bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dermatoscopic Patterns of Nonfacial Actinic Keratosis: Characterization of Pigmented and Nonpigmented Lesions
Authors: Reinehr Clarissa P.H. , Garbin Gabriela C. , Bakos Renato M. 
Published: May 2017

BACKGROUND
Actinic keratoses (AKs) are dysplastic proliferations of keratinocytes. Studies evaluating nonfacial dermatoscopic pattern of AKs are scarce.

OBJECTIVE
This study aimed to evaluate the dermatoscopic patterns of AKs located in nonfacial sites and to compare their patterns with facial lesions.

MATERIALS AND METHODS
Patients with concomitant facial and nonfacial AKs were recruited to participate and evaluated by clinical and dermatoscopic images of their AKs.

RESULTS
Sixty-eight patients were included in the study. A total of 258 nonfacial AKs and 68 facial AKs were analyzed. The most frequent nonfacial AK dermatoscopic structures were white opaque scales (97.3%) and erythema (57.4%). When analyzed in combination, white scales plus erythema were found in 55.4% of nonfacial AKs. Pigmented structures were observed in 22.5% nonfacial AKs. Homogeneous brown pigmentation was the most prevalent pigmented structure in nonfacial pigmented AK (pAK) (93.1%). There was a positive association between patients having concomitant pigmented facial and nonfacial AKs (p < .001).

CONCLUSION
The combinations of erythema and white opaque scales or yellow opaque scales and homogeneous pigmentation are suggestive, respectively of nonpigmented and pigmented nonfacial AKs. Pigmented AKs occur concomitantly in facial and nonfacial areas.
Use of fertility medications and cancer risk: a review and update
Authors: Kroener Lindsay , Dumesic Daniel , Al-Safi Zain 
Published: May 2017

Purpose of review
There is increasing use of fertility medications for ovulation induction and ovarian stimulation for in-vitro fertilization in the treatment of female infertility. In this review, recent literature regarding the association between fertility medication and cancer risk is reviewed.

Recent findings
Several important publications have recently addressed the relationship between use of fertility medications and cancer risk. There are methodological limitations to many of these studies, including unique challenges in studying rare cancers that often develop several years after the time of fertility medication exposure. Although infertility per se is a risk factor for some female cancers, including breast, endometrial and ovarian cancer, most studies do not show a significant risk of these cancers with the use of fertility medications. Some studies, however, have shown a possible increased relative risk of borderline ovarian cancer, although the increased absolute risk is small without a clear causal relationship.

Summary
The collective data regarding the risk of developing cancer from use of fertility medications are reassuring, although several methodological issues in these studies limit definitive conclusions.
A systematic review of the exercise effect on bone health: the importance of assessing mechanical loading in perimenopausal and postmenopausal women
Authors: Sañudo Borja , de Hoyo Moisés , del Pozo-Cruz Jesús , Carrasco Luis , del Pozo-Cruz Borja , Tejero Sergio , Firth Elwyn 
Published: May 2017

Abstract

Objective:
The aims of this systematic review were to determine the general effects of exercise on areal bone mineral density (BMD) in perimenopausal and postmenopausal women, and to provide information on the most suitable bone-loading exercise regimens that may improve bone health in this population group.

Methods:
A computerized, systematic literature search was performed in the electronic databases PubMed, Web of Science, CINAHL, SPORTDiscus, and The Cochrane Library, from January 2005 to November 2015, to identify all randomized controlled trials related to exercise in perimenopausal and postmenopausal women. The initial search identified 915 studies, with a final yield of 10 studies. Only randomized controlled trials that examined the effects of exercise programs longer than 24 weeks in women aged 35 to 70 years were included. The 10 studies quantified at least BMD and described training variables adequately (training period, frequency, volume, intensity).

Results:
Ten studies with moderate quality evidence (6.4 ± 1.8 points, range 4-9) were included. Significant changes in lumbar and femoral neck BMD were found mainly with high-impact exercise and whole body vibration interventions.

