bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhinophyma: A Treatment Review
Authors: Fink Caitlin , Lackey Jeffrey , Grande Donald J. 
Published: November 2017

BACKGROUND
Rhinophyma is the overgrowth of sebaceous glands in nasal tissue and its etiology unclear. Without treatment, rhinophyma can be progressive and cause concern both with respect to function and cosmesis.

OBJECTIVE
The objective of this work is to describe treatment options for rhinophyma and their respective risks and benefits.

MATERIALS AND METHODS
A PubMed search was performed to include the terms “rhinophyma” and “treatment.”

RESULTS
Numerous physically destructive modalities exist for treatment of rhinophyma, falling primarily into 3 categories: mechanical destruction, directed electrical energy/radiofrequency, and directed laser energy.

CONCLUSION
There are multiple treatment modalities available to dermatologists for the treatment of rhinophyma. To the best of our knowledge, there are no randomized, prospective, control studies for any treatment, which makes it difficult to recommend a single treatment over another. Nonetheless, it is important to recognize that scarring and hypopigmentation most often occur on or near the nasal ala. Moreover, risks may increase if tissue destruction extends to the papillary dermis or pilosebaceous units are ablated.
Beneficial Effects of Angiotensin-(1–7) on CD34+ Cells From Patients With Heart Failure
Authors: Cole-Jeffrey Colleen T. , Pepine Carl J. , Katovich Michael J. , Grant Maria B. , Raizada Mohan K. , Hazra Sugata 
Published: November 2017

Abstract:
The dysfunctional nature of CD34+ cells from patients with heart failure (HF) may make them unsuitable for autologous stem-cell therapy. In view of evidence that the vasoprotective axis of the renin–angiotensin system (RAS) improves CD34+ cell functions, we hypothesized that CD34+ cells from patients with HF will be dysfunctional and that angiotensin-(1–7) [Ang-(1–7)] would improve their function. Peripheral blood was collected from New York Heart Association class II-IV patients with HF (n = 31) and reference subjects (n = 16). CD34+ cell numbers from patients with HF were reduced by 47% (P < 0.05) and also displayed 76% reduction in migratory capacity and 56% (P < 0.05) lower production of nitric oxide. These alterations were associated with increases in RAS genes angiotensin-converting enzyme and AT2R (595%, P < 0.05) mRNA levels and 80% and 85% decreases in angiotensin-converting enzyme 2 and Mas mRNA levels, respectively. Treatment with Ang-(1–7) enhanced CD34+ cell function through increased migratory potential and nitric oxide production, and reduced reactive oxygen species generation. These data show that HF CD34+ cells are dysfunctional, and Ang-(1–7) improves their functions. This suggests that activation of the vasoprotective axis of the RAS may hold therapeutic potential for autologous stem-cell therapy in patients with HF.
Changes in sexual function among midlife women: “I’m older… and I’m wiser”
Authors: Thomas Holly N. , Hamm Megan , Hess Rachel , Thurston Rebecca C. 
Published: November 2017

Abstract

Objective:
Women experience a variety of changes at midlife that may affect sexual function. Qualitative research approaches can allow a deeper understanding of women's experiences. We conducted 20 individual interviews and three focus groups among sexually active women aged 45 to 60 years (total n = 39) to explore how sexual function changes during midlife.

Methods:
Interviews and focus groups were conducted by a trained facilitator using a semistructured guide. All data were audio-recorded and transcribed. Two investigators used a subsample of data to iteratively develop a codebook. The primary investigator coded all data. A second investigator coded a randomly selected 25% of interviews. Codes regarding changes in sexual function were examined and key themes emerged.

Results:
The mean age was 52, and most women were peri- or postmenopausal. Fifty-four per cent of women were white, 36% black, and 10% of another race. Participants discussed positive and negative changes in sexual function. The most common negative changes were decreased frequency of sex, low libido, vaginal dryness, and anorgasmia. Participants attributed negative changes to menopause, partner issues, and stress. Most participants responded to negative changes with adaptation, including changing sexual behavior and prioritizing different aspects of sex. Participants also reported positive changes, attributed to higher self-confidence, increased self-knowledge, and better communication skills with aging.

