bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased sexual desire with exogenous testosterone administration in men with obstructive sleep apnea: a randomized placebo‐controlled study
Authors: Melehan K. L. , Hoyos C. M. , Yee B. J. , Wong K. K. , Buchanan P. R. , Grunstein R. R. , Liu P. Y. 
Published: November 2015

SummaryTestosterone (T) deficiency, sexual dysfunction, obesity and obstructive sleep apnea (OSA) are common and often coexist. T prescriptions have increased worldwide during the last decade, including to those with undiagnosed or untreated OSA. The effect of T administration on sexual function, neurocognitive performance and quality of life in these men is poorly defined. The aim of this study was to examine the impact of T administration on sexual function, quality of life and neurocognitive performance in obese men with OSA. We also secondarily examined whether baseline T might modify the effects of T treatment by dichotomizing on baseline T levels pre‐specified at 8, 11 and 13 nmol/L. This was a randomized placebo‐controlled study in which 67 obese men with OSA (mean age 49 ± 1.3 years) were randomized to receive intramuscular injections of either 1000 mg T undecanoate or placebo at baseline, week 6 and week 12. All participants were concurrently enrolled in a weight loss program. General and sleep‐related quality of life, neurocognitive performance and subjective sexual function were assessed before and 6, 12 and 18 weeks after therapy. T compared to placebo increased sexual desire (p = 0.004) in all men, irrespective of baseline T levels. There were no differences in erectile function, frequency of sexual attempts, orgasmic ability, general or sleep‐related quality of life or neurocognitive function (all p = NS). In those with baseline T levels below 8 nmol/L, T increased vitality (p = 0.004), and reduced reports of feeling down (p = 0.002) and nervousness (p = 0.03). Our findings show that 18 weeks of T therapy increased sexual desire in obese men with OSA independently of baseline T levels whereas improvements in quality of life were evident only in those with T levels below 8 nmol/L. These small improvements would need to be balanced against potentially more serious adverse effects of T therapy on breathing.
Laying open (deroofing) and curettage of sinus as treatment of pilonidal disease: a systematic review and meta‐analysis
Authors: Garg Pankaj , Menon Geetha R. , Gupta Vikas 
Published: November 2015

AbstractBackgroundLaying open (deroofing, not excision) and curettage of the sinus is a minimally invasive procedure to treat pilonidal disease. A consensus on its efficacy and outcomes has not been reached. We reviewed and meta‐analysed the efficacy of this procedure.MethodsPubMed, Medline, Scopus, Ovid, Cochrane central register of controlled trials (CENTRAL) and Google scholar databases were searched. All studies describing laying open (not excision) of sinus with curettage of the tract to treat pilonidal disease (simple and complicated) were included. The primary outcome parameter was recurrence and the secondary outcome parameters were complication rate, operating time, return to work and healing time.ResultsA total of 1194 studies were screened. Out of these, 13 studies were finally included for the analysis. The analysis (n = 1445) demonstrated a net proportion meta‐analysis (random effect) pooled rate of 4.47% (95% CI = 0.029–0.063) for recurrence, 1.44% (95% CI = 0.005–0.028) for complications, 34.59 min (95% CI = 13.58–55.61) for operating time, 21–72 days for healing time and 8.4 days (95% CI = 5.23–11.72) for return to work. The procedure was possible under local anaesthesia in seven out of 13 studies.ConclusionsThe meta‐analysis demonstrates that laying open (deroofing) and curettage has distinct advantages. These are high success rate, possible in all types of pilonidal disease (simple and complex), low complication rate, short operating time and early return to normal routine and work. This procedure can be conveniently under local anaesthesia as an outpatient procedure.
Enhanced recovery pathways in abdominal gynecologic surgery: a systematic review and meta‐analysis
Authors: de Groot Jeanny J.A. , Ament Stephanie M.C. , Maessen José M.C. , Dejong Cornelis H.C. , Kleijnen Jos M.P. , Slangen Brigitte F.M. 
Published: November 2015

