bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD—A randomized controlled pilot study
Authors: Singh VP , Rao V. , V. Prem , RC Sahoo , K. Keshav Pai
Published: January 2017

Acute effects of music and relaxation have not been evaluated in hospitalized subjects with chronic obstructive pulmonary disease (COPD). This study aims to evaluate the acute effects of music and progressive muscle relaxation (PMR) in hospitalized COPD subjects after a recent episode of exacerbation. A Randomized controlled study was performed of pre-test post-test design after recruiting 82 COPD subjects from K.M.C hospitals. All patients were admitted for acute exacerbation and were medically stabilized. After being screened for the inclusion and exclusion criteria, 72 subjects were selected for the study. Demographic and baseline data was taken on the day subjects were screened. Music group listened to a self selected music of 60-80 beats per minute for 30 minutes. PMR group practiced relaxation through a pre-recorded audio of instructions of 16 muscle groups. Outcome variables were Spielberger’s state anxiety inventory (SSAI), Spielberger’s trait anxiety inventory (STAI), dyspnea, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR) and respiratory rate (RR). There was statistically significant main effect across the sessions for state anxiety (F = 62.621, p = 0.000), trait anxiety (F = 19.528, p = 0.000), dyspnea ( F = 122.227, p = 0.000), SBP ( F = 63.885, p = 0.000), PR ( F = 115.780, p = 0.000) and RR ( F = 202.977, p = 0.000). There was statistically significant interaction effect between the two groups for state anxiety ( F = 6.024, p = 0.003), trait anxiety ( F = 8.222, p = 0.000), dyspnea ( F = 10.659, p = 0.000), SBP ( F = 12.889, p = 0.000), PR ( F = 4.746, p = 0.008) and RR ( F = 12.078, p = 0.000). There were greater changes observed after the second session in both groups however, change in DBP was not significant in either group. Music and PMR are effective in reducing anxiety and dyspnoea along with physiologic measures such as SBP, PR and RR in two sessions in COPD patients hospitalized with exacerbation. However, reductions in the music group were greater compared to the PMR group.
Sharing the Gift of Life: An Intervention to Increase Organ and Tissue Donation for American Indians
Authors: Fahrenwald Nancy L. , Belitz Christine , Keckler Arliss , Sharma Manoj
Published: January 2017

Context

Growing waiting lists for organ transplantation require attention to populations with a high demand for organs but a low donation rate. American Indians experience a high demand for kidney transplantation because of an epidemic of type 2 diabetes, yet donation consent rates are low in this group.

Objective

To design and evaluate an educational intervention to increase the intention to serve as an organ or tissue donor among American Indians.

Intervention

Sharing the Gift of Life was designed for reservation-dwelling American Indians living in the Northern Plains area of the United States. The intervention addressed important cultural traditions and was derived from the Transtheoretical Model of behavior change.

Design

A 2-stage descriptive evaluation design was used.

Setting and Participants

Two evaluation groups were included. American Indian members of a project advisory council served as cultural expert evaluators (stage 1). Northern Plains reservation–dwelling American Indian adults were community member evaluators (stage 2).

Measures

Stage 1 used an Educational Materials Review Form. Stage 2 used an adapted community member evaluation tool.

Results

The cultural expert evaluation was strong. All items met the <3.0 mean acceptability criterion (range 1.93–2.89). Content validity indices met criterion of 0.80 for the overall evaluation and for all items. Cultural specific changes to the materials were suggested. After revision, community member evaluation was favorable. Mean evaluation scores met criterion and content validity indices were acceptable. Pronunciation of traditional language was corrected in the video. Sharing the Gift of Life is a promising intervention that should undergo efficacy testing.
An Analysis of Critical Care Staff's Attitudes to Donation in a Country with Presumed-Consent Legislation
Authors: Pelleriaux Béatrice , Roels Leo , Van Deynse Dominique , Smits Jacqueline , Cornu Olivier , Delloye Christian
Published: January 2017

Context

Lack of knowledge and confidence among critical care staff in identifying potential donors and communicating with donor families may explain missed organ and tissue donations.

Objectives

To elucidate attitudes of critical care staff toward donation and their knowledge, involvement, and self-reported skills and confidence levels with donation-related tasks.

Methods

Between January 2004 and May 2006, Donor Action Foundation's Hospital Attitude Survey was used to collect data from staff members in critical care units in our university hospital (study group) and 2 other Belgian university hospitals (control group). In total, 92 physicians, 433 nurses, and 26 other staff members participated.

Results

The 2 groups did not differ significantly with regard to donation-related attitudes. The study group had a significantly lower perception of the public's approval of organ donation than did the control group ( P <.001). Nurses reported significantly less involvement than did physicians ( P <.001) in caring for potential donors, communicating severe brain damage, explaining brain death, requesting donation, and contacting procurement staff. Probably because of previous training, physicians in the study group reported less need for additional training on donation-related issues than did control physicians. However, compared with physicians, nurses in the study group requested significantly more training on a number of donation tasks. Nurses with more than 5 years of critical care experience were consistently more confident with donation-related tasks.

