bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anal High-Grade Squamous Intraepithelial Lesions in Pharmacologically Immunocompromised Patients Followed in a Referral Center
Authors: Albuquerque Andreia , Cappello Carmelina , Cuming Tamzin , De Masi Anke , Bowring Julie , Rosenthal Adam N. , Nathan • Mayura 
Published: October 2018

BACKGROUND:
Information is lacking regarding anal/perianal precancerous lesions in referral cohorts of pharmacologically immunocompromised patients.

OBJECTIVE:
The aim of this study is to evaluate the prevalence of anal/perianal high-grade squamous intraepithelial lesions in a referral cohort of patients on immunomodulator/immunosuppressive medications, who were assessed and followed with high-resolution anoscopy.

DESIGN:
This is a retrospective study.

SETTING:
This study was conducted in a single anal neoplasia service from January 2012 to June 2017.

PATIENTS:
Patients on chronic immunomodulator/immunosuppressive medications were included. Cases of concomitant immunosuppression due to HIV infection were excluded, and immunosuppression due to chemotherapy was not considered for this analysis.

INTERVENTION:
High-resolution anoscopy was performed.

MAIN OUTCOME:
The primary outcome measured was the prevalence of anal/perianal high-grade squamous intraepithelial lesions in a referral cohort of pharmacologically immunocompromised patients.

RESULTS:
Fifty-four patients were included, of whom 40 were women (74%), with a mean age of 48 ± 17 years. A total of 232 high-resolution anoscopy examinations were performed in this cohort. At the first evaluation, 28 patients (52%) were diagnosed with anal and/or perianal high-grade squamous intraepithelial lesions (including 2 cases of perianal squamous cell carcinoma); 11 cases (20%) were new diagnoses. Ten of 46 patients (22%) with follow-up developed a new lesion (high-grade/cancer) during a median follow-up period of 17 (interquartile range, 6–28) months. Overall, 37 patients (69%) in our cohort had anal/perianal high-grade squamous intraepithelial lesions ever diagnosed (including previous history, first visit, and follow-up); 5 patients had perianal squamous cell carcinoma. At our center, 6% of the new referrals were known to be pharmacologically immunocompromised patients.

LIMITATIONS:
The retrospective nature of this study, the heterogeneity of the cohort, and the absence of human papillomavirus testing were limitations of this study.

CONCLUSIONS:
The presence of anal and/or perianal high-grade squamous intraepithelial lesions or cancer detected by high-resolution anoscopy in this referral population was high, and the detection of new lesions suggests that long-term follow-up is needed. Patients on immunomodulator/immunosuppressive drugs represented only a small percentage of the new referrals to our center. See Video Abstract at http://links.lww.com/DCR/A748.
Air pollution and autism in Denmark
Authors: Ritz Beate , Liew Zeyan , Yan Qi , Cuia Xin , Virk Jasveer , Ketzel Matthias , Raaschou-Nielsen Ole 
Published: October 2018

Background:Previous autism spectrum disorder (ASD) and air pollution studies focused on pregnancy exposures, but another vulnerable period is immediate postnatally. Here, we examined early life exposures to air pollution from the pre- to the postnatal period and ASD/ASD subtypes in the Danish population.Methods:With Danish registers, we conducted a nationwide case–control study of 15,387 children with ASD born 1989–2013 and 68,139 population controls matched by birth year and sex identified from the birth registry. We generated air dispersion geographic information system (AirGIS) model estimates for nitrogen dioxide (NO2), sulfur dioxide (SO2), particulate matter 2.5 (PM2.5), and particulate matter 10 (PM10) at mothers’ home from 9 months before to 9 months after pregnancy and calculated odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for parental age, neighborhood socioeconomic indicators, and maternal smoking using conditional logistic regression.Results:In models that included all exposure periods, we estimated adjusted ORs for ASD per interquartile range (IQR) increase for 9 months after pregnancy with NO2of 1.08 (95% CI = 1.01, 1.15) and with PM2.5of 1.06 (95% CI = 1.01, 1.11); associations were smaller for PM10(1.04; 95% CI = 1.00, 1.09) and strongest for SO2(1.21; 95% CI = 1.13, 1.29). Also, associations for pollutants were stronger in more recent years (2000–2013) and in larger cities compared with provincial towns/rural counties. For particles and NO2, associations were only specific to autism and Asperger diagnoses.Conclusions:Our data suggest that air pollutant exposure in early infancy but not during pregnancy increases the risk of being diagnosed with autism and Asperger among children born in Denmark.
Family planning as a contributor to environmental sustainability: weighing the evidence
Authors: Gaffikin Lynne , Engelman Robert 
Published: October 2018