AbstractIntroductionEnhanced recovery pathways have been widely accepted and implemented for different types of surgery. Their overall effect in abdominal gynecologic surgery is still underdetermined. A systematic review and meta‐analysis were performed to provide an overview of current evidence and to examine their effect on postoperative outcomes in women undergoing open gynecologic surgery.Material and methodsSearches were conducted using Embase, Medline, CINAHL, and the Cochrane Library up to 27 June 2014. Reference lists were screened to identify additional studies. Studies were included if at least four individual items of an enhanced recovery pathway were described. Outcomes included length of hospital stay, complication rates, readmissions, and mortality. Quantitative analysis was limited to comparative studies. Effect sizes were presented as relative risks or as mean differences (MD) with 95% confidence intervals (CI).ResultsThirty‐one records, involving 16 observational studies, were included. Diversity in reported elements within studies was observed. Preoperative education, early oral intake, and early mobilization were included in all pathways. Five studies, with a high risk of bias, were eligible for quantitative analysis. Enhanced recovery pathways reduced primary (MD −1.57 days, 95% CI CI −2.94 to −0.20) and total (MD −3.05 days, 95% CI −4.87 to −1.23) length of hospital stay compared with traditional perioperative care, without an increase in complications, mortality or readmission rates.ConclusionThe available evidence based on a broad range of non‐randomized studies at high risk of bias suggests that enhanced recovery pathways may reduce length of postoperative hospital stay in abdominal gynecologic surgery.
A simultaneous population pharmacokinetic analysis of rifampicin in Malawian adults and children
Authors: Schipani Alessandro , Pertinez Henry , Mlota Rachel , Molyneux Elizabeth , Lopez Nuria , Dzinjalamala Fraction K. , van Oosterhout Joep J. , Ward Steve A. , Khoo Saye , Davies Gerry 
Published: November 2015

AIMSLow rifampicin plasma concentrations can lead to treatment failure and increased risk of developing drug resistant tuberculosis. The objectives of this study were to characterize the population pharmacokinetics (popPK) of rifampicin in Malawian children and adults with tuberculosis, simulate exposures under revised WHO dosing guidelines that aim to reduce the risk of low exposures of rifampicin and examine predicted exposures using weight‐ and age‐based dosing bands under new dosing recommendations.MethodsPatients were recruited at least two weeks after initiation of the intensive phase of treatment and received RIF in FDC of anti‐TB drugs. A total of 5‐6 rich and 1‐2 sparse samples were collected. nonmem (v7.2) was used to build a population‐PK model.ResultsA 165 TB patients, 115 adults and 50 children, aged 7 months to 65 years and weighing 4.8 to 87 kg, were included in the one compartment model with first order absorption best described the data. The mean population estimate for CL/F was 23.9 (l h–1 70 kg–1) with inter‐individual variability of 46.6%. Exposure was unaffected by HIV status. Relative bioavailability in children was estimated at 49% lower compared to adults (100% relative bioavailability). Simulations showed significantly lower rifampicin exposure in children vs. adults. In children average AUC was 13.5 mg l‐1 h, which was nearly half that was observed in adults (26.3 mg l‐1 h). Using age as a surrogate for weight in dosing bands gave similar results compared with the weight bands. Increasing dose to approximately 15 mg kg–1, increased AUC in children to an average of 22 mgl‐1 h. bringing expected exposures in children closer to those predicted for adults.ConclusionThe popPK model developed can be used to optimize rifampicin exposures through dosing simulations. WHO dosing recommendations may not be achieved using currently licensed fixed dose combination formulations of TB therapy.
Modelling of the Sedative Effects of Propofol in Patients undergoing Spinal Anaesthesia: A Pharmacodynamic Analysis
Authors: Roh Go Un , Kim Youngsoon , Ha Sang Hee , Jeong Kyu Hee , Choi Sumin , Han Dong Woo 
Published: November 2015