Conclusions:
In this qualitative study, women described experiencing both positive and negative changes in sexual function during midlife. When negative changes occurred, women often adapted behaviorally and psychologically. Providers should recognize that each woman's experience is unique and nuanced, and they should provide tailored care regarding sexual function at midlife.
Cross-cultural validation of the Modified Falls Efficacy Scale in Serbian community-dwelling women at risk for osteoporotic fracture
Authors: Aleksic Jelena , Zvekic-Svorcan Jelena , Vujasinovic Stupar Nada , Jeremic Ivica , Grgurevic Anita 
Published: November 2017

Abstract

Objective:
Cross-cultural validation of the Serbian version of the Modified Falls Efficacy Scale (MFES).

Methods:
This cross-sectional study involved 257 women aged 65 years and above who were referred for dual-energy x-ray absorptiometry examination at the Railway Healthcare Institute in Belgrade, Serbia, between January and April 2016. Data collection comprised of a sociodemographic questionnaire and Geriatric Depression Scale-Short Form (GDS-SF) questionnaire, and data related to fractures, level of physical activity, use of medications that can increase the risk of falls, and frequency of falls in the past 12 months. None of the study participants had been previously treated for osteoporosis. The internal consistency of the questionnaire items was assessed via Cronbach's alpha, whereas the interclass correlation coefficient (ICC) was used to calculate test-retest reliability based on the sample of 257 women. We also evaluated concurrent, convergent, and construct validity.

Results:
Cronbach's alpha for the total assay score was 0.98. Correlations among the items ranged from 0.84 to 0.93. While ICC for the scale as a whole was 0.99 (95% confidence interval 0.98-0.99), ICC pertaining to individual items ranged from 0.82 to 0.99. Concurrent validity analysis revealed a significant positive correlation between MFES scores and the reported level of physical activity (ρ = 0.34; P < 0.01). Convergent validity was tested through the ratio of MFES and sociodemographic variables. The findings indicated presence of a significant negative correlation between the MFES scores and age (ρ = −0.32; P < 0.01), age of menopause onset (ρ = −0.16; P = 0.01), and GDS-SF scores (ρ = −0.12; P = 0.04), and positive correlation between MFES and the level of social activity (ρ = 0.22; P < 0.01). Significant differences were noted between the MFES scores of participants who had no history fractures and those who did (U = 5277.50; P < 0.01), and between scores of women who reported falling in the past 12 months and those who did not (U = 4968.50; P < 0.01). Similarly, significant differences (P < 0.01) in the scores pertaining to each MFES item were observed between women who had experienced falls in the past (n = 101) and those who had not (n = 156).

Conclusion:
The Serbian version of the MFES is a reliable and valid instrument that can be used in both clinical practice and research to describe and measure self-perceived fear of falling in older individuals.
Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy
Authors: Venetkoski Minttu , Savolainen-Peltonen Hanna , Rahkola-Soisalo Päivi , Hoti Fabian , Vattulainen Pia , Gissler Mika , Ylikorkala Olavi , Mikkola Tomi S. 
Published: November 2017

Abstract

Objective:
The aim of the study was to evaluate the risk of cardiac and stroke deaths in women who discontinue postmenopausal hormone therapy (HT).

Methods:
We analyzed the risk of death due to cardiac (n = 5,204) and cerebrovascular (n = 3,434) causes in Finnish women who discontinued systemic HT during 1994 to 2013 (n = 432,775). The risks were compared with those in the age-matched female background population and with those in age-matched HT users. Women diagnosed with cardiac or cerebrovascular events within 1 year before discontinuation of HT were excluded (n = 8,711).

Results:
Women younger than 60 years at discontinuation of HT showed a significantly increased risk of cardiac death (after ≤5 y of HT exposure, standardized mortality ratio [SMR] 1.52, 95% CI 1.13-2.00; after >5 y of exposure, SMR 2.08, 95% CI 1.44-2.90) and stroke death (after ≤5 y of exposure, SMR 2.62, 95% CI 2.07-3.28; after >5 y of exposure, SMR 3.22, 95% CI 2.29-4.40) during the first year after treatment as compared with age-matched female background population. When compared with HT users, elevations in risks of cardiac and stroke deaths were even higher. Increased mortality risks were limited to the first post-HT year because increases in risks vanished or markedly decreased when the follow-up time was extended over more than 1 year.

Conclusions:
Discontinuation of postmenopausal HT may be associated with increased risk of cardiac and stroke death in the first posttreatment year. Further investigation is required to evaluate causality of the observed associations.
Association of age at menarche with obesity and hypertension among southwestern Chinese women: a new finding
Authors: Liu Gang , Yang Yuan , Huang Wei , Zhang Nan , Zhang Fan , Li Ge , Lei Han 
Published: November 2017

Abstract

Objectives:
The purpose of this study was to assess the association of the age at menarche with obesity and hypertension among southwestern Chinese women.

