bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors related to age at menopause among Korean women: the Korean Longitudinal Survey of Women and Families
Authors: Kim Young-taek , Cha Chiyoung , Lee Mi-ran 
Published: December 2018

Abstract

Objective:
The purpose of this study was to explore factors influencing age of menopause among Korean women.

Methods:
For this secondary analysis study, panel data for Waves 4 through 6 of the Korean Longitudinal Survey of Women were used. Women aged 40 to 60 who were menstruating at Wave 4 were included in the analysis (N = 5,437). Sociodemographic, health status, and health behavioral factors were examined to explore their influence on menopause using Kaplan–Meier analysis and Cox regression analysis.

Results:
Korean women who perceived themselves to be overweight or obese, who had depressive symptoms, or who smoked or were current smokers had higher probabilities of experiencing the onset of menopause, whereas those who had educational achievement lower than high school had a lower probability of experiencing the onset menopause.

Conclusions:
Various factors influenced menopause, including sociodemographic, health status, and health behaviors. Specific tailored interventions for the management of depressive symptoms and smoking cessation could be developed to target modifying variables for Korean women, in preparation for menopause. Also, the role of perceived body weight on menopause could be further explored to identify sociocultural factors for age at menopause.
The effect of a midwife-based counseling education program on sexual function in postmenopausal women: a randomized controlled clinical trial
Authors: Naeij Ehtram , Khani Soghra , Firouzi Armin , Moosazadeh Mahmood , Mohammadzadeh Farnaz 
Published: December 2018

Abstract

Objective:
The present study was conducted to investigate the effect of a midwife-based counseling education program on sexual function in postmenopausal women.

Methods:
A randomized clinical trial was conducted on 52 eligible postmenopausal women. Participants’ sexual function was assessed using the Female Sexual Function Index (FSFI). The women were randomly allocated into two groups: (1) the intervention group, in which the participants received a midwife-based counseling education program in 4 sessions held at 10-day intervals, with each session lasting for 70 minutes; (2) the control group, in which the participants only received routine care. Data were collected 1 week before the start of the sessions, 2 weeks after the end of the sessions, and 2 months after the last follow-up.

Results:
No statistically significant differences were reported between the groups in terms of personal and sociodemographic characteristics and sexual function before the intervention; the total FSFI score was 17.05 (±4.54) in the intervention group and 16.66 (±3.62) in the control group. After the program, in the first and second follow-ups, the scores reached 27.18 (±4.61) and 28.20 (±4.43) in the intervention group and 16.06 (±3.94) and 16.32 (±2.98) in the control group. Significant improvements were observed in the total score of sexual function and all the FSFI domains in the intervention group, but not in the control group (P < 0.001).

Conclusion:
Midwife-based counseling education can be an appropriate approach to improving sexual function in postmenopausal women.
Glaucoma Workup in Congenital Zika Syndrome
Authors: de Oliveira Daniela R. , Ventura Camila V. , Esporcatte Bruno L.B. , Gracitelli Carolina P.B. , Dias Natalia de Carvalho , Ventura Liana O. , Belfort Rubens , Rolim-de-Moura Christiane 
Published: December 2018

Purpose:
The main aim of this study was to perform a glaucoma workup in infants with congenital Zika syndrome (CZS).

Patient and Methods:
This cross-sectional study included 188 eyes of 107 children (1.1±0.3 y; range, 0.3 to 1.8 y) with CZS. The confirmation of the syndrome was possible in 77 of 107 (72.0%) of the enrolled infants based on positive immunoglobulin M antibody capture enzyme-linked immunosorbent assay for Zika virus in the cerebrospinal fluid. All infants underwent a complete ophthalmic examination and bilateral fundus imaging was captured using a wide-angle digital fundus camera (RetCam).

Results:
Five eyes (2.6%) presented 2 criteria for glaucoma diagnosis: 1 eye (0.5%) presented increased intraocular pressure and increased vertical cup-to-disc ratio (CDR); 3 eyes (1.6%) presented increased horizontal corneal diameter and increased vertical, and 1 eye (0.5%) presented myopia related to increased axial length and increased vertical CDR. When excluding the CDR criterion, there was no case of glaucoma in this sample. A significant correlation was observed between high vertical CDR and small cephalic perimeter at birth (P=0.002) and the presence of clinical macular lesions (P=0.031).

