bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacteriology of Chronic Sinusitis in Relation to Middle Meatal Secretion
Authors: Jiang Rong-San , Su Mao-Chang , Liao Chung-Yu , Lin Jen-Fu 
Published: August 2018

Background The bacteriology of chronic sinusitis has been studied widely, but some factors may affect the results, such as sample sources and sampling techniques. However, whether the presence of secretion in the middle meatus affects the culture result has been studied rarely. Methods When patients with chronic sinusitis underwent functional endoscopic sinus surgery, swab specimens were taken from the ipsilateral middle meatuses and ethmoid sinuses under endoscopic guidance. While taking specimens from the middle meatuses, we observed the presence of secretions in the middle meatuses. The severity of chronic sinusitis was evaluated by preoperative computed tomography, which was scored by the Lund–Mackay system. The scores of the frontal, anterior ethmoid, maxillary sinus, and ostiomeatal complex were cumulated. Results Between March 2001 and February 2004, 210 pairs of specimens were collected. The secretion was present in 82 middle meatuses and was absent in the other 128 middle meatuses. The culture rates of middle meatus and ethmoid sinus specimens were 70.7 and 51.2%, respectively, for patients with secretions in the middle meatuses and 53.1 and 44.5%, respectively, for patients without secretions in the middle meatuses. The culture rate was significantly different for middle meatus specimens (p = 0.011) and the mean cumulated computed tomography score also was significantly higher in patients with secretions in the middle meatuses than in patients without secretions in the middle meatuses (p < 0.001). Conclusion The results of this study suggest that the presence of secretion in the middle meatus indicates more severe disease in the anterior group of paranasal sinuses.
Medical Students’ Attitudes toward the use of an Endoscopic Sinus Surgery Simulator as a Training Tool
Authors: Glaser Aylon Y. , Hall Charles B. , Uribe S. Jose I. , Fried Marvin P. 
Published: August 2018

Background Modern adult learning theory characterizes self-directed learning as most effective. While studying the effectiveness of an endoscopic sinus surgery simulator (ES3) as a training tool and acknowledging that its successful integration into a training program is dependent on its acceptance and self-driven use by trainees, we sought to determine our study subjects’ attitudes toward the simulator. Methods Twenty-six medical students were enrolled and trained in our ES3 study. Each student was asked to complete a 28-item questionnaire on completion of training. This questionnaire contained 10-point Likert scale instruments, yes/no questions, and one open-ended question. Results All but four subjects responded to the questionnaire; 90.9% of the respondents rated the training benefit derived from the simulator's novice mode as 6 or greater on a 10-point scale; the mean was 7.82 (±2.22). The training benefit of the intermediate mode also was scored highly, with a mean score in the 7–9 range for all but one component–-heart rate response to actions performed. Trainees appreciated the simulator's ability to help them adapt to a three-dimensional space on a two-dimensional display. They also noted its strengths in elucidating intranasal anatomy. Conclusion Medical students who enrolled in our study, as a group, felt that the ES3 provided them with significant training benefits. Although subjective, these attitudes, coupled with objective data indicating that there is a measurable benefit from use of the ES3, will ensure its full acceptance and use in otolaryngology training programs.
Low-Dosage Adrenaline Induces Transient Marked Decrease of Blood Pressure during Functional Endoscopic Sinus Surgery
Authors: Zhao Feng , Wang Zhongyun , Yang Jianjun , Sun Jie , Wang Qiuping , Xu Jianguo 
Published: August 2018

Background Low-dosage adrenaline contained in local anesthetics is commonly used for hemostasis during functional endoscopic sinus surgery (FESS), but often causes significant hemodynamic side effects that might be neglected. A randomized, controlled, prospective clinical trial was designed to find out these effects after local infiltration of different concentrations and/or different dosages of adrenaline during FESS under general anesthesia. Methods One hundred eight adult patients were randomized into one of four groups to receive 2 mL of 2% lidocaine and adrenaline 1:200,000 (group I), 4 mL of 1% lidocaine and adrenaline 1:400,000 (group II), 4 mL of 1% lidocaine and adrenaline 1:200,000 (group III), or 4 mL of 1% lidocaine (group IV) for local infiltration, respectively. Heart rate, systolic blood pressure (BP), diastolic BP, and mean arterial pressure were monitored continuously in radial artery. Results Significant hemodynamic changes, particularly decrease of BP (p < 0.001) with slightly increased heart rate (p < 0.001) ∼1.5 minutes after local infiltration, were observed in group I, group II, and group III compared with the baseline, but not in group IV. However, no significant hemodynamic changes were observed between group I, group II, and group III at the same time points (p > 0.05). Conclusions Local infiltration of low-dosage adrenaline causes temporary significant hemodynamic changes, particularly marked decrease of BP during FESS, and there were no significant hemodynamic changes between adrenaline 1:200,000 and 1:400,000.
Endoscopic Vidian Neurectomy
Authors: Robinson Simon R. , Wormald Peter John 
Published: August 2018

