bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications in the Treatment of Intracranial Aneurysms with Silk Stents: An Analysis of 30 Consecutive Patients
Authors: Cirillo L. , Leonardi M. , Dall'Olio M. , Princiotta C. , Stafa A. , Simonetti L. , Toni F. , Agati R. 
Published: January 2017

Flow-diverting stents (Silk and PED) have radically changed the approach to intracranial aneurysm treatment from the use of endosaccular materials to use of an extraaneurysmal endoluminal device. However, much debate surrounds the most appropriate indications for the use of FD stents and the problems raised by several possible complications. We analysed our technical difficulties and the early (less than ten days after treatment) and late complications encountered in 30 aneurysms treated comprising 13 giant lesions, 12 large, five with maximum diameters <10 mm and one blister-like aneurysm. In our experience the primary indications for the use of FD stents can be the symptomatic intracavernous giant aneurysms. Although the extracavernous carotid siphon aneurysms have major risk of bleeding, FD stents are indicated clearly explaining the risks to the patient in case of severe mass effect. There is a very complex assessment for aneurysms of the vertebrobasilar circulation.
Intracranial Stenting for Severe Symptomatic Stenosis: Self-Expandable versus Balloon-Expandable Stents
Authors: Park Soonchan , Kim Jae-Hyuk , Kwak Jae Kyun , Baek Hye Jin , Kim Bo Hyun , Lee Dong-Geun , Lee Deok Hee , Kim Jong Sung , Suh Dae Chul 
Published: January 2017

Intracranial atherosclerosis against optimal medical treatment requires reperfusion therapy to improve the clinical outcome. We compared outcomes between self-expandable stent (SES) and/ or balloon-expandable stent (BES) and present the potential advantages of using each stent. During the same time frame before and after Wingspan introduction to our institute, 115 consecutive patients underwent intracranial stenting for symptomatic severe intracranial stenosis against optimal medical treatment using BES alone (n = 71) vs. BES or SES (n = 44). We analyzed 15 factors including outcome related to an adverse event (AE), modified Rankin Scale (mRS) and restenosis at six months and retrospectively compared the potential advantages of using each stent. BES or SES groups had a significantly lower AE rate (2.3%) than the BES only group (14%) (P = 0.049) revealing mRS of ≤ 2 in all patients at six months compared to 93% of the patients in the BES group. Analysis of BES or SES subgroups revealed that BES was associated with less residual stenosis after stenting than SES (18 vs. 32%; P < 0.001). Both SES and BES can improve the clinical outcome of intracranial stenting especially with a selective choice of SES or BES. Further study is needed to analyse the difference in long-term outcome and the restenosis rate between SES and BES.
Feasibility of the Superselective Test with Propofol for Determining Eloquent Brain Regions in the Endovascular Treatment of Arteriovenous Malformations
Authors: González José A Jordán , Guerra Juan Carlos Llibre , López José A. Prince , Luna Frank Vázquez , Ramos Raúl Marino Rodríguez , Suárez José Carlos Ugarte 
Published: January 2017

The superselective test for determining eloquent brain areas, carried out prior to the embolization treatment for arteriovenous malformations (AVMs), is a tool contributing to increase the safety of endovascular procedures. Taking into account amobarbital unavailability, it was decided to carry out the present study to demonstrate the efficacy and safety of propofol as an alternative to amobarbital to perform this test. A group of 58 patients were treated in 91 embolization sessions for brain AVMs using endovascular surgery between February 2006 and February 2011. The superselective test was performed prior to embolization with Histoacryl, using the intra-arterial administration of 20 mg propofol through a microcatheter positioned near the AVM nidus. Ten (7.8%) of the 128 superselective tests were positive. Neurological deficits appeared immediately after propofol administration, lasted for one minute and disappeared after five minutes. Only one of the patients showing a negative test result developed neurological deficits after embolization, for 99.2% negative predictive vale. Despite their positive test results, six patients were embolized and five developed post-embolization neurological deficits, for 83.3% positive predictive value. The test showed 83.3% sensitivity and 99.2% specificity. The use of propofol to perform the superselective test during brain AVM embolization is a safe and effective alternative to amobarbital, and may predict the occurrence of post-embolization ischemic complications.
Brain Reorganization after Endovascular Treatment in a Patient with a Large Arteriovenous Malformation: The Role of Diagnostic and Functional Neuroimaging Techniques
Authors: La Piana Roberta , Bourassa-Blanchette Samuel , Klein Denise , Mok Kelvin , Nino Maria Del Pilar Cortes , Tampieri Donatella 
Published: January 2017

