bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Scala Tympani Height on Insertion Depth of Straight Cochlear Implant Electrodes
Authors: Morrel William G. , Holder Jourdan T. , Dawant Benoit M. , Noble Jack H. , Labadie Robert F. 
Published: February 2020

ObjectiveStudies suggest lateral wall (LW) scala tympani (ST) height decreases apically, which may limit insertion depth. No studies have investigated the relationship of LW ST height with translocation rate or location.Study DesignRetrospective review.SettingCochlear implant program at tertiary referral center.Subjects and MethodsLW ST height was measured in preoperative images for patients with straight electrodes. Scalar location, angle of insertion depth (AID), and translocation depth were measured in postoperative images. Audiologic outcomes were tracked.ResultsIn total, 177 ears were identified with 39 translocations (22%). Median AID was 443° (interquartile range [IQR], 367°‐550°). Audiologic outcomes (126 ears) showed a small, significant correlation between consonant‐nucleus‐consonant (CNC) word score and AID (r = 0.20, P =. 027), although correlation was insignificant if translocation occurred (r = 0.11, P =. 553). Translocation did not affect CNC score (P =. 335). AID was higher for translocated electrodes (503° vs 445°, P =. 004). Median translocation depth was 381° (IQR, 222°‐399°). Median depth at which a 0.5‐mm electrode would not fit within 0.1 mm of LW was 585° (IQR, 405°‐585°). Median depth at which a 0.5‐mm electrode would displace the basilar membrane by ≥0.1 mm was 585° (IQR, 518°‐765°); this was defined as predicted translocation depth (PTD). Translocation rate was 39% for insertions deeper than PTD and 14% for insertions shallower than PTD (P =. 008).ConclusionAID and CNC are directly correlated for straight electrodes when not translocated. Translocations generally occur around 380° and are more common with deeper insertions due to decreasing LW ST height. Risk of translocation increases significantly after 580°.
Primary Paraganglioma of the Facial Canal: An Evidence‐Based Approach
Authors: Yuhan Brian T. , Trang Amy , Hutz Michael J. , Leonetti John P. 
Published: February 2020

ObjectivesTo perform an evidence‐based review evaluating presenting symptoms, imaging, and management for primary paragangliomas of the facial canal (PPFCs).Data SourcesPubMed/MEDLINE, Embase, Cochrane Library, and Web of Science.Review MethodsStudies were assessed for quality of evidence and bias with the Cochrane bias tool, GRADE, and MINORS criteria. Demographic data, imaging modalities, management strategies, and status at last follow‐up were obtained.ResultsSixteen studies met inclusion criteria. In total, 21 patients with PPFCs were identified, 19 of which were histologically confirmed. Most common presenting symptoms included unilateral facial nerve dysfunction (n = 14, 73.7%) and pulsatile tinnitus (n = 8, 42.1%). Mean time from reported onset of facial dysfunction was 17.8 months. Computed tomography findings included an expanded descending facial nerve canal (n = 13, 76.5%). All cases with magnetic resonance imaging reported enhancement with contrast. Of the 18 patients who had surgery, 16 (88.9%) underwent full tumor resection while 1 (5.6%) had partial tumor debulking with adjuvant radiotherapy. Overall improvement in facial weakness was documented in 5 of 9 patients (55.6%) with initial facial nerve dysfunction and >6‐month follow‐up. No evidence of tumor recurrence was reported.ConclusionsPPFCs are extraordinarily rare vascular neoplasms of the temporal bone. Early imaging with both computed tomography and magnetic resonance imaging is essential for narrowing the differential diagnosis, assessing the extent of tumor invasion, and accurate surgical planning. Surgical tumor resection with subsequent facial nerve reconstruction is recommended for patients with facial nerve dysfunction, while tumor biopsy or debulking may be indicated when normal facial movement in present.
Relationship between fibrinogen level and its regulatory gene with Alzheimer’s disease and vascular dementia
Authors: Sun Yanan , Li Qi , Liu Wei , Zhang Benshu 
Published: February 2020