Methods:
Participants in a cross-sectional study were required to recall and complete a standard self-reporting questionnaire, including age at menarche and lifestyle habits. Cardiovascular risk factors were obtained from the questionnaire or a physical examination. The main outcomes were obesity and hypertension. The association was examined by binary logistic regression and birth cohort. Odds ratios for adiposity and hypertension were computed across menarcheal ages.

Results:
A cohort of 7,119 women with a mean age of 44.7 years was included in the study. After adjustments, odds ratios (and 95% confidence interval) for obesity across menarcheal age categories (≤11, 12-13, 14-15, 16-17, ≥18) were 3.75 [1.35-10.41], 1.15 [0.90-1.48], 1 (referent), 0.92 [0.75-1.12], and 0.74 [0.58-0.96], respectively (P
trend < 0.001). For hypertension, they were 0.38 [0.13-1.08], 1.03 [0.80-1.33], 1 (referent), 1.21 [0.98-1.49], and 1.39 [1.08-1.80], respectively (P
trend = 0.03). After adjustment by birth cohort, age at menarche was not associated with obesity but was still positively associated with hypertension.

Conclusions:
This study is the first to report that, among southwestern Chinese women, a late menarche tends to be associated with a high risk of hypertension, but with a low risk of obesity. The association between menarche and obesity tends to differ among birth cohorts. Knowledge of the menarcheal history could be a preventive marker for cardiovascular disease.
Designing a Fibular Flow-Through Flap with a Proximal Peroneal Perforator-Free Flap for Maxillary Reconstruction
Authors: Trinh Becky B. , French Brooke , Khechoyan David Y. , Deleyiannis Frederic W.-B. 
Published: November 2017

Summary:
Reconstruction of a composite maxillary defect is frequently performed with a fibular osteocutaneous free flap to address both the bony and mucosal defect. If during the harvest of the fibula a distal skin perforator is not present due to vascular variations, reconstruction can potentially be done using the soleus muscle for filling of the palatal mucosal defect. An additional challenge arises when the accompanying skin paddle that has been harvested is not perfused, but the fibula remains viable. This case report describes salvage following loss of the skin paddle in an osteocutaneous fibular free flap by designing a fibular flow-through flap using a proximal peroneal perforator free flap. The use of this second free flap allows a skin paddle to be positioned on the distal fibular segment, provides a surgical backup, and limits the donor sites to the same extremity.
Genetic Overview of Syndactyly and Polydactyly
Authors: Ahmed Humayun , Akbari Hossein , Emami Abdolhasan , Akbari Mohammad R. 
Published: November 2017

Summary:
Syndactyly and polydactyly—respectively characterized by fused and supernumerary digits—are among the most common congenital limb malformations, with syndactyly presenting at an estimated incidence of 1 in 2,000–3,000 live births and polydactyly at a frequency of 1 in approximately 700–1,000 live births. Despite their relatively regular manifestation in the clinic, the etiologies of syndactyly and polydactyly remain poorly understood because of their phenotypic and genetic diversity. Further, even though concrete knowledge of genotypic links has been established for some variants of syndactyly and polydactyly, there appears to be no single comprehensive published summary of all syndromic and nonsyndromic syndactyly and polydactyly presentations, and there is decidedly no resource that maps all syndromic and nonsyndromic syndactylies and polydactylies to their genetic bases. This gap in the literature problematizes comprehensive carrier screening and prenatal diagnosis and complicates novel diagnostic attempts. This review thus attempts to collect all that is known about the genetic bases of syndromic and nonsyndromic syndactylies and polydactylies, as well as to highlight the dactyly manifestations for which no genetic bases are as yet known. Then, having established a summation of existing and missing knowledge, this work briefly outlines the diagnostic techniques that a genetics-reinforced understanding of syndactyly and polydactyly could inform.
Superficial Soft-Tissue Sarcomas Rarely Require Advanced Soft-Tissue Reconstruction following Resection
Authors: Eward William C. , Lazarides Alexander L. , Griffin Anthony M. , O’Donnell Patrick W. , Sternheim Amir , O’Neill Anne , Hofer Stefan O. , Ferguson Peter C. , Wunder Jay S. 
Published: November 2017

Objective:
Soft-tissue sarcomas are most frequently located deep within myofascial compartments. Superficial soft-tissue sarcomas (S-STS) are relatively less common and may be managed differently than deep sarcomas because generous resection margins are often possible without sacrificing critical structures. We sought to investigate the frequency and types of soft-tissue reconstructive procedures that are required following excision of S-STS.