We describe a case of brain cortical reorganization after embolization of a large right temporal arteriovenous malformation. A comprehensive imaging protocol, including functional magnetic resonance imaging (fMRI), cortical thickness analysis and 320-row computed tomography (CT) perfusion was used to provide information on brain plasticity and potential steal phenomenon. A 25-year-old man known for a right temporal grade V Spetzler-Martin classification arteriovenous malformation (AVM) presented with left progressive hemiparesis. He underwent functional 3T magnetic resonance imaging (fMRI), cortical thickness analysis, and CT perfusion (CT 320 row, Aquilion ONE, Toshiba, Tokyo, Japan) before and after endovascular treatment. The results were compared to look for modifications in brain perfusion and organization. An improvement in the left hemiparesis and a reorganization of motor function were observed after endovascular treatment. Modifications in the angioarchitecture and perfusion of an extensive AVM may be accompanied by a functional and structural reorganization of the brain. The location in the so-called eloquent regions may not be sufficient to explain the wide spectrum of symptoms that these patients can present. A more comprehensive approach considering a global involvement of the brain in patients with large AVMs is suggested to achieve the best treatment strategy and to stage treatment in incurable AVMs.
CT-Guided Core Needle Biopsy of Deep Suprahyoid Head and Neck Lesions in Untreated Patients
Authors: Wu En-Haw , Chen Yao-Liang , Toh Cheng-Hong , Ko Sheung-Fat , Lin Yu-Chun , Ng Shu-Hang 
Published: January 2017

This study aimed to evaluate the efficacy of CT-guided core needle biopsy (CNB) in the diagnosis of deep head and neck tumors in untreated patients. We retrospectively reviewed the records of ten consecutive CT-guided CNB procedures from ten patients without a related history from March 2004 to February 2012. The surgical results, treatment response and clinical follow-up were used as the diagnostic standards. All specimens were considered adequate. Nine out of ten cases matched the final diagnosis. Biopsy failed to diagnose the infratemporal meningioma en plaque in a particular case. Three cases were carcinomas. No complication was encountered. CT-guided core needle biopsy is an efficient and safe technique for histological diagnosis of skull base lesions in patients without a related history. This technique can offer a definite tissue diagnosis and avoid unnecessary surgical interventions for such patients.
Endovascular Treatment of Vertebral Artery Injury during Cervical Posterior Fusion (C1 Lateral Mass Screw)
Authors: Yoon Kyeong-Wook , Ko Jung-Ho , Cho Chun-Sung , Lee Sang-Koo , Kim Young-Joon , Kim Young Jin 
Published: January 2017

We describe two cases of vertebral artery injury during posterior cervical fusion. We treated both cases by an endovascular technique. The vertebral artery injury may result in catastrophic situations, such as, infarction, massive blood loss and even death. Our clinical outcome was good and we prove that endovascular treatment is an effective and less invasive way to treat vertebral artery injury.
Dural venous sinus stenting for medically and surgically refractory idiopathic intracranial hypertension
Authors: Satti Sudhakar R , Leishangthem Lakshmi , Spiotta Alejandro , Chaudry M Imran 
Published: January 2017

