bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current screening practice in patients under long-term hydroxychloroquine medication in Taiwan
Authors: Yen Chu-Yu , Lee Pei-Hsuan , Yen Ju-Chuan , Chen Chun-Chen , Hu Hsiao-Yun , Tseng Po-Chen 
Published: April 2019

Abstract
Hydroxychloroquine (HCQ), an analog of chloroquine, is widely used in various rheumatologic and dermatologic disorders. However, it may cause severe retinopathy with long-term use. The guidelines proposed by the American Academy of Ophthalmology suggested a baseline fundus examination and an annual screening after 5 years by using automated visual fields (VF) plus spectral-domain optical coherence tomography (SD-OCT). Both multifocal electroretinogram (mfERG) and fundus autofluorescence (FAF) can also be used to improve the accuracy of diagnosis. The purpose of this study was to examine if the current HCQ screening practice in Taiwan was sufficient according to the guidelines to prevent severe macular complications.
This study could remind every doctor to explain visual side effects thoroughly to every patient using HCQ, and refer patients for the ophthalmologic survey to eliminate potential visual impairment caused by this medicine.
This nationwide population-based cohort study included all patients who started taking HCQ (n = 5826) from January 1, 1997, to December 31, 2007, in the Longitudinal Health Insurance Database 2000. The ICD codes used for HCQ retinopathy were 362.10, 362.55, 362.89, and 362.9. Patients previously diagnosed these retinal disorders were excluded. Demographic data including sex, age, diagnostic tools used, and the date of the initial diagnosis of the subsequent HCQ-related retinal disorder were collected. Patients were divided into 2 groups. The patients taking HCQ <5 years were defined as group 1, and >5 years as group 2. The risk of developing retinal diseases between these 2 groups was compared with a 2-sample t-test for continuous variables, and Fisher's exact test for discrete variables. Multiple logistic regressions were used for odds ratio calculation.
The baseline examination ratio of the automated VF, SD-OCT scans, and multifocal electroretinograms (mfERGs) in the first 3 months were only 0.2% in both groups. The screening ratio of the 3 examination tools after 5 years were 1.1% in group 1 and 1.2% in group 2. 2.5% and 3.9% of patients developed a retinal disorder after HCQ use in group 1 and 2, respectively. The risk of developing retinal disorder was significantly higher in group 2 (relative risk = 1.53, P = .006). The odds ratio (OR) was also significantly higher in group 2 (1.67 with 95% cumulative incidence 1.20–2.30)
The examination ratio according to the guidelines was very low in Taiwan. Thus, it is very important for doctors who prescribe HCQ to schedule both baseline and annual ophthalmology screening tests and inform patients of possible severe ocular complications, even in the patient taking HCQ <5 years. It is also important for ophthalmologists to review medical history carefully to find out the causes of retinotoxicity. Medications should be stopped, if possible when toxicity is recognized or strongly suspected.
Should We Use Tegaserod for Irritable Bowel Syndrome?
Authors: Marciniak Thomas A. , Serebruany Victor 
Published: April 2019

Background:
Tegaserod, a serotonin (5-HT4) agonist initially approved for constipation but withdrawn from use in 2007 because of concerns about cardiovascular adverse effects, was resubmitted to the Food and Drug Administration (FDA) in 2018 for use in a restricted population.

Areas of Uncertainty:
Despite an 18-year regulatory history, there remain pharmacology and clinical trial concerns that have not been addressed but are critical for proper assessment of the drug safety and efficacy profile.

Sources:
Original FDA reviews, FDA and developer advisory committee briefing documents, and published literature.

Results:
The major pharmacology concern is that the fate and effects of half of the molecule, the pentylaminoguanidine moiety, are unknown. There is evidence that pentylaminoguanidine may contribute to both efficacy and safety. There are other metabolites that are poorly characterized, and potential receptor interactions that suggest cardiovascular effects are possible. The major clinical trial concern is that, while the trial data support a low but definite cardiovascular risk, both subject follow-up and cardiovascular event descriptions were incomplete such that an accurate estimate of cardiovascular risk is not possible.