Methods:
We reviewed 457 consecutively treated patients with S-STS with a minimum 2-year follow-up from our prospectively maintained database between 1989 and 2009.

Results:
Mean follow-up was 10.5 years (range, 2–23). Four hundred twenty-one tumors (91%) were excised with negative margins, 38 (8.3%) had microscopically positive margins, and three (0.7%) had grossly positive margins. One patient required an amputation. In 271 (58%) patients, the wounds were closed primarily. In comparison, 93 patients (20%) required a rotation flap, 70 (15%) required a split-thickness skin graft, and 23 (5%) underwent a free tissue transfer (ie, advanced reconstructive procedure). The overall complication rate was 12%, although 43% of patients undergoing free tissue transfer developed complications (P = 0.04). An unplanned excision before referral to our center was a risk factor for local recurrence (P = 0.03) when residual tumor was recovered in the reexcision specimen pathologically.

Conclusions:
Although concern about the morbidity associated with a free tissue transfer (ie, advanced reconstructive procedure) may potentially limit the adequacy of resection in some patients with S-STS, the results of this study showed that the majority of patients had complete excisions with negative margins and primary closure. Obtaining a negative margin when excising a known or suspected S-STS rarely requires an advanced reconstructive procedure and almost never results in loss of limb.
Outcome of Therapeutic Keratoplasty in Hopeless Microbial Keratitis Cases Otherwise Advised Evisceration
Authors: Jain Rajat , Bhutia Karma L. , Mohan Neha , Gupta Col K. C. , Ghai Ashwani 
Published: November 2017

Purpose:
To study the outcome of therapeutic keratoplasty in severe microbial keratitis cases otherwise advised evisceration.

Methods:
A retrospective, single-center clinical audit included 28 patients with severe microbial keratitis presenting from April 2014 to April 2016. Patients with microbial keratitis either affecting more than 2 quadrants of the limbus and/or cases with infections involving more than 180 mm2 of the cornea who were advised evisceration by more than one ophthalmologist were included. Cases with endophthalmitis were excluded. At 3 months, the outcome was “success” if resolution of infection occurred without recurrence and evisceration was not required. Success was termed “complete” if best vision was 6/24 or better and “partial” otherwise. The outcome was termed a “failure” if infection recurred in the graft or the eye was eviscerated.

Results:
Mean age of the patients (male:female, 17:11) was 49.5 years, and the mean duration of symptoms before surgery was 28.6 days. Evisceration was required in 2/28 cases. The outcome was “success” in 22/28 cases (78.6%)—complete (10/22); partial (12/22)—and “failure” in 6/28 cases. The outcome was poorer in general in fungal keratitis (n = 16) than bacterial keratitis (n = 7).

Conclusions:
Primary evisceration is best avoided in infections limited to the anterior segment. Even in hopeless cases, every eye deserves a fair chance.
Adjustment of Intrastromal Corneal Ring Segments After Unsuccessful Implantation in Keratoconic Eyes
Authors: Monteiro Tiago , Mendes José Ferreira , Faria-Correia Fernando , Franqueira Nuno , Madrid-Costa David , Alfonso José F. 
Published: November 2017

Purpose:
To evaluate visual, refractive, and corneal topography outcomes in eyes with keratoconus that have undergone exchange/adjustment surgery with a new intrastromal corneal ring segment (ICRS) combination after unsuccessful visual and/or refractive outcomes after primary ICRS surgery.

Methods:
A retrospective nonrandomized case series was conducted including consecutive eyes of patients with keratoconus that underwent ICRS adjustment after an unsuccessful visual outcome. Patients were divided into 2 groups: group 1 was made up of patients with Intacs ICRSs that were exchanged for the Ferrara ICRS type, and group 2 consisted of patients who maintained the same ICRS type after undergoing ICRS adjustment surgery (change of the arc length or thickness). Uncorrected distance visual acuity, best-corrected distance visual acuity (CDVA), keratometry, asphericity, higher-order aberrations, and corneal regularity indexes (ISV and IHD) (Pentacam HR; OCULUS) were assessed preoperatively and 12 months after each procedure.