Conclusion

Support rates for donation are high overall, and previous training is associated with improved attitudes and decreased educational needs. Educational efforts tailor-made for nurses should increase nurses' confidence levels when confronted with potential donors and their next of kin.
Teaching Organ and Tissue Donation in Medical and Nursing Education: A Needs Assessment
Authors: Anker Ashley E. , Feeley Thomas Hugh , Friedman Erica , Kruegler Joan
Published: January 2017

Context

Research on organ donation education is limited by its reliance on convenience samples (ie, small sample sizes and local schools) and its failure to assess methods of instruction on the topic.

Objective

To describe medical and nursing students' training in organ donation by examining curriculum content and methods of instruction by using a national sample of medical schools and a statewide sample (New York) of nursing schools.

Design

Self-report online survey.

Participants

Nursing and medical deans responsible for curriculum development and evaluation.

Main Outcome Measure

Participants provided information on the inclusion of specific topics in organ donation, skills related to organ donation, and the declaration of personal donation intentions within their respective educational programs. Methods of instruction on such topics (eg, standardized patients, lectures, small groups) also were assessed.

Results

Although many educational programs include an organ donation component, a significant proportion of schools failed to provide instruction on donation consent processes, definitions of brain and cardiac death, and the discussion of organ donation during a routine health care visit. Most schools rely on lectures as the sole method of instruction. Recommendations are made for how deficits in instruction might be addressed through future interventions and education.
Traumatized Liver Grafts for Organ Donation? A Single-Center Experience
Authors: Bova Roberta , Schumacher Guido , Neumann Ulf , Pratschke Johann , Neuhaus Peter , Glanemann Matthias
Published: January 2017

Because the number of patients on waiting lists increases each year, new strategies are urgently needed to expand the donor pool. The use of traumatized donor livers for orthotopic liver transplantation at a transplant center is described. After transplantation, no increased incidence of perioperative complications such as bleeding, bile leakage, or liver graft dysfunction were observed and the transplanted livers exhibited appropriate long-term function. Thus, the use of injured livers may offer new opportunities in transplantation.
Pelvic Kidney in Organ Donation: Case Study
Authors: Yushkov Yuriy , Giudice Anthony
Published: January 2017

An ectopic kidney is a rare congenital anomaly that occurs when the kidney fails to ascend to its normal position. Often an ectopic kidney is asymptomatic and the kidney is an unexpected finding during organ recovery. The kidney described in this case report had normal function and could have been used for transplantation, if it had been recovered without 2 renal arteries being damaged because of anatomic variation. The renal vasculature in this type of abnormality usually ascends from the iliac vessels, and this variation in anatomy should be taken into consideration by the recovering surgeon during arterial cannulation for organ flushing.
Occupational Embeddedness during a Reaching and Placing Task with Survivors of Cerebral Vascular Accident
Authors: Gasser-Wieland Tiffany L. , Rice Martin S.
Published: January 2017

This study examined the effects of enhanced occupational embeddedness on the upper extremity movement dynamics in survivors of a cerebral vascular accident (CVA). Seventeen persons who survived a CVA participated in this repeated measures study with two conditions. The occupationally embedded (OE) condition involved three labeled soup cans; the nonoccupationally embedded (NOE) condition involved three nonrepresentational clay masses. The task consisted of moving the objects from a kitchen counter to the cabinet with each limb. Movement dynamics were recorded using an electronic goniometer that was attached to each elbow. Dependent variables were movement time, displacement, movement units, peak velocity, and percentage of movement time at which the peak velocity occurred. It was hypothesized that the OE condition would result in significantly different movement dynamics than the NOE condition. It was also hypothesized that the movement dynamics of the affected limb would be significantly different than those of the unaffected limb. During the OE condition, there were significantly fewer movement units and smaller movement times. No significance was found with displacement, peak velocity, or percentage of movement time to peak velocity. Further, there were no significant differences between the two limbs' movement dynamics. The results of this study support the concept that greater occupational embeddedness can promote enhanced motor performance. Specifically, this study suggests that occupationally embedded occupational forms can enhance performance of movement units and movement time in a reaching and placing task with individuals who survived a stroke. Additionally, OE occupational forms do not appear to influence the affected limb differently than the unaffected limb.
The Painful Sacrifice: The Epidemiology of Hand Injuries During the Holy Festivals in the Sultanate of Oman—A 10-Year Case-Control Study
Authors: Al-Shaqsi Sultan , Al-Bulushi Taimoor , Al-Salmi Ayman , Al-Kashmiri Ammar , Al-Lawatti Ali
Published: January 2017