AbstractSedation can increase patient comfort during spinal anaesthesia. Understanding the relationship between the propofol effect‐site concentration (Ce) and patient sedation level could help clinicians achieve the desired sedation level with minimal side effects. We aimed to model the relationship between the propofol Ce and adequate and deep sedation and also incorporate covariates. Thirty patients scheduled for orthopaedic surgery received spinal anaesthesia with 0.5% bupivacaine. Propofol was administered via an effect‐site target‐controlled infusion device using the Schnider pharmacokinetic model. The pharmacodynamic models for both adequate sedation [Observer's Assessment of Alertness/Sedation (OAA/S) scores of 3–4] and deep sedation (OAA/S scores of 1–2) were developed using nonlinear mixed‐effects modelling. Increments in the propofol Ce were associated with increased depths of sedation. In the basic model, the estimated population Ce50 values for adequate and deep sedation were 0.94 and 1.52 μg/ml, respectively. The inclusion of the patient's age and sensory block level for adequate sedation and of age for deep sedation as covariates significantly improved the basic model by decreasing the objective function's minimum value from 10696.72 to 10677.92 (p = 0.0003). The simulated Ce50 values for adequate sedation in 20‐year‐old patients with a T12 sensory level and in 80‐year‐old patients with a T4 level were 1.63 and 0.53 μg/ml, respectively. Both age and sensory block level should be considered for adequate sedation, and the propofol concentration should be reduced for elderly patients with a high spinal block to avoid unnecessarily deep levels of sedation.
Contemporary Argentina and the Rise of Brazil
Authors: RUSSELL ROBERTO , TOKATLIAN JUAN G. 
Published: November 2015

This article focuses on: (a) Argentine elites' perception of Brazil's international rise from 2001/2002 up to the present; and (b) the three strategic options implemented by Argentina as a response to Brazil's growing power and influence. These options – regionalism, light balancing and soft hedging – constitute a new typology, since the corresponding behaviors cannot be inscribed within the conventional logic of balancing or bandwagoning. The article concludes with brief comments on what could be seen as a new stage in bilateral relations.
Refining the head and neck cancer referral guidelines: a two‐centre analysis of 4715 referrals
Authors: Tikka T. , Pracy P. , Paleri V. 
Published: November 2015

ObjectivesTo identify the set of referral criteria that will offer optimal diagnostic efficacy in patients suspected to have head and neck cancer (HNC) in the primary care setting.DesignStatistical analysis of referral criteria and outcomes.SettingTwo tertiary care cancer centres in the United Kingdom.Participants4715 patients who were referred via the fast‐track system with a suspected HNC between 2007 and 2010.Main outcome measuresParameters of diagnostic efficacy, multivariate regression model to calculate estimated probability of HNC and area under the receiver operating characteristic curve (AUROC).ResultsThe majority of referring symptoms had a positive predictive value higher than the 3% cut‐off point stated to be significant for HNC detection in the 2015 NICE recommendations. Nevertheless, our multivariate analysis identified nine symptoms to be linked with HNC. Of these, only four are included in the latest NICE guidelines. The best fit predictive model for this data set included the following symptoms: hoarseness >3 weeks, dysphagia >3 weeks, odynophagia, unexplained neck mass, oral swelling >3 weeks, oral ulcer >3 weeks, prolonged otalgia with normal otoscopy, the presence of blood in mouth with concurrent sensation of lump in throat and the presence of otalgia with concurrent lump in throat sensation. Intermittent hoarseness and sensation of lump in throat were negatively associated with HNC. The AUROC demonstrated that our model had a higher predictive value (0.77) compared to those generated using the NICE 2005 (0.69) and 2015 (0.68) referral criteria (P < 0.0001). An online risk calculator based on this study is available at http://www.orlhealth.com/risk-calculator.html.ConclusionsThis study presents a significantly refined version of referral guidelines which demonstrate greater diagnostic efficacy than the current NICE guidelines. We recommend that further iterative refinements of referral criteria be considered when referring patients with suspected HNC.
The relationship between arterial stiffness and the lifestyle habits of female athletes after retiring from competitive sports: a prospective study
Authors: Koshiba Hiroya , maeshima Estuko , Okumura Yuka 
Published: November 2015

SummaryThis study investigated the relationship between changes in arterial stiffness and the lifestyle habits of endurance athletes after retiring from competition. The subjects were 10 female university endurance athletes. We used formPWV/ABI® as an index for arterial stiffness and measured brachial‐ankle pulse‐wave velocity (baPWV) directly before subjects retired (0Y) and at 2 years after retirement (2Y). Furthermore, to investigate the relationship between arterial stiffness and lifestyle habits 2 years later, Lifecorder ® PLUS was used to measure physical activity levels, hours of sleep were surveyed using a questionnaire, and a food intake survey was conducted using Excel Eiyoukun Food Frequency Questionnaire Based on Food Group, FFQg Ver. 3.5. We found that baPWV increased significantly from 0Y to 2Y (P<0·05). Furthermore, negative correlations were observed between 2Y baPWV and step count as the physical activity index (r = −0·653, P<0·05) and moderate physical activity (r = −0·663, P<0·05). With regard to lifestyle habits that affected the amount of increase in baPWV from 0Y to 2Y (ΔbaPWV), negative correlations were noted between the step count (r = −0·690, P<0·05) and total physical activity (r = −0·657, P<0·05). However, no significant correlations were observed between 2Y baPWV and ΔbaPWV with food intake or hours of sleep. The results of this study suggested that physical activity was a lifestyle habit that inhibited an increase in arterial stiffness after retirement from competition and that having a high step count or engaging in physical activity for long periods of time in particular was useful in this regard.
Pseudosyndactyly – an inflammatory and fibrotic wound healing disorder in recessive dystrophic epidermolysis bullosa
Authors: Breitenbach Jenny , Gruber Christina , Klausegger Alfred , Trost Andrea , Bogner Barbara , Reitsamer Herbert , Bauer Johann W. 
Published: November 2015

