bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight-Related Concerns as Barriers to Exclusive Breastfeeding at 6 Months
Authors: Zimmerman Emily , Rodgers Rachel F. , O’Flynn Jennifer , Bourdeau Althea 
Published: September 2018

Background: Human milk is considered the gold standard for infant nutrition, but more data are needed that examine the constellation of weight-related concerns as barriers to exclusive breastfeeding. Research aims: The aim of this study was to examine how mothers’ concerns regarding their own and their infants’ weight, as well as disordered eating behaviors, were associated with breastfeeding self-efficacy and exclusive breastfeeding at 6 months. Methods: A prospective, quantitative, and self-report online survey design was used. Participants included 206 women (88.30% White, 59.20% with graduate degrees), with a mean age of 33.04 years ( SD = 4.31 years) and a mean prepregnancy body mass index (BMI) of 24.80 kg/m2 ( SD = 5.50 kg/m2), who had given birth within the past 6 months. Results: Participants who reported not exclusively breastfeeding at 6 months had significantly higher prepregnancy BMI ( p < .001), higher body dissatisfaction ( p = .003), more disordered eating ( p = .036), higher child weight concerns ( p < .001), and lower breastfeeding self-efficacy ( p < .001). Mediation modeling revealed a direct negative relationship between prepregnancy BMI and exclusive breastfeeding at 6 months ( p < .001). Indirect negative relationships between prepregnancy BMI and exclusive breastfeeding at six months via (a) body dissatisfaction, (b) disordered eating, and (c) child weight concern, as well as breastfeeding self-efficacy (entered as concurrent mediators), were all significant. Conclusions: Mothers’ weight, body image and eating concerns, concern regarding their children’s weight, and breastfeeding self-efficacy may constitute critical barriers to exclusive breastfeeding at 6 months. Interventions to improve breastfeeding duration and confidence should target maternal body image and eating concerns.
Effect of oral misoprostol, alone or in combination with aglepristone, on mid-term pregnancy termination in cats
Authors: Ay Serhan Serhat , Aslan Selim , Önyay Firdevs , Kaya Duygu , Koldaş Ece , Arslan Serhat , Fındık Murat 
Published: September 2018

Objectives This study aimed to determine the efficacy and safety of oral misoprostol (MIS) administration in the induction of mid-term pregnancy termination in cats. Methods Twenty-eight cats that were pregnant for 30–40 days were allocated to four groups. The aglepristone (AGL) group (n = 7) received 10 mg/kg SC aglepristone q24h for two consecutive days. In the AGL+MIS group (n = 7), AGL (as administered in the AGL group) and MIS (200 µg/cat PO q12h until the start of abortion) were administered. The MIS200 (n = 7) and MIS400 groups (n = 7) received MIS (200 or 400 µg/cat misoprostol, respectively) alone PO q12h until the start of abortion. Blood samples were collected at the start of treatment (d0), 4 days after the start of treatment (d4) and on the day of complete abortion/end of administration (dA/d7). Results The efficacy of the treatment was 71.4% in the AGL group, 100% in the AGL+MIS group, 0% in MIS200 group and 57.4% in MIS400 group ( P = 0.004). No significance was found in relation to the interval from treatment to the start/end of abortion and the duration of abortion in all groups. The most observed side effect was vomiting in both groups administered MIS, particularly in the MIS400 group (56.7%). Progesterone (P4) concentrations were reduced during the abortion, but not to basal levels, in all groups. P4 concentrations were significantly lower at dA/d7 in the MIS400 group compared with the AGL and AGL+MIS groups ( P = 0.002). Conclusions and relevance The results obtained from this study showed that low doses of MIS do not induce abortions in cats but increase the effect of AGL. Although higher doses could terminate pregnancies, this also causes intense unwanted side effects. Therefore, the use of MIS alone as an abortifacient in cats is not recommended. For mid-term pregnancy termination in cats, the combination of misoprostol and aglepristone provides a more effective abortifacient than using either of them alone.
Low wear rate at 6-year follow-up of vitamin E-infused cross-linked polyethylene: a randomised trial using 32- and 36-mm heads
Authors: Lindalen Einar , Thoen Peder S , Nordsletten Lars , Høvik Øystein , Röhrl Stephan M 
Published: September 2018

