bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence for the use of robotically assisted surgery in gynecologic cancers
Authors: Ngô Charlotte , Cornou Caroline , Rossi Léa , Bats Anne-Sophie , Bensaid Chérazade , Frati Albane , Nos Claude , Lécuru Fabrice 
Published: July 2016

Purpose of review
Robotically assisted laparoscopy has been introduced in the armamentarium of gynaecologic oncology surgeons. A lot of studies compared robotic surgery and laparotomy when the real issue is to demonstrate the interest and added value of robotically assisted laparoscopy versus standard laparoscopy. In this review, we will describe the most meaningful indications and advantages of robotically assisted laparoscopy in gynaecologic oncology.

Recent findings
The learning curve for advanced procedures in robot-assisted laparoscopy is shorter and easier than with the standard laparoscopy, especially for beginners. In most of the series, operating time is longer with robot, but complication rates are often decreased, especially in obese patients with a conversion rate to laparotomy that is decreased compared with standard laparoscopy. Robot-assisted laparoscopy can be used for surgery of high-risk endometrial cancer, staging of early-ovarian cancer, and pelvic exenteration in case of recurrent malignancies. Furthermore, more recent robots allow performing sentinel node biopsy in endometrial or cervical cancer using fluorescence detection with indocyanine green.

Summary
The spreading of robotic surgery led to an enhancement of minimal invasive surgical approach in general, and to the development of new indications in gynaecologic oncology. The superiority of robot-assisted laparoscopy still has to be demonstrated with properly designed trials.
Vulvar Recurrences After Intensity-modulated Radiation Therapy for Squamous Cell Carcinoma of the Anus
Authors: Bagshaw Hilary P. , Sause William T. , Gawlick Ute , Kim H. Tae , Whisenant Jonathan , Cannon George M. 
Published: July 2016

Objectives:
The objective is to determine localregional control (LRC), distant metastasis free survival, disease-free survival, overall survival (OS), and toxicity for patients with squamous cell carcinoma of the anus treated with definitive chemotherapy and intensity-modulated radiation therapy (IMRT).

Materials and Methods:
We conducted a retrospective review of patients treated using IMRT for squamous cell carcinoma of the anus at our institution since 2005. Patients with local recurrences were identified and reviewed. The Kaplan-Meier curves were used for LRC and OS.

Results:
From 2005 to 2014, 52 patients were treated with IMRT-based chemoradiation for squamous cell carcinoma of the anus. Median dose to the primary tumor was 54 Gy. LRC, distant metastasis free survival, OS, and disease-free survival were 92.3%, 88.5%, 86.5%, and 84.6%, respectively, with a median follow-up of 20 months. Two local failures occurred at the anal primary site and 2 in the vulva. Despite subsequent palliative radiotherapy and chemotherapy, neither patient with a vulvar recurrence achieved disease control.

Conclusions:
In a cohort of patients treated with IMRT-based chemoradiation, 2 vulvar recurrences were identified within the avoided external genitalia despite limited recurrence rates within the cohort overall. This experience suggests that for patients with a locally advanced primary tumor and bulky bilateral inguinal or pelvic disease, the in-transit vulvar dermal lymphatics may be at risk for subclinical involvement and subsequent recurrence. If substantiated by a similar pattern of recurrence at other institutions, the external genitalia may need to be reclassified from an avoidance structure to a clinical treatment volume in patients with locally advanced anal cancer.
Anxiety as a risk factor for menopausal hot flashes: evidence from the Penn Ovarian Aging cohort
Authors: Freeman Ellen W. , Sammel Mary D. 
Published: July 2016

Abstract

Objective:
The aim of this study was to identify temporal associations of anxiety dimensions with menopausal hot flashes in women progressing through the menopausal transition. We hypothesized that associations of both somatic and affective dimensions of anxiety with hot flashes increased in the menopausal transition, and that somatic anxiety was an independent risk factor for menopausal hot flashes.

Methods:
Hot flashes, anxiety symptoms, hormone levels, and other psychosocial variables were assessed annually for 14 years of follow-up. The 233 women were premenopausal at baseline and continued through 1 year or more after the final menstrual period. Anxiety dimensions were assessed with the Zung Anxiety Scale, a validated measure of affective anxiety and somatic anxiety. Summed item scores were divided by the number of items rated, so that ranges of the two dimensions were comparable.