Background: The human hand is an important functional and sensory organ. Its complex anatomy reflects its important functional capabilities. Many Muslim countries observe the holy festivals with a traditional sacrifice of an animal in order to share the meat (basic commodity) with beloved ones. During such festivals hand injuries have been reported to increase. This study aimed to compare cases and controls of hand injuries treated at the national trauma center in the Sultanate of Oman during a 10-year time period. Methods: This is a case-control retrospective review for 10 years in the Sultanate of Oman. The cases were all hand injuries registered and assessed at Khoula Hospital in the Sultanate of Oman during the 3 days of both holy festivals from January 2004 to December 2013. Controls were hand injuries registered and assessed at Khoula Hospital in the Sultanate of Oman during nonfestival days. Data were extracted and collected from the Emergency Department database. A descriptive and comparative analysis was done. Results: There were 1091 cases reviewed in this study. Knife laceration was 2.4 more common during holy festivals than any other time. Extensor tendon injuries were 2.7 more common during holy festivals than nonfestival times. Thumb and index fingers constituted around 40% of the total injuries. Of all patients reviewed, 85% were treated and discharged home without admission. Conclusion: Holy festivals in the sultanate of Oman are risky times for hand injuries. Knife lacerations are more common during such times than any other times. Emergency and plastic services should be aware of the pattern of hand injuries during such times in order to prepare and plan services accordingly.
Medical Modeling for Precision Ulna Reconstruction Using a Microvascular Fibula Free Flap
Authors: Alperovich Michael , Bekisz Jonathan M. , Thanik Vishal D.
Published: January 2017

Background: Despite the growing use of medical modeling in other surgical specialties, its utilization in extremity reconstruction has remained limited. Methods: We present the application of medical modeling for ulna reconstruction using a microvascular fibula free flap. Results: Following a motor vehicle accident, the patient suffered segmental loss of the right radius and ulna with concomitant forearm soft tissue and muscle loss. Using medical modeling, imaging from the unaffected contralateral forearm and lower extremity was used to plan a reconstruction that restored the anatomic length and orientation of the ulna. Accurate ulna length was recreated from the contralateral ulna, which served as a template. Conclusions: Cutting guides for the osteotomies on both the fibula and ulna maximized surface contact at the native ulna and fibula junction to aid in osseous healing of the fibula flap, stabilized the fibula orientation on the ulna, and allowed for lag screw placement for additional fixation.
Intraaneurysmal Embolization for Wide-Necked Aneurysms Remodeling Technique, Combined Neck-Clipping and Coiling Therapy, Scaffolding Technique
Authors: Nakahara T. , Hidaka T. , Kutsuna M. , Yamanaka M. , Sakoda K.
Published: January 2017

We reported the results of the endovascular treatment using Guglielmi detachable coil (GDC) for wide-necked aneurysms. Fourteen aneurysms were treated with remodeling technique. One aneurysm was performed endovascular treatment followed by partial neck clipping. The other was treated with scaffolding technique. All aneurysms could not be performed by conventional GDC treatment initially because of coil protrusion into the parent artery due to wide neck of these aneurysms.

These aneurysms sited at anterior circulation system in 10 cases, and at posterior circulation system in 6 cases. Immediately after the procedure, the obliteration rate could be obtained complete occlusion in 3 cases, > 95% occlusion in 7 cases, > 90% occlusion in 3 cases and < 90% occlusion in 3 cases. In 14 patients follow-up angiography or magnetic resonance image (MRI) was carried out. The angiographic follow-up period is range from 2 to 19 months (mean: 10 months).

The results of angiographical follow-up indicated increasing obliteration rate with all aneurysms except for 2 cases. In these 2 cases, the reembolization was needed for recanalization of the aneurysm. The clinical follow-up period is range form one to 26 months (mean: 15 months). There is no evidence of aneurysmal rupture and all cases have been survival without any permanent neurological deficits. The GDC treatment with additional technique (remodeling technique, combined neck-clipping and coiling therapy, scaffolding technique) provides safety and effectiveness, even if there are wide-necked aneurysms.
Indications and Problems of Intracranial Stenting Report of Two Cases
Authors: Deguchi J. , Kuroiwa T. , Nagasawa S. , Satoh G. , Ohta T.
Published: January 2017

There have been few reports of stenting in the intracranial arteries. We used coronary stents in the chronically occluded intracranial vertebral artery and stenosis of internal carotid artery by the external force, and good blood flow were resumed. Stenosis in the intracranial arteries is also a good indication for stent placement when it is due to chronic total occlusion or artery compression by external force. But stent placement in the intracranial arteries has some problems. Stent placement in the intracranial artery is indicated only when the site of stent placement has a diameter of 3 mm or more, is a relatively linear portion of the vertebrobasilar artery or the internal carotid artery proximal to the C3 segment, and does not branch off perforating arteries or is already completely occluded.
Embolic Complications of Endovascular Surgery for Cerebrovascular Diseases Evaluation with Diffusion-Weighted MR Imaging
Authors: Sakai H. , Sakai N. , Nakahara I. , Shimozuru T. , Higashi T. , Takahashi J.C. , Ohta H. , Kokuzawa J. , Manaka H. , Morizane A. , Kawabata Y. , Nagata I. , Kikuchi H.
Published: January 2017

The purpose of this study was to evaluate asymptomatic embolisms during cerebral endovascular surgery for cerebrovascular diseases with diffusion-weighted magnetic resonance imaging (DWI) which allowed sensitive and early detection of cerebral ischemic lesions. 71 patients who underwent a total of 74 cerebral endovascular procedures were subjected to DWI screening study. MR imaging was performed on a 1.5T system by using single-shot SE echo-planar imaging (EPI) with b value of 1100 seconds per mm2 in pre- and post-treatment periods (between day 2 and 5 after procedures).

