bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies
Authors: Kalogera Eleftheria , Bakkum-Gamez Jamie N. , Weaver Amy L. , Moriarty James P. , Borah Bijan J. , Langstraat Carrie L. , Jankowski Christopher J. , Lovely Jenna K. , Cliby William A. , Dowdy Sean C. 
Published: October 2016

OBJECTIVE:
To investigate opioid use and pain scores associated with incisional injection of liposomal bupivacaine compared with bupivacaine hydrochloride after laparotomy for gynecologic malignancies.

METHODS:
A retrospective cohort study was conducted to compare abdominal incision infiltration with liposomal bupivacaine with bupivacaine hydrochloride after modification of a pre-existing enhanced recovery pathway. Patients undergoing staging laparotomy or complex cytoreductive surgery under the updated pathway were compared with patients treated under the original pathway (historic controls). Endpoints included cumulative opioid use (primary outcome) in oral morphine equivalents and cumulative pain score.

RESULTS:
In the complex cytoreductive cohort, median oral morphine equivalents were lower in the liposomal bupivacaine group through 24 hours (30 compared with 53.5 mg, P=.002), 48 hours (37.5 compared with 82.5 mg, P=.005), and the length of stay (62 compared with 100.5 mg, P=.006). Fewer liposomal bupivacaine patients required intravenous rescue opioids (28.9% compared with 55.6%, P<.001) or patient-controlled analgesia (4.1% compared with 33.3%, P<.001). Cumulative pain score was no different between groups through 48 hours (161 compared with 158, P=.69). Postoperative nausea and ileus were less frequent in patients receiving liposomal bupivacaine. Median hospital stay was 5 days in both groups. In the staging laparotomy cohort, cumulative opioids and cumulative pain score were no different between groups (through 48 hours: 162 compared with 161, P=.62; 38 compared with 38, P=.68, respectively). Intravenous rescue opioids (15.3% compared with 28.6%, P=.05) and patient-controlled analgesia (1.4% compared with 8.3%, P=.05) were used less frequently in the liposomal bupivacaine group. Median hospital stay was 4 days in both groups. Despite the higher cost of liposomal bupivacaine, total pharmacy costs did not differ between groups.

CONCLUSION:
Abdominal incision infiltration with liposomal bupivacaine was associated with less opioid and patient-controlled analgesia use with no change in pain scores compared with bupivacaine hydrochloride after complex cytoreductive surgery for gynecologic malignancies. Improvements were also seen in patients undergoing staging laparotomy.
A Prospective, Open-Label, Observational, Postmarket Study Evaluating VYC-17.5L for the Correction of Moderate to Severe Nasolabial Folds Over 12 Months
Authors: Sattler Gerhard , Philipp-Dormston Wolfgang G. , Van Den Elzen Helga , Van Der Walt Cornelius , Nathan Myooran , Kolodziejczyk Julia , Kerson Graeme , Dhillon Benjeev 
Published: October 2016

BACKGROUND
VYC-17.5L (17.5 mg/mL hyaluronic acid, 0.3% lidocaine) is a dermal filler intended for deep dermis injection for the treatment of skin depressions.

OBJECTIVE
To evaluate 12-month effectiveness and safety of VYC-17.5L for the treatment of moderate/severe nasolabial folds (NLFs).

METHODS
Subjects ≥18 years old with moderate/severe NLFs were recruited (N = 70). Injected volume was aimed at achieving optimum correction; top-up treatment was given at 2 weeks if needed. The primary endpoint was investigator-assessed change in NLF severity over 12 months using the validated photonumeric NLF Severity Scale. Secondary endpoints included investigator- and subject-assessed satisfaction and safety. Adverse events judged to be more severe or prolonged than routinely observed were recorded.

RESULTS
Sixty-five subjects completed study requirements. Mean volume injected was 3.0 ± 1.0 mL for both NLFs combined. Significant improvement was maintained in investigator-assessed NLF severity at 12 months, and investigators and subjects reported high satisfaction with VYC-17.5L throughout the study. Two unexpected adverse events were reported: (1) redness, swelling, and decreased sensitivity (resolved after 4 days) and (2) swelling (resolved after 48 hours); neither event was serious or life threatening.

