bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conventional Transbronchial Needle Aspiration
Authors: Mehta Ravindra M. , Singla Abhinav , Balaji Arjun Lakshmana , Krishnamurthy Shantha , Bhat Rajani S. , Lokanath Chakravarthi 
Published: September 2017

Introduction:Conventional transbronchial needle aspiration (C-TBNA) is the originally described method for sampling mediastinal lymph nodes (MLN). After the advent of endobronchial ultrasound, the practice and reports of C-TBNA have dwindled. We report a large series of C-TBNA from the Indian subcontinent, highlighting aspects such as pathological spectrum, yield and complications, and reiterating its relevance in MLN sampling.Methods:The study population included 400 consecutive patients over 6.8 years who had C-TBNA done for MLN ≥1 cm in size. C-TBNA was done using a 19-G needle, with conscious sedation. A maximum of 7 passes per node were done. Rapid-on-site evaluation was done in >95% cases. Lymph nodes sampled were labeled “adequate” if lymphocytes were present, and “diagnostic” if a definitive diagnosis was made.Results:The study included 228 males and 172 females, mean age 49.4±14.7 years. The “adequacy” rate was 383/400 (95.75%), and “diagnostic” yield was 347/400 (86.75%). C-TBNA was the sole diagnostic modality in 215/400 (53.75%) patients. The diagnoses included tuberculosis (43%), sarcoidosis (25.5%) and malignancy (18.25%). Complications were rare.Conclusions:This is one of the largest studies of C-TBNA in literature, and one of the few studies to define accurate pathologic diagnosis of enlarged MLN in India. This is also the one of the largest series to define the yield of TBNA with rapid-on-site evaluation in MLN sampling. Currently, in many parts of the world, C-TBNA is still the most common MLN sampling procedure, from an availability, expertise, economic, and safety perspective.
Usefulness of Medical Thoracoscopy in the Management of Pleural Effusion Caused by Chronic Renal Failure
Authors: Colella Sara , Fioretti Federica , Massaccesi Chiara , Primomo Gian L. , Panella Gianluca , D’Emilio Vittorio , Pela Riccardo 
Published: September 2017

Introduction:
Although pleural effusion (PE) can be caused by several pathologies like congestive heart failure, infections, malignancies, and pulmonary embolism, it is also a common finding in chronic kidney disease (CKD). Diagnostic thoracentesis is of limited value in the differential diagnosis, and the role of more invasive investigations like medical thoracoscopy (MT) is still unclear.

Aim:
To evaluate the usefulness of MT in unexplained PE in CKD.

Materials and Methods:
In the electronic database of our Institution, we retrospectively searched for patients with CKD who underwent MT for unexplained PE between January 2008 and August 2016.

Results:
Ten patients were included in the present study. The average age was 72.4 years, the male:female ratio 9:1 and the average blood creatinine value 5.96 mg/dL. The average follow-up was 18 months.
A thoracentesis showed an exudate was found in 9 patients and in 1 case pleural fluid characteristics were not recorded for technical reasons; in none of them the cytologic or microbiological analyses were considered diagnostic.
The clinical suspicion was a neoplastic (5) or an infectious disease (5). In 4 patients with recurrent PE, MT was performed to obtain talc pleurodesis.
No immediate procedure-related complications were recorded; 1 patient developed empyema after 2 months. In 6 cases final diagnosis was chronic uremic pleuritis, hydrothorax in 2, and chronic lymphocytic pleurisy in 2.

Conclusions:
MT represents a safe and effective diagnostic and therapeutic procedure in patients with CKD, that itself is a common cause of exudative effusion, and those patients may not require MT.
Incidence of Anal Dysplasia in a Population of High-Risk Women: Observations at a Cervical Pathology Unit
Authors: Oliver-Pérez María de los Reyes , Bravo Violeta Victoria , Legorburu Alonso Beatriz , Betancor Pérez Diana , Bebia Conesa Vicente , Jiménez López Jesús S. 
Published: September 2017

Objectives
This study aimed to evaluate the incidence of anal dysplasia in women at high risk of developing those lesions and to assess the relationships between positive anal cytology and different risk factors.