Conclusions:
While training effects must be interpreted with caution because of the heterogeneity of the protocols and exercises performed, this systematic review confirmed the effectiveness of impact exercises combined with other forms of training (vibration or strength training) to preserve BMD in perimenopausal and postmenopausal women. Despite the results possibly not representing a general dose-response relationship, we highlight the importance of quantifying loading intensity and frequency by means of accelerometry as these parameters are determinants for bone adaptation.
Topical, geospatial, and temporal diffusion of the 2015 North American Menopause Society position statement on nonhormonal management of vasomotor symptoms
Authors: Carpenter Janet S. , Laine Tei , Harrison Blake , LePage Meghan , Pierce Taran , Hoteling Nathan , Börner Katy 
Published: May 2017

Abstract

Objective:
We sought to depict the topical, geospatial, and temporal diffusion of the 2015 North American Menopause Society position statement on the nonhormonal management of menopause-associated vasomotor symptoms released on September 21, 2015, and its associated press release from September 23, 2015.

Methods:
Three data sources were used: online news articles, National Public Radio, and Twitter. For topical diffusion, we compared keywords and their frequencies among the position statement, press release, and online news articles. We also created a network figure depicting relationships across key content categories or nodes. For geospatial diffusion within the United States, we compared locations of the 109 National Public Radio (NPR) stations covering the statement to 775 NPR stations not covering the statement. For temporal diffusion, we normalized and segmented Twitter data into periods before and after the press release (September 12, 2015 to September 22, 2015 vs September 23, 2015 to October 3, 2015) and conducted a burst analysis to identify changes in tweets from before to after.

Results:
Topical information diffused across sources was similar with the exception of the more scientific terms “vasomotor symptoms” or “vms” versus the more colloquial term “hot flashes.” Online news articles indicated media coverage of the statement was mainly concentrated in the United States. NPR station data showed similar proportions of stations airing the story across the four census regions (Northeast, Midwest, south, west; P = 0.649). Release of the statement coincided with bursts in the menopause conversation on Twitter.

Conclusions:
The findings of this study may be useful for directing the development and dissemination of future North American Menopause Society position statements and/or press releases.
CORRELATION BETWEEN PREOPERATIVE EN FACE OPTICAL COHERENCE TOMOGRAPHY OF PHOTORECEPTOR LAYER AND VISUAL PROGNOSIS AFTER MACULAR HOLE SURGERY
Authors: Kim Kiyoung , Kim Eung Suk , Kim Yonguk , Yu Seung-Young , Kwak Hyung Woo 
Published: May 2017

Purpose:
To investigate the correlation between preoperative en face spectral domain optical coherence tomography findings of the photoreceptor layer with restoration of foveal microstructure and visual acuity in repaired macular holes.

Methods:
Medical records of 106 patients with surgically closed macular holes were retrospectively reviewed. Preoperative OCT slabs of the external limiting membrane (ELM) and ellipsoid zone (EZ) were generated using embedded tools. All patients were classified into two groups according to the presence of preoperative retinal pigment epithelium protrusion seen as hyperreflective spots in EZ slab. Visual acuity, homogenous reflectivity, and glial proliferation in the ELM and EZ slabs were followed for 12 months.

Results:
Baseline hyperreflective spots in the EZ slab was observed in 51 (48.1%) eyes. Postoperative homogenous reflectivity and glial proliferation were related to the presence of baseline hyperreflective spots. Vision improvement was significantly greater in the absence of hyperreflective spots group from 9 months after the operation. In logistic regression analysis, the area of hyperreflective spots was significantly associated with foveal homogenous reflectivity at 12 months (P = 0.004).