Conclusion and Relevance:
Although childhood glaucoma was not detected in this sample, increased vertical CDR is present in children with CZS, associated with microcephaly and clinical macular lesions at birth. This finding may lead to a misdiagnosis of glaucoma.
Identification of Gardnerella vaginalis and Atopobium vaginae in Women With Bacterial Vaginosis in Northern Iran
Authors: Roohbakhsh Esmaeil , Mojtahedi Ali , Roohbakhsh Zahra , Khavari-Nejad Ramezan Ali , Amirmozafari Nour 
Published: December 2018

Background
Bacterial vaginosis is the most common lower genital tract infection among women of reproductive age. Its causative agent is often the bacterium Gardnerella vaginalis, which exists in synergism with other mostly anaerobic bacteria such as Atopobium vaginae, Mobiluncus curtisii, and Megasphaera type I.

Methods
A total of 211 women, who referred to obstetrics and gynecology clinics in Rasht City for suspected vaginal infections, were tested for possible bacterial vaginosis. The presence of G. vaginalis and A. vaginae was verified by 5 different laboratory methods based on the Amsel criteria. These methods included determination of pH, whiff test, and observation of clue cells in a direct smear. Polymerase chain reaction using specific primers was performed on the extracted DNA from the vaginal specimens.

Results
Sixty cases of bacterial vaginosis, of the 211 women tested for suspected vaginal infections, were confirmed using Amsel criteria. In 44% (29/66) and 29% (19/66) of these bacterial vaginosis cases, the presence of G. vaginalis and A. vaginae was confirmed by polymerase chain reaction, respectively.

Conclusions

Gardnerella vaginalis had a very high prevalence in the 18- to 35-year-old women suffering from bacterial vaginosis in this region of Iran. Presumably, these cases were recommended for appropriate treatment, but the wider issue is about prevention in this age group and appropriate public health messages to raise awareness.
Translating peripheral bladder afferent mechanosensitivity to neuronal activation within the lumbosacral spinal cord of mice
Authors: Grundy Luke , Harrington Andrea M. , Caldwell Ashlee , Castro Joel , Staikopoulos Vasiliki , Zagorodnyuk Vladimir P. , Brookes Simon J.H. , Spencer Nick J. , Brierley Stuart M. 
Published: December 2018

AbstractPrimary afferent neurons transduce distension of the bladder wall into action potentials that are relayed into the spinal cord and brain, where autonomic reflexes necessary for maintaining continence are coordinated with pathways involved in sensation. However, the relationship between spinal circuits involved with physiological and nociceptive signalling from the bladder has only been partially characterised. We used ex vivo bladder afferent recordings to characterise mechanosensitive afferent responses to graded distension (0-60 mm Hg) and retrograde tracing from the bladder wall to identify central axon projections within the dorsal horn of the lumbosacral (LS) spinal cord. Labelling of dorsal horn neurons with phosphorylated-MAP-kinase (pERK), combined with labelling for neurochemical markers (calbindin, calretinin, gamma aminobutyric acid, and parvalbumin) after in vivo bladder distension (20-60 mm Hg), was used to identify spinal cord circuits processing bladder afferent input. Ex vivo bladder distension evoked an increase in primary afferent output, and the recruitment of both low- and high-threshold mechanosensitive afferents. Retrograde tracing revealed bladder afferent projections that localised with pERK-immunoreactive dorsal horn neurons within the superficial laminae (superficial dorsal horn), dorsal gray commissure, and lateral collateral tracts of the LS spinal cord. Populations of pERK-immunoreactive neurons colabelled with calbindin, calretinin, or gamma aminobutyric acid, but not parvalbumin. Noxious bladder distension increased the percentage of pERK-immunoreactive neurons colabelled with calretinin. We identified LS spinal circuits supporting autonomic and nociceptive reflexes responsible for maintaining continence and bladder sensations. Our findings show for the first time that low- and high-threshold bladder afferents relay into similar dorsal horn circuits, with nociceptive signalling recruiting a larger number of neurons.
The Value of Diffusion-Weighted MRI in the Long-term follow-up After Subtotal Petrosectomy for Extensive Cholesteatoma and Chronic Suppurative Otitis Media
Authors: Delrue Stefan , De Foer Bert , van Dinther Joost , Zarowski Andrzej , Bernaerts Anja , Vanspauwen Robby , Casselman Jan W. , Offeciers Erwin , Somers Thomas 
Published: December 2018