CONCLUSION
VYC-17.5L is effective and well tolerated for the treatment of moderate to severe NLFs for 1 year.
An investigation of life circumstances associated with the experience of hot flashes in Campeche, Mexico
Authors: Huicochea-Gómez Laura , Sievert Lynnette Leidy , Cahuich-Campos Diana , Brown Daniel E. 
Published: October 2016

AbstractObjective:The purpose of this study was to better understand the experience ofcalores(hot flashes) in the state of Campeche, Mexico, and characteristics of women's lives. This study was carried out to understand the sociocultural context of women's lives before conducting a larger semistructured survey in the same communities.Methods:Eighty-five women from rural and urban settings participated in open-ended interviews about the menopausal transition, with particular attention to hot flashes. Univariate and logistic regression analyses identified potential determinants of hot flashes. Qualitative responses were analyzed for central themes from the 40 women who experienced “calores” associated with menopause at the time of interview.Results:The word “calores” was used to describe a variety of sensations and experiences related to the hot climate, infections, going in and out of air-conditioning, emotional stress, and physical exertion, as well as the symptom associated with menopause. In quantitative analyses, the likelihood of experiencing hot flashes varied by menopause status and rural/urban residence. In qualitative analyses, themes that characterized the lives of women with hot flashes were as follows: the search for, and the availability of, biomedical care; presence or absence of networks of social support; marital status and quality of the relationship; and occupational stress.Conclusions:Hot flash questionnaires can elicit different symptom frequencies depending on the language used and the sociocultural context of women's lives. Qualitative findings suggest that the themes most likely to influence the perception and experience of hot flashes in Campeche are biomedicine, social support, marriage, and stress.
Cultural issues in menopause: an exploratory qualitative study of Macedonian women in Australia
Authors: Strezova Anita , O’Neill Sheila , O’Callaghan Cathy , Perry Astrid , Liu Jinzhu , Eden John 
Published: October 2016

Abstract

Objective:
This study explored the attitudes to, and experience of, menopause among Macedonian women living in Australia, including attitudes and responses to hormone therapy (HT) and complementary therapies, as well as related psycho-sexual, relationship and other midlife issues.

Methods:
Using qualitative methodology, the study was based on seven unstructured, nondirective group discussions. Natural social groups were recruited, meeting wherever each group felt most at home. A total of 81 participants ranged in age from 45 to 75 years. The women included both first-generation immigrants and women born in Australia to Macedonian parents. A bilingual Macedonian researcher conducted the fieldwork.

Results:
Participants typically claimed they lacked information about menopause in their native language, and their knowledge of HT was highly variable. Some women only felt comfortable approaching Macedonian doctors. Others reported an easing of symptoms when they revisited their homeland. Deeply religious participants claimed their faith helped them through this phase of life, and that they were as likely to consult a priest as a doctor. A recurring theme was that Macedonian men tended to regard their wives differently after menopause, sometimes treating them as “non-sexual.” Women regarded this shift in male attitudes as a precipitating factor in domestic violence, extramarital affairs and divorce. Symptoms such as hot flashes and mood swings were associated with negative attitudes toward menopause.

Conclusions:
Culturally determined attitudes appear to affect the perception and experience of menopause. Other influencing factors include migration, women's roles, marital status, religion, use of herbal and traditional remedies, social situation, access to information, knowledge and experience of menopausal symptoms.
Extended-release oxybutynin therapy for vasomotor symptoms in women: a randomized clinical trial
Authors: Simon James A. , Gaines Tatiana , LaGuardia Katherine D. 
Published: October 2016

Abstract

Objective:
Assess effects of once-daily, extended-release oxybutynin chloride on frequency and severity of vasomotor symptoms in healthy, postmenopausal symptomatic women.

Methods:
A 12-week, multicenter, double-blind, placebo-controlled, phase 2 clinical trial randomized naturally postmenopausal women experiencing at least seven moderate-to-severe vasomotor symptoms daily to oxybutynin 15 mg once daily (n = 73) or placebo (n = 75). Co-primary outcomes were the change from baseline to week 12 in the frequency and severity of moderate-to-severe vasomotor symptoms.

Results:
Significant reductions in both frequency and severity of moderate-to-severe vasomotor symptoms in women who received oxybutynin compared with placebo were observed at all weeks of treatment (P ≤ 0.007, all time points) through week 12. Mean changes in frequency in the oxybutynin and placebo groups were −9.48 and −4.69 episodes/d, respectively, at week 12. Mean changes in severity (scale 0-3) in the oxybutynin and placebo groups were −1.27 and −0.30, respectively, at week 12. At the end of treatment, 73% of women in the oxybutynin group and 26.1% in the placebo group rated symptom improvement “much better” (P ≤ 0.001). Women treated with oxybutynin showed significant improvement in sleep quality, sleep disturbance, and the global sleep index on the Pittsburgh Sleep Quality Index (P ≤ 0.023). Dry mouth was reported by 52.1% of participants given oxybutynin and 5.3% of participants given placebo, leading to discontinuation of oxybutynin in 6.8% of participants.