Results:
Seventy-two percent of the sample reported moderate/severe hot flashes during the 14-year interval. There was no significant interaction between anxiety dimensions and menopausal stages. When adjusted for menopausal stage, the magnitude of association between somatic anxiety and hot flashes, however, dramatically increased (odds ratio [OR], 3.03; 95% CI, 2.12-4.32; P < 0.001), whereas the association between affective anxiety and hot flashes increased to a lesser extent (OR, 1.27; 95% CI, 1.03-1.57; P = 0.024). Women with high levels of somatic anxiety (top third of the sample) had the greatest risk of hot flashes (P < 0.001). When the anxiety dimensions were considered in combination, the additive effect of high affective anxiety symptoms was minimal, with no significant difference between the group with high affective/low somatic symptoms and the low symptom group in incident hot flashes at each menopausal stage (P = 0.54). In multivariable analysis, somatic anxiety increased the risk of hot flashes more than three times (OR, 3.13; 95% CI, 2.16-4.53; P < 0.001), but affective anxiety was not significantly associated with hot flashes after adjustment for other study variables (OR, 1.19; 95% CI, 0.96-1.48; P = 0.117). Time-lagged somatic anxiety scores significantly predicted hot flashes, with a 71% increase in risk (OR, 1.71; 95% CI, 1.21-2.41; P = 0.002). Time-lagged affective anxiety scores did not predict hot flashes (OR, 1.06; 95% CI, 0.87-1.31; P = 0.58).

Conclusions:
This study showed a strong predictive association of somatic anxiety with the risk of menopausal hot flashes. The temporal associations suggest that somatic anxiety is not simply a redundant measure of hot flashes but predicts the risk of menopausal hot flashes and may be a potential target in clinical management of perimenopausal women.
Most bothersome symptom in women with genitourinary syndrome of menopause as a moderator of treatment effects
Authors: Pinkerton JoAnn V. , Bushmakin Andrew G. , Abraham Lucy , Cappelleri Joseph C. , Komm Barry S. 
Published: July 2016

Abstract

Objective:
Conjugated estrogens/bazedoxifene (CE/BZA) is indicated to treat moderate/severe menopausal vasomotor symptoms and prevent postmenopausal osteoporosis. This analysis examines the impact of the most bothersome vaginal symptom at baseline on effects of CE/BZA.

Methods:
This post hoc analysis used data from a 12-week clinical trial of nonhysterectomized postmenopausal women (n = 664) randomly assigned to double-blind treatment with CE/BZA (0.45/20 mg and 0.625/20 mg), BZA 20 mg, or placebo. At baseline, women indicated which moderate/severe vaginal symptom (dryness, itching/irritation, or pain with intercourse) bothered them most. Repeated measures models were used to explore treatment effects in relationship to the most bothersome symptom. We calculated effect sizes for treatment differences versus placebo (effect sizes: trivial, 0.1; small, 0.2; medium, 0.5; large, 0.8).

Results:
At baseline, 52% of women selected pain with intercourse, 35% selected vaginal dryness, and 13% selected vaginal itching/irritation as most bothersome. For these three symptom groups respectively, CE/BZA was associated with statistically significant improvements in Menopause-Specific Quality of Life sexual functioning (effect size: 0.45/20 mg, −0.36, −0.30, −0.67; 0.625/20 mg, −0.37, −0.40, −0.26) and/or overall score (effect size: 0.45/20 mg, −0.29, −0.41, −0.78; 0.625/20 mg, −0.41, −0.48, −0.68). Both those doses significantly improved the ease of lubrication item on the Arizona Sexual Experiences Scale in those with pain with intercourse (effect size: 0.45/20 mg, −0.43; 0.625/20 mg, −0.50) and produced some statistically significant improvements in vaginal cell counts in women with dryness or pain with intercourse as the most bothersome symptom. The higher dose was associated with greater treatment satisfaction on the Menopause Symptoms Treatment Satisfaction Questionnaire versus placebo in women who selected pain with intercourse (effect size: 0.40) or dryness (effect size: 0.43) as most bothersome.