Results:
Twenty-six eyes from 26 patients were included, 8 eyes in group 1 and 18 eyes in group 2. The eyes in both groups improved their CDVA values after ICRS exchange, in group 1 from 0.27 ± 0.11 preoperatively to 0.54 ± 0.17 postoperatively (P = 0.001), and in group 2 from 0.34 ± 0.22 to 0.61 ± 0.15 (P < 0.0001). In both groups, there was also a significant improvement in the refractive cylinder, topographic cylinder, and coma after ICRS adjustment (P < 0.05).

Conclusions:
ICRS implantation has been shown to be a reversible and adjustable surgical procedure for keratoconus treatment. Good outcomes can be obtained after ICRSs are exchanged.
Norovirus and Rotavirus Disease Severity in Children: Systematic Review and Meta-analysis
Authors: Riera-Montes Margarita , O’Ryan Miguel , Verstraeten Thomas 
Published: November 2017

Background:
Rotaviruses (RVs) and noroviruses (NoVs) are the most common causes of severe acute gastroenteritis in children. It is generally accepted that RVs cause severe acute gastroenteritis in a higher proportion of cases compared with NoVs. To our knowledge, there are no systematic reviews and meta-analyses comparing the severity of NoV and RV disease.

Methods:
We searched MEDLINE for studies reporting data for NoV and RV medically attended disease severity in children. We included studies where all children had been tested for both NoV (reverse transcription polymerase chain reaction) and RV (enzyme-linked immunosorbent assay or reverse transcription polymerase chain reaction) and that reported disease severity using the Vesikari or modified Vesikari score, or provided clinical information on severity. We generated pooled estimates of the mean with 95% confidence intervals using random effects meta-analysis.

Results:
We identified 266 publications, of which 31 were retained for qualitative analysis and 26 for quantitative analysis. Fourteen studies provided data on severity score for the meta-analysis. The pooled mean severity scores (95% confidence interval) among outpatients were 10 (8–12) and 11 (8–14) for NoV and RV, respectively. Among inpatients, they were 11 (9–13) for NoV and 12 (10–14) for RV. The difference was statistically significant among inpatients, but relatively small (1 point in a 20-point scale). About 20% more children with RV required rehydration when compared with children with NoV.

Conclusions:
NoV causes moderate to severe disease similar to RV in young children. This information should be useful for future evaluations of an eventual introduction of NoV vaccines in national immunization programs.
Interleukin-4 mediates the analgesia produced by low-intensity exercise in mice with neuropathic pain
Authors: Bobinski Franciane , Teixeira Juliana Maia , Sluka Kathleen Anne , Santos Adair Roberto Soares 
Published: November 2017

Abstract
Peripheral nerve injury (PNI) activates the immune system, resulting in increased proinflammatory cytokines at the site of injury and in the spinal cord dorsal horn. Exercise modulates the immune system promoting an anti-inflammatory phenotype of macrophages in uninjured muscle, and increases in anti-inflammatory cytokines can promote healing and analgesia. We proposed that PNI will decrease, and treadmill exercise will increase, release of anti-inflammatory cytokines at the site of injury and in the spinal cord. We show that 2 weeks of treadmill exercise improves neuropathic pain behaviors in mice: mechanical hyperalgesia, escape and avoidance behavior, and spontaneous locomotor activity. Peripheral nerve injury reduced anti-inflammatory cytokines (interleukin-4 [IL-4], IL-1ra, and IL-5) at the site of nerve injury and in the spinal dorsal horn, whereas exercise restored IL-4, IL-1ra, and IL-5 concentrations to preinjury levels. IL4−/− mice and mice treated with IL-4 antibody did not develop analgesia to treadmill exercise. Using immunohistochemical staining of the sciatic nerve, treadmill exercise increased the percentage of M2 macrophages (secretes anti-inflammatory cytokines) and decreased M1 macrophages (secretes proinflammatory cytokines) when compared with sedentary mice. The increased M2 and decreased M1 macrophages in exercised mice did not occur in IL-4−/− mice. In the spinal cord, PNI increased glial cell activation, brain-derived neurotrophic factor and β-nerve growth factor levels, and decreased IL-4 and IL-1ra levels, whereas treadmill exercise suppressed glial cells activation (Glial Fibrillary Acidic Protein and Iba1 immunoreactivity), reduced brain-derived neurotrophic factor and β-nerve growth factor, and increased IL-4, IL-1ra, and IL-5 concentrations. Our results suggest that IL-4 mediates the analgesia produced by low-intensity exercise by modulating peripheral and central neuroimmune responses in mice with neuropathic pain.