bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prädiktoren gesundheitsbezogener Lebensqualität bei bayerischen Einschulungskindern
Authors: Weigl Korbinian , Herr Caroline , Meyer Nicole , Otto Christiane , Stilianakis Nikolaos , Bolte Gabriele , Nennstiel-Ratzel Uta , Kolb Stefanie 
Published: April 2016

Zusammenfassung
Hintergrund: In Deutschland gibt es bisher wenige Daten zur gesundheitsbezogenen Lebensqualität von Einschulungskindern.
Ziel: Ziel dieser Studie war es daher, die gesundheitsbezogene Lebensqualität von Einschulungskindern in Bayern zu untersuchen und, unter Berücksichtigung von Umweltfaktoren, Prädiktoren dafür zu finden.
Methoden: Die analysierten Daten stammen aus dem fünften Survey (2010/2011) der in Bayern durchgeführten Gesundheits-Monitoring-Einheiten. Mittels eines Elternfragebogens wurden Informationen zur gesundheitsbezogenen Lebensqualität der Einschulungskinder (KINDL-R(evised)), zu Verhaltensauffälligkeiten und -stärken ( Strength and Difficulties Questionnaire (SDQ)), zu soziodemografischen Merkmalen sowie zu Umweltfaktoren erfasst.
Ergebnisse: Es konnten 3 744 Kinder (45,9% Mädchen; Altersdurchschnitt 6,0 Jahre; SD=0,4) in die Analyse eingeschlossen werden. Mädchen hatten signifikant höherer Werte als Jungen sowohl im Gesamt KINDL-R (83,7 vs. 82,4; p≤0,0001) als auch in allen KINDL-R Subskalen mit Ausnahme der Bereiche „psychisches Wohlbefinden“ und „körperliches Wohlbefinden“. Für letzteres fanden sich bei Jungen signifikant höhere Werte als bei Mädchen (84,1 vs. 82,9; p=0,0103). Multiple lineare Regressionsanalysen zeigten, dass von Eltern berichtete Luftverschmutzung oder Lärmbelästigung, die Möglichkeit der Kinder sicher draußen zu spielen und die Zeit, die ein Kind im Sommer unter der Woche draußen verbringt, signifikante Prädiktoren der mit dem KINDL-R gemessenen gesundheitsbezogenen Lebensqualität sind. Adipositas stand nicht im Zusammenhang mit der gesundheitsbezogenen Lebensqualität. Kinder mit Migrationshintergrund hatten signifikant höhere Werte in den Subskalen „Familie“ und „Freunde“.
Schlussfolgerung: Umweltfaktoren stehen im Zusammenhang mit der gesundheitsbezogenen Lebensqualität von Einschulungskindern in Bayern, sind jedoch nur teilweise von relevanter Bedeutung. Obwohl sich signifikante Assoziationen zeigen, ist ihre Aussagekraft aufgrund der geringen erklärten Varianz eher limitiert.
Intraoperative and Postoperative Administration of Dexmedetomidine Reduces Anesthetic and Postoperative Analgesic Requirements in Patients Undergoing Cervical Spine Surgeries
Authors: Gandhi Komal A. , Panda Nidhi B. , Vellaichamy Amutha , Mathew Preethy J. , Sahni Neeru , Batra Yatindra K. 
Published: April 2016

Background:Early recovery from anesthesia and avoidance of analgesics with respiratory depressant properties are vital for maintenance of extubated airway in cervical spine surgeries. The current study investigated the role of dexmedetomidine as an anesthetic sparing agent and as a sole postoperative analgesic in these cases.Materials and Methods:Sixty adult patients undergoing cervical spine surgeries were randomized into 2 groups. Group D received intravenous dexmedetomidine infusion 0.5 μg/kg/h throughout the surgery after a loading dose of 1 μg/kg over 10 minutes. Postoperatively, dexmedetomidine infusion was continued at 0.2 μg/kg/h for 24 hours. Group C received a volume-matched bolus and infusion of 0.9% saline. Intraoperative anesthetic requirement, time to recovery, and discharge were recorded. Patients were observed for rescue analgesic requirements for 24 hours after surgery. Hemodynamic stability, sedation scores, and pain scores were assessed for 48 hours after surgery.Results:There was significant reduction in intraoperative anesthetic requirement in group D (P<0.001). Although sedation scores and recovery criteria were comparable, pain scores were significantly lower in group D compared with group C for first 24 hours postoperatively at all corresponding times. The mean pain-free period after surgery was significantly longer in group D (1460.67±517.16 min) with significantly less rescue analgesic requirement during 24-hour postoperative period (P=0.018) compared with group C (98.17±81.20 min). Hemodynamic parameters were maintained within clinically normal range during study period.Conclusions:Dexmedetomidine lowered the anesthetic requirement with clinically permissible hemodynamic variations without undue prolongation of recovery time. Postoperative dexmedetomidine infusion provided effective analgesia without excessive sedation in patients undergoing cervical spine surgeries.
Can Patients With Low Back Pain Be Satisfied With Less Than Expected?
Authors: Silvis Wouter L. , Lakke Sandra E. , Stegeman Patrick , Speijer Bert L.G.N. , Vroomen Patrick C.A.J. , Coppes Maarten H. , Reneman Michiel F. , Soer Remko 
Published: April 2016