Conclusions:
The approved dose of CE/BZA had clear benefits, particularly in women with pain with intercourse (the most common bothersome symptom), in whom it improved lubrication, superficial cell counts, and sexual functioning.
Short-term effects of low-dose estradiol on endothelial function and blood viscosity in nondiabetic postmenopausal overweight women: a double-blind, placebo-controlled study
Authors: Panazzolo Diogo G. , da Silva Lucia H.A. , Maranhão Priscila A. , Souza Maria G.C. , Nogueira Neto José F. , Leão Lenora M.C.S.M. , Bouskela Eliete , Kraemer-Aguiar Luiz G. 
Published: July 2016

Abstract

Objective:
The beneficial effects of estrogen on endothelial function depend on its integrity. This study evaluates the short-term effects of low-dose transdermal estradiol on endothelial function, insulin sensitivity, and blood viscosity in nondiabetic overweight/obese women.

Methods:
Forty-four nondiabetic overweight/obese women with a history of recent menopause were randomly allocated, in a double-blind fashion, to receive transdermal estradiol (1 mg/d, n = 22) or placebo (n = 22). The following parameters were assessed: endothelial reactivity (venous occlusion plethysmography and nailfold videocapillaroscopy), plasma levels of soluble adhesion molecules, insulin sensitivity (homeostasis model assessment of insulin resistance and areas under the curve of insulin and glucose during an oral glucose tolerance test), and blood and plasma viscosity. Data were expressed as means ± SD or medians [first to third quartiles].

Results:
Participants were aged 51.8 ± 2.3 years with a body mass index of 31.5 ± 2.5 kg/m2 and time since menopause was 3 [2-5] years. At baseline, no differences between the groups were observed; however, after 3 months of treatment, the following changes were observed in the estradiol group compared with the placebo group: a decrease in the forearm vascular resistance at baseline (36.37 [24.9-51.27] vs 51.3 [40.88-70.03] mm Hg/mL per min 100 mL tissue−1, P < 0.01) and during the postocclusive reactive hyperemia response (15.93 [11.32-22.29] vs 22.13 [16.46-29.7] mm Hg/mL per min 100 mL tissue−1, P < 0.01), and an increase in red blood cell velocity at rest (0.316 [0.309-0.326] vs 0.303 [0.293-0.308] mm/s, P < 0.001) and during postocclusive reactive hyperemia response (0.374 [0.353-0.376] vs 0.341 [0.333-0.355] mm/s, P < 0.001). Furthermore, blood viscosity was lower in the estradiol group than in the placebo group (3.57 ± 0.12 vs 3.76 ± 0.22 mPa.s; P < 0.01).

Conclusions:
Short-term use of low-dose transdermal estradiol in nondiabetic overweight/obese women with a history of recent menopause improved endothelial function and decreased blood viscosity compared with placebo.
An assessment of the safety and efficacy of a fractional CO2 laser system for the treatment of vulvovaginal atrophy
Authors: Sokol Eric R. , Karram Mickey M. 
Published: July 2016

Abstract

Objectives:
The aim of the study was to assess the safety and efficacy of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause (GSM).

Methods:
Women presenting with GSM and meeting study criteria were enrolled. Examinations at baseline and follow-up (3 mo after final treatment) evaluated dilator tolerance and vaginal pH. Visual analog scales were used to assess pain, vaginal burning, vaginal itching, vaginal dryness, dyspareunia, and dysuria; Vaginal Health Index scores were completed before each treatment and at follow-up; Female Sexual Function Index and Short Form 12 questionnaires were also completed. Participant satisfaction was measured on a 5-point Likert scale (1 = very dissatisfied, 5 = very satisfied). Women received three laser treatments, 6 weeks apart.

Results:
Thirty women participated (mean age 58.6 ± 8.8 y). None withdrew or were discontinued due to an adverse event; three were lost to follow-up. Average improvement in visual analog scale scoring was 1.7 ± 3.2 for pain, 1.4 ± 2.9 for burning, 1.4 ± 1.9 for itching, 6.1 ± 2.7 for dryness, 5.1 ± 3.0 for dyspareunia, and 1.0 ± 2.4 for dysuria; improvement in average Vaginal Health Index and Female Sexual Function Index scores were statistically significant (P < 0.001). Twenty-five of 30 participants (83%) showed increase in comfortable dilator size at 3-month follow up. Before the second and third treatments, 86.6% (26 of 30) of women reported they were better or much better than at the previous treatment; 26 of 27 women (96%) were reportedly satisfied or extremely satisfied at follow-up.