Background: Free radicals formed in the cross-linking process may over time alter the mechanical properties of highly cross-linked polyethylene. Vitamin E-infused highly cross-linked polyethylene was therefore developed to achieve low wear-rate and good mechanical properties in the long term. Aim: To present 6-year results from the initial randomised controlled trial. Patients and methods: We measured wear and periacetabular bone remodelling in cementless total hip arthroplasty; 32- or 36-mm Biolox Delta heads and vitamin E-infused highly cross-linked polyethylene (E-Poly) were used. Markerless radiosterometric analysis measured the in vivo wear and dual energy x-ray absorptiometry was used to analyse bone remodelling in 40 hips at 6-year follow-up. Results: In the proximal direction the wear for 32- and 36-mm heads was 0.15 mm (95% confidence interval [CI], 0.08–0.21) and 0.06 mm (95% CI, -0.002–0.12), respectively ( p = 0. 015). However, between 3 months and 6 years (excluding the period of “bedding in”), the proximal wear for 32- and 36-mm heads was 0.10 mm (95% CI, 0.05–0.15) and 0.05 mm (95% CI, -0.01–0.11), respectively ( p = 0.12). The annual proximal wear rate for 32- and 36-mm heads from 3 months to 6 years was 0.02 mm and 0.01 mm, respectively. There was no difference in bone remodelling around the cup from baseline to 6 years for the total material and no differences between study groups. Conclusion: Wear of this vitamin E-infused highly cross-linked polyethylene is still low at 6-year follow-up, with no significant difference in wear from 3 months to 6 years between 32- and 36-mm heads.
Multiple aneurysms on the subarcuate artery arising from the anterior inferior cerebellar artery in a patient with a Borden type I transverse-sigmoid dural arteriovenous fistula manifesting as subarachnoid hemorrhage: A case report
Authors: Suzuki Tomoaki , Okamoto Kouichirou , Genkai Nobuyuki , Ito Yasushi , Abe Hiroshi 
Published: September 2018

Background Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare and commonly associated with vascular malformations, such as cerebellar arteriovenous malformations (AVMs). We present a case wherein multiple AICA feeding aneurysms on the subarcuate artery as a feeding artery of a Borden type I transverse-sigmoid dural arteriovenous fistula (dAVF) manifested as subarachnoid hemorrhage. Case description A 67-year-old woman presented with acute severe headache. Brain computed tomography (CT) demonstrated subarachnoid hemorrhage mainly in the posterior fossa. A transverse-sigmoid dAVF was detected on magnetic resonance angiography (MRA) and three-dimensional-CT angiography (3D-CTA), with no cortical venous reflex. The patient underwent conventional angiography, which showed multiple aneurysms on a small branch of the AICA, feeding a transverse-sigmoid dAVF (Borden type I). The AICA aneurysms seemed flow dependent and ruptured owing to high-flow arteriovenous shunts through the dAVF. Based on the source images of the MRA, the small artery arising from the AICA was considered the subarcuate artery, and it was confirmed on 3D-CTA after the artery was successfully embolized with Onyx without any complications. Multiple aneurysms on the subarcuate artery are extremely rare, and the artery has not been identified as a feeding artery of the transverse-sigmoid dAVF. Conclusion A rare case of multiple ruptured aneurysms on the subarcuate artery was reported in a patient with a Borden type I dAVF at the transverse-sigmoid sinuses manifesting as subarachnoid hemorrhage. Onyx embolization of the parent artery occlusion was feasible and useful in treating this type of feeding artery aneurysm of the AICA with a dAVF.
Cryotherapy for the Treatment of Chronic Rhinitis: A Qualitative Systematic Review
Authors: Kompelli Anvesh R. , Janz Tyler A. , Rowan Nicholas R. , Nguyen Shaun A. , Soler Zachary M. 
Published: September 2018