Background Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial hypertension without radiographic evidence of a mass lesion in the brain. Dural venous sinus stenosis has been increasingly recognized as a treatable cause, and dural venous sinus stenting (DVSS) is increasingly performed. Methods A 5 year single-center retrospective analysis of consecutive patients undergoing DVSS for medically refractory IIH. Results There were 43 patients with a mean imaging follow-up of 6.5 months and a mean clinical follow-up period of 13.5 months. DVSS was performed as the first procedure for medically refractory IIH in 81.4% of patients, whereas 18.6% of patients included had previously had a surgical procedure (ventriculoperitoneal (VP) shunt or optic nerve sheath fenestration (ONSF)). Headache was present in all patients and after DVSS improved or remained stable in 69.2% and 30.8%, respectively. Visual acuity changes and visual field changes were present in 88.4% and 37.2% of patients, respectively. Visual field improved or remained unchanged in 92%, but worsened in 8% after stenting. There was a stent patency rate of 81.8%, with an 18.2% re-stenosis rate. Of the 43 procedures performed, there was a 100% technical success rate with zero major or minor complications. Conclusion Based on this single-center retrospective analysis, DVSS can be performed with high technical success and low complication rates. A majority of patients presented primarily with headache, and these patients had excellent symptom relief with DVSS alone. Patients presenting with visual symptoms had lower success rates, and this population, if stented, should be carefully followed for progression of symptoms.
Pitfalls of GDC Embolisation of Intracranial Aneurysms
Authors: Mena F. , Viñuela F. , Duckwiler G. , Gobin Y.P. , Murayama Y. , Guglielmi G. 
Published: January 2017

We present a critical analysis of the cerebral aneurysm GDC embolisation technique and its numerous possible pitfalls with the experience of 448 aneurysms in 401 patients performed during a seven year period at UCLA's Division of Interventional Neuroradiology. A “pitfall” is defined as any hidden or not easily recognized danger or difficulty. We review pitfalls related to micro-catheterization, GDC coil delivery, complex vascular anatomy, post-embolisation management, and pre-existing patient's clinical condition. The possible associated technical and clinical complications include aneurysm rupture, parent artery occlusion, thrombo-embolic stroke, coil stretching/rupture, coil migration, incomplete embolisation or embolisation failure. Lastly we present a discussion of our experience and suggestions of how to avoid some of these pitfalls.
Pressure Measurements across Vascular Stenoses
Authors: Imbesi S.G. , Kerber C.W. 
Published: January 2017

We describe and analyze pressure measurements across vascular stenoses in an atherosclerotic human carotid bulb replica using catheters of different diameters. Replicas of an atherosclerotic human carotid bulb were created using the lost wax technique, and were placed in a circuit of pulsating non-newtonian fluid. Flows were adjusted to replicate human physiologic flow profiles. Common carotid artery total flow volume of 600 milli-liters/minute was studied. A pressure recording device was calibrated; data were received from catheters placed longitudinally in the common carotid artery and internal carotid artery. The internal carotid artery pressures were obtained both through the stenosis as is usually performed in the angiography suite and through the vessel side-wall beyond the stenosis as a control. Internal carotid artery flow volumes were also measured with and without the catheter through the stenosis. Multiple pressure recordings and volume measurements were obtained in the replica using 7 French, 5 French, and 2.5 French catheters. Measurements of the replica showed a 58% diameter stenosis and an 89% area stenosis of the carotid bulb. All longitudinal pressure measurements in the common carotid artery agreed with control values regardless of the diameter of the catheter used. Pressure measurements were also in agreement with control values in the internal carotid artery using the 2.5 French catheter. However, when larger diameter catheters were employed, pressures measured with the catheter through the stenosis fell when compared to control values. Additionally, internal carotid artery flow volumes were also decreased when the larger diameter catheters were placed across the stenosis. Large diameter catheters when placed across vascular stenoses may cause an occlusive or near-occlusive state and artifactually increase the measured transstenotic vascular pressure gradient as well as decrease forward vascular flow.
A combined bile and urine proteomic test for cholangiocarcinoma diagnosis in patients with biliary strictures of unknown origin
Authors: Voigtländer Torsten , Metzger Jochen , Schönemeier Bastian , Jäger Mark , Mischak Harald , Manns Michael P , Lankisch Tim O 
Published: January 2017

