bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palpebral Pleomorphic Adenomas of the Lacrimal Gland
Authors: Vahdani Kaveh , Rose Geoffrey E. 
Published: May 2020

Aims:
To report the characteristics and management for patients with palpebral pleomorphic adenoma of the lacrimal gland.

Methods:
The records for patients with palpebral pleomorphic adenoma seen at Moorfields Eye Hospital between 1978 and 2019 were reviewed for demographics, presentation, imaging, histopathology, management, and outcome.

Results:
Forty-three patients (25 male; 58%) with palpebral pleomorphic adenoma were identified, presenting at a mean age of 46 years (median 46.4 years; range 24–81 years) with symptoms for an average of 31 months (median 18.0 months; range 1 month to 17 years). The commonest symptom was a painless upper lid lump (37 patients; 86%), although 4 patients (9%) had a localized ache, and 1 (2%) had episodic epiphora. A moderately-mobile, firm round mass (like a “chick-pea”) was readily palpable in 39/43 (91%) patients, and significant ptosis and upper lid swelling was noted in 6 cases (14%). Imaging was reviewed in 35 patients, 28 (80%) having a well-defined homogeneous mass in front of the orbital rim, on the anterior pole of the lacrimal gland. With the exception of 8 tumors removed from the actual palpebral lobe using a conjunctival incision, all others were excised intact through an upper eyelid skin-crease incision. Histopathology confirmed an intact pseudocapsule in 39/43 (91%) and 10 (23%) had a mild chronic lymphocytic inflammation within the tumor and/or neighboring lacrimal gland. There were no tumor recurrences at an average follow-up of 40 months (median 9.1; range 2 weeks to 230 years).

Conclusion:
Most palpebral pleomorphic adenomas are discovered as an upper lid lump and a few first become manifest as upper lid swelling with ptosis. To avoid inadvertent incisional biopsy, they should be recognized preoperatively—especially as most are readily palpable as a hard lump superotemporally, often freely mobile in the suborbicularis plane (anterior to the tarsus and main lacrimal gland). Excision, generally easiest through a transcutaneous route, was judged intact in all cases and confirmed in 91% of histological reports, with no recurrent tumors.
Differential expression of cerebrospinal fluid neuroinflammatory mediators depending on osteoarthritis pain phenotype
Authors: Flores Bjurström Martin , Bodelsson Mikael , Montgomery Agneta , Harsten Andreas , Waldén Markus , Janelidze Shorena , Hall Sara , Hansson Oskar , Irwin Michael R. , Mattsson-Carlgren Niklas 
Published: May 2020

Abstract
Neuroinflammation is implicated in the development and maintenance of persistent pain states, but there are limited data linking cerebrospinal fluid (CSF) inflammatory mediators with neurophysiological pain processes in humans. In a prospective observational study, CSF inflammatory mediators were compared between patients with osteoarthritis (OA) who were undergoing total hip arthroplasty due to disabling pain symptoms (n = 52) and pain-free comparison controls (n = 30). In OA patients only, detailed clinical examination and quantitative sensory testing were completed. Cerebrospinal fluid samples were analyzed for 10 proinflammatory mediators using Meso Scale Discovery platform. Compared to controls, OA patients had higher CSF levels of interleukin 8 (IL-8) (P = 0.002), intercellular adhesion molecule 1 (P = 0.007), and vascular cell adhesion molecule 1 (P = 0.006). Osteoarthritis patients with central sensitization possibly indicated by arm pressure pain detection threshold <250 kPa showed significantly higher CSF levels of Fms-related tyrosine kinase 1 (Flt-1) (P = 0.044) and interferon gamma-induced protein 10 (IP-10) (P = 0.024), as compared to subjects with PPDT above that threshold. In patients reporting pain numerical rating scale score ≥3/10 during peripheral venous cannulation, Flt-1 was elevated (P = 0.025), and in patients with punctate stimulus wind-up ratio ≥2, CSF monocyte chemoattractant protein 1 was higher (P = 0.011). Multiple logistic regression models showed that increased Flt-1 was associated with central sensitization, assessed by remote-site PPDT and peripheral venous cannulation pain, and monocyte chemoattractant protein-1 with temporal summation in the area of maximum pain. Multiple proinflammatory mediators measured in CSF are associated with persistent hip OA-related pain. Pain phenotype may be influenced by specific CSF neuroinflammatory profiles.
Impaired alcohol-induced dopamine release in the nucleus accumbens in an inflammatory pain model: behavioral implications in male rats
Authors: Campos-Jurado Yolanda , Lorente Jesús David , González-Romero José Luis , Granero Luis , Polache Ana , Hipólito Lucía 
Published: May 2020