Study Design.
A prospective cohort study within care as usual.

Objective.
(1) To explore the psychometric properties of a baseline disability questionnaire designed to collect patients’ expectation. (2) To analyze relations between satisfaction with care and treatment success in patients with chronic low back pain (CLBP). (3) To determine the chances of being satisfied with the received care in absence of treatment success.

Summary of Background Data.
There is a lack of evidence on determinants of treatment satisfaction in patients with CLBP, specifically the role of patient's expectation of disability reduction after treatment.

Methods.
Treatment expectation was measured with questions inspired by the Pain Disability Index (PDI) at baseline. Treatment success was considered if disability at the end of therapy was lower than, or equal to pretreatment expectation. An exploratory factor analysis was performed on the new questionnaire. Binary logistic regression models were used to analyze how much variance of satisfaction with care was explained by treatment success, pain disability at baseline, sex, age, duration of complaints, and pain intensity. The odds ratio of being satisfied when treatment was successful was calculated.

Results.
Six hundred nine patients were included. The factor structure of the PDI-expectancy had optimal fit with a one factor structure. There were low correlations between the expected and baseline disability, pain intensity, and duration of pain. Correlation between treatment success and satisfaction with care was low (χ
2 = 0.13; P < 0.01). Treatment success had a low contribution to satisfaction with care. Of all participating patients, 51.4% were satisfied with care even when treatment was not successful. The odds ratio for being satisfied was 2.42 when treatment was successful compared to when treatment was not successful.

Conclusion.
The PDI-expectancy is internally consistent. Pretreatment expectation contributes uniquely but slightly to satisfaction with care; patients whose treatment was considered successful have 1.38 to 4.24 times higher chance of being satisfied at the end of treatment. Even when treatment was not successful, 51.4% of the patients with CLBP are satisfied with care.

Level of Evidence: 2
Does Tobacco Use Attenuate Benefits of Early Decompression in Patients With Cervical Myelopathy?
Authors: Kusin David J. , Li Samuel Q. , Ahn Uri M. , Ahn Nicholas U. 
Published: April 2016

Study Design.
A retrospective cohort.

Objective.
This study investigates the interplay between duration of preoperative symptoms and smoking status with respect to postoperative outcomes in patients with cervical spondylotic myelopathy (CSM).

Summary of Background Data.
Many studies have established the harms of smoking and several have identified the benefits of early decompression in patients with cervical myelopathy, but to our knowledge, none have assessed the relationship between these two variables.

Methods.
The medical records of all 212 patients operated on by the senior author between March 2005 and July 2012 were reviewed. Inclusion criteria were the diagnosis of CSM with a Nurick score, surgical intervention, and at least 2 years of follow-up. Patients were categorized according to smoking status and quantification of tobacco use by packs per day and pack-years, and duration of symptoms according to thresholds of 6, 12, or 24 months. Age, sex, preoperative Nurick score, duration of preoperative symptoms, duration of follow-up, procedure performed, prior surgery, number of levels operated on, diabetes status, ethanol use, and signal change on preoperative magnetic resonance imaging were also recorded for ordered logistical regression analysis.

Results.
One hundred twenty-five patients met all criteria. Eighty patients were smokers and 45 were nonsmokers. The median change in Nurick score for nonsmokers was 2 compared with 1 in smokers. Nonsmokers had a statistically significant likelihood of decreased change in Nurick score for symptom duration of greater than 24 months (odds ratio = 0.06, P = 0.0025). Smokers did not show a significant difference in the change in Nurick score for any threshold of symptom duration.

Conclusion.
Increased duration of symptoms significantly affects outcomes in surgical decompression of CSM. A history of cigarette use may attenuate the benefit of early decompression and results in lower improvement in Nurick score regardless of symptom duration.