Conclusions:
In this sample, the data suggest that the fractional CO2 laser is effective and safe for treatment of the symptoms associated with GSM.
Modulation of musculoskeletal hyperalgesia by brown adipose tissue activity in mice
Authors: Goudie-DeAngelis Elizabeth M. , Abdelhamid Ramy E. , Nunez Myra G. , Kissel Casey L. , Kovács Katalin J. , Portoghese Philip S. , Larson Alice A. 
Published: July 2016

Abstract
Cold exposure and a variety of types of mild stress increase pain in patients with painful disorders such as fibromyalgia syndrome. Acutely, stress induces thermogenesis by increasing sympathetic activation of beta-3 (β3) adrenergic receptors in brown adipose tissue. Chronic stress leads to the hypertrophy of brown adipose, a phenomenon termed adaptive thermogenesis. Based on the innervation of skeletal muscle by collaterals of nerves projecting to brown adipose, we theorized an association between brown adipose tissue activity and musculoskeletal hyperalgesia and tested this hypothesis in mice. Exposure to a cold swim or injection of BRL37344 (β3 adrenergic agonist) each enhanced musculoskeletal hyperalgesia, as indicated by morphine-sensitive decreases in grip force responses, whereas SR59230A (β3 adrenergic antagonist) attenuated swim-induced hyperalgesia. Chemical ablation of interscapular brown adipose, using Rose Bengal, attenuated the development of hyperalgesia in response to either swim stress or BRL37344. In addition, elimination of the gene expressing uncoupling protein-1 (UCP1), the enzyme responsible for thermogenesis, prevented musculoskeletal hyperalgesia in response to either a swim or BRL37344, as documented in UCP1-knockout (UCP1-KO) mice compared with wild-type controls. Together, these data provide a convergence of evidence suggesting that activation of brown adipose contributes to stress-induced musculoskeletal hyperalgesia.
Safety and Efficacy of Teduglutide (Gattex) in Patients With Crohn’s Disease and Need for Parenteral Support Due to Short Bowel Syndrome–associated Intestinal Failure
Authors: Kochar Bharati , Long Millie D. , Shelton Edward , Young Lorraine , Farraye Francis A. , Yajnik Vijay , Herfarth Hans 
Published: July 2016

Background:
Teduglutide is a GLP-2 analogue indicated for treatment of adults with short bowel syndrome (SBS). Because of the rarity of SBS, real-world safety or efficacy data are not available in patients with Crohn’s disease (CD) and SBS treated with teduglutide.

Aim:
To evaluate teduglutide’s safety and efficacy in CD patients with SBS.

Methods:
We conducted a retrospective cohort study at 3 tertiary centers in the United States between 2012 and 2014. Demographic, clinical, and therapeutic data were retrieved from medical record systems.

Results:
Thirteen CD patients were included, 8 (62%) of whom were on concomitant immunosuppression. Median duration of teduglutide therapy was 365 days [interquartile range (IQR), 122 to 482 d] and 9/13 patients (69%) remain on therapy. At teduglutide initiation, 69% were on parenteral nutrition. At conclusion of follow-up, 1 patient was on parenteral nutrition. All patients were on intravenous fluids (IVF) before teduglutide; median IVF were 9000 mL/wk (IQR, 7000 to 14,000 mL/wk). IVF requirements decreased by a median of 3100 mL/wk (IQR, 2400 to 8400 mL/wk). Six patients (46%) ceased IVF. Adverse events attributed to teduglutide were obstructive symptoms (n=1), pancreatitis (n=1), asymptomatic lipase and amylase elevation (n=1), nausea (n=1), and abdominal pain (n=1). Catheter-related sepsis occurred in 4 patients.

Conclusions:
This is the first report evaluating the safety and efficacy of teduglutide in a cohort of CD patients with SBS requiring parenteral support. More of half the cohort was on concomitant immunosuppression. Teduglutide seemed to be safe and the majority of patients were weaned off parenteral support.
Intestinal phospholipid and lysophospholipid metabolism in cardiometabolic disease
Authors: Hui David Y. 
Published: July 2016

Purpose of review
Phospholipids are major constituents in the intestinal lumen after meal consumption. This article highlights current literature suggesting the contributory role of intestinal phospholipid metabolism toward cardiometabolic disease manifestation.

