani Laura , Truffi Marta 
Published: August 2020

Abstract
The aim of this study was to provide an innovative nomogram to predict the risk of >2 positive nodes in patients fulfilling the Z0011 criteria with 1-2 sentinel lymph nodes (SLNs) only retrieved.
From 2007 to 2017, at the Breast Unit of ICS Maugeri Hospital 271 patients with 1-2 macrometastatic SLNs, fulfilling the Z0011 criteria, underwent axillary dissection and were retrospectively reviewed.
A mean of 1.5 SLNs per patient were identified and retrieved. One hundred eighty-seven (69.0%) had 1-2 positive nodes, and 84 (31.0%) had >2 metastatic nodes. Independent predictors of axillary status were: positive SLNs/retrieved SLNs ratio (odds ratio [OR] 10.95, P = .001), extranodal extension (OR 5.51, P = .0002), and multifocal disease (OR 2.9, P = .003). A nomogram based on these variables was constructed (area under curve after bootstrap = 0.74).
The proposed nomogram might select those patients fulfilling the Z0011 criteria, with 1-2 SLNs harvested, in whom a high axillary tumor burden is expected, aiding to guide adjuvant treatments.
Severe reflux esophagitis and multiple congenital defects
Authors: Ma Jia-Yi , Wang Dan , Li Zhao-Shen , Hu Liang-Hao 
Published: August 2020

Abstract

Introduction:
Gastroesophageal reflux disease is a common and troublesome condition. This paper reports a rare case of gastroesophageal reflux disease caused by ectopic biliary drainage accompanying the absence of a pyloric channel and duodenal bulb in a female patient with multiple underlying malformations.

Patient concerns:
A 24-year-old female presented with acid regurgitation and abdominal pain for one month. She was born two weeks premature and with blindness of the right eye. Cardiac murmur was detected in the physical examination.

Diagnosis:
Gastroendoscopy was performed, and a class D reflux esophagitis and ectopic papilla complicated with the absence of a pyloric channel and duodenal bulb were found. Doppler echocardiography further confirmed the defects of atrial and ventricular septa. Trio-based whole exome sequencing was performed on the proband and her family to find the potential association of multiple variations. However, no putative pathogenic mutations were found.

Interventions:
The patient received proton pump inhibitors and prokinetic treatment and underwent surgical repair of septal defects.

Outcomes:
The symptoms were quickly relieved, and the patient was kept stable upon follow-up.

Conclusion:
The combination of an absent pylorus and ectopic papilla is a rare cause of reflux esophagitis. Unusual gastrointestinal anatomical variations may be accompanied by other malformations. Though no remarkable mutation were detected in this case, sequencing is an efficient technique worth full consideration.