Level of Evidence: 3
How to Calculate the Exact Angle for Two-level Osteotomy in Ankylosing Spondylitis?
Authors: Zheng Guoquan , Song Kai , Yao Ziming , Zhang Yonggang , Tang Xiangyu , Wang Zheng , Zhang Xuesong , Mao Keya , Cui Geng , Wang Yan 
Published: April 2016

Study Design.
A prospective case series study.

Objective.
To describe and assess a two-level osteotomy method for the management of severe thoracolumbar kyphosis (TLK) in patients with ankylosing spondylitis (AS).

Summary of Background Data.
To achieve better postoperative outcomes in these patients, a sophisticated preoperative surgical plan is required. Most deformities are managed using a one-level osteotomy and a two-level osteotomy is seldomly reported. Till date, no study has described a two-level osteotomy for these cases.

Methods.
From January 2011 to December 2012, 10 consecutive patients with ankylosing spondylitis who underwent two-level spinal osteotomy were studied. Pre- and postoperative full-length free-standing radiographs, including the whole spine and pelvis, were available for all patients. Pre- and postoperative radiological parameters, including T5-S1 Cobb angles, TLK, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, and sagittal vertical axis were measured. Health related quality of life , including Oswestry Disability Index and Scoliosis Research Society-22 surveys were administered before surgery and at 1-year follow up.

Results.
The preoperative and postoperative T5-S1 Cobb angles was 51.3° and −7.1°, respectively (P < 0.001). All patients demonstrated changes in postoperative radiographic parameters including decreased pelvic tilt (from 37.1° to 14.3°, P < 0.001), TLK (from 36.9° to 12.6°, P < 0.001), and sagittal vertical axis (from 21.4 cm to 7.1 cm, P < 0.001), increased lumbar lordosis (from -5.1° to −47.1°, P < 0.001), sacral slope (from 13.4° to 37.7°, P < 0.001), but no significant change in pelvic incidence. Health related quality of life scores at 1-year follow up were significantly improved compared to those before surgery.

Conclusion.
This calculation of two-level osteotomy provides an accurate and reproducible method for ankylosing spondylitis correction. By which, we can obtain satisfactory radiological parameters and clinical outcomes.

Level of Evidence: 4
Self-assembling Peptide Reduces Glial Scarring, Attenuates Posttraumatic Inflammation, and Promotes Neurite Outgrowth of Spinal Motor Neurons
Authors: Ando Kei , Imagama Shiro , Ito Zenya , Kobayashi Kazuyoshi , Hida Tetsuro , Nakashima Hiroaki , Ito Kenyu , Tsushima Mikito , Ishikawa Yoshimoto , Matsumoto Akiyuki , Nishida Koji , Nishida Yoshihiro , Ishiguro Naoki 
Published: April 2016

Study Design.
Self-assembling peptide gel (SPG-178) provides new evidence for the role of a scaffold for treatment of the spinal cord through induction of neuroprotective factors.

Objective.
To verify the reproducibility of SPG-178 as scaffold after spinal cord injury, we examine the characteristics of SPG-178 and protective effect on neural cells in vitro and in vivo.

Summary of Background Data.
The central nervous system extracellular matrix may play a role in maintenance of the neuronal network by inhibiting axonal growth and suppressing formation of additional inadequate synapses. In this study, we show increased expression of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-4 (NT-4), and tropomyosin receptor kinase (TrkA and TrkB) in SPG-178-promoted neurite outgrowth of motor neurons in vitro, and decreased inflammation and glial scar with use of SPG-178 in vivo.

Methods.
We examined the effect of a self-assembling peptide, SPG-178, as a scaffold for neurite outgrowth of spinal motor neurons in vitro. An in vivo analysis was performed to evaluate if the SPG-178 scaffold attenuated or enhanced expression of various genes after spinal cord injury model rats.

Results.
Expression of NGF, BDNF, NT-4, TrkA, and TrkB increased in SPG-178-promoted neurite outgrowth of motor neurons in vitro. In vivo, SPG-178 increased expression of glial cell line-derived neurotrophic factor and NGF, and decreased glial scar.

Conclusion.
This study provides new evidence for the role of SPG-178 as a scaffold in the spinal cord and suggests that this peptide is a neuroprotective factor that may serve as an alternative treatment for neuronal injuries.