In 38 (51.3%) of 74 procedures, new high intensity lesions, as recent infarctions related to procedures, were detected on post-procedural DWI. In 18 Of the patients (47.4%), symptomatic infarctions occurred and resulted in TIAs (n = 4), RINDs (n = 8), minor strokes (n = 6) and no major strokes and no death. 20 (52.6%) of the recent infarctions detected by DWI were asymptomatic lesions. Most of the asymptomatic ischemic lesions were likely to be distributed in watershed border areas. On the other hand, symptomatic lesions tended to be distributed in cortical and/or perforator regions and to be multiple.

Thus, DWI is a useful method that can detect neurologically silent and asymptomatic ischemic lesions. It can be used to help to evaluate the safety and efficacy of neurovascular intervention.
Oral Contraceptive Induced Cerebral Venous Thrombosis Treated by Local Catheter Directed Thrombolysis
Authors: Prochazka V. , Rajner J. , Prochazka M. , Dvorak J. , Cizek V.
Published: January 2017

We report on a case of cerebral venous thrombosis (CVT) induced by oral contraception (OC) activated coagulopathy and its endovascular treatment. Deep venous system and dural sinuses thrombosis complicated with severe neurological deficit and coma due to right thalamic edema and ischemia in a young woman was treated by local thrombolysis with an administration of 0.6 mg/h of the rtPA and the concomitant intravenous unfractioned heparin infusion (700 IU/h). 3D-Xra digital rotational venography performed at the beginning and after treatment confirmed thrombus resolution with rapid flow restoration. Dynamic flow imaging gives interesting information on the deep venous system and the cortical venous collectors drainage. Final NIHSS (National Institute of Health Stroke Scale) and mRS (modified Rankin Scale) confirmed an excellent clinical outcome of the interventional therapy.
Follow-up of Large Aneurysms Treated with Coil Embolization at an Acute Stage in Patients with Poor-Grade Subarachnoid Hemorrhage
Authors: Hagiwara S. , Tanaka N. , Tani S. , Nakamura S. , Ohbuchi H. , Hirota K. , Iwabuchi S. , Kasuya H.
Published: January 2017

This study evaluated the clinical and angiographic outcome of large aneurysms treated with coil embolization at an acute stage in patients with poor-grade subarachnoid hemorrhage (SAH).

Between July 1, 2001 and June 30, 2004, eight consecutive WFNS grade 5 patients with large aneurysms (15!23mm) were treated with endovascular coil embolization within two days and followed for at least 30 months. There were three middle cerebral and five internal carotid artery aneurysms. No patients were treated by craniotomy and none survived without treatment.

Two patients died of primary brain damage or cerebral vasospasm within one month. One patient died of pneumonia at 24 months. Four patients were alive with good recovery or moderate disability at the time of final follow-up (30!66 months). Angiography immediately after the procedure showed complete occlusion in three, neck remnant in four, and body filling in one patient. No complication was seen related to the procedure. Three aneurysms that were initially neck remnant developed body filling due to coil compaction. Two were re-treated with coils at six and 12 months and resulted in neck remnant. One patient refused re-treatment and died of re-bleeding.

Endovascular coil embolization can be selected at an acute stage for the treatment of aneurysms in patients with poor-grade SAH without intraparenchymal hematoma even if the aneurysm is large. Serial follow up by MRA/angiography is necessary for at least 12 months.
Endovascular Treatment of Intracranial Aneurysms Associated with Moyamoya Disease or Moyamoya Syndrome
Authors: Yu J.-L. , Wang H.-L. , Xu K. , Li Y. , Luo Q.
Published: January 2017

Direct surgical clipping proves to be difficult and dangerous for intracranial aneurysms associated with moyamoya disease (MMD) or moyamoya syndrome (MMS). This study presents our clinical experience of endovascular embolization of intracranial aneurysms associated with these diseases. A total of 13 cases of intracranial aneurysms associated with MMD or MMS were treated by endovascular embolization between January 2001 and January 2009. Patients were divided into two groups: a saccular aneurysm group (n=10) and a pseudoaneurysm group (n=3). Different endovascular therapeutic strategies were employed for each type of case. Of the 13 cases, 11 received successful endovascular embolization and had an uneventful postoperative course during one to two years of follow-up. However, endovascular embolization failed in the other two cases, of whom one died from rebleeding after the five-month follow-up, while the other was conservatively treated and experienced no rebleeding during the two-year follow-up. A favorable prognosis may be secured through careful selection of endovascular treatment regimens for patients with intracranial aneurysms associated with MMD or MMS according to the site of intracranial aneurysms.
Treatment of Intracranial Aneurysms Using Flow-Diverting Silk Stents (BALT): A Single Centre Experience
Authors: Leonardi M. , Cirillo L. , Toni F. , Dall'Olio M. , Princiotta C. , Stafa A. , Simonetti L. , Agati R.
Published: January 2017

The Silk stent (Balt, Montmorency, France) is a retractable device designed to achieve curative reconstruction of the parent artery associated with an intracranial aneurysm. We present our initial experience with the Silk flow-diverting stent in the management and follow-up of 25 patients presenting with intracranial aneurysms.