Materials and Methods
We performed an observational cross-sectional study involving a patient survey and chart review. The study was conducted at the cervical pathology unit at the Hospital Universitario 12 de Octubre, Madrid, Spain, from 2011 to 2015. Patients were 215 women aged 18 to 65 years old with risk factors for anal dysplasia, for whom anal evaluation was indicated. Anal cytology was performed in all patients. High-resolution anoscopy and anal biopsy were used to investigate abnormalities. All patients completed a survey regarding sexual practices. The patients' demographic and clinical data were collected by using a retrospective chart review. The main outcome measure was the incidence of anal dysplasia in this population.

Results
Of the 215 patients, 45 (21.0%) presented with cytological abnormalities (atypical squamous cells of undetermined significance, 13.5%; low-grade squamous intraepithelial lesion, 5.6%; high-grade squamous intraepithelial lesion, 1.9%). Anoscopy was performed in 31 patients (14.4%) and 2 patients (0.9%) had abnormal findings. One case (0.5%) of low-grade anal intraepithelial neoplasia was identified. Only immunosuppression (p = .01) and smoking status (p = .02) were significantly correlated with positive anal cytology results. Limitations of the study include the small single-center sample, a lack of controls, the retrospective design, potential survey response biases, and the nonstandardized survey.

Conclusions
The incidence of abnormal cytological findings was 21.0%, whereas low-grade anal intraepithelial was confirmed in 0.5% of the patients. There is a higher incidence of cytological abnormalities among immunosuppressed women and smokers.
ASCCP Colposcopy Standards: Risk-Based Colposcopy Practice
Authors: Wentzensen Nicolas , Schiffman Mark , Silver Michelle I. , Khan Michelle J. , Perkins Rebecca B. , Smith Katie M. , Gage Julia C. , Gold Michael A. , Conageski Christine , Einstein Mark H. , Mayeaux Edward J. , Waxman Alan G. , Huh Warner K. , Massad L. Stewart 
Published: September 2017

Objectives
The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy for cervical cancer prevention in the United States.

Materials and Methods
The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. This article describes the rationale, evidence, and recommendations related to risk-based colposcopy practice.

Results
Women referred to colposcopy have a wide range of underlying precancer risk, which can be estimated by referral screening tests including cytology and human papillomavirus testing, in conjunction with the colposcopic impression. Multiple targeted biopsies, at least 2 and up to 4, are recommended to improve detection of prevalent precancers. At the lowest end of the risk spectrum, untargeted biopsies are not recommended, and women with a completely normal colposcopic impression can be observed. At the highest end of the risk spectrum, immediate treatment is an alternative to biopsy confirmation.

Conclusions
Assessing the risk of cervical precancer at the colposcopy visit allows for modification of colposcopy procedures consistent with a woman's risk. Implementation of these recommendations is expected to lead to improved detection of cervical precancers at colposcopy, while providing more reassurance of negative colposcopy results.
ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards
Authors: Waxman Alan G. , Conageski Christine , Silver Michelle I. , Tedeschi Candice , Stier Elizabeth A. , Apgar Barbara , Huh Warner K. , Wentzensen Nicolas , Massad L. Stewart , Khan Michelle J. , Mayeaux Edward J. , Einstein Mark H. , Schiffman Mark H. , Guido Richard S. 
Published: September 2017

Objectives
The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts.

Materials and Methods
The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations.

Results
Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up.

Conclusions
These guidelines are intended to serve as a guide to standardize colposcopy across the United States.
Association of Vulvar Symptoms With Pelvic Organ Prolapse and Urinary Incontinence
Authors: Whitis Avery A. , Lipinski Susan W. , Bradley Catherine S. , Stockdale Colleen K. 
Published: September 2017

Objective
The aim of this study was to compare vulvar symptoms between urogynecology patients diagnosed with urinary incontinence (UI) and/or pelvic organ prolapse to women presenting for annual gynecological care.