Conclusions:
The uncertainties and lack of reliable evidence regarding tegaserod metabolism and cardiovascular risk estimates may discourage clinical use. Signals for cardiovascular toxicity in typical drug development programs are subtle and must be pursued aggressively, with complete case follow-up and cardiovascular event capture in the clinical trials.
Dysphagia in patients with non-head and neck cancer
Authors: Frowen Jacqui 
Published: April 2019

Purpose of review
To review the current evidence on dysphagia in non-head and neck cancer, including its cause, prevalence, impact, management, and areas for future research.

Recent findings
Dysphagia is widely recognised as a common and debilitating side-effect of head and neck cancer (HNC) and its treatment; however, minimal attention has been given to dysphagia in other cancer populations. Detailed data regarding the exact nature and prevalence of dysphagia are limited, in part because of the lack of any validated tools specifically for non-HNC patients. Dysphagia can be due to a variety of different causes in cancer patients. It can have a significant impact on physical and psychological wellbeing, and its management can be complex and multifactorial.

Summary
Preliminary evidence suggests that the prevalence of dysphagia in non-HNC patients may be high. Cancer patients are vulnerable and survivorship is a key component of cancer care, so further research is essential to better understand the problem and thus provide optimal care and outcomes for patients.
Chronic lung allograft dysfunction: light at the end of the tunnel?
Authors: Verleden Stijn E. , Vos Robin , Verleden Geert M. 
Published: April 2019

Purpose of review
Chronic lung allograft dysfunction (CLAD) has been recently introduced as an umbrella-term encompassing all forms of chronic pulmonary function decline posttransplant with bronchiolitis obliterans syndrome and restrictive allograft syndrome as the most important subtypes. Differential diagnosis and management, however, remains complicated.

Recent findings
Herein, we provide an overview of the different diagnostic criteria (pulmonary function, body plethysmography and radiology) used to differentiate bronchiolitis obliterans syndrome and restrictive allograft syndrome, their advantages and disadvantages as well as potential problems in making an accurate differential diagnosis. Furthermore, we discuss recent insights in CLAD management and treatment and advances in the search for accurate biomarkers of CLAD.

Summary
Careful dissection of CLAD phenotypes is of utmost importance to assess patient prognosis, but uniform diagnostic criteria are desperately needed. There is a long way ahead, but the first steps towards this goal are now taken; tailored individualized therapy will be the golden standard to treat CLAD in the future, but randomized placebo-controlled and multicentre trials are needed to identify new and powerful therapeutic agents.
Chronic Asymptomatic Pancreatic Hyperenzymemia
Authors: Amodio Antonio , De Marchi Giulia , Granato Anna , de Pretis Nicolò , Gabbrielli Armando , Manfredi Riccardo , Pozzi Mucelli Roberto , Frulloni Luca 
Published: April 2019

Objectives
Chronic asymptomatic pancreatic hyperenzymemia (CAPH) was described as a benign disease. However, we already described clinically relevant findings requiring surgery or follow-up in half of the subjects. The aim of this study was to evaluate the long-term outcome of CAPH in terms of symptoms and evolution toward chronic pancreatitis.

Methods
Subjects previously enrolled in the first phase of the study (from 2005 to 2010) were reinvestigated from December 2013 to January 2017 with a phone call ± magnetic resonance cholangiopancreatography with secretin stimulation.

Results
A total of 133 subjects were eligible for the follow-up study (75 males, 58 females; age, 48.4 [standard deviation {SD}, 14] years); 24 (18%) of them dropped out. During a mean follow-up of 9.3 (SD, 5.2) years after the first diagnosis of CAPH, no episode of acute pancreatitis or abdominal pain was reported. Sixty-three subjects (58%) of 109 underwent magnetic resonance cholangiopancreatography with secretin stimulation with a mean follow-up of 5.7 [SD, 3.1] years (range, 1–11 years). Secretin stimulation-MRCP resulted unchanged in 54 (90%) of 60 subjects, worsened in 3 (5%) and improved in 3 (5%). Two subjects died from causes unrelated to pancreatic disease.

Conclusions
Excluding subjects with a pancreatic disease at index magnetic resonance imaging, CAPH is a benign condition.
Addressing Spiritual and Religious Influences in Care Delivery
Authors: LeDoux Jeannie , Mann Chikita , Demoratz Michael , Young Jared 
Published: April 2019

Purpose:
The impact of spiritual and religious factors on health and care delivery has been identified in case management field research. The purpose of this article is to examine how case managers, taking a holistic, patient-centered approach, are required under professional and ethical standards to address the spiritual and religious influences that may impact the individual's health, care choices, and care delivery.