Background Chronic rhinitis impacts 60 million Americans and is associated with significant costs for patients. Although medical treatments are first line, some patients require surgical intervention such as vidian or posterial nasal neurectomy. Previous reviews have investigated the role of surgical management in chronic rhinitis, but none have investigated a longstanding treatment with recent interest: cryotherapy. Objective To identify the safety, efficacy, and durability of treatment response of cryotherapy in treating chronic rhinitis. Methods A systematic literature review was performed to identify studies that investigated the utility of cryotherapy in chronic rhinitis. Only studies with the primary objective of assessing the efficacy of cryotherapy on chronic rhinitis were included. Patients were classified as allergic rhinitis, nonallergic rhinitis (vasomotor rhinitis), or mixed rhinitis using the original author’s criteria. Data were extracted regarding reported complications, treatment efficacy, and length of follow-up. Results A total of 110 abstracts were identified, of which 15 were included in this review. Epistaxis and nasal obstruction were commonly reported complications. No serious adverse events were reported. For obstructive symptoms, “reduced” symptoms were reported in 63.4% to 100% of patients. In regard to rhinorrhea, reports of reduced symptoms were experienced from 77% to 100% of patients. Seven studies used only patient-reported improvements without stratifying results based on symptom type; general improvements ranged from 67% to 100%. Nine studies noted symptom improvement in nonallergic cohorts ranging from 67% to 97.5% of patients. Four studies noted improvement in allergic cohorts ranging from 63.4% to 80% of patients. Two studies noted improvement in patients with mixed pictures ranging from 92.5% to 100%. Conclusions Although cryotherapy appears safe and efficacious, heterogeneous past investigations with low-quality evidence make strong, evidence-based recommendations difficult to make. Further study with validated metrics and controlled populations is certainly warranted and should be encouraged.
Retrospective Analysis of Geriatric Patients Undergoing Hip Fracture Surgery: Delaying Surgery Is Associated With Increased Morbidity, Mortality, and Length of Stay
Authors: Bennett Andrew , Li Hsin , Patel Aakash , Kang Kevin , Gupta Piyush , Choueka Jack , Feierman Dennis E. 
Published: September 2018

Introduction: Hip fractures are common in elderly patients. However, this population frequently presents with significant medical comorbidities requiring extensive medical optimization. Methods: This study sought to elucidate optimal time to surgery and evaluate its effect on postoperative morbidity, mortality, and length of stay (LOS). We performed a retrospective analysis of data collected from 2008 to 2010 on 841 patients who underwent hip fracture surgery. Patients were classified based on time to surgery and were also classified and analyzed according to the American Society of Anesthesiologists (ASA) physical classification system. Results: Patients with a delay of greater than 48 hours had a significant increase in overall LOS, postoperative days, and overall postoperative complications. Patients classified as ASA 4 had an odds ratio for postoperative morbidity of 3.32 compared to the ASA 1 and 2 group ( P = .0002) and 2.26 compared to the ASA 3 group ( P = .0005). Delaying surgery >48 hours was also associated with increased in-hospital mortality compared to 24 to 48 hours ( P = .0197). Increasing ASA classification was also associated with significantly increased mortality. Patients classified as ASA 4 had 5.52 times the odds of ASA 1 and 2 ( P = .0281) of in-hospital mortality. Those classified ASA 4 had 2.97 times the odds of ASA 3 ( P = .0198) of an in-house mortality. Anesthetic technique (spinal vs general) and age were not confounding variables with respect to mortality or morbidity. Discussion: Surgical timing and ASA classification were evaluated with regard to LOS, number postoperative days, morbidity, and mortality. Conclusions: Delaying surgery >48 hours, especially in those with increased ASA classification, is associated with an increase in overall LOS, postoperative days, morbidity, and mortality. However, rushing patients to surgery may not be beneficial and 24 to 48 hours of preoperative optimization may be advantageous.
Predictors of Successful Outcomes of Selective Nerve Root Blocks for Acute Lumbar Disc Herniation
Authors: Kanna Rishi M. , Shetty Ajoy P. , Rajasekaran S. 
Published: September 2018

Study Design: Prospective, observational cohort study. Objective: Selective nerve root block (SNRB) is an effective, standard interventional procedure for failed medical management in lumbar disc herniation (LDH). However, the factors that would predict successful outcomes in patients undergoing SNRB have not been clearly studied. Methods: Patients with failed conservative treatment for acute LDH, treated with SNRB were periodically followed till 1 year. Patients who failed to have pain relief or had recurrent pain after SNRB, underwent surgery. The pattern of radiculogram during SNRB was classified into 4 types—“arm,” “arrow,” “linear,” and “splash.” Various clinical factors, radiological factors, and radiculograms were compared between patients who had consistent pain relief (group A) and those patients who did not (group B). Results: A total of 91 patients underwent SNRB. Sixty-nine had good pain relief maintained till 1 year (75.8% success). Twenty-two patients underwent surgery after failed NRB at a mean of 6.3 weeks. Patients with sensory symptoms ( P = .01), higher mean preinjection Oswestry Disability Index (ODI) score ( P = .02), higher mean postinjection ODI score at 3 weeks ( P = .004), nonmanual job ( P = .01), lumbosacral transitional segment ( P = .00 005), and splash pattern of radiculogram ( P = .005) were predictive of failed NRB. Logistic regression analysis showed that lumbosacral transitional segment at the level of LDH is the most significant factor predicting poor outcome. Conclusions: SNRB is an effective technique to provide consistent symptom relief at least till 1 year in patients with acute LDH. The study identified several factors that predicted poor outcomes of SNRB and such patients can be forewarned about need for later surgery.
Back to the Original Question in Endometriosis: Implantation or Metaplasia?
Authors: Viganò Paola , Somigliana Edgardo , Gentilini Davide , Benaglia Laura , Vercellini Paolo 
Published: September 2018