Methods
This is a retrospective cross-sectional study. Vulvar symptoms (burning, pain, itching, dyspareunia, and discharge) were measured by asking respondents to rate the severity of each symptom from 0 (none) to 10 (most severe). Patient history, diagnoses, and the Urogenital Distress Inventory-6 (UDI-6) score were abstracted from records. Vulvar symptom results were categorized (0, none; 1–3), mild; ≥4, moderate to severe). Logistic regression models explored whether UI symptoms (UDI-6) and urogynecology diagnoses were associated with each vulvar symptom (moderate to severe vs none).

Results
A total of 606 urogynecology patients grouped by the following urogynecology clinical diagnoses: UI (n = 230), prolapse (n = 193), UI + prolapse (n = 183), and 258 controls (general gynecology patients) were included. The mean (± SD) age (years) was 57.5 ± 16.1, 62.4 ± 13.9, 59.0 ± 14.9, and 41.3 ± 13.8 in the UI, prolapse, UI + prolapse, and control groups, respectively (p < .01). Increasing urinary symptoms were associated with all vulvar symptoms (odds ratio [OR], 1.1–1.2 for each 1 point increase in UDI-6; p < 0.05 for all). Prolapse and UI + prolapse diagnoses (compared with controls) were associated with vulvar burning (OR [95% confidence interval {CI}], 2.5 [1.2–5.0] and 2.9 [1.3–6.1] and pain (OR (95% CI), 3.6 [1.5–8.5] and 3.3 [1.4–8.2], respectively). Prolapse diagnoses were also associated with dyspareunia (OR [95% CI], 5.4 [2.2–13.3]).

Conclusions
Patients with pelvic organ prolapse are more likely to report vulvar burning, pain, and dyspareunia than gynecologic control patients. Urinary symptoms were associated with all vulvar symptoms.
Doctors in Denial: The Forgotten Women in the “Unfortunate Experiment”
Authors: Wilkinson Edward J. 
Published: September 2017

Abstract
The “unfortunate experiment” that took place for a period of more than 20 years at the New Zealand Woman's Hospital in Auckland, New Zealand, had tragic results for numerous unsuspecting women and ultimately caused a 20-year setback in cervical cancer screening in New Zealand. The story of Herbert Green's evolving beliefs about cervical cancer, his pursuit of proof for his unfounded theory, based on “no more that a whim and misbelief” according to author Ron Jones, as well as the history of the active as well as passive complicity of superiors and colleagues for years in the rarified realm of academic medicine, is recounted in this engrossing and well-documented book.
A historical account of an unfortunate experiment in cervical neoplasia diagnosis and management is presented.
Assessment of Behavioral Problems in Children With Hearing Loss
Authors: Fiorillo Caitlin E. , Rashidi Vania , Westgate Philip M. , Jacobs Julie A. , Bush Matthew L. , Studts Christina R. 
Published: September 2017

Objective:
To compare the prevalence of disruptive behavior problems between preschool-aged children with hearing loss and normal hearing.

Study Design:
Cross-sectional study.

Setting:
Tertiary academic center.

Patients:
Caregivers of children (2–5 yr old) with normal hearing (NH) (n = 39), hearing loss using hearing aid(s) (HA) (n = 29), or cochlear implant(s) (CI) (n = 21).

Intervention(s):
Demographic information and a mental health history were obtained. Child behavior and language development were assessed.

Main Outcome Measure(s):
The Young Child-Diagnostic Interview Schedule for Children-IV and the MacArthur-Bates Communication Development Inventory III.

Results:
Distributions of race, socioeconomic status, insurance status, and parental home situation (single versus two parent family) were similar across all groups. Parents of children with hearing loss were significantly more likely to report behavior problems (HA = 41%, CI = 38%) than parents of NH children (10%; p = 0.002). Children with hearing loss were significantly more likely to meet diagnostic criteria for oppositional defiant disorder (HA = 48%, CI = 48%) than NH children (23%; p = 0.02). More NH children (8%) than hearing impaired children (0%) had accessed mental health services (p = 0.08). NH children were found to have more advanced language development than hearing-impaired children (p < 0.01), but controlling for Communication Development Inventory III percentiles, the observed behavioral differences remained.