Purpose of review
To highlight recent evidence that family planning, readily accessible to all who seek it and exercised as a human right, can contribute to environmental sustainability. As global concern increases about the health of our planet, better understanding of the role family planning programs play in maintaining a sustainable environment could bolster public and policymaker support for access to family planning.

Recent findings
A recent Worldwatch Institute review of scientific literature (FPESA) exploring this relationship covered two potential cause–effect pathways: one demographic, one personal. Although nonconfirmatory, a decade of reviewed studies overwhelmingly supported the hypothesis that family planning benefits environmental sustainability. A complementary review by the Evidence Project of population, health and environment projects over a similar time period strongly suggests that transdisciplinary efforts including family planning can yield multiple benefits – health, empowerment, economic and environmental.

Summary
Cumulative research generally supports but cannot confirm the thesis that family planning contributes to efforts to achieve environmental sustainability. This does not equate to no relationship but rather a lack of adequate methodologies. For research on complex relationships like this, novel research designs may prove more effective.
Health outcomes associated with use of hormonal contraception: breast cancer
Authors: Schneyer Rebecca , Lerma Klaira 
Published: October 2018

Purpose of review
To review recent literature on health outcomes associated with use of hormonal contraception with a focus on breast cancer.

Recent findings
A large cohort study documented an increased risk of breast cancer among hormonal contraceptive users compared to those who had never used hormonal contraception. The overall relative risk of breast cancer among current or recent users was 1.2 [95% confidence interval (CI), 1.14–1.26]. Overall, this translates into one additional case of breast cancer for every 7690 users of hormonal contraception. Recent publications have also documented a decrease in risk for endometrial, ovarian, and colorectal cancers among hormonal contraceptive users. Based on these data, it is estimated that a third of endometrial and ovarian cancers and a fifth of colorectal cancers were prevented with combined oral contraceptive use.

Summary
Several factors must be taken into consideration regarding the risk of breast cancer associated with hormonal contraceptive use. Contraceptive benefits related to preventing unintended pregnancy are protective against associated maternal morbidity and mortality. Noncontraceptive benefits of protecting against other types of cancers must also be considered. Overall, breast cancer risk is low among hormonal contraceptive users and women should be counseled accordingly.
Evaluation and management of defecatory dysfunction in women
Authors: Pratt Toya , Mishra Kavita 
Published: October 2018

Purpose of review
To summarize the current recommendations for the evaluation and management of defecatory dysfunction in women and highlight key relationships between defecatory dysfunction and other pelvic floor disorders, including pelvic organ prolapse, fecal incontinence, and voiding dysfunction.

Recent findings
Conservative measures including lifestyle modifications, pharmacotherapy, and biofeedback continue to be the mainstay of treatment with newer therapies emerging. Physiologic testing and/or radiologic imaging should be considered for those who fail conservative therapy or are clinically complex. Surgical management is appropriate for carefully selected patients with anatomic causes of defecatory dysfunction. Further research is needed on surgical outcomes and patient expectations.

Summary
Pelvic floor disorders, including defecatory dysfunction, have a significant societal impact and are highly prevalent among women. Given its potential complexity, a broader focus is needed when evaluating women with defecatory symptoms and effective treatment may require multidisciplinary care.
Laser-assisted Lipolysis Burn Safety: Proposed Detailed Parameters with Assessment of Their Efficacy and Safety
Authors: Ali Yasser Helmy 
Published: October 2018

Background:
Many recent studies have evaluated the clinical safety and efficacy of therapeutic lasers in laser lipolysis, but without detailed description of the safe and effective parameters.