Conclusions:
Oxybutynin is an effective, nonhormonal therapy for moderate-to-severe vasomotor symptoms in postmenopausal women.
Reinserting the Hump in Primary Rhinoplasty: The Gain Is Three-fold
Authors: Constantinidis Jannis , Fyrmpas Georgios 
Published: October 2016

Background:
Hump reduction in aesthetic rhinoplasty destabilizes the middle vault. Secondary maneuvers are necessary to avoid the long-term functional and aesthetic sequelae of middle vault collapse. We describe a new technique of reinserting the resected hump that combines (a) placement of the modified hump between the upper laterals and (b) bridging sutures between the upper laterals.

Methods:
Retrospective review of patients undergoing primary aesthetic rhinoplasty with hump resection.

Results:
Sixty-two patients, 46 with a straight and 16 with a deviated nose, enrolled. Twenty-three patients were operated through an open approach and 39 through a closed approach. Osteotomies were necessary in 56 patients. Mean follow-up was 13 months (range, 9–16 mo). A satisfactory result was achieved in all but 3 patients who had visible irregularities. Two of them required minimal rasping under local anesthesia and the third patient refused any further treatment.

Conclusions:
Our modification of Skoog’s original technique has certain advantages: the hump acts as a spreader and onlay graft, which preserves the natural dorsal lines. The sutures increase the nasal valve angle while preventing displacement of the reinserted hump. Indications include a straight or mildly deviated nose, a long thin-skinned nose with short nasal bones. The technique is also feasible through the closed or open approach and offers a valuable alternative to spreader grafts or flaps.
ANALYSIS OF AGE-RELATED CHOROIDAL LAYERS THINNING IN HEALTHY EYES USING SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Ruiz-Medrano Jorge , Flores-Moreno Ignacio , Peña-García Pablo , Montero Javier A. , García-Feijóo Julián , Duker Jay S. , Ruiz-Moreno José M. 
Published: October 2016

Purpose:
To study the changes in the choroidal layers thickness with age in a healthy population using swept-source optical coherence tomography.

Methods:
Retrospective data analysis of a subgroup of eyes from a previous single-center, prospective, cross-sectional, noninterventional study. One hundred and sixty-nine healthy eyes were evaluated using swept-source optical coherence tomography. Inclusion criteria were best-corrected visual acuity between 20/20 and 20/25, spherical equivalent between ±3 diopters, and no systemic or ocular diseases. Two independent investigators determined the macular horizontal choroidal thickness (CT) and the Haller's layer thickness across a 9 mm line centered at the fovea. Subjects were divided into five age groups.

Results:
Mean subfoveal choroidal thickness was 305.76 ± 80.59 μm (95% confidence interval: 294.85–319.33). Mean subfoveal thickness for Haller's layer was 215.47 ± 67.70 μm (95% confidence interval: 207.30–227.86) and mean subfoveal thickness for choriocapillaris plus Sattler's layer was 87.31 ± 40.40 μm (95% confidence interval: 83.38–95.65). No significant differences were found due to gender. Choroidal thickness profile was similar between groups with choroidal thickness and Haller's layer thickness decreasing with age (P = 0.002).

Conclusion:
Choroidal and Haller's layer thickness profiles are similar between different age groups. Age-related choroidal thinning is mostly at the expense of Haller's layer.
REVERSIBLE NYCTALOPIA ASSOCIATED WITH VITAMIN A DEFICIENCY AFTER RESECTED MALIGNANT ILEAL CARCINOID AND PANCREATIC ADENOCARCINOMA
Authors: Hansen Bradley A. , Mendoza-Santiesteban Carlos E. , Hedges Thomas R. 
Published: October 2016

Purpose:
To describe the rapid time course of visual and electroretinographic recovery from vitamin A deficiency in a patient with a history of multiple resected abdominal tumors, including ileal carcinoid and pancreatic adenocarcinoma.

Methods:
A 61-year-old white man with a history of resected malignant ileal carcinoid and Stage III pancreatic adenocarcinoma referred with complaints of 6 weeks of difficulty with night vision.

Results:
Initial testing showed significantly reduced scotopic rod responses in both eyes and decreased vitamin A levels and a normal cancer-associated retinopathy laboratory panel. He had complete recovery of both his symptoms and full-field electroretinography within 5 days of starting intramuscular vitamin A.