Conclusion:
Controlling for language development, children with hearing loss have higher prevalence of and impairment from disruptive behaviors than their NH peers. These children are less likely to receive appropriate behavioral interventions. Further research is warranted to investigate the impact of disruptive behaviors on speech and hearing rehabilitation. Methods to improve access to effective behavioral interventions in this population are needed.
Acute kidney injury and electrolyte disorders in the critically ill patient with cancer
Authors: Rosner Mitchell H. , Capasso Giovambattista , Perazella Mark A. 
Published: September 2017

Purpose of review
Patients with cancer increasingly make up a significant proportion of patients receiving care in the intensive care unit (ICU). Acute kidney injury and cancer-associated electrolyte disorders are encountered in many of these patients and can significantly impact both short-term and long-term outcomes.

Recent findings
Advances in chemotherapeutic regimens as well as in our understanding of cancer-associated kidney disease highlight the need for specialized knowledge of the unique causes and therapies required in this subset of critically ill patients. This is especially the case as targeted cancer therapies may have off-target effects that need to be recognized in a timely manner.

Summary
This review outlines key knowledge areas for critical care physicians and nephrologists caring for patients with cancer and associated kidney issues such as acute kidney injury and electrolyte disorders. Specifically, understanding kidney-specific effects of new chemotherapeutic approaches is outlined, and provides an up-to-date compendium of these effects.
Emergency Department Treatment of Cannabinoid Hyperemesis Syndrome: A Review
Authors: Khattar Neera , Routsolias Joanne C. 
Published: September 2017

Background:
Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic vomiting associated with chronic cannabis use. As cannabis consumption steadily increases each year, CHS is becoming a commonplace and costly occurrence in hospitals nationwide. Currently, there are no best treatment strategies agreed upon universally.

Areas of Uncertainty:
Thus far, most data about CHS have come from case reports and case series. Consequently, the pathophysiology of the syndrome is unclear, and its occurrence in some cannabis users, but not others, is not understood.

Data Sources:
A literature search was conducted through PubMed, Embase, and Google Scholar from inception until 2017. Publications only in English describing the epidemiology, pathophysiology, diagnostic criteria, and treatments of CHS were incorporated after thorough evaluation. National government surveys were also referred to for current information about the CHS patient population.

Results:
CHS should be considered in the differential diagnosis of any patient presenting with persistent nausea and vomiting. In particular, the diagnosis is suggested if the patient demonstrates regular and chronic cannabis use, intractable nausea and vomiting, cyclical vomiting, relief of symptoms with hot baths, and resolution of symptoms after cannabis cessation. There are currently many possible explanations regarding the mechanisms behind CHS. A variety of treatment options have also been examined, including hot water baths, haloperidol, capsaicin, and benzodiazepines.

Conclusions:
CHS is becoming an increasingly prevalent and complicated problem for health care providers and patients. Further research must be done to address the diagnostic and therapeutic challenges of this syndrome.
The Survival Benefit of a Novel Trauma Workflow that Includes Immediate Whole-body Computed Tomography, Surgery, and Interventional Radiology, All in One Trauma Resuscitation Room
Authors: Kinoshita Takahiro , Yamakawa Kazuma , Matsuda Hiroki , Yoshikawa Yoshiaki , Wada Daiki , Hamasaki Toshimitsu , Ono Kota , Nakamori Yasushi , Fujimi Satoshi 
Published: September 2017

Objective:
The aim of this study was to evaluate the impact of a novel trauma workflow, using an interventional radiology (IVR)–computed tomography (CT) system in severe trauma.

Background:
In August 2011, we installed an IVR-CT system in our trauma resuscitation room. We named it the Hybrid emergency room (ER), as it enabled us to perform all examinations and treatments required for trauma in a single place.

