bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and endovascular treatment of iliac venous compression syndrome
Authors: Sang Hong-fei , Li Jia-hong , Du Xiao-long , Li Weng-dong , Lei Feng-rui , Yu Xiao-bin , Zhu Li-wei , Li Cheng-long , Li Xiao-qiang 
Published: April 2018

Objectives To report *The first two authors contributed equally to this work. our clinical experience on diagnostic criteria and endovascular management in patients with iliac venous compression syndrome. Method Between July 2013 and May 2015, 85 consecutive patients with suspected iliac venous compression syndrome were evaluated by transfemoral venography and intravascular ultrasonography. Venographic evidence of iliac venous occlusion, stenosis, or pelvic collateral vessels, and the degree of stenosis as examined with intravascular ultrasonography were recorded. The endovascular procedure, complications, clinical outcome, and the Venous Clinical Severity Score were evaluated before and after the intervention. Results Of the 85 limbs, 66 cases of iliac venous compression syndrome were confirmed and 19 cases were excluded. In all of the 66 patients, we successfully performed endovascular intervention (22 balloon dilations, 44 balloon dilations + stenting). Two patients with stent implantation developed acute lower extremity deep vein thrombosis, resulted in successful lysis of the thrombus with catheter-directed thrombolysis. Conclusions The presence of intraluminal spurs and pelvic collateral vessels represents not only pathological and anatomical changes by long-term mechanical compression, but also indicators of the severity of iliac venous compression syndrome. The degree of stenosis cannot accurately represent the severity and treatment of iliac venous compression syndrome, especially in the right iliac vein. Endovascular intervention is a safe and effective treatment that reduces lower extremity symptoms. Full and intentional dilation of the intraluminal spurs is an important technical aspect, which is often ignored.
Safety of concurrent adjuvant radiotherapy and chemotherapy for locally advanced soft tissue sarcoma
Authors: Greto Daniela , Loi Mauro , Saieva Calogero , Muntoni Cristina , Delli Paoli Camilla , Becherini Carlotta , Ciabatti Cinzia , Perna Marco , Campanacci Domenico , Terziani Francesca , Beltrami Giovanni , Scoccianti Guido , Bonomo Pierluigi , Meattini Icro , Desideri Isacco , Simontacchi Gabriele , Mangoni Monica , Livi Lorenzo 
Published: April 2018

Introduction: This retrospective study analyzes the safety and feasibility of concurrent chemoradiotherapy (CRT) in adjuvant treatment of soft tissue sarcoma (STS). Methods: A total of 158 patients with STS were retrospectively analyzed. Anthracycline-based computed tomography was performed in high-risk patients. Acute radiotherapy toxicity and chemotherapy-related toxicity were assessed according to the Common Terminology Criteria for Adverse Events 4.0; late radiotherapy toxicity was recorded according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Results: Fifty-four (34.2%) patients received CRT. Mean follow up was 5.4 years (range .2–21.1 years). Local DFS–recurrence-free survival, distant DFS–relapse-free survival, and overall survival were 79.1%, 76.4%, and 64.6%, respectively, at last follow-up. Leukopenia occurred in 11.4% of patients. Skin acute toxicity developed in 60.1% of patients and determined interruption of radiotherapy treatment in 19 (12%) patients. Nineteen patients (12%) experienced moderate fibrosis (grade 2). Mild and moderate joint stiffness was recorded in 16 (10.1%) patients. Size ≥5 cm was the only predictor of local recurrence at multivariate analysis (hazard ratio [HR] 9.65, 95% confidence interval [CI] 1.28–72.83, p = .028). Age and stage resulted as independent distant relapse predictors (HR 4.77, 95% CI 1.81–12.58, p = .002 and HR 4.83, CI 1.41–16.57, p = .012, respectively). At Cox regression univariate analysis, Karnofsky Performance Status, size, and stage were significant survival predictors (HR 2.23, 95% CI 1.02–4.87, p = .045; HR 2.88, 95% CI 1.10–7.52, p = .031; HR 2.59, 95% CI 1.11–6.04, p = .028). Conclusions: Concurrent CRT is a well-tolerated treatment option with no additional toxicity compared to exclusive radiotherapy or sequential CRT.
The influence of work on the transition to retirement: A qualitative study
Authors: Eagers Jackie , Franklin Richard C , Broome Kieran , Yau Matthew K 
Published: April 2018