Level of Evidence: 5
Interleukin-9 Promotes TNF-α and PGE2 Release in Human Degenerated Intervertebral Disc Tissues
Authors: Zhang Yuanqiang , Zhao Yunpeng , Li Jingkun , Wang Shuaishuai , Liu Yi , Nie Lin , Cheng Lei 
Published: April 2016

Study Design.
Based on human disc surgical samples and isolated cells in vitro, we undertook a descriptive and mechanistic investigation of proinflammatory effects of interleukin (IL)-9 in intervertebral disc (IVD) degeneration.

Objective.
To investigate the proinflammatory role of IL-9 in the pathological process of IVD degeneration.

Summary of Background Data.
IL-9 is known as a pleiotropic cytokine that regulates the human pathogenesis of inflammatory and autoimmune diseases. However, whether IL-9 cytokine is involved in the immuno-inflammatory pathogenesis of IVD degeneration is unclear.

Methods.
The IVD samples were obtained from 45 patients. Immunohistochemistry, western blot, and real-time Polymerase Chain Reaction (PCR) were performed to detect the expression of IL-9 and tumor necrosis factor alpha (TNF-α) in the degenerated IVDs. Moreover, nucleus pulposus (NP) cells were treated with 0, 1, 10, and 100 ng/mL IL-9 cytokine and stimulated with IL-9 alone at 100 ng/mL for 0, 12, 24, and 48 hours. TNF-α expression was determined by immunofluorescence staining, western blot, and real-time PCR, respectively. The amounts of TNF-α and prostaglandin E2 (PGE2) in the supernatant were quantified by enzyme-linked immunosorbent assay. Additionally, Spearman correlation analyses were performed to analyze the correlation between Pfirrmann grading score of the involved degenerated IVDs and serum levels of IL-9.

Results.
The expressions of IL-9 and TNF-α in degenerated IVD tissues were dramatically elevated in comparison with the control. IL-9 significantly up-regulated the TNF-α and PGE2 secretion of NP cells in dose- and time-dependent manner. Moreover, there is a positive correlation between IL-9 serum level and severity of involved IVD degeneration.

Conclusion.
Our findings suggest that IL-9 may play a potential role in the inflammatory processes of IVD degeneration. IL-9 may be involved in the IVD degeneration, at least in part, though stimulating the release of TNF-α and PGE2 in NP cells.

Level of Evidence: N/A
Patient Priority Weighting of the Roland Morris Disability Questionnaire Does Not Change Results of the Lumbar Epidural Steroid Injections for Spinal Stenosis Trial
Authors: Makris Una E. , Edwards Todd C. , Lavallee Danielle C. , Bauer Zoya , Comstock Bryan A. , Jarvik Jeffrey G. , Patrick Donald L. , Lotfi Mahshid , Friedly Janna L. 
Published: April 2016

Study Design.
Secondary analysis of lumbar epidural steroid injections for spinal stenosis randomized controlled trial data.

Objective.
To reevaluate whether outcomes for older adults receiving epidural steroid injections with or without corticosteroid improve after using patient-prioritized Roland-Morris Disability Questionnaire (RDQ) items.

Summary of Background Data.
Epidural corticosteroid injections are commonly used to treat lumbar spinal stenosis symptoms, despite limited evidence for their effectiveness in clinical trials. It is unclear whether evaluating patient-prioritized outcomes would alter results of a large clinical trial.

Methods.
Outcomes from the trial of lumbar epidural corticosteroid injections for spinal stenosis (LESS) trial were reanalyzed using RDQ, Sickness Impact Profile (SIP) weights assigned to the RDQ items, and patient-prioritized RDQ items. Differences between corticosteroid + lidocaine versus lidocaine-alone groups and 95% confidence intervals (CI) were calculated using analysis of covariance with adjustment for baseline values of the RDQ and recruitment site.

Results.
At 6 weeks, both the corticosteroid + lidocaine group and the lidocaine-alone group had improvement in the RDQ scores (RDQ, RDQ using SIP weights, patient-prioritized RDQ) as compared with baseline scores (corticosteroid + lidocaine: −4.2 points, −4.1 points, −4.2; lidocaine-alone: −3.1 points, −2.9 points, and −3.1 points, respectively). However, there was no significant between-group difference in the RDQ or patient-prioritized RDQ (average treatment effect −1.0 points, 95% CI −2.1 to 0.1, P = 0.07; −1.0 points, 95% CI −2.0 to 0.1, P = 0.08, respectively). Although the between-group difference of RDQ using SIP weights was statistically significant (average treatment effect −1.1, 95% CI −2.2 to −0.1, P = 0.04), this was not clinically important.