Methods:
This retrospective historical control study conducted in Japan included consecutive severe (injury severity score ≥16) blunt trauma patients. Patients were divided into 2 groups: Conventional (from August 2007 to July 2011) or Hybrid ER (from August 2011 to July 2015). We set the primary endpoint as 28-day mortality. The secondary endpoints included cause of death and time course from arrival to start of CT and surgery. Multivariable logistic regression analysis adjusted for clinically important variables was performed to evaluate the clinical outcomes.

Results:
We included 696 patients: 360 in the Conventional group and 336 in the Hybrid ER group. The Hybrid ER group was significantly associated with decreased mortality [adjusted odds ratio (OR), 0.50 (95% confidence interval, 95% CI, 0.29–0.85); P = 0.011] and reduced deaths from exsanguination [0.17 (0.06–0.47); P = 0.001]. The time to CT initiation [Conventional 26 (21 to 32) minutes vs Hybrid ER 11 (8 to 16) minutes; P < 0.0001] and emergency procedure [68 (51 to 85) minutes vs 47 (37 to 57) minutes; P < 0.0001] were both shorter in the Hybrid ER group.

Conclusion:
This novel trauma workflow, comprising immediate CT diagnosis and rapid bleeding control without patient transfer, as realized in the Hybrid ER, may improve mortality in severe trauma.
Complications of Urethral Bulking Agents for Stress Urinary Incontinence: An Extensive Review Including Case Reports
Authors: de Vries Allert M. , Wadhwa Harpreet , Huang Jason , Farag Fawzy , Heesakkers John P.F.A. , Kocjancic Ervin 
Published: September 2017

Objectives
Stress urinary incontinence in women is a common problem that significantly impacts quality of life. Periurethral injection of urethral bulking agents (UBAs) is a simple, noninvasive, and cost-effective treatment. However, complications associated with UBA are often underappreciated. Objective of this review was to get a complete overview of all published complications of UBA.

Methods
An extensive search of the scientific literature was conducted to quantitatively summarize the complications and their treatments of 8 UBAs. A total of 117 articles (original articles and case reports) were included in the final analysis. Complication incidence, treatment incidence, and follow-up time were extracted when mentioned. Statistical analysis of complication incidence of each UBA was calculated if possible.

Results
A total of 2095 complications in 6462 treated patients were reported in 79 studies. Sixty-seven (3%) were considered serious implying operative correction (Clavien grade III); of these, 46 (69%) required incision and drainage, and 21 (31%) required a more invasive procedure. In 38 case reports and small case series, 49 patients were treated for 110 complications. Of these 110 complications, 41 (37%) can be classified as Clavien grade III.

Conclusions
This extensive review shows that various UBAs have different complication rates, with certain UBAs being more prone to serious complications. Based on available publications, most UBAs have a good safety profile, with low complication rates. However, although the majority of UBA complications are transient and require no or noninvasive treatment, serious complications may require invasive intervention and treatment.
Effects of confinement on body mass and site fidelity of feral pigeons during the setting-up of pigeon houses
Authors: Gasparini Julien , Dauphin Lise , Favrelière Justine , Frantz Adrien , Jacquin Lisa , Récapet Charlotte , Prévot Anne-Caroline 
Published: September 2017

AbstractFeral pigeons can reach high densities in the urban environments and have thus been subject to various regulation programs. Recently, an alternative ethical regulation strategy based on the installation of artificial breeding facilities has been tested in European cities. In Paris (France), pigeons are first confined for several weeks within the pigeon house before being released. According to authorities, this method allows to retain confined pigeons in this new habitat and to attract more conspecifics. This study aims at evaluating the efficiency and potential side-effects of this method by assessing pigeon fidelity behaviour and pigeon welfare after release. Results show that confinement in pigeon houses induced a significant body mass loss in birds. Only 19% of confined pigeons became faithful to their new habitat. This fidelity depended on the origin of birds suggesting that pigeons captured closer to the pigeon houses are more likely to stay in the vicinity of the pigeon house one year after. Investigations on methods of regulation on animal behavior may help to improve management procedures.