The pathogenesis of some forms of endometriosis is still controversial. Different research approaches have been used to clarify this issue and an intense debate has derived over the years among scientists. This paper presents and discusses aged and modern ideas derived from various observations in different research areas on this specific topic. More specifically, data derived from histological results, animal studies, anatomical findings and basic research activity are presented. Although an increasing body of evidence tends to support the implantation theory, which currently represents the most recognized pathogenic model for endometriosis, some aspects of this disease remain obscure and the scientific and medical communities have still not made significant progress in terms of completely elucidating the histogenesis of some forms of the disease.
Involvement of Iron, Nuclear Factor-Kappa B (NF-κB) and Prostaglandins in the Pathogenesis of Peritoneal Endometriosis-Associated Inflammation: A Review
Authors: Lousse Jean-Christophe , Defrère Sylvie , Ramos Reinaldo González , Van Langendonckt Anne , Colette Sébastien , Donnez Jacques 
Published: September 2018

Peritoneal endometriosis is a chronic pelvic inflammatory disease, characterized by increased numbers of peritoneal macrophages and their secreted products such as cytokines, growth and angiogenic factors in peritoneal fluid. Inflammation plays a major role in pain and infertility associated with endometriosis, but is also extensively involved in the molecular and cellular processes that lead to peritoneal endometriotic lesion development. Several inflammatory mediators have therefore been studied in the context of endometriosis over the last few years. The aim of this review is to focus on three that have been clearly implicated in the pathogenesis of endometriosis and may be linked: peritoneal iron metabolism, nuclear factor-kappa B (NF-κB) activation, and prostaglandin biosynthesis. Peritoneal iron overload has been conclusively demonstrated in endometriosis patients and may induce oxidative stress in the peritoneal cavity. Oxidative stress and proinflammatory cytokines are well known to be potent activators of the NF-κB pathway, which has recently been implicated in peritoneal endometriosis. Induced NF-κB activation leads to expression of numerous proinflammatory genes such as cytokines, which may provide positive feedback to the pathway, self-perpetuating the inflammatory response. Other important NF-κB-regulated molecules are prostaglandin biosynthesis enzymes, and cyclooxygenase-2 (COX-2) in particular. Increased concentrations of prostaglandins have been evidenced in the peritoneal fluid of endometriosis patients and COX-2 inhibitors have proved to be effective in ‘in vitro’ and ‘in vivo’ experimental models. In the light of available data collected from patient biopsies, as well as ‘in vitro’ and ‘in vivo’ studies, the respective implication and potential molecular association of iron, NF-κB and prostaglandins in the pathogenesis of endometriosis are discussed. The key role of peritoneal macrophages is emphasized and potential therapeutic targets are examined.
Quality of the Clinical Diagnosis of Endometriosis
Authors: Djalali Schima , Janson Dietlinde , Altgassen Christopher , Agic Admir , Diedrich Klaus , Hornung Daniela 
Published: September 2018