Twenty-five patients (age range, 34–81 years; 24 female) were treated with the Silk flow-diverting device. Aneurysms ranged in size from small (5), large (10) and giant (10) and included wide-necked aneurysms, multiple, nonsaccular, and recurrent intracranial aneurysms. Nine aneurysms were treated for headache, 14 for mass effect. None presented with haemorrhage. All patients were pretreated with dual antiplatelet medications for at least 72 hours before surgery and continued taking both agents for at least three months after treatment. A total of 25 Silk stents were used. Control MR angiography and/or CT angiography was typically performed prior to discharge and at one, three, six and 12 months post treatment. A follow-up digital subtraction angiogram was performed between six and 19 months post treatment.

Complete angiographic occlusion or subtotal occlusion was achieved in 15 patients in a time frame from three days to 12 months. Three deaths and one major complication were encountered during the study period. Two patients, all with cavernous giant aneurysms, experienced transient exacerbations of preexisting cranial neuropathies and headache after the Silk treatment. Both were treated with corticosteroids, and symptoms resolved completely within a month.

In our experience the Silk stent has proven to be a valuable tool in the endovascular treatment of intracranial giant partially thrombosed aneurysms and aneurysms of the internal carotid artery cavernous segment presenting with mass effect. The time of complete occlusion of the aneurysms and the risk of the bleeding is currently not predictable.
Bleeding Source Identification and Treatment in Brain Arteriovenous Malformations
Authors: Mjoli N. , Le Feuvre D. , Taylor A.
Published: January 2017

Arteriovenous malformation (AVM) patients who initially present with intracerebral haemorrhage may have an identifiable source of bleeding on angiogram, which can be a treatment target. Previous work suggests that the re-bleed rate may be lowered if a weak area is eliminated.

A retrospective cohort study was conducted on patients who presented over a six-year period with a bled AVM. Cases were reviewed looking for the source of the hemorrhage by correlating haematoma location on CT or MRI and any angio-architectural weakness seen on digital subtraction angiography (DSA). Neuroendovascular notes were reviewed to identify the treatment targets.

One hundred patients presented with a brain AVM with a 1.7:1 male: female ratio, 41 patients had an initial presentation of hemorrhage. The source of hemorrhage was identified in 18 subjects with 11 intranidal false aneurysms, five flow-related aneurysms, two associated aneurysms and one venous pouch.

The location of haemorrhage on the presenting scan significantly correlated with the identified bleeding source using Chi-square analysis (P-value 0.039). Partial targeted embolization was used successfully in 90% with a 9% related technical complication rate not resulting in long-term morbidity or mortality. The mean follow-up period was 34 months with an annual hemorrhage rate of 0.7%.

In just under half the patients with AVM bleeding a source of haemorrhage can be identified on DSA and in most cases this will be an intranidal false aneurysm. Flow-related and associated aneurysms in patients with brain AVM can cause haemorrhage and these patients are more likely to have SAH than intracerebral haemorrhage. These weak points are a good target for partial endovascular treatment, are usually accessible and may reduce the higher haemorrhage rate expected over the next two years.
Seizures after Onyx Embolization for the Treatment of Cerebral Arteriovenous Malformation
Authors: De Los Reyes K. , Patel A. , Doshi A. , Egorova N. , Panov F. , Bederson J.B. , Frontera J.A.
Published: January 2017

Onyx embolization of cerebral arteriovenous malformations (AVM) has become increasingly common. We explored the risk of seizures after Onyx use.

A retrospective review was conducted of 20 patients with supratentorial brain arteriovenous malformation (AVM) who received Onyx embolization between 2006 and 2009. Baseline demographics, clinical history, seizure history, AVM characteristics and treatment were compared between those who developed post-onyx seizure and those who did not. MRIs were reviewed for edema following Onyx treatment.

Of 20 patients who underwent Onyx embolization, the initial AVM presentation was hemorrhage in 40% (N=8). The median number of embolizations was two (range 1–4) and the median final obliteration amount was 90% (range 50–100%). A history of seizure was present in 50% (N=10) of patients pre-embolization and 12 (60%) patients received seizure medications (treatment or prophylaxis) prior to embolization. Seizur post-Onyx embolization occurred in 45% (N=9). The median time to seizur post-Onyx was seven days (range 0.3–210). Four patients (20%) with seizures post-Onyx had no seizure history. Two of these patients (10%) had no other identifiable cause for seizure other than recent Onyx embolization. Seizures in these two patients occurred within 24 hours of Onyx administration. Among patients with post-Onyx seizures, there was a trend toward larger AVM size (P=0.091) and lower percent obliteration (P=0.062). Peri-AVM edema was present in 75% of MRIs performed within one month of Onyx treatment and may represent a possible etiology for seizures.