Background Vidian neurectomy has in the past been advocated for the treatment of vasomotor rhinitis. With the recent better understanding of nasal and sinus anatomy, the surgical technique and outcomes of this procedure have been reassessed in this preliminary report. Methods A total of nine patients with symptoms of vasomotor rhinitis underwent 14 endoscopic vidian neurectomies between 1998 and 2001. All patients had negative screening for allergies on their serum or on skin-prick tests. The surgical technique for endoscopic vidian neurectomy is presented. The outcomes for the patients were retrospectively assessed with patients asked to score their pre- and postoperative symptoms rating these symptoms on a scale of 1–10 after a mean follow-up of 25 months (range, 21–36 months). Results On this retrospective analysis there was a significant improvement in the symptoms of rhinorrhea (p = 0.018) and nasal obstruction (p = 0.011). There was no significant difference between the pre- to postoperative symptoms for postnasal drip or sneezing. The most common minor adverse effect was dry eyes (35.7%) and nasal crusting (28.6%). Conclusion Endoscopic vidian neurectomy improves the symptoms of nasal obstruction and rhinorrhea in patients with vasomotor rhinitis.
Decongestion Test in Patients with Allergic Rhinitis: Functional Evaluation of Nasal Airflow
Authors: Ciprandi Giorgio , Cirillo Ignazio , Vizzaccaro Andrea , Pallestrini Eugenio , Tosca Maria Angela 
Published: August 2018

Background Rhinomanometry measures nasal airflow that is frequently impaired in allergic rhinitis. Decongestion tests consist of spraying an intranasal vasoconstrictor drug to evaluate the reversibility of nasal airflow limitation. The aim of this study was to evaluate the decongestion test in patients with seasonal allergic rhinitis (SAR) caused by pollen sensitization, perennial allergic rhinitis (PAR) caused by sensitization to perennial allergens only, or mixed allergic rhinitis (MAR) caused by sensitization to both allergens. Methods One hundred twenty-three subjects (112 men and 11 women, mean age, 22.9 ± 5.7 years) were studied; 40 subjects had PAR, 43 subjects had MAR, and 40 subjects had SAR. Total symptom score (including: nasal itching, sneezing, rhinorrhea, and nasal obstruction) was assessed. Rhinomanometry and decongestion tests were performed in all subjects. Results Nasal symptom severity was superimposable in the three groups (p was not significant). After decongestion tests, an increase of nasal airflow and a decrease of nasal resistance was shown in PAR (p < 0.01), MAR (p < 0.001), and SAR subjects (p < 0.001). The intergroup analysis showed that SAR patients had less reversibility than PAR (p < 0.01). Conclusion This study provides the first evidence of the different response to decongestion tests, taking into consideration the causal allergens.
Progression of Sinus Disease in the Intubated Patient
Authors: Payne Spencer C. , Benninger Michael S. 
Published: August 2018

Background Sinus disease in the intubated patient remains a frequent reason behind otolaryngological consultation to the Intensive Care Unit. Previous prospective studies often have been limited to only one computed tomography (CT) scan of the sinuses. The purpose of this study was to verify the development of sinus disease in the orotracheally intubated patient and determine a radiographic pattern of its progression if present. Methods The charts of all patients admitted to the hospital with a diagnosis of aneurysm or subarachnoid hemorrhage over a 2-year period were evaluated. Patients who were orotracheally intubated with at least one postintubation CT scan of the head were included. CT scans obtained after the initiation of antibiotics or tracheostomy were excluded. The Lund–Mackay staging system was used to evaluate the scans. Results A total of 50 patients with 172 scans were evaluated. Analysis revealed a significant trend toward increasing severity of radiological sinus disease over the first 7 days of intubation (p < 0.001). The presence of a nasogastric tube (NGT) resulted in an increased Lund–Mackay score, but the trend remained significant for patients without an NGT as well. Conclusion This study shows that the presence and progression of sinus findings is fairly common in the intubated patient and that although the placement of an NGT increased the rate of development of sinus findings, the lack of one did not preclude sinus disease. Clinical exam remains a more important indicator of disease when evaluating the Intensive Care Unit patient for rhinosinusitis.
Validation of the Oswestry Risk of Knee Arthroplasty Index (ORKA-1) for Patients Undergoing Autologous Chondrocyte Implantation
Authors: Ackermann Jakob , Barbieri Mestriner Alexandre , Arango Dillon , Ogura Takahiro , Gomoll Andreas H. 
Published: August 2018