Background Endometriosis is a benign but chronic disease, often associated with chronic pelvic pain and sterility in reproductive age women. Definite diagnosis of endometriosis requires surgical intervention. In our study we determined the sensitivity and specificity of the routine non-invasive diagnosis of endometriosis. Methods 543 women underwent laparoscopy or laparotomy for benign gynecological reasons; of these, 156 women presented with endometriosis and 387 women presented without endometriosis. Charts were examined for preoperative prediction and diagnosis of endometriosis by gynecologists in private practice and by clinicians. Charts were also examined for the diagnosis after surgical and histological confirmation. Results Out of 101 cases, where first time endometriosis was diagnosed, in 43 patients (42.6%) the diagnosis of endometriosis was accurately predicted preoperatively by clinicians. Gynecologists in private practice suspected endometriosis in 29.7% of the cases. In the group of at least one recurrence of endometriosis (n=55), 89.1% clinic and 74.5% private practice suspected the correct diagnosis before surgery. The sensitivity for clinical diagnosis of endometriosis was calculated to be 59.0% in the clinic and 54.5% in private practice. The specificity was calculated to be 95.6% in the clinic and 96.9% in private practice. Conclusions According to the results of this study, the sensitivity of the clinical diagnosis for patients with newly detected endometriosis is very low, whereas it increases significantly for patients with recurrent disease. We recommend more investigations using non-invasive diagnostic tools. It should thereupon be possible to detect endometriosis earlier than the current delay of around nine years between the onset of symptoms and the final diagnosis.
Expression of the Epidermal Growth Factor Receptor Family in Correlation to the Estrogen Receptor α Expression in Peritoneal and Ovarian Endometriosis
Authors: Herbel Johanna , Mechsner Sylvia , Gericke Christine , Bartley Julia , Loddenkemper Christoph , Salomon David S. , Ebert Andreas D. 
Published: September 2018

Purpose Endometriosis is a benign estrogen-responsive disease which shares some characteristics with malignant tumors such as invasion and unrestrained growth. In this respect, the epidermal growth factor receptor family (EGFR or erbB-1 and erbB-2 to -4) is known to play an important role in tumor biology. The aims of the present study were: 1) to investigate the expression patterns of the four erbB receptors, 2) to ascertain if there was a correlation between the EGFR family expression and the expression of the estrogen receptor α (ERα). Methods Retrospective study: 48 peritoneal and 12 ovarian human endometriotic lesions were analyzed by immunohistochemistry. The confirmation of the immunohistochemical findings was made by Western blot analysis. Using the Mann-Whitney-U test, statistical analysis was performed. Results In peritoneal and ovarian endometriosis, all members of the EGFR family and ERα are detectable in stromal and epithelial cells, but the expression is different within the tissues. Only in ovarian endometriosis was a statistical association observed between EGF receptor and ERα expression (p<0.017). Conclusions The differential expression of the erbB receptors suggest that the erbB family might play an important role in the pathogenesis of endometriosis. A significant association between EGF receptor expression and the ERα expression was only found in ovarian endometriosis.
Hysterectomy-Related Morbidity and Mortality Rates in Turkey from 1999 to 2008
Authors: Güven Davut , Kilico Ismail , Koçak Idris , üstün Cazip 
Published: September 2018

Objective The aim of this study was to report the morbidity and mortality rates associated with hysterectomies performed at our unit and to recommend a plan to reduce complications. Methods: In this retrospective review of morbidity and mortality rates, we reviewed the charts of 1188 patients who underwent hysterectomy between 1999 and 2008 at the Ondokuz Mayis University Hospital in Samsun, Turkey. Results The overall hysterectomy-related morbidity rate was 4.3%. There were no operative or postoperative deaths. The incidence of intraoperative bowel injury was 0.4%, bladder injury was 0.5%, while the incidence of vesicovaginal fistula was 0.2% in this study. Conclusions In order to reduce the hysterectomy-related morbidity rate, proper selection, pre-operative preparation and less invasive alternative treatments can be employed, such as various methods of endometrial ablation or resections. (Journal of Endometriosis 2010; 2: 41–4)
Primary Umbilical Endometriosis
Authors: Battista Raffaele , Tamburro Stefano , Leonenko Marina , Lesec Guy , Bayeh Samih , Nohuz Erdogan 
Published: September 2018

Introduction Endometriosis is a common gynecological disease that affects 5% to 10% of fertile women. The pelvis is the most common site of the disease. Extragenital endometriosis is less common but even more difficult to diagnose and treat. Case report We report one case of primary umbilical and pelvic endometriosis. A 32-year-old woman presented with a cutaneous black mass in the umbilicus. She had a previous history of abdominal pain, dyspareunia and infertility. Technique The patient was offered surgical management and she underwent laparoscopy with excision of the nodule and umbilical reconstruction. Conclusions Complete excision is the mainstay of treatment for this condition. Diagnostic laparoscopy should be suggested in these patients to ensure a complete surgical approach.