Conclusion:
Preoperative hyperreflective spots in en face EZ slab might be indicative of functional and anatomical restoration after macular hole surgery.
CHOROIDAL MELANOMA, SECTOR MELANOCYTOSIS, AND RETINAL PIGMENT EPITHELIAL MICRODETACHMENTS IN BIRT–HOGG–DUBÉ SYNDROME
Authors: Marous Charlotte L. , Marous Molly R. , Welch R. Joel , Shields Jerry A. , Shields Carol L. 
Published: May 2017

Purpose:
Birt–Hogg–Dubé Syndrome (BHDS) is a rare autosomal dominant condition that can predispose patients to numerous cutaneous fibrofolliculomas and other cutaneous lesions, pulmonary cysts with spontaneous pneumothorax, and multifocal renal tumors and cancer. The genetic mutations responsible for BHDS are related to tumor suppression and the mammalian target of rapamycin (mTOR) pathway. Previous reports of the ocular findings in BHDS include eyelid fibrofolliculomas, “flecked chorioretinopathy,” and one report of choroidal melanoma. We report a patient with BHDS who presented with choroidal melanoma, sector melanocytosis, and retinal pigment epithelial microdetachments.

Methods:
Observational case report.

Results:
A 38-year-old man with BHDS manifesting with facial fibrofolliculomas/tricodiscomas and pulmonary cysts with previous pneumothorax of both lungs was noted to have a large choroidal nevus, managed with observation elsewhere. On referral 1 year later, photopsia and visual field defect were noted, and the patient was discovered to have subtle patchy sector ocular melanocytosis of the iris and choroid with choroidal melanoma and dependent subretinal fluid. The melanoma measured 14 mm in basal dimension and 6.8 mm in thickness. In addition, pinpoint retinal pigment epithelial microdetachments were observed in both eyes at the equator and confirmed on optical coherence tomography. Custom-fit plaque radiotherapy was provided for tumor control.

Conclusion:
The BHDS can be associated with tumors of the skin and kidney. In this case, we noted ocular melanocytosis, malignant choroidal melanoma, and bilateral pinpoint retinal pigment epithelial detachments.
Dichotic Listening Deficit Associated With Solvent Exposure
Authors: Landry Simon P. , Fuente Adrian 
Published: May 2017

Hypothesis:
A significant left ear deficit can be observed in solvent-exposed individuals using the dichotic digit test.

Background:
Solvents are ubiquitous in global industrial processes. Due to their lipophilic nature, solvents can adversely affect large white matter tracks such as the corpus callosum. Previous investigations reveal that long-term workplace exposure to solvents is also deleterious to various auditory processes. Investigations in exposed populations suggest a decreased performance for dichotic listening.

Methods:
In this present study, we examined the lateralization of a dichotic digit test score for 49 solvent-exposed individuals along with 49 age- and sex-matched controls. We evaluated group differences between test scores and the right ear advantage using a laterality index (LI).

Results:
Individual ear results suggest that long-term workplace solvent exposure is associated with a significantly lower dichotic listening score for the left ear. A binaural compound score analysis using a laterality index supports this left-ear deficit.

Conclusion:
These results provide an insight on the effects of solvent exposure on dichotic listening abilities. Further research should investigate the importance of using dichotic listening tasks to screen for solvent-induced auditory dysfunction in exposed individuals.
Efficacy of Intratympanic Gentamicin in Menière's Disease With and Without Migraine
Authors: Liu Yuan F. , Renk Elizabeth , Rauch Steven D. , Xu Helen X. 
Published: May 2017

Objective:
To compare the efficacy of intratympanic gentamicin injection (ITG) on vertigo control, drop attacks, and functional level in Menière's disease patients with and without a history of migraine.

Patients:
Menière's disease patients (patients with migraine and age- and sex-matched control patients without migraine) treated from 2002 to 2012 who failed medical management and received ITG, with a minimum 2-year follow up.

Intervention:
ITG.

Main Outcome Measures:
Vertigo control, drop attack prevalence, and change in functional level.

Results:
Twenty-eight Menière's disease patients were included in this study (14 with migraine and 14 matched patients without migraine). There were three men and 11 women in each groups, with a mean age of 53 ± 8.9 years. Baseline characteristics (Menière's stage, vertigo frequency, drop attack prevalence, and functional level) before ITG were not significantly different between the two groups. Two years after ITG, 71% of Menière's disease with migraine patients and 78% of Menière's disease without migraine patients had class A, B, or C vertigo control (p > 0.999). Change in prevalence of drop attacks (43–7% versus 50–0%, respectively) was also similar (p > 0.999). However, significantly fewer vertigo control class A, B, and C migraine patients achieved functional level 1 or 2 (40%) compared with non-migraine patients (91%) (p = 0.007).