SummaryBackgroundA genetic blistering skin disease, recessive dystrophic epidermolysis bullosa (RDEB), is marked by severe wound healing defects and finger contractures. The purpose of this investigation was to elucidate the mechanisms of impaired wound healing and pseudosyndactyly occurring in RDEB patients by studying the role of known inflammation and fibrosis markers in RDEB pseudosyndactyly tissue.Patients and methodsWe studied the expression of the fibrosis and/or inflammation markers tenascin‐C, α‐smooth muscle actin, transforming growth factor‐β1, interleukin‐1β, and interleukin‐6 in scarring and nonscarring tissue from healthy donors and RDEB patients by semiquantitative real time‐PCR and, where applicable, by immunoblots. Furthermore, the distribution pattern of α‐smooth muscle actin and tenascin‐C were assessed by immunofluorescence microscopy.ResultsBased on mRNA and protein analysis, we found upregulation of tenascin‐C, interleukin‐1β, and interleukin‐6 – but not of transforming growth factor‐β1 – in recessive dystrophic epidermolysis bullosa scar samples taken from pseudosyndactyly hands. Unexpectedly, α‐smooth muscle actin was not upregulated.ConclusionsOur results confirm inflammation and fibrosis in recessive dystrophic epidermolysis bullosa, especially in scars, suggesting major roles for these processes in pseudosyndactyly. Our data therefore suggests the potential use of antiinflammatory and antifibrotic drugs in the prevention of pseudosyndactyly.
Die diagnostische Relevanz der direkten Immunfluoreszenz beim okulären Schleimhautpemphigoid
Authors: Mehra Tarun , Guenova Emmanuella , Dechent Frieder , Würth Florian , Zierhut Manfred , Röcken Martin , Schaller Martin , Deuter Christoph 
Published: November 2015

ZusammenfassungHintergrund und ZielsetzungZiel war es, den diagnostischen Wert der direkten Immunfluoreszenz (DIF) beim okulären Schleimhautpemphigoid (okuläres MMP – „mucous membrane pemphigoid“) unter Beachtung der Immunfluoreszenzmuster und der Biopsiestellen zu bestimmen.Patienten und MethodenGeprüft wurden DIF‐Ergebnisse und Krankenakten von 54 Patienten mit Verdachtsdiagnose eines okulären MMP.ErgebnisseEs gab insgesamt eine Prävalenz des okulären MMP in 70,4 % der Fälle. Lineare Ablagerungen von IgA, IgG oder C3 zeigten einen hohen positiven prädiktiven Wert (84 ‐ 100 %). Der Empfindlichkeitswert und der negative prädiktive Wert von IgG, IgM, IgG und C3 bei DIF waren bei kutanen Proben höher als bei Bindehaut‐Biopsien, und lieferten daher eine höhere diagnostische Genauigkeit. Die Empfindlichkeit der DIF scheint beim okulären MMP geringer zu sein als beim bullösen Pemphigoid.SchlussfolgerungenDer diagnostische Wert der DIF bei der Abklärung des okulären MMP wurde bestätigt. Biopsien aus nicht‐konjunktivalem, kutanen Gewebe scheinen jedoch genauere Ergebnisse zu liefern.
Efficacy and safety of a 5‐day regimen of azacitidine for patients with high‐risk myelodysplastic syndromes
Authors: Fujimaki Katsumichi , Miyashita Kazuho , Kawasaki Rika , Tomita Naoto 
Published: November 2015