Objective:To report the long-term follow-up with diffusion-weighted magnetic resonance imaging (DW MRI) after subtotal petrosectomy (SP) with blind sac closure of the external auditory canal for extensive cholesteatoma and chronic suppurative otitis media.Study Design:Retrospective clinical record study.Setting:Tertiary referral center.Patients:Thirty-one patients (31 ears) with extensive cholesteatoma and 17 patients (19 ears) with chronic suppurative otitis media without cholesteatoma who underwent SP between July 1995 and December 2015.Interventions:All 48 patients were followed clinically and with DW MRI to rule out residual cholesteatoma.Main Outcome Measure:Residual cholesteatoma, indicated by a marked hyperintensity on non-echoplanar (non-EP) DW MRI.Results:In the cholesteatoma group the mean interval between surgery and the latest DW MRI was 3.9 years. Seven patients presented with a residual cholesteatoma pearl. The mean interval between surgery and detection of residual disease was 3.7 years. In the chronic suppurative otitis media group the mean interval between surgery and the latest DW MRI was 5.3 years. Residual cholesteatoma was found in three patients. Mean interval between surgery and the detection of disease was 4.5 years.Conclusions:This study shows the importance of DW MRI in the follow-up after SP for cholesteatoma and chronic suppurative otitis media. A little higher residual cholesteatoma rate was found compared with earlier studies, where patients were followed only clinically. One may wonder whether reintervention is always needed or whether in selected cases with small pearls, one may still observe these by a watchful waiting policy with DW MRI.
Otopathology of Unilateral Cochlear Implantation in Patients With Bilateral Temporal Bone Fracture
Authors: Trakimas Danielle R. , Knoll Renata M. , Ishai Reuven , Lee Daniel J. , Jung David H. , Nadol Joseph B. , Remenschneider Aaron K. , Kozin Elliott D. 
Published: December 2018

Objective:
Audiometric outcomes following cochlear implantation (CI) in patients with temporal bone fracture (TBF) are variable and the pathophysiology is not well understood. Herein, we describe otopathologic findings in two such cases to provide insight into pathophysiology and outcomes.

Patients:
Two patients had a history of head trauma resulting in bilateral TBF and sudden, profound, sensorineural hearing loss.

Intervention:
Both cases underwent unilateral CI following head trauma.

Main Outcome Measures:
Both TBs from each patient were harvested postmortem and histologically analyzed to determine fracture lines, intralabyrinthine fibroosseous changes, and spiral ganglion neuron (SGN) counts. Clinical histories and audiometric outcomes were also reviewed.

Results:
In both cases, the implanted TB showed extensive intracochlear ossification, which was greater when fracture involved the cochlea. In contrast, the nonimplanted cochleae were patent with small osseous deposits at the round window membrane. Interaural SGN counts were lower on the implanted side and hearing results were moderate to poor.

Conclusions:
Otopathologic analyses of patients with a CI after bilateral TBF are rare. Based on otopathology of two patients with bilateral TBF and subsequent CI, implanted TBs show extensive intracochlear fibroosseous changes greater than the nonimplanted side. Findings have implications for auditory rehabilitation after TBF.
Phenotypic Characterization of DFNB16-associated Hearing Loss
Authors: Back Daniela , Shehata-Dieler Wafaa , Vona Barbara , Hofrichter Michaela A. H. , Schroeder Joerg , Haaf Thomas , Rahne Torsten , Hagen Rudolf , Schraven Sebastian P. 
Published: December 2018

Hypothesis:
We hypothesized that patients with DFNB16 caused hearing loss show characteristical audiological findings depending on genetic results.

Background:
Hearing loss belongs to the most frequent congenital diseases. In 50–70% of individuals, hearing loss is caused by genetic defects. DFNB1 (deafness, neurosensory, autosomal-recessive) is the most frequently affected locus. Despite its great genetic heterogeneity, comprehensive analysis of genes like STRC, encoding stereocilin (DFNB16) is possible. The genetic architecture of the DFNB16 locus is challenging and requires a unique molecular genetic testing assay. The aim of the study is a systematic characterization of the audiological phenotype in DFNB16-positive patients.

Methods:
Since 2011, 290 patients with suspicion of inherited hearing loss received a human genetic exploration. Eighty two DFNB1-negative patients advanced to further testing in the DFNB16 locus. STRC-positive patients obtained complete audiological diagnostic workup. Additionally, epidemiological data was collected.