New onset seizures post-Onyx embolization are not uncommon. Further study of seizure prevention is warranted.
Endovascular Angioplasty before Resection of a Sphenoidal Meningioma with Vascular Encasement
Authors: Chivoret N. , Fontaine D. , Lachaud S. , Chau Y. , Sedat J.
Published: January 2017

We describe a case of sphenoid wing meningioma presenting with cerebral infarction due to extended vascular encasement in which endovascular angioplasty was performed before surgery to avoid perioperative ischemia. A severe stenosis involved the intracranial internal carotid artery and the proximal segments of the middle and anterior cerebral arteries. Endovascular dilatation was followed by complete surgical resection. Preoperative mild aphasia and hemiparesia resolved completely after surgery. Endovascular angioplasty of arterial trunks and their branches can be proposed before the resection of skull base meningiomas encasing these arteries to decrease the risk of perioperative brain ischemia related to their surgical manipulation or vasospasm.
The Efficacy of Endovascular Treatment of Ruptured Blood Blister-Like Aneurysms Using Stent-Assisted Coil Embolization
Authors: Ihn Y.K. , Kim S.H. , Sung J.H. , Kim T-G.
Published: January 2017

We report our experience with endovascular treatment and follow-up results of a ruptured blood blister-like aneurysm (BBA) in the supraclinoid internal carotid artery. We performed a retrospective review of ruptured blood blister-like aneurysm patients over a 30-month period. Seven patients (men/women, 2/5; mean age, 45.6 years) with ruptured BBAs were included from two different institutions. The angiographic findings, treatment strategies, and the clinical (modified Rankin Scale) and angiographic outcomes were retrospectively analyzed.

All seven BBAs were located in the supraclinoid internal carotid artery. Four of them were ≥ 3 mm in largest diameter. Primary stent-assisted coiling was performed in six out of seven patients, and double stenting was done in one patient. In four patients, the coiling was augmented by overlapping stent insertion. Two patients experienced early re-hemorrhage, including one major fatal SAH. Complementary treatment was required in two patients, including coil embolization and covered-stent placement, respectively. Six of the seven BBAs showed complete or progressive occlusion at the time of late angiographic follow-up. The clinical midterm outcome was good (mRS scores, 0–1) in five patients.

Stent-assisted coiling of a ruptured BBA is technically challenging but can be done with good midterm results. However, as early regrowth/re-rupture remains a problem, repeated, short-term angiographic follow-up is required so that additional treatment can be performed as needed.
Endovascular Treatment of Ruptured Dissecting Posterior Inferior Cerebellar Artery Aneurysms
Authors: Ioannidis I. , Nasis N. , Andreou A.
Published: January 2017

Dissecting aneurysms of the posterior inferior cerebellar artery (PICA) distal to its origin from vertebral artery (VA) are very rare. Although rare, they associated with a high risk of rebleeding and they present a therapeutic challenge. This study reviewed the clinical presentations, angiographic characteristics of dissecting aneurysms of the PICA and to assess the clinical and angiographic outcomes of patients who underwent endovascular treatment.

Ten patients with ten dissecting aneurysms who underwent endovascular treatment were identified in the clinical records of a single medical center from January 2000 to December 2010. The mean follow-up duration was 2.8 years.

All patients presented with subarachnoid hemorrhage (SAH). They all underwent endovascular treatment, which included occlusion of the dissected segment and the parent artery after detailed angiographic evaluation of the vascular anatomy, and test occlusion of the PICA. In all patients the endovascular treatment was successfully completed without procedure related complications. Long-term follow-up studies in seven out of ten patients showed complete occlusion of the aneurysm with no new neurologic deficits. The clinical outcome was good in eight cases, whereas two patients with poor clinical condition at admission died during their initial hospital stay.

Endovascular occlusion of the parent vessel and the dissected segment is relatively safe treatment option for dissecting aneurysms of the PICA distal to its origin.
Endovascular Treatment of AICA Flow Dependent Aneurysms
Authors: Mahmoud M. , El Serwi A. , Habib M. Alaa , Gamrah S. Abou
Published: January 2017

Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare, accounting for less than 1% of all cerebral aneurysms. To our knowledge 34 flow-related cases including the present study have been reported in the literature.

Three patients harbouring four flow dependent aneurysms were referred to our institution. Two patients presented with subarachnoid hemorrhage, one presented with cerebellar manifestations. They were all treated by endovascular embolization of the aneurysm as well as the parent artery using liquid embolic material. Two cases were embolized using NBCA, Onyx was used in the third case.

No bleeding or rebleeding were encountered during the follow-up period which ranged from five to nine months.

One patient developed facial palsy, cerebellar symptoms and sensorineural hearing loss. The remaining two cases did not develop any post treatment neurological complications.

Endovascular management of flow-dependent AICA aneurysms by parent artery occlusion is feasible and efficient in terms of rebleeding prevention.

Post embolization neurological complications are unpredictable. This depends upon the adequacy of collaterals from other cerebellar arteries.
Treatment of Ruptured Saccular Aneurysms of the Fenestrated Vertebrobasilar Junction with Balloon Remodeling Technique
Authors: Gupta Vivek , Ahuja Chirag K , Khandelwal N , Kumar Ajay , Gupta S K
Published: January 2017

Fenestration of the intracranial arteries is a relatively common occurrence. This anatomic variation may predispose to aneurysm formation at certain sites. Treatment of such aneurysms is difficult as it may occlude one of the limbs of fenestration with resultant deficit. Thus, preservation of both the limbs with adequate exclusion of the aneurysm from the circulation should be the aim of any treatment. We describe a series of four cases of ruptured aneurysms arising from a fenestrated vertebrobasilar junction treated with endovascular balloon remodeling technique.
Stent/Balloon Combination Assist Technique for Wide-Necked Basilar Terminal Aneurysms
Authors: Miyachi Shigeru , Matsubara Noriaki , Izumi Takashi , Asai Takumi , Yamanouchi Takashi , Ota Keisuke , Oda Keiko , Wakabayashi Toshihiko
Published: January 2017