Recent findings
Group 1b phospholipase A2 (PLA2g1b) catalyzes phospholipid hydrolysis in the intestinal lumen. The digestive product lysophospholipid, particularly lysophosphatidylcholine (LPC), has a direct role in mediating chylomicron assembly and secretion. The LPC in the digestive tract is further catabolized into lysophosphatidic acid and choline via autotaxin-mediated and autotaxin-independent mechanisms. The LPC and lysophosphatidic acid absorbed through the digestive tract and transported to the plasma directly promote systemic inflammation and cell dysfunction, leading to increased risk of cardiovascular disease and obesity/diabetes. The choline moiety generated in the digestive tract can also be used by gut bacteria to generate trimethylamine, which is subsequently transported to the liver and oxidized into trimethylamine-N-oxide that also enhances atherosclerosis and cardiovascular abnormalities.

Summary
Products of phospholipid metabolism in the intestine through PLA2g1b and autotaxin-mediated pathways directly contribute to cardiometabolic diseases through multiple mechanisms. The implication of these studies is that therapeutic inhibition of PLA2g1b and autotaxin in the digestive tract may be a viable approach for cardiovascular and metabolic disease intervention.
Salmonellosis acquired from poultry
Authors: Chousalkar Kapil , Gole Vaibhav Chandrakant 
Published: July 2016

Purpose of review
Among the various poultry product-related foodborne pathogens, gastrointestinal infections caused by egg-borne nontyphoidal Salmonella is a major concern in developed and developing countries. This review is focused on the latest findings and implications for food safety.

Recent findings

Salmonella enteritidis is a predominant serovar for egg-associated human salmonellosis except for Oceania. In Australia, Salmonella typhimurium is the predominant serovar. The cross-section and longitudinal epidemiological investigations yielded mixed results but mainly reported that faecal sampling is the best indicator of egg contamination. Salmonella serovars are able to survive on eggshell for several weeks and form biofilm. The invasion potential of some Salmonella serovars is influenced by the enrichment factors in the environment. Whole-genome sequencing is being adopted for investigation of Salmonella outbreaks, although the culture method remains a prerequisite.

Summary
Industry stakeholders and public health authorities have different perceptions regarding ecology and control of Salmonella from farm to fork. Given the challenges such as variation in Salmonella serovars, emergence of virulent types, ability of bacteria to sustain harsh environment and host defence mechanisms, expensive diagnostics and lack of a single robust intervention, joint efforts from regulators and public health officials are required.
Three-Dimensional Against 2-Dimensional Laparoscopic Colectomy for Right-sided Colon Cancer
Authors: Tao Kaixiong , Liu Xinghua , Deng Meizhou , Shi Wenjia , Gao Jinbo 
Published: July 2016

Background:
Major limitations of conventional 2-dimensional (2D) laparoscopy are a lack of depth perception and spatial orientation. Three-dimensional (3D) laparoscopy was developed to overcome the limitations of the 2D technique. However, it has not been widely accepted due to a lack of conclusive evidence of benefit. The aim of this study was to evaluate the effect of 3D laparoscopy on the operative performance during elective laparoscopic right colectomy.

Methods:
A total of 58 consecutive patients underwent laparoscopic colectomy for right-sided colon cancer by a single experienced surgeon between January 2014 and July 2015. Patients were classified into 2 groups according to the vision system of laparoscopy: 27 patients were operated by 3D laparoscopy (3D group, n=27) and 31 patients were performed by 2D laparoscopy (2D group, n=31). Data of these patients were collected and analyzed retrospectively.

Results:
The operative time was significantly shorter in the 3D group than in the 2D group (130.5±27.6 vs. 152.2±28.9 min, P=0.005). There was no significant difference in blood loss in the 3D group when compared with the 2D group. There was no operative mortality in the 2 groups. The number of lymph nodes resected was similar in both groups. Time to pass the first flatus and postoperative hospital stay showed no significant differences between the 2 groups. The postoperative complication rate for the 3D and the 2D groups were similar: 14.8% (4/27) and 9.7% (3/31), respectively.

Conclusions:
3D laparoscopy appears to reduce the performance time of laparoscopic colectomy when compared with 2D laparoscopy. Further studies are required to address the role of the 3D vision system in laparoscopic colectomy.