Primary Practice Settings:
Case managers across health or human services must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery. This includes case managers in acute care, primary care, workers' compensation, hospice, mental health counseling, and other practice settings. Regardless of their professional discipline, specialization, or practice setting, case managers must ensure that the voice of the individual is heard and that each person receives the support that is most relevant and meaningful.

Implementations for Case Management Practice:
The impact of spiritual and religious factors on health and care delivery has been identified in case management field research, known as role and function studies, which are conducted every 5 years, and which set the blueprint for the Certified Case Manager (CCM) certification examination. The most recent role and function study affirmed the knowledge domain of multicultural, spiritual, and religious factors that may affect the health status of the individual receiving case management services. Essential activities of case management include identifying multicultural, spiritual, and religious factors that may affect the client's health status and incorporating the effects of the client's multicultural, spiritual, and religious factors in the development of the plan of care and service delivery (H. Tahan, A. Watson, & P. Sminkey, 2016). To demonstrate competency in the required knowledge domain and essential activities, case managers must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery.
Mismatch Repair Deficiency Identifies Patients With High-Intermediate–Risk (HIR) Endometrioid Endometrial Cancer at the Highest Risk of Recurrence: A Prognostic Biomarker
Authors: Backes Floor J. , Haag Jennifer , Cosgrove Casey M. , Suarez Adrian , Cohn David E. , Goodfellow Paul J. 
Published: April 2019

(Abstracted from Cancer 2019;125:398–405)
More than 70% of patients diagnosed with endometrial cancer (EC) are stage I, and such early-stage disease has good outcomes, with reported 5-year survival rates of 90%. However, a small subgroup has been identified—the so-called high-intermediate–risk (HIR) EC—which has relatively high local and distant recurrence rates, resulting in poor survival.
Association of Sexually Transmitted Diseases With Cervical Ectopy: A Systematic Review
Authors: Soares Leila Cristina , Braz Fernanda Lehrer Turbae Amaral , Araújo Amanda Rodrigues , Oliveira Marco Aurélio Pinho 
Published: April 2019

Objective
The aim of this study was to review the available literature to explore evidence indicating an association between cervical ectopy and sexually transmitted diseases, which could help in the decision to treat or not to treat this condition.

Methods
A review of the literature was conducted using the PubMed, EMBASE and clinicaltrials.gov databases on ectopy of the cervix using the terms “ectopy OR ectropium AND cervix” filtered only by language, without limit of date. A total of 71 studies were found in the initial selection, of which 56 were deleted by title, abstract, or full text. The remaining 15 articles were analyzed in this study.

Results
Cervical ectopy showed a positive association with human papillomavirus, human immunodeficiency virus, bacterial vaginosis, cervical epithelial atypia, postcoital bleeding, and desquamative inflammatory vaginitis. High-quality studies reported no association between ectopy and chlamydia infection. It was also not associated with gonococcal infection and herpes simplex.

Conclusions
Cervical ectopy shows a probable association with increased acquisition of some sexually transmitted diseases. Additional studies are required to confirm the possible beneficial effects of treatment and to evaluate the possible complications of these treatments.
Treatment Outcomes of Stenotrophomonas maltophilia Bacteremia in Critically Ill Children: A Multicenter Experience
Authors: Tokatly Latzer Itay , Nahum Elhanan , Cavari Yuval , Lazar Isaac , Ben-Ari Yossi , Ben-Shimol Shalom , Ben-Shalom Gal , Geffen Yuval , Goldberg Lior , Rubinstein Marina , Keller Nathan , Pessach Itai M. , Paret Gideon 
Published: April 2019

Objectives
: Stenotrophomonas maltophilia is a gram-negative opportunistic bacterium that may cause a myriad of clinical diseases in immunocompromised individuals. We aimed to describe the clinical characteristics, risk factors, mortality, and treatment of S. maltophilia bacteremia in critically ill children, a topic on which data are sparse.

Design:
A multicenter observational retrospective study in which medical charts of critically ill children with S. maltophilia bacteremia were reviewed between 2012 and 2017.

Setting:
Data were collected from each of the four largest PICUs nationwide, allocated in tertiary medical centers to which children with complex conditions are referred regularly.