Abstract
Recent studies have drawn the attention to the link between alcohol use disorder and the presence of pain. Indeed, the correct management of pain in patients with a previous history of alcohol use disorder has been reported to decrease the risk of relapse in alcohol drinking, suggesting that in this prone population, pain may increase the vulnerability to relapse. Previous data in male rats revealed that inflammatory pain desensitizes mu-opioid receptors in the ventral tegmental area and increases intake of high doses of heroin. Owing to the relevant role of mu-opioid receptors in alcohol effects, we hypothesize that pain may also alter alcohol reinforcing properties and therefore affect alcohol relapse in male rats. Our microdialysis studies show that the presence of inflammatory pain blunted the increase of extracellular dopamine levels in the nucleus accumbens induced by 1.5 g/kg of ethanol (s.c.). Moreover, we also revealed that the administration of 52 nmol of ethanol into the ventral tegmental area failed to induce place preference only in inflammatory pain-suffering animals, and a higher dose (70 nmol) was necessary to reverse this effect. Finally, we evaluated the effect of inflammatory pain on the alcohol deprivation effect in long-term ethanol-experienced male rats. After 4 cycles of free ethanol intake and abstinence periods, inflammatory pain induced alcohol deprivation effect without affecting its magnitude. These intriguing data reveal the impact of pain on neurochemical and behavioral effects after alcohol administration but also underscore the necessity of finding an appropriate paradigm to determine the long-term behavioral consequences.
Relationships Between Personal Satisfaction, Cardiovascular Disease Risk, and Health Promoting Behavior Among Arab American Middle-Aged Women
Authors: Ashgar Rnda I. 
Published: May 2020

Background
Cardiovascular disease (CVD) is the leading cause of death among middle-aged women. Health-promoting behavior is essential to the prevention of CVD. During middle adulthood, women experience biopsychosocial changes that may reduce personal satisfaction and affect health-promoting behavior and CVD risk.

Objective
This study aimed to examine the impact of personal satisfaction on health-promoting behavior and CVD risk in middle-aged Arab American women.

Methods
A convenience sample of 114 middle-aged Arab American women was recruited from 2 clinical sites in Michigan in the United States. Participants completed a demographic questionnaire, the Health-Promoting Lifestyle Profile-II, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale, the Rosenberg Self-esteem Scale, and a single item assessing health satisfaction. Risk for CVD was calculated using the 10-year atherosclerotic CVD Risk Estimator.

Results
Health-promoting behavior was significantly correlated with self-satisfaction (r = 0.54, P < .0001), health satisfaction (r = 0.45, P < .0001), and life satisfaction (r = 0.41, P < .0001). Risk for CVD was significantly negatively correlated with self-satisfaction (r = −0.17, P = .039), health satisfaction (r = −0.18, P = .029), and life satisfaction (r = −0.27, P = .002). Self-satisfaction and health satisfaction accounted for 32% of the variance in health-promoting behavior (F = 7.568, P < .0001). Age and life satisfaction accounted for 50% of the variance in CVD risk score (F = 58.28, P < .0001).

Conclusions
Personal satisfaction was associated with health-promoting behavior and CVD risk. Future research would benefit from the inclusion of longitudinal data and comparative groups.
Physical Activity and Factors Affecting Its Maintenance Among Patients With Coronary Heart Disease Not Undergoing Cardiac Rehabilitation in China
Authors: Wang Jianhui , Liu Huaping , Chen Changxiang , Chang Wenhong , Ma Yi , Zhao Caijie , Smith Sidney C. , Han Jing , Yu Miao , Ma Jiahui , Qi Jing , Xing Yan 
Published: May 2020

Background
The level of physical activity (PA) among patients with coronary heart disease (CHD) living in Chinese communities who do not participate in cardiac rehabilitation programs and the factors contributing to patient maintenance of PA are unclear.