We describe an enhanced endovascular procedure for the coiling of broad-necked basilar terminal aneurysms with a combined balloon/stent assist technique. A balloon-assisted catheter is inserted in the origin of one posterior cerebral artery (PCA) and an assisted stent is deployed from the opposite PCA to the basilar artery. A microcatheter for coiling is inserted through the stent strut (trans-cell approach), and the aneurysm is coiled under stent support and assisted balloon inflation to keep the patency of both PCAs. This technique is more beneficial for reducing the risk of stent deformity than Y-stenting, and it provides a simpler procedure than other advanced stent techniques. Additionally, it enables an easy approach when retreatment is necessary for aneurysm recurrence. This technique may be one of the useful procedures for embolizing broad-necked basilar terminal aneurysms safely and effectively.
Development of an automatic visual grading system for grafting seedlings
Authors: Tian Subo , Wang Zifan , Yang Jifeng , Huang Zichen , Wang Ruili , Wang Liping , Dong Jianghui
Published: January 2017

In this study, a visual grading system of vegetable grafting machine was developed. The study described key technology of visual grading system of vegetable grafting machine. First, the contrasting experiment was conducted between acquired images under blue background light and natural light conditions, with the blue background light chosen as lighting source. The Visual C++ platform with open-source computer vision library (Open CV) was used for the image processing. Subsequently, maximum frequency of total number of 0-valued pixels was predicted and used to extract the measurements of scion and rootstock stem diameters. Finally, the developed integrated visual grading system was experimented with 100 scions and rootstock seedlings. The results showed that success rate of grading reached up to 98%. This shows that selection and grading of scion and rootstock could be fully automated with this developed visual grading system. Hence, this technology would be greatly helpful for improving the grading accuracy and efficiency.
Reliability models of belt drive systems under slipping failure mode
Authors: Gao Peng , Xie Liyang
Published: January 2017

Conventional reliability assessment and reliability-based optimal design of belt drive are based on the stress–strength interference model. However, the stress–strength interference model is essentially a static model, and the sensitivity analysis of belt drive reliability with respect to design parameters needs further investigations. In this article, time-dependent factors that contribute the dynamic characteristics of reliability are pointed out. Moreover, dynamic reliability models and failure rate models of belt drive systems under the failure mode of slipping are developed. Furthermore, dynamic sensitivity models of belt drive reliability based on the proposed dynamic reliability models are proposed. In addition, numerical examples are given to illustrate the proposed models and analyze the influences of design parameters on dynamic characteristics of reliability, failure rate, and sensitivity functions. The results show that the statistical properties of design parameters have different influences on reliability and failure rate of belt drive in cases of different values of design parameters and different operational durations.
Identification of damage-expected members of truss structures using frequency response function
Authors: Kim Moon-Jeong , Eun Hee-Chang
Published: January 2017

A damaged member in a truss structure leads to a variation in the initial responses of its adjacent members. A flexibility-based approach extracting from the modal data should be implemented as one of the structural damage detection methods. The frequency response function data as dynamic measurements provide more information on the system characteristics compared with modal data. Proper orthogonal modes from the frequency response functions extracted in the given frequency ranges and their modified forms can be utilized as damage indices to detect damages. This study considers damage detection of a truss structure using a frequency response function–based approach transformed to the proper orthogonal modes and a flexibility-based approach using the first few modal data for undamaged and damaged states. The utilization of these two methods is compared through numerical experiments on truss structures. The methods can rarely detect the damaged member accurately, but a group of damage-expected members is detected despite the existence of external noise. It is shown that the frequency response function–based approach can be utilized more explicitly than the flexibility-based approach.
Treatment of Inflammatory Acne with a Combination Therapy with Lymecycline and Adapalene Followed by Maintenance Treatment with Adapalene
Authors: Cassano N. , Amoruso A. , Alessandrini G. , Biuso A. , Carrieri G. , Fai D. , Gabellone M. , Ligori P. , Malvindi C. , Mancino A. , Mangano R. , Mannino V. , Martina G. , Messina V. , Pelle' S. , Randazzo F. , Randazzo G. , Ricciuti F. , Ruggiero A. , Senia G. , Serrati' E. , Sodo M.R. , Stasi R. , Vena G.A.
Published: January 2017