Objective The purpose of this study was first to externally validate the Oswestry Risk of Knee Arthroplasty index (ORKA-1) by applying it to an autologous chondrocyte implantation (ACI) patient cohort in the United States with a broader definition of failure than only arthroplasty, and second, to determine predictive factors for the risk of ACI failure as defined by the senior author. Design A total of 171 patients that underwent ACI were included to validate the ORKA-1 as all factors needed for calculation and outcomes were recorded. For Cox regression analysis, 154 patients were included as they completed preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, Lysholm, International Knee Documentation Committee (IKDC), and 12-item Shor Form (SF-12) scores. Patient- and lesion-associated parameters were recorded for each patient. Results At final follow-up (maximum of 10 years post-ACI), a total of 27 patients (15.8%) were considered a failure by senior author’s definition. With ACI failure as endpoint, the mean survival was 7.96 years in risk group 1 and 5.4 years in risk group 5. Cox regression analysis identified preoperative KOOS Sport/Recreation as the only significant predictive factor for ACI failure ( P = 0.007). Conclusion The ORKA-1 is a helpful tool for surgeons to estimate an individual patient’s likelihood of ACI survival. Further studies with larger patient cohorts as well as a consensus definition of failure are needed to further refine predictors of ACI failure.
Osteoarthritic Synovial Fluid and TGF-β1 Induce Interleukin-18 in Articular Chondrocytes
Authors: Carballo Camila B. , Coelho Thiago R. P. , de Holanda Afonso Rosenilde C. , Faria Jane Cristina de Oliveira , Alves Tercia , Monte Samylla M. , Ventura Matioszek Grasiella M. , Moura-Neto Vivaldo , Brito José M. de 
Published: August 2018

Objective Synovial fluid (SF) plays an important role in the maintenance of articular cartilage. SF is a dynamic reservoir of proteins derived from cartilage and synovial tissue; thus, its composition may serve as a biomarker that reflects the health and pathophysiological condition of the joint. The purpose of the current study was to evaluate the osteoarthritic synovial fluid (OASF) and transforming growth factor-β1 (TGF-β1) activity in articular chondrocytes catabolic and inflammatory responses. Design Chondrocytes were seeded at passage 2 and cultured for 72 hours under different conditions. Human chondrocytes were subjected to OASF while rat chondrocytes were subjected to either healthy synovial fluid (rSF) or TGF-β1 and then assigned for cell viability analysis. In addition, the effects of OASF and TGF-β1 on chondrocytes metalloprotease (MMP)-3 and MMP-13 and interleukin-18 (IL-18) expression were evaluated by immunocytochemistry, ELISA, and reverse transcriptase-polymerase chain reaction. Results SF from osteoarthritic patients significantly induced MMP-3, MMP-13, and IL-18 receptor expression in chondrocytes. To put in evidence the inflammatory activity of OASF, healthy chondrocytes from rat were cultured with TGF-β1. In the presence of TGF-β1 these cells started to express MMP-3, MMP-13, and IL-18 genes and attached to each other forming a chondrocyte aggregated structure. Healthy SF was able to maintain a typical monolayer of rounded chondrocytes with no inflammatory response. Conclusion In summary, these observations demonstrated that TGF-β1, one of the components of OASF, has a dual effect, acting in chondrocyte maintenance and also inducing inflammatory and catabolic properties of these cells.
Post marketing study of hemodynamic and hematological noninvasive readings in a blood bank
Authors: Segman Yosef (Joseph) , Sheiman Ella 
Published: August 2018