Introduction Retirement from work is a complex process, with work influencing this transition. Occupational therapists can facilitate a meaningful occupational transition to retirement for better health and wellbeing in later life. This article explores (1) how work attributes influence and relate to the work-to-retirement transition stages, (2) the relationship of findings to the Model of Human Occupation volitional processes and (3) the potential occupational therapy role. Method Semi-structured interviews were completed with retirees. In this qualitative study, themes were identified in relation to the work-to-retirement transition stages using thematic analysis with findings related to the Model of Human Occupation volitional processes. Findings Eleven Australian participants (five females, six males) were recruited. Themes and sub-themes were identified within each stage of the work-to-retirement transition and collectively encapsulated all volitional processes. Themes were time to move on, taking action, ceasing work, feeling retired, letting go and work-related involvement. Conclusion Work attributes related to personal factors, social factors, meaningful occupational engagement and the nexus of work and retirement influence all work-to-retirement transition stages. Volition assists in explaining the complexity of this transition. Occupational therapists can assist older workers to continue working or identify and implement meaningful occupations to replace work activities in retirement.
Combined Hemodialysis-hemoperfusion Treatment Reduces the time of Substitutive Therapy in Chronic Uremia
Authors: Stefoni S. , Feliciangeli G. , Colì L. , Scolari M.P. , Bonomini V. 
Published: April 2018

Charcoal hemoperfusion has long been used in chronic uremia as an adjunct or substitute for conventional hemodialysis. In this study a regular combination of hemoperfusion and hemodialysis was used to cut down the weekly substitutive sessions from 3 to 2. Ten RDT patients were treated with the reduced-time schedule for 5–56 weeks. Clinical and metabolic conditions remained stable in all patients and no sign of inadequate treatment appeared. Long-term charcoal hemoperfusion was confirmed to be a safe and risk-free procedure. No change in platelets, white cells, red cells, fibrinogen and other hematochemical parameters were detected.
Plasma Exchange in Five Patients with Acute Guillain Barré syndrome
Authors: de Jager A.E.J. , The T.H. , Sibinga C. Th. Smit , Das P.C. 
Published: April 2018

During the last 3 years plasma exchanges were undertaken in 5 patients with acute Guillain Barré syndrome (G.B.S.). All the patients were admitted in the intensive respiratory care unit and had received six plasma exchange procedures over two weeks (each procedure consists of 2–3 L exchange). The first patient improved dramatically after the second exchange. Moderate success was obtained in two patients. One patient did not show any effect. The fifth patient received plasma exchange one day after her recovery phase had begun but the course of recovery remained uneffected. The effect of plasma exchange was analysed as the patients’ response to motor activity, and compaired with a historical control group consisting of 50 acute G.B.S. patients admitted in the intensive respiratory care area over the last 25 years. Plasma exchange does not seem to have excerted any significant effect although at any given time the plasma exchange group had higher motor activity than that of the control group. A controlled clinical trial especially in the early phase of the disease is emphasized.
Patients with High Titers of Circulating Immune Complexes are Most Likely to Benefit from Plasmapheresis Treatment
Authors: Valbonesi M. , Garelli S. , Mosconi L. , Manca F. , Cantarella S. , Celada F. 
Published: April 2018

Intermittent flow centrifugation system was utilized in the management of 17 patients with IC diseases. 14 out of 14 patients that had high levels of ICs prior to plasmapheresis showed both clinical and immunochemical evidence of improvement with plasmapheresis. 3 patients had no evidence of circulating ICs prior to plasmapheresis: in these cases no apparent result was acheived after the apheretic therapy. Although the striking correlation between IC removal and clinical result is not a formal proof of responsibility of CIC in the pathogenesis of the disease, it is suggested that quantitative determinatin of CICs (utilizing several different recognition units) may be a useful parameter in the decision to apply plasmapheresis in the therapy of selected autoimmune diseases.
Heterogeneous Density and Ultrastructure of rabbit's Peritoneal Microvasculature
Authors: Gotloib L. , Shustak A. , Bar-Sella P. , Eiali V. 
Published: April 2018