BackgroundDetection of cholangiocarcinoma (CC) remains a diagnostic challenge particularly in patients with primary sclerosing cholangitis (PSC). We recently established diagnostic peptide marker models in bile and urine to detect CC. Our aim was to combine both models to reach a higher diagnostic accuracy of CC diagnosis.MethodsBile (BPA) and urine (UPA) proteome analysis by capillary electrophoresis mass spectrometry was performed in a case‐control phase II study on 87 patients (36 CC including 13 with CC on top of PSC, 33 PSC and 18 other benign disorders). A logistic regression model with both analyses was developed and subsequently validated in a prospective cohort of 45 patients.ResultsIn the retrospective study, single BPA and UPA showed sensitivities of 83 and 89 % and specificities of 80 and 86 % with an area under the curve (AUC) value of 0.85 and 0.93. If CC was defined as positive UPA and BPA the combination resulted in a sensitivity of 72 % and a specificity of 96 %. The logistic regression model resulted in an increase in sensitivity to 92 % at 84 % specificity with an AUC of 0.96. Applied to the prospective study cohort, the logistic regression model was superior in its sensitivity (94%) and specificity (76%) over single BPA (63% sensitivity, 69% specificity) and UPA (81% sensitivity, 72% specificity) with an AUC of 0.84.ConclusionOur logistic regression model enables CC diagnosis with a higher accuracy than currently available diagnostic tools leading potentially to an earlier diagnosis.
Effect of prophylactic clipping in colorectal endoscopic resection: A meta‐analysis of randomized controlled studies
Authors: Nishizawa Toshihiro , Suzuki Hidekazu , Goto Osamu , Ogata Haruhiko , Kanai Takanori , Yahagi Naohisa 
Published: January 2017

Background and aimThe efficacy of clipping for preventing delayed bleeding after colorectal endoscopic resection is still controversial. To assess the efficacy of prophylactic clipping, we conducted a meta‐analysis of randomized controlled trials.MethodsWe searched PubMed, the Cochrane library, and the Igaku‐chuo‐zasshi database for randomized trials eligible for inclusion in our meta‐analysis. We identified seven eligible randomized trials from the database search, and compared the effect of clipping versus non‐clipping with respect to delayed bleeding and perforation. Data from eligible studies were combined to calculate pooled odds ratios (ORs).ResultsPostoperative bleeding was observed in 41 of 1526 cases (2.7%) without clipping and in 32 of 1533 cases (2.1%) with clipping (OR 0.76, 95% CI: 0.39–1.47, p  = 0.414). There was no significant heterogeneity among the trial results (I‐Square = 26.7%, p  = 0.22). In the subgroup analysis based on small tumor size (<20 mm) and large tumor size (≥20 mm), there were no significant differences. Compared with non‐clipping, the pooled OR of developing perforation with clipping was 1.00 (95% CI: 0.14–7.25), indicating no significant difference between the two groups.ConclusionsProphylactic clipping did not decrease the occurrence of delayed bleeding after colorectal endoscopic resection. Clipping could be of interest in patients with a high risk of bleeding (anticoagulation) or large lesions, but with the available trials data to prove this are scarce.
Community-Based Exercise in the Context of HIV: Factors to Consider when Developing and Implementing Community-Based Exercise Programs for People Living with HIV
Authors: Li Anna , McCabe Taylor , Silverstein Erin , Dragan Stephanie , Salbach Nancy M. , Zobeiry Mehdi , Beldick Sarah , Godi Chris , O’Brien Kelly K. 
Published: January 2017

Objective: To identify factors to consider for developing and implementing a community-based exercise (CBE) program for people living with HIV (PLWH). Methods: We conducted a qualitative descriptive study using semi-structured interviews with PLWH, rehabilitation professionals, and recreation providers from Canada and the United Kingdom. We asked participants to describe their experience with exercise, facilitators, and barriers to accessing and participating in exercise, and factors to consider in developing a CBE program for PLWH. Interviews were analyzed using content analytical techniques. Results: We developed a Framework of CBE in the Context of HIV that describes (1) exercise experiences of PLWH (nature of exercise, motivators for initiating or sustaining exercise, perceived benefits, and barriers and facilitators to exercise) and (2) 11 factors to consider in developing and implementing a CBE program for PLWH. Conclusion: Recommendations for the development and implementation of an accessible and feasible CBE program may enhance exercise participation among PLWH.
p53-related protein kinase confers poor prognosis and represents a novel therapeutic target in multiple myeloma
Authors: Hideshima Teru , Cottini Francesca , Nozawa Yoshihisa , Seo Hyuk-Soo , Ohguchi Hiroto , Samur Mehmet K. , Cirstea Diana , Mimura Naoya , Iwasawa Yoshikazu , Richardson Paul G. , Munshi Nikhil C. , Chauhan Dharminder , Massefski Walter , Utsugi Teruhiro , Dhe-Paganon Sirano , Anderson Kenneth C. 
Published: January 2017