Results:
Nine of 82 (11%) of the examined patients (mean age 5 yr) showed mutations in the STRC (3 homozygous, 6 compound heterozygous). Aside from a moderate hearing loss in the pure tone audiogram, auditory brainstem response thresholds were 40–50 dB nHL. Otoacoustic emissions were detectable in only one patient.

Conclusions:
Examination of the DFNB16-locus should be a standard diagnostic test after negative DFNB1-gene screening result. Notably, DFNB16-associated hearing loss can be audiologically characterized as moderate sensorineural hearing loss in the main speech field with absent otoacoustic emissions. Our study is the first to correlate audiological findings with genetic results in patients with hearing loss due to STRC.
Symptom Care at Home
Authors: Mooney Kathi , Whisenant Meagan S. , Beck Susan L. 
Published: December 2018

Introduction:
There is growing recognition that systematically obtaining the patient’s perspective on their health experience, using patient-reported outcomes (PRO), can be used to improve patient care in real time. Few PRO systems are designed to monitor and provide symptom management support between visits. Patients are instructed to contact providers between visits with their concerns, but they rarely do, leaving patients to cope with symptoms alone at home. We developed and tested an automated system, Symptom Care at Home (SCH), to address this gap in tracking and responding to PRO data in-between clinic visits. The purpose of this paper is to describe SCH as an example of a comprehensive PRO system that addresses unmet need for symptom support outside the clinic.

Methods for PRO Score Interpretation:
SCH uses pragmatic, single-item measures for assessing symptoms, which are commonly used and readily interpretable for both patients and providers. We established alerting values for PRO symptom data, which was particularly important for conserving oncology providers’ time in responding to daily PRO data.

Methods for Developing Recommendations for Acting on PRO Results:
The SCH system provides automated, just-in-time self-management coaching tailored to the specific symptom pattern and severity levels reported in the daily call. In addition, the SCH system includes a provider decision support system for follow-up symptom assessment and intervention strategies.

Discussion:
SCH provides PRO monitoring, tailored automated self-management coaching, and alerts the oncology team of poorly controlled symptoms with a provider dashboard that includes evidence-based decision support for follow-up to improve individual patients’ symptom care. We particularly emphasize our process for PRO selection, rationale for determining alerting thresholds, and the design of the provider dashboard and decision support. Currently, we are in the process of updating the SCH system, developing both web-based and app versions in addition to interactive voice response phone access and integrating the SCH system in the electronic health record.
Pseudomyxoma Peritonei After a Total Pancreatectomy for Intraductal Papillary Mucinous Neoplasm With Colloid Carcinoma in Lynch Syndrome
Authors: Hackeng Wenzel M. , de Guerre Livia E. V. M. , Kuypers Karel C. , Snoek Alexander M. , Morsink Folkert H. , Offerhaus G. Johan A. , Brosens Lodewijk A. A. 
Published: December 2018

Abstract
We report a case of pseudomyxoma peritonei (PMP) arising in a 62-year-old male patient with Lynch syndrome (LS). The patient's medical history included an adenocarcinoma of the colon for which a right hemicolectomy was performed and a pancreatectomy due to an intraductal papillary mucinous neoplasm (IPMN) with invasive colloid carcinoma. It was considered that the PMP could be a metastasis of the earlier colonic or pancreatic carcinoma. The pancreatic carcinoma, colon carcinoma, and PMP tissues were examined, and immunohistochemical and molecular analyses were performed to determine the PMP origin. Histopathologic examination revealed morphological similarities with the pancreatic colloid carcinoma, and further immunohistochemical and molecular analyses, including a shared GNAS mutation, confirmed the pancreatic origin of the PMP. In conclusion, this is a unique case of a patient with LS presenting with PMP originating from an IPMN with invasive colloid carcinoma, several years after pancreatectomy. The present case has important diagnostic implications. The IPMN should be considered as a rare extracolonic manifestation of LS, and pancreatic carcinoma origin should be considered in patients presenting with PMP. This case report highlights the added value of molecular diagnostics in daily pathology practice.
The Frequency of Lysosomal Acid Lipase Deficiency in Children With Unexplained Liver Disease
Authors: Kuloglu Zarife , Kansu Aydan , Selbuz Suna , Kalaycı Ayhan G. , Şahin Gülseren , Kirsaclioglu Ceyda Tuna , Demirören Kaan , Dalgıç Buket , Kasırga Erhun , Önal Zerrin , İşlek Ali ,   National LAL‐D Study Group
Published: December 2018