Purpose:
To propose a method for adjusting safe and effective parameters for laser lipolysis.

Methods:
Detailed calculations of the safe and effective laser parameters for fat melting are proposed in the study. Amount of energy delivered in joules was calculated based on data from Havenith research. External skin and internal tissues temperatures during the procedure were kept in a recommended range and monitored for safety and efficacy. Prospective statistical study was designed on a series of 300 patients who underwent laser-assisted lipolysis and /or liposuction using 2 different machine manufacturers, delivering 1,064/1,320 nm.

Results:
All areas submitted to laser-assisted liposuction in this series have resulted in no clinical thermal burns injury to the skin. There was improvement in the bulk of fats, skin tightening, skin textures, and cellulites.

Conclusion:
This study is proposing a simple method for calculations of safe and effective laser lipolysis. Skin burn injury could be highly prevented by following up the proposed detailed basic parameters for laser lipolysis treatment.
Renal replacement therapy in the ICU: intermittent hemodialysis, sustained low-efficiency dialysis or continuous renal replacement therapy?
Authors: Wang Amanda Ying , Bellomo Rinaldo 
Published: October 2018

Purpose of review
Severe acute kidney injury in the ICU setting often requires renal replacement therapy (RRT). Intermittent hemodialysis (IHD), hybrid forms of RRT such as sustained low-efficiency dialysis (SLED), as well as continuous renal replacement therapy (CRRT) are the three common modalities of extracorporeal RRT used in the adult ICU setting in developed countries. This review summarizes recently published data regarding comparisons of these three RRT modalities on clinical outcomes (e.g., mortality and recovery of renal function) in severe acute kidney injury (AKI) patients.

Recent findings
There is still controversy on the superiority of one RRT modality over another in terms of clinical outcomes in patients with AKI in ICU. Although there is increasing acceptance that CRRT should be used in hemodynamic unstable patients, its survival advantages over IHD remains unproven because of inadequate evidence from suitably powered randomized controlled trials (RCTs). Moreover, CRRT does not show superiority to intermittent renal replacement therapy (IRRT) in hemodynamic stable patients. Although patients receiving sustained low-efficiency dialysis appear to have lower mortality than CRRT, its survival benefit is largely derived from observational studies and is confounded by selection bias. Current literature supports no differences in mortality among the three RRT modalities. However, the effect of choice of RRT modality on short-term and long-term renal outcomes need further studies, especially larger RCTs and longer duration of follow-up.

Summary
There is lack of solid evidence showing superiority of any mode of RRT in patients with severe AKI in terms of patient survival. However, based on observational data, IHD treatment of AKI may delay renal recovery. Patients’ hemodynamic status, coexisting medical conditions, local expertise, and availability of staff and resources as well as potential effect on long-term renal outcomes should be taken into consideration when selecting modalities of RRT for adult ICU patients.
Continuous renal replacement therapy: understanding circuit hemodynamics to improve therapy adequacy
Authors: Michel Thibault , Ksouri Hatem , Schneider Antoine G. 
Published: October 2018

Purpose of review
The utilization of continuous renal replacement therapy (CRRT) increases throughout the world. Technological improvements have made its administration easier and safer. However, CRRT remains associated with numerous pitfalls and issues.

Recent findings
Even if new-generation CRRT devices have built-in safety features, understanding basic concepts remains of primary importance.

Summary
CRRT circuits’ maximum recommended lifespan (72 h) can often not be achieved. Such early artificial kidney failures are typically related to two processes: circuit clotting and membrane clogging. Although these processes are to some degree inevitable, they are facilitated by poor therapy management. Indeed, the majority of device-triggered alarms are associated with blood pump interruption, which through blood stasis, enhance clotting and clogging. If the underlying issue is not adequately managed, further alarms will rapidly lead to prolonged stasis and complete circuit clotting or clogging making its replacement mandatory. Hence, rapid recognition of issues triggering alarms is of paramount importance. Because most alarms are related to circuit's hemodynamics, a thorough understanding of these concepts is mandatory for the staff in charge of delivering the therapy.
This review describes CRRT circuits, measured and calculated pressures and the way their knowledge might improve therapy adequacy.
Personalization of arterial pressure in the perioperative period
Authors: Godet Thomas , Grobost Romain , Futier Emmanuel 
Published: October 2018

Purpose of review
This review aims to discuss recent findings on the relationship between intraoperative arterial hypotension and organ dysfunction in surgical patients and examines the available evidence for personalizing blood pressure (BP) management as a strategy to improve patient outcome.