Key Points
TP53RK confers poor prognosis in MM patients. TP53RK knockdown or inhibition by IMiDs triggers MM cell apoptosis, validating TP53RK as a novel therapeutic target in MM.
Education, job insecurity and the within country migration of couples
Authors: Mariotti Francesco , Mumford Karen , Pena-Boquete Yolanda 
Published: January 2017

Abstract
We consider the migration movements of power couples (couples where both members have at least a college degree), half-power and no-power couples within Australia. We explicitly allow for potential association of these movements with local labour market features including perceived job insecurity. The results support an urbanisation hypothesis; partnered college graduates like to live in major cities regardless of their gender or the qualifications of their partner.

JEL Classification: J3, J7
What Changes Are Needed to Keep Vascular Surgery Alive and Vigorous?
Authors: Green Richard M. 
Published: January 2017

To keep vascular surgery alive and vigorous, we need to regain our preeminence as the principal therapists for patients with aneurysms, carotids, and occlusive disease of the lower extremities. We must regain the sense of excitement about our specialty and refocus training for residents and practicing surgeons toward those skills necessary to provide the full range of therapies at the highest level. Attaining these goals will require embracing, obtaining, and applying endovascular expertise throughout the vascular workforce. We can no longer moan and whine over encroachments into our turf by nonsurgeons. We must make our own opportunities. Changes in our attitude, our identity, and our structure will be necessary to do so. Our ability to make change will depend upon our values, defined as the judgment as to whether we remain a derivative of our general surgical roots (with continued emphasis on improved quality from traditional operations) or embrace the disruptive technology of endoluminal therapy as the next iteration of vascular surgical practice. We cannot do both because the preparation for the latter precludes the former. We are at a crossroads because if we accept endovascular technologies as critical to our future, our path is clear.
Early Spontaneous Resolution of an Iatrogenic Acute Type A Aortic Dissection
Authors: Zafar Mohammad , Pang Philip , Henry Glen , Ziganshin Bulat , Tranquilli Maryann , Elefteriades John 
Published: January 2017

AbstractAcute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month.
Tests, scans and investigations, 6: X-ray
Authors: Peate Ian 
Published: January 2017

There are a variety of imaging procedures that are carried out in order to help make a diagnosis, or to assess a patient's response to treatment, or their disease progression. One of the most common radiological procedures (imaging techniques) performed in the healthcare setting is an X-ray. These are carried out in specifically designated areas, in order to ensure safety for the public and staff. This article provides the reader with an overview of the historical background to the X-ray, an outline of the procedure and a discussion of the role and function of the healthcare assistant and the assistant practitioner (HCA and AP) in relation to this procedure.
Revisiting Multiplicity of Bubble Equilibria in a Search Model with Posted Prices
Authors: Rabinovich Stanislav 
Published: January 2017

AbstractMultiplicity of equilibria naturally obtains in search models of money with price posting: buyers’ money holdings depend on posted prices, which, in turn, depend on buyers’ money holdings. I show that this multiplicity of equilibria exists in general even when money is replaced with a dividend-bearing asset, as long as the asset is useful as a medium of exchange. If the fundamental value of the asset is sufficiently high, there is a unique equilibrium, in which the price of the asset equals its fundamental value. For lower fundamental values, there is a continuum of bubble equilibria, in which the price of the asset exceeds the fundamental value. For very low fundamental values, the equilibrium is again unique but the asset is not used as a medium of exchange. I characterize the set of symmetric and asymmetric bubble equilibria for both positive and negative fundamental values.