Objective
This cross-sectional study, guided by the Transtheoretical Model, evaluated (1) the maintenance of PA in Chinese patients with CHD 12 months after hospital discharge and (2) the demographic, clinical, and psychological characteristics associated with maintenance of PA.

Methods
A total of 1162 patients completed 6 questionnaires at 12 months posthospitalization to assess their maintenance of PA, stage of change, symptoms of depression and anxiety, and health-related quality of life and sleep.

Results
Only 40% of patients with CHD maintained regular PA 12 months after hospital discharge. Walking was their primary PA. Thirty-seven percent of patients reported no intention of having regular PA. Male sex (odds ratio [OR], 1.69), awareness of PA's cardiac benefit (OR, 4.12), a history of regular PA before the cardiac event (OR, 6.08), history of chronic disease (OR, 1.43), mild depressive symptoms (OR, 1.40), moderate and severe depressive symptoms (OR, 0.41), smoking (OR, 0.54), and years of CHD (OR, 0.96) were related to maintenance of regular PA. Patients with CHD who maintained regular PA had better quality of life and sleep (P < .001) and fewer unplanned clinic visits (P = .001) and cardiac cause readmissions (P = .012) and reported fewer declines in PA capacity (P < .001).

Conclusions
Walking is the most common form of PA 12 months posthospitalization among patients with CHD in China. Patient education and counseling about the cardiac benefits of PA, taking into account stage of change, are important considerations to improve maintenance of PA.
Demonstration and Mitigation of Aerosol and Particle Dispersion During Mastoidectomy Relevant to the COVID-19 Era
Authors: Chen Jenny X. , Workman Alan D. , Chari Divya A. , Jung David H. , Kozin Elliott D. , Lee Daniel J. , Welling D. Bradley , Bleier Benjamin S. , Quesnel Alicia M. 
Published: May 2020

Background:
COVID-19 has become a global pandemic with a dramatic impact on healthcare systems. Concern for viral transmission necessitates the investigation of otologic procedures that use high-speed drilling instruments, including mastoidectomy, which we hypothesized to be an aerosol-generating procedure.

Methods:
Mastoidectomy with a high-speed drill was simulated using fresh-frozen cadaveric heads with fluorescein solution injected into the mastoid air cells. Specimens were drilled for 1-minute durations in test conditions with and without a microscope. A barrier drape was fashioned from a commercially available drape (the OtoTent). Dispersed particulate matter was quantified in segments of an octagonal test grid measuring 60 cm in radius.

Results:
Drilling without a microscope dispersed fluorescent particles 360 degrees, with the areas of highest density in quadrants near the surgeon and close to the surgical site. Using a microscope or varying irrigation rates did not significantly reduce particle density or percent surface area with particulate. Using the OtoTent significantly reduced particle density and percent surface area with particulate across the segments of the test grid beyond 30 cm (which marked the boundary of the OtoTent) compared with the microscope only and no microscope test conditions (Kruskall–Wallis test, p = 0.0066).

Conclusions:
Mastoidectomy with a high-speed drill is an aerosol-generating procedure, a designation that connotes the potential high risk of viral transmission and need for higher levels of personal protective equipment. A simple barrier drape significantly reduced particulate dispersion in this study and could be an effective mitigation strategy in addition to appropriate personal protective equipment.
Clinical features, sex differences and outcomes of myocardial infarction with nonobstructive coronary arteries: a registry analysis
Authors: Jung Richard G. , Parlow Simon , Simard Trevor , Chen Christopher , Ghataura Harshpreet , Kishore Aditya , Perera Aravinda , Moreland Rob , Hughes Ian , Tavella Rosanna , Hibbert Benjamin , Beltrame John , Singh Kuljit 
Published: May 2020

Introduction
Clinical characteristics and outcomes of patients diagnosed with myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) remain largely unknown. Furthermore, we do not yet understand if women with MINOCA have worse outcomes similar to what has historically been observed with MI. The aims of the current study were to evaluate the (1) incidence of MINOCA in patients presenting with MI, (2) compare in-hospital outcomes of MINOCA and obstructive atherosclerotic coronary artery disease MI (OACD-MI), and (3) comparison of in-hospital clinical outcomes of patients with MINOCA stratified by sex.