AbstractAlthough a 7‐day (d) regimen of azacitidine (AZA) is the standard treatment of high‐risk myelodysplastic syndromes (MDS), AZA is difficult to administer during weekends in an outpatient setting. We retrospectively investigated the outcome of a 5‐d regimen of AZA in patients with high‐risk MDS. High‐risk MDS was defined as MDS with intermediate‐2‐ or high‐risk MDS according to the International Prognostic Scoring System. Every months AZA was given at 75 mg/m2 per day for 5–7 d in hospital for first cycle and 5 d in outpatient for second cycle and later. Between April 2011 and December 2013, AZA treatment was initiated in 25 patients (men, 22; women, 3; median age, 75 yr; age range, 59–86 yr). The median number of AZA cycles was 10 (range, 1–24). Twenty patients received more than three cycles of AZA and 13 (52%) achieved any hematological improvement (HI). The median time to first response was two cycles (1–3). The most common non‐hematological adverse events were neutropenia in 21 patients and thrombocytopenia in 17 patients. Nineteen patients died. The main cause of death was disease progression (five patients) and infectious complications (11 patients). The median overall survival was 13.2 months. The 5‐d AZA regimen showed a good continuation rate of more than three cycles and an equivalent HI with the 7‐d regimen.
Motion‐induced disturbance of auditory–motor synchronization and its modulation by transcranial direct current stimulation
Authors: Ono Kentaro , Mikami Yusuke , Fukuyama Hidenao , Mima Tatsuya 
Published: November 2015

AbstractThe timing of personal movement with respect to external events has previously been investigated using a synchronized finger‐tapping task with a sequence of auditory or visual stimuli. While visuomotor synchronization is more accurate with moving stimuli than with stationary stimuli, it remains unclear whether the same principle holds true in the auditory domain. Although the right inferior–superior parietal lobe (IPL/SPL), a center of auditory motion processing, is expected to be involved in auditory–motor synchronization with moving sounds, its functional relevance has not yet been investigated. The aim of the present study was thus to clarify whether horizontal auditory motion affects the accuracy of finger‐tapping synchronized with sounds, as well as whether the application of transcranial direct current stimulation (tDCS) to the right IPL/SPL affects this. Nineteen healthy right‐handed participants performed a task in which tapping was synchronized with both stationary sounds and sounds that created apparent horizontal motion. This task was performed before and during anodal, cathodal and sham tDCS application to the right IPL/SPL in separate sessions. The time difference between the onset of the sounds and tapping was larger with apparently moving sounds than with stationary sounds. Cathodal tDCS decreased this difference, anodal tDCS increased the variance of the difference and sham stimulation had no effect. These results supported the hypothesis that auditory motion disturbs efficient auditory–motor synchronization and that the right IPL/SPL plays an important role in tapping in synchrony with moving sounds via auditory motion processing.
Functional dissociation between regularity encoding and deviance detection along the auditory hierarchy
Authors: Aghamolaei Maryam , Zarnowiec Katarzyna , Grimm Sabine , Escera Carles 
Published: November 2015

AbstractAuditory deviance detection based on regularity encoding appears as one of the basic functional properties of the auditory system. It has traditionally been assessed with the mismatch negativity (MMN) long‐latency component of the auditory evoked potential (AEP). Recent studies have found earlier correlates of deviance detection based on regularity encoding. They occur in humans in the first 50 ms after sound onset, at the level of the middle‐latency response of the AEP, and parallel findings of stimulus‐specific adaptation observed in animal studies. However, the functional relationship between these different levels of regularity encoding and deviance detection along the auditory hierarchy has not yet been clarified. Here we addressed this issue by examining deviant‐related responses at different levels of the auditory hierarchy to stimulus changes varying in their degree of deviation regarding the spatial location of a repeated standard stimulus. Auditory stimuli were presented randomly from five loudspeakers at azimuthal angles of 0°, 12°, 24°, 36° and 48° during oddball and reversed‐oddball conditions. Middle‐latency responses and MMN were measured. Our results revealed that middle‐latency responses were sensitive to deviance but not the degree of deviation, whereas the MMN amplitude increased as a function of deviance magnitude. These findings indicated that acoustic regularity can be encoded at the level of the middle‐latency response but that it takes a higher step in the auditory hierarchy for deviance magnitude to be encoded, thus providing a functional dissociation between regularity encoding and deviance detection along the auditory hierarchy.