Patients:
A total of 68 suitable cases of S. maltophilia bacteremia were retrieved and reviewed.

Measurements and Main Results:
The total occurrence rate of S. maltophilia isolation had increased significantly during the study period (r = 0.65; p = 0.02). The crude mortality was 42%, and the attributed mortality was 18%. Significant risk factors for mortality were a longer length of hospital stay prior to infection (33 d in nonsurvivors vs 28 in survivors; p = 0.03), a nosocomial source of infection (p = 0.02), presentation with septic shock (p < 0.001), and treatment with chemotherapy (p = 0.007) or carbapenem antibiotics (p = 0.05) prior to culture retrieval. On multivariate analysis, septic shock (odds ratio, 14.6; 95% CI, 1.45–147.05; p = 0.023) and being treated with chemotherapy prior to infection (odds ratio, 5.2; 95% CI, 1.59–17.19; p = 0.006)] were associated with mortality. The combination of ciprofloxacin, trimethoprim-sulfamethoxazole, and minocycline resulted in the longest survival time (p < 0.01).

Conclusions:
The significant attributed mortality associated with S. maltophilia bacteremia in critically ill children calls for an aggressive therapeutic approach. The findings of this investigation favor a combination of trimethoprim-sulfamethoxazole, ciprofloxacin, and minocycline.
Relationship Between Different Experimental Measures of Distorted Symptom Perception in Functional Syndrome Patients
Authors: Van Den Houte Maaike , Van Oudenhove Lukas , Bogaerts Katleen , Van Diest Ilse , De Bie Jozef , Persoons Philippe , Van den Bergh Omer 
Published: April 2019

ABSTRACT

Objective
Patients with functional somatic syndromes show reduced correspondence between induced physiological changes and self-reported symptoms in a rebreathing paradigm, as well as elevated symptoms unrelated to physiological changes after induction of negative affective states in an affective picture-viewing paradigm. Detailed results of both paradigms separately were published elsewhere. The main goal of the current report is to describe the relationship between the responses to these two paradigms measuring distortions in symptom perception in a well-described sample of patients with fibromyalgia and/or chronic fatigue syndrome.

Methods
Patients (N = 81) with fibromyalgia and/or chronic fatigue syndrome participated in a test session comprising four well-validated paradigms, including the picture-viewing and rebreathing paradigm. Using mixed model analyses, we tested whether the amount of affective modulation of symptom reporting was related to distorted perception of induced dyspnea. In an exploratory way, we assessed the role of several individual difference variables as moderators.

Results
There was no relationship between patients' amount of affective modulation of symptom reporting, as assessed with the picture paradigm, and level of distortion in dyspnea perception, as assessed with the rebreathing paradigm (effect of affective modulation in the subjective recovery from induced dyspnea: F
1,70 = 0.16, p = .70; time by affective modulation interaction effect: F
4,70 = 0.14, p = .97).

Conclusions
Biased symptom reporting in one paradigm is unrelated to biased symptom reporting in the other paradigm, indicating that distortions in symptom perception in patients with functional somatic syndromes are not a trait-like, cross-situationally stable condition, but a versatile dysfunction that is context dependent.
Gender Affirmation Surgery From a Public Health Perspective: Advances, Challenges, and Areas of Opportunity
Authors: Williams Eva A. , Patete Carissa L. , Thaller Seth R. 
Published: April 2019

Abstract
Gender affirmation surgery (GAS) is sought out by approximately 20 to 40% of transgender individuals. These patients possess unique mental and physical health needs. These are compounded by prejudices and lack of education about transgender individuals within the medical system and society at large. Societal and medical barriers are associated with increased risks of violence, suicide, and sexually transmitted infections. This combination of high medical needs and barriers to accessing appropriate care may give rise to a self-perpetuating cycle of risk exposure, stigmatization, prejudice, and eventually poor health outcomes. It is imperative that plastic and reconstructive surgeons understand GAS from a public health perspective, so that they may provide the highest quality of care and help alleviate these disparities. The authors describe unique public health topics in GAS. These are specifically related to healthcare access, surgical education, cultural sensitivity, as well as mental health outcomes for patients who undergo GAS.
Low-Cost Desktop-Based Three-Dimensional-Printed Patient-Specific Craniofacial Models in Surgical Counseling, Consent Taking, and Education of Parent of Craniosynostosis Patients: A Comparison With Conventional Visual Explanation Modalities
Authors: Alshomer Feras , AlFaqeeh Faisal , Alariefy Mohammed , Altweijri Ikhlass , Alhumsi Taghreed 
Published: April 2019