Objective Several investigations have shown that the level of fibrinogen (Fg) is associated with the susceptibility to dementia and is usually affected by polymorphisms in its gene. Our study aimed to investigate the relationship between Fg level and the fibrinogen β ( FGB) −148C/T gene polymorphism in patients with Alzheimer’s disease (AD) and vascular dementia (VaD). Methods The study included 64 AD patients, 72 VaD patients, and 56 healthy controls (HC). Plasma Fg level was detected by turbidimetry. Among the participants, 64 AD patients, 52 VaD patients, and 56 HC underwent FGB −148C/T polymorphism analysis using restriction fragment length polymorphism-PCR. Results Plasma Fg was significantly higher in AD and VaD groups than in HC. The AD and VaD patients with FGB −148 TT genotype had significantly higher plasma Fg than those with CC or CT genotypes. The distribution of CC and CT+TT genotypes differed in the three groups, with the frequency of CT+TT genotypes being higher in AD patients than in the HC group. Conclusions Plasma Fg level was significantly correlated with AD and VaD and related to the −148C/T polymorphism of FGB. The TT+CT genotypes and the distribution frequency of the T allele may be related to AD.
Hospice Utilization Among Residents in Long-Term Care Facilities
Authors: Xiong Beibei , Freeman Shannon , Banner Davina , Spirgiene Lina 
Published: February 2020

Background: Hospice care can improve quality of life for persons nearing end of life, yet little is known about utilization of hospice care among persons residing in long-term care facilities (LTCFs). Given the increasing number of deaths that occur in LTCFs, it is important to examine hospice care practices in LTCFs. Aim: The aim of the cross-sectional study was to describe residents who received hospice care in LTCFs and explore factors that can predict hospice use in LTCFs across Canada. This study included 185 715 residents aged 19 years or older in LTCFs in Canada in 2015. Results: Of all residents, 2.7% (n = 4973) received hospice care and 6.8% (n = 12 684) were profiled as having an end-stage disease. Among those who received hospice care, most were noted as end stage (89.5%) and had severe physical impairment (Activities of Daily Living Hierarchy Scale ≥ 5, 74.3%), mild-to-severe pain (Pain Scale ≥ 1, 76.0%), and moderate-to-severe health instability (Changes in Health, End-Stage Disease, Signs, and Symptoms Scale ≥3, 82.9%). Residents who received hospice care were in more severe and complex clinical conditions than those who did not receive hospice care. Conclusion: Only a small proportion of residents in LTCFs received hospice care. Further investigation of standardized assessment of terminal status is needed as accuracy of end-stage diagnosis continues to be challenging and criteria for hospice eligibility are narrow. Special attention should be paid to improve access to hospice care among residents with dementia or other progressive chronic diseases with severe and complex clinical needs.
Online Pro-Tobacco Marketing Exposure Is Associated With Dual Tobacco Product Use Among Underage US Students
Authors: Marion Hunter , Garner William , Estrada Alex , Moorer Christopher , Acosta-Velazquez Ixel 
Published: February 2020

Purpose: To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age. Design: Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey. Setting: The survey was administered in public and private middle and high schools across the United States. Participants: The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period. Measures: The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade). Analysis: Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure. Results: Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing. Conclusions: Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.
Effect of Androgens on Anemia and Malnutrition in Renal Failure: Implications for Patients on Peritoneal Dialysis
Authors: Navarro Juan F. , Mora Carmen 
Published: February 2020

Objective To analyze the implications of the potential use of androgens in peritoneal dialysis patients, focusing on their effects on hematologic and nutritional parameters. This manuscript reviews the different compounds for clinical use, dosage schedules, adverse effects, and how therapy with androgens might be used to treat anemia and malnutrition in these dialysis patients. Data Sources Studies in the literature dealing with the effects of androgens on hematologic and nutritional parameters, and their role in uremic anemia and malnutrition. Study Selection Studies in which uremic patients received androgens as therapy for anemia or malnutrition. Data Extraction Data were abstracted from all of these studies. Results This review shows that androgens are anabolic substances that also have significant actions on erythropoiesis. A number of clinical studies in uremic patients have found that these compounds have beneficial effects on hematologic parameters and nutritional status, similarly to other therapies, such as recombinant human erythropoietin and recombinant human growth hormone, respectively. Conclusions Androgens have been shown to have a beneficial effect on anemia due to renal disease and on nutritional status in uremic patients. Further studies need to be done with larger groups of patients. Objectives for additional research are suggested.
Hyponatremia in Patients Undergoing CAPD: Role of Water Gain and/or Malnutrition
Authors: Zevallos Gonzalo , Oreopoulos Dimitrios G. , Halperin Mitchell L. 
Published: February 2020