Conclusion:
Vitamin A deficiency–related retinopathy after abdominal surgery may be an underreported complication. This case provides a unique clinical perspective in our patient with a history of ileal carcinoid and Stage III pancreatic adenocarcinoma and confirms that rapid symptomatic and electroretinographic recovery is possible with appropriate treatment.
NOVEL PRERETINAL HAIR PIN–LIKE VESSEL IN RETINAL ASTROCYTIC HAMARTOMA WITH VITREOUS HEMORRHAGE
Authors: Soeta Megumi , Arai Yusuke , Takahashi Hidenori , Fujino Yujiro , Tanabe Tatsuro , Inoue Yuji , Kawashima Hidetoshi 
Published: October 2016

Backgroud/Purpose:
To report a case of retinal astrocytic hamartoma with vitreous hemorrhage and a hair pin-like vessel adhering to a posterior vitreous membrane. A 33-year-old man with a retinal astrocytic hamartoma presented with vitreous hemorrhage 5 times.

Methods:
Multimodal imaging, including fundus photography, fluorescein angiography, optical coherence tomography, and B-mode ultrasonography.

Results:
Multimodal imaging demonstrated a novel hair pin-like vessel that adhered to the posterior vitreous membrane.

Conclusion:
Some cases of retinal astrocytic hamartoma with vitreous hemorrhage may be related to structure abnormalities of tumor vessels.
Pharmacokinetic Drug-Drug Interactions of Mood Stabilizers and Risperidone in Patients Under Combined Treatment
Authors: Schoretsanitis Georgios , Haen Ekkehard , Gründer Gerhard , Stegmann Benedikt , Schruers Koen R. J. , Hiemke Christoph , Lammertz Sarah E. , Paulzen Michael 
Published: October 2016

Background
The combination of anticonvulsant mood stabilizers with antipsychotic drugs may lead to clinically relevant drug-drug interactions. The objective of the study was to identify pharmacokinetic interactions of different mood stabilizers on the metabolism of risperidone (RIS) under natural conditions.

Methods
A large therapeutic drug monitoring database containing plasma concentrations of RIS and its metabolite 9-hydroxy-RIS (9-OH-RIS) of 1,584 adult patients was analyzed. Four groups (n = 1,072) were compared: a control group without a potentially cytochrome interacting comedication (R0, n = 852), a group comedicated with valproate (VPA) (RVPA, n = 153), a group comedicated with lamotrigine (LMT) (RLMT, n = 46), and a group under concomitant medication with carbamazepine (CBZ) (RCBZ, n = 21). Dose-adjusted plasma concentrations (C/D ratio) for RIS, 9-OH-RIS and active moiety (AM) (RIS + 9-OH-RIS), as well as metabolic ratios (RIS/9-OH-RIS) were computed.

Results
Groups did not differ with regard to the daily dosage (P = 0.46). Differences were detected for the distributions of the C/D ratios for RIS, 9-OH-RIS and AM (P = 0.003, P < 0.001 and P < 0.001, respectively). Differences remained significant after conducting a Bonferroni correction (P = 0.0125). Pairwise comparisons of the concomitant medication groups with the control group revealed significant differences; RIS C/D ratios were significantly higher in the VPA and the LMT group than in the control group (P = 0.013; P = 0.021). However, these differences did not remain significant after Bonferroni correction. In contrast, CBZ-treated patients showed lower dose-adjusted plasma concentrations of 9-OH-RIS (P < 0.001) as well as the AM (P < 0.001) than the control group; this difference survived the Bonferroni correction.

Conclusions
The data give evidence for pharmacokinetic interactions between RIS and different anticonvulsant mood stabilizers. Carbamazepine decreased serum concentrations of 9-OH-RIS and the AM when compared with the control group. In case of VPA and LMT, findings were less significant; hints for a weak RIS metabolism inhibition by LMT of unclear clinical significance were found.
Oropharyngeal Dysphagia Is Strongly Correlated With Apparent Life‐Threatening Events
Authors: Duncan Daniel R. , Amirault Janine , Mitchell Paul D. , Larson Kara , Rosen Rachel L. 
Published: October 2016