In this study, samples of mesenteric diaphragmatic peritoneum and peritoneum covering the inner side of the ventral abdominal wall of apparently normal rabbits were examined under electron microscopy. Mesentery appeared as the most vascularized peritoneal segment (71,1% of the total number of observed capillaries). Diaphragmatic and parietal peritoneum contributions to the total examined microvascular bed were of 17,9% and 10,9% respectively. Only 3,2% of peritoneal diaphragmatic capillaries were of the fenestrated type. This qualitative and quantitative heterogeneity of the peritoneal microcirculation combined with the different contribution of each peritoneal segment to the total peritoneal surface area, the different mesothelial cell density of visceral and parietal peritoneum, and the different permeability of parietal visceral peritoneum suggest that, in vivo, whole organ permeability studies would eventually show just an average of an unknown distribution of segmental peritoneal permeabilities.
Optimization of Heparin Anticoagulation during Membrane Plasma Separation
Authors: Frascà G.M. , Buscaroli A. , Borgnino L.C. , Vangelista A. 
Published: April 2018

This study analyses 75 membrane plasma exchanges carried out in 18 patients where various amounts of heparin were used to define the heparin kinetic during plasma exchange and the appropriate anticoagulation. A specific assay was employed to measure heparin concentration. Our results showed that: 1) the heparin distribution volume exceeded the expected value by 10 to 25%; 2) the drug is filtered with a sieving coefficient = 1; 3) the appropriate concentration range is within 0.2 and 0.5 Ul/ml.; 4) the heparin blood levels strictly correlate with a PTT (p<0.001); 5) the individual need for heparin is related to the patient Hct (p<0.001) and plasma flow (p<0.001). Simple quidelines are provided to determine the appropriate heparin dosage in single patients.
Urea Kinetic Modelling by Partial Dialysate Collection
Authors: Garred L.J. , Rittau M. , McCready W. , Canaud B. 
Published: April 2018

Conventional urea kinetic modelling (UKM) has several drawbacks, in particular the complexity of the required calculations and the need for accurate values of parameters which are difficult to measure, such as dialyzer clearance and blood flow. An alternative method of UKM is proposed based on collecting a small fraction of spent dialysate flow for 3 consecutive dialyses. Application of a urea mass balance to the 7 day period permits neglecting changes in body urea stores. Thus no blood sampling is required for most patients. The required calculations are simple and straightforward. The partial dialysate collection (PDC) method was compared to conventional UKM in a 3 patient, 15 week study. Protein catabolic rate (PCR) from PDC was a smooth curve and consistent with dietary estimation for each patient. Conventional UKM gave variable PCR results which were 17–27% higher on average. This discrepancy was attributed to overestimation of dialyzer clearance. PDC was concluded to be more convenient and accurate than conventional UKM and therefore ideal for routine clinical use
Blood Glucose Measurement by Infrared Spectroscopy
Authors: Zeller H. , Novak P. , Landgraf R. 
Published: April 2018

For the development of an implantable artificial endocrine pancreas, a sensor for blood glucose measurement is needed providing a long-term stability. This goal can be achieved by the application of infrared spectroscopy which, unlike electrochemical sensors, responds directly to the glucose molecule. An investigation under physiological conditions revealed five glucose absorption bands in the near and middle infrared range. These are 1040, 1085, 1109, 1160 and 1365 cm–1. Only the 1040 cm–1 frequency coincides with none of the other infrared-active blood substances like proteins, lipids and urea. Nevertheless, the other absorption bands too, especially the 1109 cm–1 frequency, can be used for blood glucose measurement, if the superimposed absorptions are compensated. Methods for the compensation have been found. Technically feasible embodiments of an infrared glucose sensor are described.
L-Lactate for High-Efficiency Hemodialysis: Feasibility Studies and a Randomized Comparison with Acetate and Bicarbonate
Authors: Dalal S.P. , Ajam M. , Gupta D.K. , Gupta R. , Nawab Z. , Manahan F.J. , Ing T.S. , Daugirdas J.T. 
Published: April 2018