Conclusions:
Although ITG appears equally effective in treating vertigo and drop attacks in Menière's disease with and without migraine, patients with migraine derive significantly less benefit in terms of functional improvement.
Where are we heading with fluid responsiveness research?
Authors: Vistisen Simon T. , Juhl-Olsen Peter 
Published: May 2017

Purpose of review
Fluid responsiveness prediction is not always possible with well established dynamic approaches such as passive leg raising or pulse pressure variation in the ICU. The purpose of the present review is to summarize emerging alternative techniques for fluid responsiveness prediction in adult critically ill patients and discuss their methodology and applicability. In addition, the future role of fluid responsiveness prediction in the ICU is discussed.

Recent findings
Several new dynamic techniques have been investigated and they all contribute to the applicability of fluid responsiveness techniques. Although increasing the applicability, most of the emerging techniques still rely on ventilator setting changes in patients that are fully or almost fully adapted to the ventilator or require reliable flow monitoring, which prevents broad applicability. Yet, the mini/micro fluid challenges and the use of extrasystolic preload changes have the potential of being more applicable but all reviewed methods need further validation and methodological refinement.

Summary
Emerging techniques are encouraging for broader applicability of fluid responsiveness prediction. Still, the clinical impact of correctly predicting fluid responsiveness remains to be investigated in the critically ill and the research community should have a clear aim of moving toward that type of studies.
Lactate and microcirculation as suitable targets for hemodynamic optimization in resuscitation of circulatory shock
Authors: Kiyatkin Michael E. , Bakker Jan 
Published: May 2017

Purpose of review
A discussion of recent research exploring the feasibility of perfusion-guided resuscitation of acute circulatory failure with a focus on lactate and microcirculation.

Recent findings
Upon diagnosis of shock, hyperlactemia is associated with poor outcome and, under appropriate clinical circumstances, may reflect inadequate tissue perfusion. Persistent hyperlactemia despite resuscitation is even more strongly correlated with morbidity and mortality. Importantly, there is minimal coherence between lactate trends and static hemodynamic measures such as blood pressure, especially after the initial, hypovolemic phase of shock. During this early period, lactate guided-resuscitation is effective and possibly superior to hemodynamic-guided resuscitation. Similar to hyperlactemia, impaired microcirculation is ubiquitous in shock and is evident even in the setting of hemodynamic compensation (i.e., occult shock). Moreover, persistent microcirculatory derangement is associated with poor outcome and may reflect ongoing shock and/or long-lasting damage. Although the wait continues for a microcirculation-guided resuscitation trial, there is progress toward this goal.

Summary
Although questions remain, a multimodal perfusion-based approach to resuscitation is emerging with lactate and microcirculation as core measures. In this model, hyperlactemia and microcirculatory derangement support the diagnosis of shock, may help guide resuscitation during the initial period, and may reflect resuscitation efficacy and iatrogenic harm (e.g., fluid overload).
Teenage pregnancy prevention: the role of young men
Authors: Vargas Gabriela , Borus Joshua , Charlton Brittany M. 
Published: May 2017

Purpose of review
Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention.

Recent findings
Young men have varying views on contraception as well as which partner(s) should be responsible for its use. Limited contraception knowledge reduces young men's sexual health communication as well as their contraception use. Healthcare providers play a major role as one of the main sources of sexual health information for young men, but there are gaps in young men's sexual health care so new guidelines have emerged.

Summary
Recent literature highlights young men's range of views on contraception as well as their low sexual health knowledge and sexual health communication. To address teenage pregnancy and improve young men's overall wellness, healthcare providers should routinely address sexual health. Healthcare providers may use our newly proposed acronym, HIS BESTT, (Hello. Initiate. Sexual health assessment. Both condoms and female dependent methods. Examine genitals. STI screening. Talking to partner(s). Talking to parent(s) or guardians), to incorporate current clinical recommendations.
Pain and Analgesia Requirements With Hip Fracture Surgery
Authors: A'Court Jamie , Lees Deborah , Harrison William , Ankers Thomas , Reed Mike R. 
Published: May 2017

BACKGROUND:
Hip hemiarthroplasty and dynamic hip screw (DHS) fixation are common procedures performed in trauma units, but there is little information regarding perioperative pain experience with respect to these treatment modalities.