ABSTRACTObjectives:Evidence suggests that lysosomal acid lipase deficiency (LAL‐D) is often underdiagnosed because symptoms may be nonspecific. We aimed to investigate the prevalence of LAL‐D in children with unexplained liver disease and to identify demographic and clinical features with a prospective, multicenter, cross‐sectional study.Methods:Patients (aged 3 months–18 years) who had unexplained transaminase elevation, unexplained hepatomegaly or hepatosplenomegaly, obesity‐unrelated liver steatosis, biopsy‐proven cryptogenic fibrosis and cirrhosis, or liver transplantation for cryptogenic cirrhosis were enrolled. A Web‐based electronic data collection system was used. LAL activity (nmol/punch/h) was measured using the dried blood spot method and classified as LAL‐D (<0.02), intermediate (0.02–0.37) or normal (> 0.37). A second dried blood spot sample was obtained from patients with intermediate LAL activity for confirmation of the result.Results:A total of 810 children (median age 5.6 years) from 795 families were enrolled. The reasons for enrollment were unexplained transaminase elevation (62%), unexplained organomegaly (45%), obesity‐unrelated liver steatosis (26%), cryptogenic fibrosis and cirrhosis (6%), and liver transplantation for cryptogenic cirrhosis (<1%). LAL activity was normal in 634 (78%) and intermediate in 174 (21%) patients. LAL‐D was identified in 2 siblings aged 15 and 6 years born to unrelated parents. Dyslipidemia, liver steatosis, and mild increase in aminotransferases were common features in these patients. Moreover, the 15‐year‐old patient showed growth failure and microvesicular steatosis, portal inflammation, and bridging fibrosis in the liver biopsy. Based on 795 families, 2 siblings in the same family were identified as LAL‐D cases, making the prevalence of LAL‐D in this study population, 0.1% (0.125%–0.606%). In the repeated measurement (76/174), LAL activity remained at the intermediate level in 38 patients.Conclusions:Overall, the frequency of LAL‐D patients in this study (0.1%) suggests that LAL‐D seems to be rare even in the selected high‐risk population.
Social Stress Affects Colonic Inflammation, the Gut Microbiome, and Short‐chain Fatty Acid Levels and Receptors
Authors: Maltz Ross M. , Keirsey Jeremy , Kim Sandra C. , Mackos Amy R. , Gharaibeh Raad Z. , Moore Cathy C. , Xu Jinyu , Somogyi Arpad , Bailey Michael T. 
Published: December 2018

ABSTRACTObjectives:Gastrointestinal disorders, such as inflammatory bowel diseases (IBDs) and functional gastrointestinal disorders (FGIDs), involve disrupted homeostatic interactions between the microbiota and the host. Both disorders are worsened during stress, and in laboratory mice, stress exposure has been shown to change the composition of the gut microbiome. Stress‐induced changes to the microbiome exacerbate intestinal inflammation and alter intestinal motility in mice. It is, however, not yet known whether microbiota‐derived short‐chain fatty acids (butyrate, propionate, and acetate) and their receptors contribute to this effect.Methods:Mice were exposed to a social disruption stress, or left undisturbed as a control. After the first stress exposure, mice were orally challenged with Citrobacter rodentium or with vehicle. The levels of short‐chain fatty acids (SCFAs) were measured using gas chromatography‐mass spectrometry. SCFA receptors were measured via real‐time polymerase chain reaction. Microbial community composition was assessed using 16S rRNA gene sequencing.Results:Stress exposure reduced colonic SCFA levels. Stress exposure and C rodentium, however, significantly increased SCFA levels and changed the expression of SCFA receptors. The levels of SCFAs did not correlate with the severity of colonic inflammation, but the colonic expression of the SCFA receptor GPR41 was positively associated with inflammatory cytokines and colonic histopathology scores. The relative abundances of several taxa of colonic bacteria were significantly changed by stress exposure, including SCFA producers.Conclusions:Social stress can have a significant effect on infection‐induced colonic inflammation, and stress‐induced changes in microbial‐produced metabolites and their receptors may be involved.