We evaluated the feasibility of using L-lactate as a base for hemodialysis. In one study, acid-base changes using 40 mM L- or DL-lactate were compared. In a second study, acid-base status using various amounts of L-lactate exclusively was studied. The third study compared symptoms and acid-base changes during 9 weeks of high-efficiency dialysis when using L-lactate, acetate, or bicarbonate as base. In the first study, plasma bicarbonate changes were equivalent with 40 mM L-lactate and 40 mM DL-lactate, but overall correction of acidosis appeared to be suboptimal. In the second study, when compared to a bicarbonate control period, correction of acidosis was reduced when using 40 mM L-lactate + 4 mM acetate solution, but increased when using a 46 mM L-lactate + 4 mM acetate solution. In the third study, correction of acidosis was comparable when using 42 mM L-lactate + 4 mM acetate, 39 mM acetate, or 35 mM HCO3 + 4 mM acetate. Whereas 46% ± 12 (SEM) treatments “failed” because of symptoms when using acetate, the percentages of “failed” treatments were only 7%±4.2 with L-lactate (p<0.05) and 11% ± 4.2 with bicarbonate (p < 0.05). The results suggest that L-lactate is a suitable dialysis solution base that is capable of correcting chronic uremic acidosis. During high-efficiency dialysis, the incidence of intradialytic symptoms with L-lactate is comparable to that with bicarbonate and less than that with acetate.
Estimation of Shear Stress-related Blood Damage in Heart Valve Prostheses - in Vitro Comparison of 25 Aortic Valves
Authors: Giersiepen M. , Wurzinger L.J. , Opitz R. , Reul H. 
Published: April 2018

The hemodynamics of heart valve prostheses can be reproducibly investigated in vitro within circulatory mock loops. By measuring the downstream velocity and shear stress fields the shear stresses which are clinically responsible for damage to platelets and red blood cells can be determined. The mechanisms of damage and the effects of shear stresses on blood corpuscles were investigated by Wurzinger et al. (3, 4) at the Aerodynamics Institute of the RWTH Aachen. In the present study, the above data are incorporated into a mathematical correlation, which serves as a basic model for the estimation of blood damage. This mathematical model was applied to in vitro investigations of 25 different aortic valve prostheses. The results were compared to clinical findings. In most cases agreement was good, indicating that this model may be directly applied to the clinical situation. This new method facilitates the estimation of clinically expected blood damage from in vitro measurements. It may be useful for the development and evaluation of new valve prostheses. By comparative evaluation of different valve types it also provides additional information to help the implanting surgeon select the optimum valve for his patient.
Study of Parameters Involved in Specific Immunoadsorption of Apolipoprotein B
Authors: Regnault V. , Rivat C. , Marcillier P. , Pfister M. , Michaely J.P. , Didelon J. , Schooneman F. , Stoltz J.F. , Siadat M. 
Published: April 2018

A therapeutic immunoadsorption system on immobilized and anti-apolipoprotein B as a plasma cholesterol lowering procedure was optimized. Several antibodies were compared and highest adsorption capacity was obtained with goat polyclonal antibodies. Optimum quantities of antibodies to be immobilized on the gel and quantities of apo-B to be applied to columns were determined. The amount of antibodies released from immunoadsorbents can be minimized by treatment with a 0.005% glutaraldehyde solution with an acceptable reduction rate of adsorption capacity. Each phase, adsorption and desorption respectively, were well-defined and synchronized so two columns could be used in parallel in an automated procedure. In these conditions, the immunoadsorption system can efficiently, specifically and safely remove cholesterol and has to be subjected to clinical trials.
Medial Structure Injury During Suture Button Insertion Using the Center-Center Technique for Syndesmotic Stabilization
Authors: Reb Christopher W. , Brandão Roberto A. , Watson B. Collier , Van Dyke Bryan , Berlet Gregory C. , Prissel Mark A. 
Published: April 2018