Conclusion.
Results of the LESS trial did not substantively differ based on reanalysis of data using RDQ with SIP weights or patient-prioritized RDQ outcomes. This provides additional evidence that epidural injection of corticosteroid + lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone for older adults with lumbar spinal stenosis.

Level of Evidence: 2
Extracorporeal Free Flap Perfusion in Case of Prolonged Ischemia Time
Authors: Taeger C. D. , Präbst K. , Beier J. P. , Meyer A. , Horch R. E. 
Published: April 2016

Summary:
In free flap surgery, a clinically established concept still has to be found for the reduction of ischemia-related cell damage in the case of prolonged ischemia. Although promising results using extracorporeal free flap perfusion in the laboratory have been published in the past, until now this concept has not yet paved its way into clinical routine. This might be due to the complexity of perfusion systems and a lack of standardized tools. Here, we want to present the results of the first extracorporeal free flap perfusion in a clinical setting using a simple approach without the application of a complex perfusion machinery.
SPECT-CT-Guided Thoracoscopic Biopsy of Sentinel Lymph Nodes in the Internal Mammary Chain in Patients with Breast Cancer: A Pilot Study
Authors: Piato José; Roberto Morales , Filassi José; Roberto , Vega Alberto Jorge Monteiro Dela , Coura-Filho George Barberio , Aguiar Fernando Nalesso , Porciuncula Ligia Maria Teixeira Pereira , Dória Maíra Teixeira , Soares José Maria , Baracat Edmund Chada 
Published: April 2016

Objective The objective of this study was to determine the impact of the use of single-photon emission computed tomography fused with computed tomography (SPECT-CT) on thoracoscopic biopsy of sentinel lymph nodes (SLNs) in the internal mammary chain in patients with breast cancer by evaluating resultant changes in staging and their clinical implications. Methods Between September 2010 and January 2014, we performed lymphoscintigraphy-assisted thoracoscopic biopsy of the internal mammary chain SLN in 20 patients with breast cancer. Single-photon emission computed tomography fused with computed tomography was also used in 13 of these patients. The sentinel nodes were surgically identified with the aid of a gamma probe. Results Sentinel lymph nodes were identified surgically in 19 of 20 patients. In the 13 patients in whom SPECT-CT was used, it readily identified SLNs, especially when they were located over an intercostal space. Change of staging occurred in three patients (15%), two of whom accordingly received adjuvant radiotherapy to the internal thoracic chain. Conclusions Compared with lymphoscintigraphy alone, the use of SPECT-CT improves localization of the SLN in the internal mammary chain, allowing more accurate planning of each individual's treatment.
Effect of Oral Insulin on the Severity and Recovery of Methotrexate‐Induced Gastrointestinal Mucositis in the Rat
Authors: Kuiken Nicoline S.S. , Rings Edmond H.H.M. , Havinga Rick , van der Aa Stijn A.J. , Groen Albert K. , Tissing Wim J.E. 
Published: April 2016

ABSTRACTObjectives:Gastrointestinal (GI) mucositis is an adverse‐effect of chemo‐ and radiotherapy. Oral insulin has been suggested as possible intestinal growth factor and possible intervention for GI mucositis. We aimed to determine the effect of oral insulin on the severity and recovery of mucositis in a methotrexate (MTX)‐induced GI mucositis rat model.Methods:Male Wistar rats (n = 24) received a single injection of 60 mg/kg MTX intravenously at day 0. From day −3 oral insulin was added to the drinking water. Group MTX received normal drinking water, group MTX+INS0.5 received 0.5 U/mL insulin, and group MTX+INS1 received 1 U/mL insulin in drinking water. The severity of mucositis was determined by intake, bodyweight, illness, and plasma citrulline. In the recovery phase, the function of the gut was tested with an oral glucose tolerance test, and villus and crypt length of the small intestine were measured.Results:MTX‐induced mucositis in all 3 groups and oral insulin did not cause a change in the severity of mucositis, with comparable bodyweight, food intake, and water intake. Oral insulin did not alter the enterocyte mass, determined with plasma citrulline. The glucose level after bolus was higher in the MTX group than the MTX+INS1 group (P < 0.05). Histology was not significant different between all groups.Conclusions:Oral insulin does not alter the severity or the acceleration of recovery of mucositis. Therefore, we conclude that it is not useful to further study oral insulin as possible intervention to prevent or treat chemotherapy‐induced GI mucositis.