Oral antibiotics, especially tetracyclines, are commonly used to treat moderate to moderately severe acne vulgaris. There are hints suggesting that a combination treatment with oral tetracyclines and topical retinoids can cause a greater and prompter improvement of acne than monotherapy with tetracyclines. We evaluated the clinical activity of a 12-week combined therapy with oral lymecycline (300mg/day for 2 weeks and then 150mg/day) and topical adapalene (gel or cream) in 419 patients with inflammatory acne. A significant reduction in the number of acne lesions was noted at 4 and 12 weeks (P<0.0001). Thereafter, 400 patients underwent a maintenance treatment with adapalene alone for 12 weeks. At week 24 a relevant improvement of acne lesions still persisted (P<0.0001) in most patients. Only 16 patients relapsed and required additional use of oral lymecycline which proved again successful. No substantial differences were noted in the magnitude of clinical response between patients treated with adapalene gel and those treated with cream formulation. Treatment was well tolerated. Local adverse reactions occurred in 11.7 % of patients and resulted in premature discontinuation of treatment in 1.4 %. Systemic (gastrointestinal) untoward effects developed in 1.2 % of patients and caused treatment interruption in 0.7 % of cases. No serious adverse events occurred.
Spotted Fever Group Rickettsiae in Ixodes Ricinus and Haemaphysalis Punctata Ticks in Italy
Authors: Ciervo A. , Simeoni J. , Khoury C. , Mancini F. , Ciceroni L.
Published: January 2017

In this study Ixodes ricinus and Haemaphysalis punctata ticks are examined. For the first time we detected Rickettsia conorii in I. ricinus and H. punctata, and Rickettsia sibirica in I. ricinus. Our results raise the question of whether other spotted fever group rickettsiae, in addition to R. conorii subsp. conorii and R. conorii subsp. israelensis, are involved in bacterial diseases in Italy and whether I. ricinus and H. punctata can act as new vectors for these rickettsiae.
Single-Blind Evaluation of Post-Tonsillectomy Pain Treatment with an Eutectic Mixture of Local Anesthetics
Authors: Neri G. , Baffa C. , Vitullo F. , Di Mascio R. , Ballone E.
Published: January 2017

The efficacy of an eutectic mixture of local anesthetics (lidocaine and prilocaine) in ointment for topical use (EMLA) in the treatment of post-tonsillectomy pain in both pediatric and adult patients was evaluated. Ninety patients affected by recurring tonsillitis and refractory to antibiotic therapy were submitted to tonsillectomy by dissection. Of the ninety patients 45 random subjects received topical treatment and the remaining 45 did not receive any treatment in the emptied tonsillar compartment. Pain intensity was evaluated at 3, 6 and 9 hours after surgical treatment using a visual subjective evaluation scale (VAS for adults and FES for children). The percentage of adults who referred pain of minor intensity was greater in the treated patients than in the controls: 51.4% vs 14.3% (p<0.001) at the third hour, 71.4% vs 2.9% (p<0.001) at the sixth hour and 88.6% vs 14.3% (p<0.001) at the ninth hour. In the pediatric groups, 80.0% of the treated subjects referred moderate pain at the third hour, compared to 40% of the control group. At the ninth hour all children (100%) referred moderate pain compared to 20% of the control group. No treated patient required analgesic therapy during the post-operative observation period. The application of EMLA in the compartment after tonsillectomy determined an extremely significant reduction of postoperative pain in terms of intensity and duration.
The Effect of Porcine Orexin a on C-Peptide Plasma Concentrations in Pigs
Authors: Papakonstantinou P. , Tziris N. , Kesisoglou I. , Gotzamani-Psarrakou A. , Tsonidis C. , Patsikas M.N. , Papazoglou L.G.
Published: January 2017

The hypothalamus and the neuropeptides that are produced and act within its neuronal circuits constitute an area of extensive laboratory research. In 1998, the neuropeptide, Orexin A, was discovered and isolated from the hypothalamus of the rat. An i.c.v. injection of Orexin A into the lateral ventricle of the rat's brain causes an increase in the consumption of food, and, apart from appetite, it also seems to be regulating many other normal functions of the organism, whose regulatory and metabolic mechanisms remain unknown to date. The neuropeptide is produced by a small cluster located in and round the lateral hypothalamic area. It has been known for decades that this area is involved in the regulation of feeding and energy homeostasis in mammals. The intravenous, subcutaneous, or i.c.v. injection of Orexin A causes changes in insulin and glucagon concentrations. The same effect is also seen under in vitro experimental conditions. In this study, we investigated the potential effects of i.c.v. administration of porcine Orexin A on c-peptide concentrations in the peripheral blood of pigs, and tested whether these changes are associated with the potential effect of the neuropeptide on the function of the pancreas.
The Efficacy of Four Ways of Administrating Dexamethasone during Surgical Extraction of Partially Impacted Lower Third Molars
Authors: Pappalardo S. , Puzzo S. , Cappello V. , Mastrangelo F. , Adamo G. , Caraffa A. , Tetè S.
Published: January 2017

Glucocorticoids are drugs noted for their potent anti-inflammatory effect and long lasting half-life. Various studies have been carried out to identify which of these molecules is best for reducing the post-operative sequelae after surgical extraction of the impacted lower third molar. This study examines four different ways of administering dexamethasone after surgical extraction of impacted lower third molars: endoalveolar application, submucous injection, intravenous administration and intramuscular injection, with the aim of identifying which method gives the least discomfort to the patient in regard to reduction of pain, edema and post-operative lock-jaw. Results show that a greater reduction of the post-operative sequelae was obtained in the group of patients treated with dexamethasone intravenously. Satisfying results were also obtained in the group treated with a topical administration of dexamethasone in powder form and in the group which was given dexamethasone through an intramuscular injection. These last two groups had similar results. Instead, the results obtained in the group that received dexamethasone through local submucous injection were not satisfactory.