Recent findings
Hypotension contributes to oxygen supply–demand mismatch and may cause an ischemia–reperfusion injury which may manifest as organ dysfunction. Evidence is accumulating suggesting that hypotension is associated with acute postoperative myocardial and kidney injury, and increased risk of mortality in surgical patients. In contrast to traditional BP management in which BP targets are empirically chosen, personalized BP management aims at individualizing BP targets according to individual patient physiology considering clinical conditions that may influence organ pressure-flow autoregulation. Recent randomized data provide clinically meaningful findings that a treatment strategy aims at targeting individualized BP values which may help improving outcome in surgical patients.

Summary
Hypotension is a common complication in surgical patients and is an important trigger of organ injury in surgical patients. Personalized BP management may contribute at reducing postoperative organ dysfunction in surgical patients.
Community-acquired pneumonia as an emergency condition
Authors: Cillóniz Catia , Dominedò Cristina , Garcia-Vidal Carolina , Torres Antoni 
Published: October 2018

Purpose of review
Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP.

Recent findings
There is consistent evidence that the trend in CAP mortality has declined over time. However, the mortality of pneumococcal CAP has not changed in the last two decades, with an increase in the rate of hospitalization and more severe forms of CAP. Streptococcus pneumoniae remains the most frequent cause of CAP in all settings, age groups and regardless of comorbidities. However, the implementation of molecular diagnostic tests in the last years has identified respiratory viruses as a common cause of CAP too. The emergency of multidrug-resistance pathogens is a worldwide concern. An improvement in our ability to promptly identify the causative cause of CAP is required in order to provide pathogen-directed antibiotic therapy, improve antibiotic stewardship programs and implement appropriate vaccine strategies.

Summary
It is time to apply all the knowledge generated in the last decade in order to optimize the management of CAP.
Resuscitation fluids
Authors: Casey Jonathan D. , Brown Ryan M. , Semler Matthew W. 
Published: October 2018

Purpose of review
Intravenous fluid administration is a fundamental therapy in critical care, yet key questions remain unanswered regarding optimal fluid composition and dose. This review evaluates recent evidence regarding the effects of fluid resuscitation on pathophysiology, organ function, and clinical outcomes for critically ill patients.

Recent findings
Recent findings suggest that intravenous fluid composition affects risk of kidney injury and death for critically ill adults. Generally, the risk of kidney injury and death appears to be greater with semisynthetic colloids compared with crystalloids, and with 0.9% sodium chloride compared with balanced crystalloids. Whether a liberal, restrictive, or hemodynamic responsiveness-guided approach to fluid dosing improves outcomes during sepsis or major surgery remains uncertain.

Summary
As evidence on fluid resuscitation evolves, a reasonable approach would be to use primarily balanced crystalloids, consider 2–3 l for initial fluid resuscitation of hypovolemic or distributive shock, and use measures of anticipated hemodynamic response to guide further fluid administration.
Updates in emergency airway management
Authors: Carlson Jestin N. , Wang Henry E. 
Published: October 2018

Purpose of review
Historically, most evidence supporting emergency airway management strategies have been limited to small series, retrospective analyses and extrapolation from other settings (i.e. the operating room). Over the past year, several large, randomized clinical trials have offered new findings to inform emergency airway management techniques.

Recent findings
One large, randomized clinical trial, found improved first attempt success rates with bougie facilitated intubation compared with traditional intubation. Two randomized clinical trials suggested better outcomes in adult out-of-hospital cardiac arrest (OHCA) with supraglottic airways (SGA) than intubation. A randomized clinical trial in OHCA patients could not identify outcome differences between endotracheal intubation (ETI) and bag-valve mask (BVM) ventilation but suggested higher rates of aspiration with BVM.