Background: The center-center technique for syndesmosis fixation has been described as an improved and reliable technique for proper reduction of the syndesmosis during ankle fracture repair. Concurrently, the use of flexible fixation with a suture button is becoming an established means of syndesmosis stabilization. The purpose of this cadaveric study was to assess for medial structure injury during the placement of a suture button using the center-center technique for ankle syndesmosis repair at 3 insertion intervals. Methods: Simulated open syndesmosis repair was performed on 10 cadaveric specimens. Three intervals were measured at 10 mm, 20 mm, and 30 mm proximal to the level of the distal tibial articular surface along the fibula. Proper longitudinal alignment of the center-center technique was completed under fluoroscopic guidance and was marked on the medial aspect of the tibia. The 3 intervals were drilled in the appropriate technique trajectory. The suture button was subsequently passed through each drill-hole interval. A single observer used a digital caliper to measure the distance from each suture button aperture with respect to the tibialis anterior tendon, tibialis posterior tendon, and greater saphenous vein and nerve. Results: A total of 30 interval measurements (10 cadavers with 3 suture button segments each) were used for data analysis. Direct impingement on the greater saphenous vein was seen in 11 of 30 (36.6%) interval measurements. Six of the 11 (54.5%) observed saphenous structure impingement events occurred at the 10-mm drill hole. Conclusion: The results of the present study suggest that the use of the center-center technique for syndesmosis repair with suture button fixation risks preventable injury to the greater saphenous neurovasculature. Clinical Relevance: To understand the medial ankle anatomy, as it pertains to insertion of flexible syndesmotic fixation in a cadaveric model, to aid in prevention of clinical iatrogenic injury.
Associations Among Obesity, Inflammation, and Tryptophan Catabolism in Pregnancy
Authors: Groer Maureen , Fuchs Dietmar , Duffy Allyson , Louis-Jacques Adetola , D’Agata Amy , Postolache Teodor T. 
Published: April 2018

Objective: To evaluate relationships among obesity in pregnancy and plasma levels of tryptophan (TRP) and kynurenine (KYN), inflammatory markers, and depressed mood. Methods: Pregnant women ( N = 374) were enrolled, and data were collected at a mean gestation of 20 weeks in this cross-sectional study. Plasma was analyzed for TRP, KYN, neopterin, and nitrite levels. Women completed demographic and mood scales. Results: There was a statistically significant inverse correlation between body mass index (BMI) and TRP and positive correlations between BMI and KYN and the kynurenine/tryptophan (KYN/TRP) ratio. Neopterin was correlated with KYN/TRP, suggesting that the indoleamine 2,3-dioxygenase-1 (IDO-1) enzyme was activated. The correlations of neopterin and nitrite with BMI were too small to be clinically meaningful but may provide mechanistic insight. There was a correlation between depressed mood and nitrite levels. Depressed mood was also associated with lower TRP levels. When the sample was divided into pregnant women with or without obesity, TRP was significantly lower and the KYN/TRP ratio was significantly higher in the women with obesity. Conclusion: The pro-inflammatory state of obesity in pregnancy may drive activation of IDO-1, resulting in diversion of TRP away from serotonin and melatonin production and toward KYN metabolites. This alteration could contribute to depression, impaired sleep, increased production of excitotoxic neurotransmitters, and reinforcement of a pro-inflammatory state in pregnancy.
Comparison of East and West Survival Nomograms in Turkish Gastric Cancer Patients Who Underwent Radical Surgery
Authors: Akgül Ö. , Ocak S. , Gündoğdu S. B. , Yalaza M. , Güldoğan C. E. , Tez M. 
Published: April 2018

Background and Aim: The clinicopathological demonstrations of gastric cancer vary widely between Eastern and Western countries. Turkey is situated in Europe and Middle East which acts as a bridge between east and west. We aimed to validate the two popular nomograms of east and west origin by means of patients who underwent curative surgery for gastric cancer in our country. Material and Methods: Of the 202 patients diagnosed with gastric cancer between the years 2006 and 2013, 145 of these patients whose data were sufficient were included in the study. For all patients, demographic, laboratory, operative, and pathologic findings were documented. For each patient, prognostic factors were incorporated into the nomograms for estimating 5-year survival probability. Results: For a Turkish cohort, the western nomogram showed a better discriminative capacity (AUC = 0.721, 95% confidence interval 0.637–0.806) and was better calibrated (the Hosmer–Lemeshow goodness-of-fit test p = 0.323), as compared to the eastern nomogram with AUC = 0.615, 95% confidence interval 0.522–0.708, and p = 0.077, respectively. Conclusion: Western nomogram was found to be more effective than eastern nomogram in prediction of estimating 5-year survival probability in patients with resectable gastric cancer in Turkish population.