ABSTRACTObjectives:The aim of the present study was to investigate the prevalence of oropharyngeal dysfunction with resultant aspiration in patients admitted after apparent life‐threatening events (ALTE) and to determine whether historical characteristics could predict this oropharyngeal dysphagia and aspiration risk.Methods:We retrospectively reviewed the records of all patients admitted to Boston Children's Hospital between 2012 and 2015 with a diagnosis of ALTE to determine the frequency of evaluation for oropharyngeal dysphagia using video fluoroscopic swallow studies (VFSS) and clinical feeding evaluations, to determine the prevalence of swallowing dysfunction in subjects admitted after ALTE and to compare presenting historical characteristics to swallow study results.Results:A total of 188 children were admitted with a diagnosis of ALTE of which 29% (n = 55) had an assessment of swallowing by VFSS. Of those who had a VFSS, 73% (n = 40) had evidence of aspiration or penetration on VFSS. Of all of the diagnostic tests ordered on patients with ALTEs, the VFSS had the highest rate of abnormalities of any test ordered. None of the historical characteristics of ALTE predicted which patients were at risk for aspiration. In patients who had both clinical feeding evaluations and VFSS, observed clinical feedings incorrectly identified 26% of patients as having no oropharyngeal dysphagia when in fact aspiration was present on VFSS.Conclusions:Oropharyngeal dysphagia with aspiration is the most common diagnosis identified in infants presenting with ALTEs. The algorithm for ALTE should be revised to include an assessment of VFSS as clinical feeding evaluations are inadequate to assess for aspiration.
Inner Speech and Clarity of Self-Concept in Thought Disorder and Auditory-Verbal Hallucinations
Authors: de Sousa Paulo , Sellwood William , Spray Amy , Fernyhough Charles , Bentall Richard P. 
Published: October 2016

Abstract
Eighty patients and thirty controls were interviewed using one interview that promoted personal disclosure and another about everyday topics. Speech was scored using the Thought, Language and Communication scale (TLC). All participants completed the Self-Concept Clarity Scale (SCCS) and the Varieties of Inner Speech Questionnaire (VISQ). Patients scored lower than comparisons on the SCCS. Low scores were associated the disorganized dimension of TD. Patients also scored significantly higher on condensed and other people in inner speech, but not on dialogical or evaluative inner speech. The poverty of speech dimension of TD was associated with less dialogical inner speech, other people in inner speech, and less evaluative inner speech. Hallucinations were significantly associated with more other people in inner speech and evaluative inner speech. Clarity of self-concept and qualities of inner speech are differentially associated with dimensions of TD. The findings also support inner speech models of hallucinations.
Prevalence and Correlates of Genital Infections Among Newly Diagnosed Human Immunodeficiency Virus–Infected Adults Entering Human Immunodeficiency Virus Care in Windhoek, Namibia
Authors: Djomand Gaston , Schlefer Madeleine , Gutreuter Steve , Tobias Sarah , Patel Roopal , DeLuca Nickolas , Hood Julia , Sawadogo Souleymane , Chen Cheng , Muadinohamba Alexinah , Lowrance David W. , Bock Naomi 
Published: October 2016

Background
Identifying and treating genital infections, including sexually transmitted infections (STI), among newly diagnosed human immunodeficiency virus (HIV)-infected individuals may benefit both public and individual health. We assessed prevalence of genital infections and their correlates among newly diagnosed HIV-infected individuals enrolling in HIV care services in Namibia.

Methods
Newly diagnosed HIV-infected adults entering HIV care at 2 health facilities in Windhoek, Namibia, were recruited from December 2012 to March 2014. Participants provided behavioral and clinical data including CD4+ T lymphocyte counts. Genital and blood specimens were tested for gonorrhea, Chlamydia, trichomoniasis, Mycoplasma genitalium, syphilis, bacterial vaginosis, and vulvovaginal candidiasis.

Results
Among 599 adults, 56% were women and 15% reported consistent use of condoms in the past 6 months. The most common infections were bacterial vaginosis (37.2%), trichomoniasis (34.6%) and Chlamydia (14.6%) in women and M. genitalium (11.4%) in men. Correlates for trichomoniasis included being female (adjusted relative risk, [aRR], 7.18; 95% confidence interval [CI], 4.07–12.65), higher education (aRR, 0.58; 95% CI, 0.38–0.89), and lower CD4 cell count (aRR, 1.61; 95% CI, 1.08–2.40). Being female (aRR, 2.39; 95% CI, 1.27–4.50), nonmarried (aRR, 2.30; (95% CI, 1.28–4.14), and having condomless sex (aRR, 2.72; 95% CI, 1.06–7.00) were independently associated with chlamydial infection. Across all infections, female (aRR, 2.31; 95% CI, 1.79–2.98), nonmarried participants (aRR, 1.29; 95% CI, 1.06–1.59), had higher risk to present with any STI, whereas pregnant women (aRR, 1.16, 95% CI 1.03–1.31) were at increased risk of any STI or reproductive tract infection.