Summary
These studies offer new findings to inform the practice of emergency airway management. Bougie use should be considered as a first-line approach in emergency intubation. SGA-based strategies should be considered as a first-line approach in the management of OHCA.
RNA-targeted therapeutics for lipid disorders
Authors: Tsimikas Sotirios 
Published: October 2018

Purpose of review
To summarize recent developments in the field of RNA-directed therapeutics targeting lipid disorders that are not effectively managed.

Recent findings
Despite a number of approved therapies for lipid disorders, significant unmet needs are present in treating persistently elevated LDL-cholesterol, remnant-cholesterol, triglycerides and lipoprotein(a) [Lp(a)]. Small molecules and antibodies are effective modalities, but they are unable to adequately treat many patients with abnormal lipid parameters. Targeting mRNA with oligonucleotides to prevent protein translation is a relatively novel method to reduce circulating atherogenic lipoproteins. Small inhibiting RNA (siRNA) molecules targeting proprotein convertase subtilisin kexin type 9 to reduce LDL-C, and antisense oligonucleotides (ASO) targeting apolipoprotein C-III (apoC-III) to reduce triglycerides, angiopoietin-like 3 (ANGPTL3) to reduce LDL-C and triglycerides and apolipoprotein(a) (LPA) to reduce Lp(a) are currently in or just completed phase 1–3 trials. Fundamental differences exist in chemistry, delivery and mechanism of action of siRNA and ASOs.

Summary
Novel RNA therapeutics are poised to provide highly potent, specific and effective therapies to reduce atherogenic lipoproteins. As these compounds are approved, clinicians will be able to choose from a broad armamentarium to treat nearly all patients to acceptable goals in order to reduce risk of cardiovascular disease and events.
Swallowing function in advanced age
Authors: Jardine Marie , Miles Anna , Allen Jacqui E. 
Published: October 2018

Purpose of review
To present current literature regarding swallowing function in advanced age, including healthy ageing, dysphagia and trends in multidisciplinary team service delivery.

Recent findings
Normative studies support swallowing efficiency but greater variability in healthy advanced age, through to 100 years old. Deviations from normative data and symptoms of dysphagia leading to aspiration or nutritional risk, imply swallowing disorder, rather than simply the ageing process. Quantitative and qualitative studies are emerging that promote management of swallow dysfunction for an ageing society, including innovative assessment, home treatment, swallowing exercise and optimized mealtimes.

Summary
Current literature on swallowing function in advanced age provides multidisciplinary perspectives and initiatives, with clear commitment to improving quality of life for older adults. The diversity of the older population and serious consequences of swallowing difficulties calls for routine screening tools for swallowing impairment and malnutrition risk. Representation of ‘oldest old’ in future normative studies is essential to guide swallowing management in adults over 85 years old.
Laryngopharyngeal reflux disease: clinical presentation, diagnosis and therapeutic challenges in 2018
Authors: Lechien Jerome R. , Saussez Sven , Karkos Petros D. 
Published: October 2018

Purpose of review
To review the recent literature on presentation, diagnosis and treatment of laryngopharyngeal reflux.

Recent findings
Patients with laryngopharyngeal reflux have a higher risk for gastroesophageal reflux and respiratory-related diseases. Many symptoms and findings are underestimated, contributing to the inconclusive results of many therapeutic trials. Additionally, little significance is given to nonacid and mixed refluxates, although a significant prevalence. The association between symptoms, signs, impedance-pH studies and pepsin detection could be the most accurate way for a clear diagnosis. ‘Reflux profiling’ is also important for the administration of a personalized treatment based on diet, proton pump inhibitors, alginate, magaldrate and other second-line drugs. There are only a handful of studies focusing on the addition of alginate or magaldrate to the treatment of laryngopharyngeal reflux, although their contribution has extensively been demonstrated.

Summary
Diagnosis remains controversial despite improvement in impedance and availability of pepsin detection in daily practice. With recent studies exhibiting a significant prevalence of nonacid or mixed refluxes, the addition of alginate or magaldrate to proton pump inhibitors should be considered. Future studies are needed to assess these new therapeutic schemes in moderate and severe laryngopharyngeal reflux.