Objectives: This validation test was conducted in the Fujisan Blood Bank, Fortaleza, Brazil and evaluated the noninvasive TensorTip MTX (MTX, Cnoga Medical Ltd.) readings of hemoglobin, hematocrit, red blood cells, blood pressure, and heart rate compared to reference lab device readings. Generally, these parameters are measured from venous or capillary blood samples run on a laboratory analyzer or handheld invasive testing devices. Needle sticks are inconvenient to blood donors with relatively high exposure risks. To our vision, noninvasive determination would be of benefit to blood contributors and medical professional teams; it would be fast and painless. Methods: A total of 334 subjects were included in the Fujisan blood bank validation (65% male, 35% female). Hemoglobin, hematocrit, and red blood cells, as well as blood pressure and heart rate, were measured noninvasively using the MTX device and were compared to venous blood samples run on two laboratory hematology analyzers (Horiba ABX Micros60 and Siemens blood count analyzer), to digital sphygmomanometer (OMRON BP786) and to manual auscultation. The noninvasive measurement with the appropriate virtual arm cuff setting was performed simultaneously with the blood sample extraction of the reference devices measurement. Results: There was no statistically significant difference ( p > 0.05, paired, two-tailed t-test) between the average daily hemoglobin, hematocrit, and red blood cells measurements provided by the MTX device and the laboratory hematology analyzer. In addition, there was no significant difference between the daily blood pressure and heart rate results provided by the MTX device and the digital and manual sphygmomanometers. The error calculated between the MTX and the reference device was found to be sufficiently accurate according to the relevant standards. Conclusion: The MTX accuracy of noninvasive hemoglobin, hematocrit, red blood cells, blood pressure, and heart rate measurements satisfies the industrial standards; therefore, the device enables more accurate, efficient, and effective patient care.
Impact of symptom bilaterality and hand dominance on patient-reported disability outcomes
Authors: Razmjou Helen , Dwyer Tim , Holtby Richard 
Published: August 2018

Objectives: It is not clear if using patients with bilateral symptoms would impact the level of disability reported in orthopaedic research. The purposes of this study were to (1) examine the prevalence of bilateral shoulder symptoms (significant pain, stiffness or weakness affecting function) in patients with rotator cuff impingement syndrome, rotator cuff tear and osteoarthritis of the glenohumeral joint, (2) explore risk factors associated with bilateral shoulder symptoms, and (3) examine the impact of symptom bilaterality and hand dominance on pre- and post-operative patient-oriented disability outcomes. Methods: This study involved secondary analysis of prospectively collected data of patients who had undergone shoulder surgery and had returned for their 1-year follow-up. Two outcome measures were collected prior to surgery and at 1-year following surgery: the American Shoulder and Elbow Surgeons and the Constant–Murley Score. Results: Data of 772 patients, 376 (49%) females, 396 males (51%); 288 (impingement syndrome), 332 (rotator cuff tear), and 152 (osteoarthritis) were included in the analysis. There was a statistically significant difference in the prevalence of bilateral symptoms being 44%, 28%, and 22% in the osteoarthritis, impingement syndrome, and rotator cuff tear groups, respectively (p < 0.0001). The prevalence of dominant side involvement was 71%, 67%, and 53% in the rotator cuff tear, impingement syndrome, and osteoarthritis groups (p < 0.0001). Older age and female sex were risk factors for development of bilateral symptoms only in patients with rotator cuff tear. Neither symptom bilaterality nor dominant arm involvement had a negative impact on patient-oriented disability outcome measures prior to or after surgery (p > 0.05). Conclusion: This study shows that patients with osteoarthritis of the glenohumeral joint have the highest prevalence of bilateral shoulder complaints. The older age and the female sex increased the risk of having bilateral symptoms in patients with rotator cuff tear. Having bilateral shoulder symptoms or dominant side involvement was not associated with higher level of disability prior or after surgery.
Hypoalbuminemia as an Independent Risk Factor for Perioperative Complications Following Surgical Decompression of Spinal Metastases
Authors: Hussain Awais K. , Cheung Zoe B. , Vig Khushdeep S. , Phan Kevin , Lima Mauricio C. , Kim Jun S. , Di Capua John , Kaji Deepak A. , Arvind Varun , Cho Samuel K. 
Published: August 2018