Background:
Craniosynostosis is a complex craniofacial deformity. Surgical decision, if needed, is always hard on the parent and requires the use of multimodalities of explanation. To the authors’ knowledge, there have been no studies tackling family counseling about the deformity and surgical decision-making process with the use of low-cost patient-specific three-dimensional (3D)-printed models.

Methods:
A cross-sectional study investigating the utility of patient-specific 3D-printed models using a desktop-based 3D printer. Questionnaire was constructed and validated screening the demographics, knowledge, expectation, and surgical decision-making process supplied using Likert. Data were collected consecutively from each parent first after explanation with conventional 3D computed tomography (CT) images, and then repeated after the 3D-printed model has been presented.

Results:
Fourteen parents were screened. Majority of parents considered the pathology to have a potential effect of child's functional and aesthetic outcomes. After using the 3D-printed models, the participants had a clear vision and needed not to read any more about the condition (P = 0.05, P = 0.019, respectively). Agreement for surgical management was in favor of the 3D-printed models compared with CT images (P = 0.028). Explanation with CT images yielded higher mean score in knowledge about potential complications compared with 3D models (P value = 0.007). For the 3D models, average printing time was 26 hours, and a mean cost of 5.2$.

Conclusion:
The utility of desktop 3D printing is an affordable modality to provide adequate information about craniosynostosis and can assist surgical decision-making. Knowledge and adaptation of such cheap technology represents a great skill aiding clinical practice.
Identification of Plasma Proteome Signatures Associated With Surgery Using SOMAscan
Authors: Fong Tamara G. , Chan Noel Y. , Dillon Simon T. , Zhou Wenxiao , Tripp Bridget , Ngo Long H. , Otu Hasan H. , Inouye Sharon K. , Vasunilashorn Sarinnapha M. , Cooper Zara , Xie Zhongcong , Marcantonio Edward R. , Libermann Towia A. 
Published: April 2019

Objectives:
To characterize the proteomic signature of surgery in older adults and association with postoperative outcomes.

Summary of Background Data:
Circulating plasma proteins can reflect the physiological response to and clinical outcomes after surgery.

Methods:
Blood plasma from older adults undergoing elective surgery was analyzed for 1305 proteins using SOMAscan. Surgery-associated proteins underwent Ingenuity Pathways Analysis. Selected surgery-associated proteins were independently validated using Luminex or enzyme-linked immunosorbent assay methods. Generalized linear models estimated correlations with postoperative outcomes.

Results:
Plasma from a subcohort (n = 36) of the Successful Aging after Elective Surgery (SAGES) study was used for SOMAscan. Systems biology analysis of 110 proteins with Benjamini-Hochberg (BH) corrected P value ≤0.01 and an absolute foldchange (|FC|) ≥1.5 between postoperative day 2 (POD2) and preoperative (PREOP) identified functional pathways with major effects on pro-inflammatory proteins. Chitinase-3-like protein 1 (CHI3L1), C-reactive protein (CRP), and interleukin-6 (IL-6) were independently validated in separate validation cohorts from SAGES (n = 150 for CRP, IL-6; n = 126 for CHI3L1). Foldchange CHI3L1 and IL-6 were associated with increased postoperative complications [relative risk (RR) 1.50, 95% confidence interval (95% CI) 1.21–1.85 and RR 1.63, 95% CI 1.18–2.26, respectively], length of stay (RR 1.35, 95% CI 0.77–1.92 and RR 0.98, 95% CI 0.52–1.45), and risk of discharge to postacute facility (RR 1.15, 95% CI 1.04–1.26 and RR 1.11, 95% CI 1.04–1.18); POD2 and PREOP CRP difference was associated with discharge to postacute facility (RR 1.14, 95% CI 1.04–1.25).

Conclusion:
SOMAscan can identify novel and clinically relevant surgery-induced protein changes. Ultimately, proteomics may provide insights about pathways by which surgical stress contributes to postoperative outcomes.