Background Hyponatremia has a number of different causes; some may have serious untoward implications for patients undergoing chronic ambulatory peritoneal dialysis (CAPD). Objective To determine the pathophysiology of hyponatremia in patients on CAPD. Methods A retrospective analysis was carried out on 210 patients on CAPD. We selected patients with 2 – 4 consecutive periods when the plasma sodium concentration was ≤130 mmol/L and again when it was > 133 mmol/L. Exclusion criteria included hyperglycemia, orthostatic hypotension, edema, and inadequate records. Results An electrolyte-free water gain appeared to be the main cause of hyponatremia in only 1 of 5 patients because this was the only patient with a significant increase in body weight. In 1 patient, there was weight loss in the hyponatremic period, suggesting tissue catabolism was present. In 3 patients, there was neither weight gain nor evidence for a contracted extracellular fluid volume in the hyponatremic period, suggesting that intracellular potassium and phosphate loss could be the major mechanism for their hyponatremia. Conclusion When hyponatremia is due to a catabolic state, its management should aim to restore intracellular fluid composition ( i.e., to correct malnutrition).
Adsorption of Erythropoietin and Growth Hormone to Peritoneal Dialysis Bags and Tubing
Authors: Schröder Cornelis H. , Swinkels Leon M.J.W. , Reddingius Roel E. , Sweep Fred G.J. , Willems Hans L. , Monnens Leo A.H. 
Published: February 2020

Objective To study the adsorption of erythropoietin and growth hormone to dialysis bags and tubing. Design In vitro study in which radiolabeled erythropoietin and recombinant human growth hormone were added to small-volume (50- and 250-mL) dialysis bags. Recovery was measured after 15-minute dwells. Experiments were performed in triplicate. Setting University hospital. Results Adsorption of erythropoietin and growth hormone was less than 7%. Conclusion Adsorption of erythropoietin and recombinant human growth hormone to dialysis bags and tubing is minimal. This finding provides another argument in favor of intraperitoneal therapy in pediatric peritoneal dialysis.
Long-Term Capd Survival and Analysis of Mortality Risk Factors: 12-Year Experience of a Single Mexican Center
Authors: Cueto–Manzano Alfonso M. , Quintana–Piña Eduardo , Correa–Rotter Ricardo 
Published: February 2020

Objective To evaluate patient and technique survival, and to analyze mortality risk factors in a large Mexican single-center continuous ambulatory peritoneal dialysis (CAPD) program. Design Cohort study. Setting Tertiary care, teaching hospital located in Mexico City. Patients All patients from our CAPD program (1985 – 1997) were retrospectively studied. Interventions Clinical and biochemical variables at the start of dialysis were recorded and considered in the analysis of risk factors. Main Outcome Measures End points were patient (alive, dead, or lost to follow-up) and technique status at the end of the study (December 1997). Results 627 patients, 37% with diabetes mellitus (DM), were included. Median patient survival (± SE) was 5.1 ± 0.6 years. In the univariate analysis, the following variables were associated ( p < 0.05) with mortality: DM, old age, hypoalbuminemia, low serum creatinine, low serum phosphate, and lymphopenia. In the multivariate analysis, the only significant mortality risk factors were DM (RR 2.56, p < 0.0001), old age (RR 1.01, p = 0.01), hypoalbuminemia (RR 0.77, p = 0.04), and lymphopenia (RR 0.98, p = 0.05). Median technique survival was 4.0 ± 0.2 years. Peritonitis, hypoalbuminemia, lymphopenia, old age, and DM were all significantly associated ( p < 0.05) with technique failure in the univariate analysis, while in the multivariate analysis, only DM (RR 1.78, p = 0.001), peritonitis (RR 1.13, p = 0.004), lymphopenia (0.98, p = 0.04), and hypoalbuminemia (RR 0.80, p = 0.06) were technique failure predictors. Conclusions Patient survival in our setting is similar to that reported in other series. Diabetes mellitus, lymphopenia, and hypoalbuminemia were the strongest predictive factors for mortality and technique failure on CAPD. Our 12-year CAPD program is one of the largest single-centers reported in CAPD literature.
Diagnostic Value of Effluent Endotoxin Level in Gram-Negative Peritonitis in Capd Patients
Authors: Muhammed Khalifa Omar , Özener Çetin , Akoglu Emel 
Published: February 2020