Methods and results
In this observational study, we combined data from two large university hospitals from Canada and Australia. Clinical characteristics and in-hospital outcomes of MINOCA and OACD-MI were analyzed by matching these patients in a 1:1 ratio after selecting patients with OACD-MI by systematic random sampling. Clinical characteristics associated with MINOCA were identified through multivariate logistic regression. Primary outcome of interest was net adverse cardiovascular events (NACE) defined as death, heart failure, stroke, and major bleeding. The incidence rate of MINOCA was 9.5%. Women, absence of traditional cardiac risk factors, and absence of ST-deviations on ECG were associated with diagnosis of MINOCA on angiography. NACE (P = 0.0001), death (P = 0.019), stroke (P = 0.002), and heart failure (P = 0.001) were significantly lower in patients with MINOCA. Subgroup analysis of women and men diagnosed with MINOCA revealed similar in-hospital outcomes.

Conclusion
The incidence of MINOCA was 9.5%. Compared to OACD-MI, patients with MINOCA have less cardiac risk factors. In-hospital outcomes of patients diagnosed with MINOCA were better than OACD-MI.
Prevalence of mild cognitive impairment is higher in hypertensive population: a cross-sectional study in less developed northwest China
Authors: Heizhati Mulalibieke , Wang Lin , Li Nanfang , Li Mei , Pan Fengyu , Yang Zhikang , Wang Zhongrong , Abudereyimu Reyila 
Published: May 2020

Abstract
Uncertainty remains about the association of hypertension with mild cognitive impairment (MCI) in less-developed areas.
This is a cross-sectional survey conducted in Xinjiang, a less-developed region in China between April and October 2019. We used multi-stage stratified sampling method to obtain study population aged ≥45 years, and we analyzed complete data for 3282 subjects. The Mini-Mental State Examination (MMSE) was used to assess cognitive function. MCI is defined as an MMSE score < 17 for illiterate subjects, <20 for subjects with 1 to 6 years of education, and <24 for subjects with ≥7 years of education.
The prevalence of MCI was significantly higher in hypertensive subjects than in non-hypertensive subjects (22.1% vs 16.1%, P < .001) and higher in hypertensives with uncontrolled blood pressure (BP) than in those with controlled BP (27.5% vs 20.7%, P = .01). Hypertensive subjects had significantly lower each item score and total score of MMSE, compared to non-hypertensive subjects. Significant negative correlations were observed between systolic and diastolic BP with MMSE scores (P for all <.001). Multivariate logistic regression analysis showed that hypertension was the significant risk factor for the presence of MCI (OR = 1.62, 95%CI: 1.34, 2.35, P < .001), independent of such factors as gender, age, education attainment, and dyslipidemia.
The prevalence of MCI is higher in hypertensive population, and hypertension is an independent risk factor for MCI in less-developed region, suggesting that hypertensives should be screened for MCI to provide improved diagnoses and optimal therapeutics for cognitive decline prevention, specially in settings with approximate conditions.
Gender differences in major adverse cardiovascular outcomes among aged over 60 year-old patients with atherosclerotic cardiovascular disease
Authors: Lee Meng-Kuang , Hsu Po-Chao , Tsai Wei-Chung , Chen Ying-Chih , Lee Hung-Hao , Lee Wen-Hsien , Chu Chun-Yuan , Lee Chee-Siong , Yen Hsueh-Wei , Lin Tsung-Hsien , Voon Wen-Chol , Lai Wen-Ter , Sheu Sheng-Hsiung , Su Ho-Ming 
Published: May 2020