PURPOSE:
To evaluate the relationship between pain, analgesia requirements, and type of procedure for hip fracture surgery.

METHODS:
An analysis was performed on consecutive patients presenting with a hip fracture in 2 hospitals over 2 years. Patients with a diagnosis of dementia were excluded because of the limitations of pain assessment. Postoperative pain scores were taken from standardized patient observation charts. Perioperative opiate consumption was calculated from inpatient drug charts.

RESULTS:
A total of 357 patients were studied; 205 patients (53%) underwent a cemented hemiarthroplasty and 152 (47%) had fixation with a DHS. Patients who underwent a DHS fixation had more pain than those who had a hemiarthroplasty and required almost double the amount of opiates.

CONCLUSION:
The reason for the elevated pain scores and higher morphine requirement in the DHS group (DG) remains unclear. It could be related to highly sensitive periosteum reaction in the DG. It is important to recognize the difference in pain experienced between the groups, and analgesia should be tailored toward the individual based upon clinical assessment and knowledge of the surgery performed. A comprehensive understanding of this principle will allow for improved perioperative surgical care and patient experience.
Bigaussian Wavefront Model for Normal and Keratoconic Eyes
Authors: Rozema Jos J. , Rodríguez Pablo , Navarro Rafael , Koppen Carina 
Published: May 2017

ABSTRACT

Purpose
To report bigaussian multivariate wavefront models capable of stochastically generating an unlimited amount of plausible wavefront data for either normal or keratoconic eyes.

Methods
The models use centroid wavefront data measured previously with an iTrace in 330 healthy right eyes and 122 keratoconic right eyes. These centroids were fitted to an 11th-order Zernike series, followed by principal component analysis to reduce dimensionality and remove correlations. The remaining parameters were then fitted to a sum of two multivariate Gaussian distributions. This fit then forms the core of the stochastic model, which may be used to generate synthetic data. Finally, the agreement between the original and synthetic data was tested using two one-sided t tests.

Results
For normal eyes, the first eigenvectors mostly represent pure Zernike polynomials, with a decreasing degree of purity with increasing order. For keratoconic eyes, eigenvector purity was considerably lower than for normal eyes. Depending on the data set, series of 22 to 29 eigenvectors were found sufficient for accurate wavefront reconstruction (i.e., root-mean-square errors below 0.05 μm). These eigenvectors were then used as a base for the stochastic models. In all models and all Zernike coefficients, the mean of the synthetic data was significantly equal to that of the original data (two one-sided t test, P > .05/75), but the variability of the synthetic data is often significantly lower (F test, P < .05/75).

Conclusions
This synthetic wavefront model may be safely used in calculations as an alternative to actual measurements should such data not be available.
Acute Gastric Volvulus Successfully Treated by Endoscopic Reduction in a 6-Year-Old Girl and a Review of the Japanese Literature
Authors: Haga Mitsuhiro , Sano Nobuyuki , Kamiyama Takamichi , Dairaku Naohiro , Ishii Mari , Nemoto Teruko , Suzuki Hoshiro , Fujie Hiromi , Suzuki Jun 
Published: May 2017

Abstract
A previously healthy 6-year-old girl suddenly developed severe abdominal pain and nausea. She was diagnosed with acute gastric volvulus, and a nasogastric tube was inserted to decompress the stomach. The volvulus did not reduce spontaneously; therefore, we performed endoscopic reduction on day 3 and were able to treat her successfully. We reviewed the Japanese literature on endoscopic reduction for gastric volvulus in children. Fifteen cases have been reported since 1994. There are no reports of perforation during the procedure. Patients whose general condition is stable and who have no severe anatomic anomalies are good candidates for endoscopic reduction.