Objective To evaluate the diagnostic usefulness of effluent endotoxin by Limulus amoebocyte lysate (LAL) assay in gram-negative peritonitis patients on continuous ambulatory peritoneal dialysis (CAPD) therapy. Design Prospective study with patients serving as their own controls. Standard microbiologic work up and endotoxin analysis of effluents (night dwell) were done during the pre- and posttreatment phases. Setting Specimens from three teaching hospitals were processed and tested at a common center. Patients were left for treatment at their respective centers without intervention. Patients 32 clinical peritonitis and 40 infection-free CAPD patients were studied. Results 75% ( n = 24) of cultures were positive: 41.6% ( n = 10) gram-negative and 58.4% ( n = 14) gram-positive bacteria. Effluents of pre- and posttreated gram-negative cultures had endotoxin levels of 1.53 ± 0.169 and 0.214 ± 0.085 endotoxin units (EU)/mL, respectively ( p < 0.0001); pre- and posttreated gram-positive levels of 0.102 ± 0.06 and 0.122 ± 0.052 EU/mL, respectively ( p > 0.05); pre- and posttreated culture-negative peritonitis levels of 0.110 ± 0.025 and 0.087 ± 0.031 EU/mL, respectively ( p > 0.05); peritonitis-free effluents contained 0.117 ± 0.079 EU/mL. The diagnostic specificity and the sensitivity of LAL assay were 100% and 98.2% respectively. Conclusion Where initial microbiological work-up cannot demonstrate a pathogen, effluent endotoxin determined by quantitative LAL assay is a useful marker for diagnosis and management, within safe time limits, of gram-negative peritonitis in CAPD patients.
Qt Dispersion and Signal-Averaged Electrocardiogram in Hemodialysis and Capd Patients
Authors: Yildiz Alaattin , Akkaya Vakur , Sahin Sevgi , Tükek Tufan , Besler Mine , Bozfakioglu Semra , Korkut Ferruh 
Published: February 2020

Objective The aim of this study was to compare QT dispersion (QTd) and signal-averaged electrocardiogram (SA-ECG) parameters that may predict risk of malignant arrhythmias in patients on hemodialysis (HD), on continuous ambulatory peritoneal dialysis (CAPD), and in controls. Setting Controlled cross-sectional study in a tertiary- care setting. Patients 28 HD (M/F 18/10; mean age 32 ± 9 years), 29 CAPD (M/F 17/12; mean age 34 ± 10 years), and 29 healthy controls (M/F 17/12; mean age 32 ± 8 years) were included. Interventions On ECG, minimum (QTmin) and maximum (QTmax) QT duration and their difference (QTd) were measured. In SA-ECG, duration of filtered QRS, HFLA signals less than 40 μV, and RMS voltage (40 ms) were also measured. Results Higher serum Ca2+ and lower K+ levels were found in CAPD compared to HD. All QT parameters were increased in HD and CAPD compared to controls. QT dispersion was significantly prolonged in HD compared to CAPD. In HD, QTd was correlated with left ventricular (LV) mass index ( r = 0.53, p = 0.004), but not in CAPD ( r = -0.09, p = 0.63). QT dispersion was significantly prolonged in patients with LV hypertrophy compared to patients without hypertrophy on HD (68 ± 18 ms vs 49 ± 18 ms, p = 0.008). In the analysis of SA-ECG, 3 of the 28 (11%) HD and 2 of the 29 (7%) CAPD patients had abnormal late potentials. Patients on HD and CAPD had significantly higher filtered-QRS duration compared to controls (105 ± 15 ms and 104 ± 12 ms vs 95 ± 5 ms, respectively, p = 0.04). Patients with LV hypertrophy had higher filtered-QRS duration compared to patients without hypertrophy (109 ± 12 ms vs 95 ± 8 ms, p < 0.001). Conclusion Dialysis patients had prolonged QTd and increased filtered-QRS duration in SA-ECG compared to controls. Patients on HD had longer QTd than patients on CAPD. QTd has been correlated to LV mass index in HD, but not in CAPD. This difference might be due to the effect of different dialysis modalities on electrolytes, especially the higher serum Ca2+ levels.
Does Enalapril Prevent Peritoneal Fibrosis Induced by Hypertonic (3.86%) Peritoneal Dialysis Solution?
Authors: Duman Soner , Günal Ali Ihsan , Sen Sait , Asçi Gülay , Özkahya Mehmet , Terzioglu Ender , Akçiçek Fehmi , Atabay Gürhun 
Published: February 2020