Study Design: Retrospective cohort study. Objective: Malnutrition has been shown to be a risk factor for poor perioperative outcomes in multiple surgical subspecialties, but few studies have specifically investigated the effect of hypoalbuminemia in patients undergoing operative treatment of metastatic spinal tumors. The aim of this study was to assess the role of hypoalbuminemia as an independent risk factor for 30-day perioperative mortality and morbidity after surgical decompression of metastatic spinal tumors using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2014. Methods: We identified 1498 adult patients in the ACS-NSQIP database who underwent laminectomy and excision of metastatic extradural spinal tumors. Patients were categorized into normoalbuminemic and hypoalbuminemic (ie, albumin level <3.5 g/dL) groups. Univariate and multivariate regression analyses were performed to examine the association between preoperative hypoalbuminemia and 30-day perioperative mortality and morbidity. Subgroup analysis was performed in the hypoalbuminemic group to assess the dose-dependent effect of albumin depletion. Results: Hypoalbuminemia was associated with increased risk of perioperative mortality, any complication, sepsis, intra- or postoperative transfusion, prolonged hospitalization, and non-home discharge. However, albumin depletion was also associated with decreased risk of readmission. There was an albumin level–dependent effect of increasing mortality and complication rates with worsening albumin depletion. Conclusions: Hypoalbuminemia is an independent risk factor for perioperative mortality and morbidity following surgical decompression of metastatic spinal tumors with a dose-dependent effect on mortality and complication rates. Therefore, it is important to address malnutrition and optimize nutritional status prior to surgery.
Short-term Outcomes of Arthroscopic Debridement and Selected Acromioplasty of Bursal- vs Articular-Sided Partial-Thickness Rotator Cuff Tears of Less Than 50%
Authors: Dwyer Tim , Razmjou Helen , Henry Patrick , Misra Shashank , Maman Eran , Holtby Richard 
Published: August 2018

Background: While it is believed that good results can be achieved by arthroscopic debridement of partial-thickness tears (PTTs) of <50% tendon thickness, few studies have directly compared the treatment of articular- versus bursal-sided PTTs of <50%. Purpose: To compare the postoperative outcomes of patients with articular- versus bursal-sided PTTs of <50% tendon thickness that were treated with arthroscopic debridement and selective acromioplasty (for type II or III acromions). Study Design: Cohort study; Level of evidence, 3. Methods: An analysis was performed with data from 76 consecutive patients diagnosed with a PTT <50% tendon width (Ellman grade II) who had undergone arthroscopic debridement and selective acromioplasty (for type II or III acromions). Outcome measures included the short version of the Western Ontario Rotator Cuff index, the American Shoulder and Elbow Surgeons score, and the relative Constant-Murley score, as well as strength of the affected shoulder. A statistical paired t test (preoperative vs 2 years postoperative) and an independent t test were utilized to compare outcomes between patients with bursal- and articular-sided tears. Results: Between 2001 and 2010, there were 40 (53%) articular- and 36 (47%) bursal-sided tears treated with debridement and selective acromioplasty. The mean patient age was 55 years (range, 36-77 years) for the bursal group and 56 years (range, 33-81 years) for the articular group. The mean follow-up was 24 months (range, 22-26 months). Both groups showed significant improvement in the short version of the Western Ontario Rotator Cuff index, American Shoulder and Elbow Surgeons score, and relative Constant-Murley score 2 years after surgery ( P < .0001) as well as in strength ( P < .0001 for bursal tears, P = .006 for articular tears). There was no statistically significant difference between groups in any of the postoperative outcome measures at 2 years. Conclusion: The results of this study demonstrate that good outcomes can be achieved with arthroscopic debridement and selective acromioplasty among patients with articular- or bursal-sided PTT of <50% tendon thickness. No difference was observed between groups at 2-year follow-up.
A cloning and expression system to probe T-cell receptor specificity and assess functional avidity to neoantigens
Authors: Hu Zhuting , Anandappa Annabelle J. , Sun Jing , Kim Jintaek , Leet Donna E. , Bozym David J. , Chen Christina , Williams Louise , Shukla Sachet A. , Zhang Wandi , Tabbaa Diana , Steelman Scott , Olive Oriol , Livak Kenneth J. , Kishi Hiroyuki , Muraguchi Atsushi , Guleria Indira , Stevens Jonathan , Lane William J. , Burkhardt Ute E. , Fritsch Edward F. , Neuberg Donna , Ott Patrick A. , Keskin Derin B. , Hacohen Nir , Wu Catherine J. 
Published: August 2018

Abstract
There is a Blood Commentary on this article in this issue.