Abstract
Atherosclerotic cardiovascular disease (ASCVD) including cerebrovascular disease (CVD), coronary artery disease (CAD), and peripheral arterial disease (PAD), contributes to the major causes of death in the world. Although several studies have evaluated the association between gender and major adverse cardiovascular outcomes in old ASCVD patients, the result is not consistent. Hence, we need a large-scale study to address this issue.
This retrospective cohort study included aged over 60 year-old patients with a diagnosis of ASCVD, including CVD, CAD, or PAD, from the database contained in the Taiwan National Health Insurance Bureau during 2001 to 2004. The matched cohort was matched by age, comorbidities, and medical therapies at a 1:1 ratio. A total of 9696 patients were enrolled in this study, that is, there were 4848 and 4848 patients in the matched male and female groups, respectively. The study endpoints included acute myocardial infarction, hemorrhagic stroke, ischemic stroke, vascular procedures, in-hospital mortality, and so on. In multivariate Cox regression analysis in matched cohort, the adjusted hazard ratios (HRs) for female group in predicting acute myocardial infarction, hemorrhagic stroke, ischemic stroke, vascular procedures, and in-hospital mortality were 0.67 (P < .001), 0.73 (P = .0015), 0.78 (P < .001), 0.59 (P < .001), and 0.77 (P = .0007), respectively.
In this population-based propensity matched cohort study, age over 60 year-old female patients with ASCVD were associated with lower rates of acute myocardial infarction, hemorrhagic stroke, ischemic stroke, vascular procedures, and in-hospital mortality than male patients. Further prospective studies may be investigated in Taiwan.
Successful management of Klippel–Trenaunay syndrome in a pregnant Asian woman
Authors: Xiao Li , Peng Bing , Qu Haibo , Dai Xiaohui , Xu Jinfeng 
Published: May 2020

Abstract

Rationale:
Klippel–Trenaunay Syndrome (KTS) is a congenital vascular disease characterized by cutaneous hemangiomas, venous varicosities, and limb hypertrophy. Although extremely rare in pregnant women, the present vascular alterations may be aggravated, consequent to postural and hormonal changes inherent to the pregnancy. Pregnancy is not advised in KTS women due to increased obstetrical risk.

Patient concerns:
A 31-year-old pregnancy woman presented with prominent vascularity in pelvis, right lower limb, spleen, and liver at 28 weeks of gestation. We started administration of anticoagulant therapy and obstetrics management.

Diagnosis:
MRI and ultrasound revealed that multiple varicosities in her pelvis, right lower limb, spleen, and liver. She was diagnosed with KTS.

Interventions:
At her first visit at 28 weeks of gestation, multidisciplinary evaluation had been done. Blood transfusion and iron supplement had been given for anemia correction. Anticoagulant therapy was performed to prevent potential thrombus risk. She had a vaginal delivery with a healthy newborn in her second visit without any complications at the gestation of 36+6 weeks due to rupture of preterm membranes.

Outcomes:
After successful management, the patient was discharged without any complications 2 days after vaginal delivery. No symptoms of hemorrhage or thrombus were observed. At 6 months follow-up, her right lower toes enlarged obviously, MRI revealed that no obvious changes of hemangiomas was found compared to those during the pregnancy and ultrasound revealed that there was no thrombus in her right lower limb.

Lessons:
Patients with KTS can be pregnant and have healthy babies safely with regularly monitor and reasonable treatment during pregnancy. A careful follow-up and guidance are necessary.
Unplanned surgical reoperations as a quality indicator in pediatric tertiary general surgical specialties
Authors: Li Ang , Zhu Hai , Zhou Hong , Liu Jianxia , Deng Yuhua , Liu Qingshuang , Guo Chunbao 
Published: May 2020

Abstract
Unplanned reoperations have not been studied extensively in pediatric patients, especially concerning risk factors. We aim to estimate the rate of unplanned reoperations and to determine the associated factors in pediatric general surgical specialties.
This analysis included a retrospective case–control study of unplanned reoperations from July 1, 2010 to June 30, 2017 in the general surgical specialties. For each case, we identified approximately 2 randomly selected controls who underwent the same type of operation. The factors involved in the unplanned reoperations were investigated using univariate and multivariate analysis.
Of the 3263 patients who underwent surgery, unplanned reoperations were performed in 139 patients (4.3%). The main indications for unplanned reoperations were wound complications (n = 52, 42.6%), followed by postoperative ileus (n = 12, 9.8%), postoperative bleeding (n = 8, 6.6%), and intraabdominal infection (n = 13, 10.7%). Following multivariate analysis, 2 factors remained significantly associated with unplanned reoperation: higher initial surgery-related risk level (P = .007, risk ratio (RR) = 0.48; 95% confidence interval (CI) = 0.27–0.82) and operation performed outside working hours (P = .031, RR = 0.52; 95% CI = 0.30–0.89).
Various patient- and procedure-related factors were associated with unplanned reoperations. This information might be helpful for the optimization of treatment planning and resource allocation.