Objective Peritoneal fibrosis (PF) is one of the most serious causes of failure in continuous ambulatory peritoneal dialysis (PD). Although the underlying mechanism responsible for the genesis of PF is still unknown, transforming growth factor p (TGFβ1) has been shown to be associated with PF. Angiotensin converting enzyme inhibitors have been shown to prevent the stimulating effect of growth factors. The aim of the present study was to investigate the effect of enalapril on peritoneal function and morphology in a rat model of experimental PF. Methods Twenty-one albino Wistar rats were divided into three groups: ( 1 ) the control group (C) received 10 mL isotonic saline intraperitoneally (IP), ( 2 ) the dextrose (Dx) group 10 mL 3.86% dextrose PD solution IP, and ( 3 ) the enalapril-treated group (ENA) 10 cc 3.86% dextrose PD solution IP plus 100 mg/L enalapril in drinking water. After 4 weeks, a 1-hour peritoneal equilibration test was performed with 20 mL 2.27% dextrose PD solution. Dialysate-to-plasma urea ratio (D/P urea), glucose reabsorption (D1/D0 glucose), ultrafiltration (UF) volume, and levels of dialysate protein, TGFβ1, and cancer antigen 125 (CA125) were determined. The parietal peritoneum was evaluated histologically by light microscopy. Results Administration of enalapril resulted in preserved UF (-0.2 ± 0.7 mL vs 1.7 ± 0.3 mL, p < 0.05), protein loss (2.3 ± 0.5 g/L vs 1.6 ± 0.2 g/L, p > 0.05), and peritoneal thickness (77 ± 7 μ vs 38 ± 5 μ, p < 0.001). D/P urea increased significantly in the Dx group ( p < 0.05). Both higher levels of TGFβ1 (undetectable vs 298 ± 43 pg/mL, p < 0.001) and lower levels of CA125 in dialysate effluent (0.94 ± 0.5 U/L vs 0.11 ± 0.1 U/L, p > 0.05) were determined in the Dx group. Conclusion These findings show that peritoneal morphology and function tests were dramatically deranged in the Dx group. The same properties were partially preserved in the ENA group. The production of TGFβ1 was significantly reduced but peritoneal thickness was not completely inhibited. In conclusion, by inhibiting the production of TGFβ1, enalapril can preserve peritoneal histology, peritoneal function, and remodeling of mesothelial cells.
Relationship between Adequacy of Dialysis and Nutritional Status, and Their Impact on Patient Survival on Capd in Hong Kong
Authors: Lo Wai-Kei , Tong Kwok-Lung , Li Chun-Sang , Chan Tak-Mao , Wong Andrew K.M. , Ho Yiu-Wing , Cheung King-On , Kwan Tze-Hoi , Wong Kin-Shing , Ng Flora S.K. , Cheng Ignatius K.P. 
Published: February 2020

Objective Superior patient survival on continuous ambulatory peritoneal dialysis (CAPD) with 3 x 2-L exchanges has been reported from Hong Kong. This study examined the relationship between indices of dialysis adequacy and nutrition and patient survival on CAPD in Hong Kong. Design A cross-sectional study on prevalent CAPD patients. Patients were assessed for indices of dialysis adequacy and nutritional status with a composite nutritional index (CNI). Patients were then followed for 24 months. Survival data were analyzed according to adequacy indices and nutritional status. Setting All prevalent CAPD patients in nine dialysis centers in Hong Kong as of 1 April 1996. Main Outcome Measure Mortality. Results 937 patients were assessed: 68.2% were using 3 x 2-L exchanges per day; mean age was 54.6 ± 13 years. Mean total Kt/V was 1.83 ± 0.42 and total creatinine clearance was 55.6 ± 19.5 L/week/1.73 m2. 19% of patients were moderately to severely malnourished according to the CNI. There was no significant correlation between indices of adequacy and serum albumin or CNI. The 1- and 2-year patient survival from the time of assessment was 90.9% and 79.8%. There was a trend toward better survival in patients with Kt/V greater than 2.0, but it was not statistically significant. Peritoneal Kt/V did not impact survival in anuric patients. Malnourished patients had poorer survival than patients who were better nourished ( p = 0.0259). After adjusting for age and diabetes, CNI was predictive of mortality but Kt/V and creatinine clearance were not. Conclusions This study demonstrates the importance of nutritional status over adequacy indices in predicting patient survival. There was a lack of correlation between nutritional status and conventional indices of dialysis adequacy.