bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herpes Zoster with Cutaneous Dissemination in a Patient 21 Years after Splenectomy for Idiopathic Thrombocytopenic Purpura
Authors: Moquete Rachel A. , Hartman Barry , Granstein Richard D. 
Published: January 2017

Background: Varicella-zoster virus is a member of the herpes virus family that causes varicella during a primary infection and herpes zoster (HZ) when reactivated. Patients who are immunocompromised often have atypical presentations of HZ and experience complications such as multidermal involvement and dissemination. Objective: We report a case of disseminated HZ in an immunocompetent patient with a history of splenectomy for idiopathic thrombocytopenic purpura (ITP). Our 46-year-old female patient presented with a painful vesiculopapular dermatomal rash with approximately 80 other lesions diffusely spread over her body. She was in good health but had a splenectomy for ITP 21 years earlier and a history of recurrent herpes labialis. The latter led to the tentative diagnosis of a widespread herpes simplex infection. However, laboratory results confirmed a diagnosis of disseminated herpes zoster. A workup of the patient's immune status did not reveal any abnormalities other than the patient's previously noted splenectomy. Conclusions: This case adds to the two reports of patients developing cutaneous disseminated HZ several years after splenectomy. Our case serves as a reminder that patients with a history of splenectomy appear to be at increased risk for cutaneous dissemination of HZ. Renseignements de base: Le virus varicelle-zona est un virus de la famille des Herpesviridae qui cause la varicelle durant une primo-infection, et l'herpès zoster (zona) (HZ) en cas de réactivation. Les patients qui sont immunocompromis ont souvent des présentations atypiques de HZ et affichent des complications telles que la participation et la dissémination multicutanées. Objectif: Nous exposons un cas de zona disséminé chez un patient immunocompétent ayant subi une splénectomie pour traiter un purpura thrombocytopénique idiopathique (PTI). Notre patiente âgée de 46 ans présentait une éruption vésiculo-papuleuse douloureuse localisée dans une zone dermatome avec environ 80 autres lésions diffuses réparties sur son corps. Elle était en bonne santé mais avait subi une splénectomie pour traiter un PTI 21 ans plus tôt et présentait des antécédents d'épisodes récurrents d'herpès labial. Ce dernier a abouti 'a un diagnostic provisoire d'une infection généralisée par le virus herpès simplex. Cependant, les résultats des analyses de laboratoire ont confirmé un diagnostic d'herpès zoster (zona) disséminé. Une investigation de l'état immunitaire de la patiente n'a pas révélé d'anomalies autres que la splénectomie que la patiente a subie antérieurement. Conclusions: Ce cas vient s'ajouter aux deux cas de patients signalés qui ont développé un HZ disséminé plusieurs années après avoir subi une splénectomie. Notre cas sert à rappeler que les patients présentant des antécédents de splénectomie semblent être exposés à un risque accru de dissémination cutanée sous forme de HZ.
Treatment with Autologous Bone Marrow Mononuclear Cells in Patients with Critical Lower Limb Ischaemia. A Pilot Study
Authors: Wester T. , Jørgensen J. J. , Stranden E. , Sandbæk G. , Tjønnfjord G. , Bay D. , Kollerøs D. , Kroese A. J. , Brinchmann J. E. 
Published: January 2017

Background and Aims: Treatment with autologous, bone marrow mononuclear stem cells has shown effects in patients with chronic limb ischaemia in one randomized clinical study. The aim of the study was to test the potential effect of stem cell treatment in a strict defined group of patients with stable critical limb ischaemia (CLI). Design: A prospective, combined-centre pilot study. Material: Eight patients with CLI of the lower extremities, and without any other treatment options. Methods: Bone marrow cells were harvested from the patient's iliac crest and, after separation, injected into the calf muscles of the affected leg. Outcome was evaluated by digital subtraction angiography (DSA), visual analogue scale (VAS) and several non-invasive circulatory physiological tests. Results: There were no complications from the procedures. Two patients were amputated two months after cell injection. Five patients reported pain relief after four months. Five patients could be evaluated at eight months. According to VAS and physiological tests, they were all either stable or showed improvement. Conclusion: This method seems to be a safe option for treating patients with CLI. Inclusion of patients took a long time, mainly because many patients with CLI are offered endovascular treatment in our institution. While symptomatic improvement was found in individual patients, larger trials are required to investigate efficacy. This will probably require multi-centre participation.
Health-Related Quality of Life in Severely and Morbidly Obese Patients Waiting for Bariatric Surgery in Finland
Authors: Victorzon M. , Tolonen P. , Sintonen H. 
Published: January 2017

Background: Important outcome measurements in bariatric surgery include the improvement or resolvement of medical comorbid conditions caused by obesity, and the possible changes in quality of life. The health-related quality of life (HRQoL) among Finnish obese subjects awaiting bariatric surgery has not previously been compared to age- and gender-standardized general population. Methods: The HRQoL in 75 obese subjects waiting for bariatric surgery was assessed by the generic 15D instrument. The resulting 15D profile and single index score were compared to those of a sample of age- and gender-standardized general population (n = 4955). Results: The patients were significantly worse off than the age- and gender-standardized general population on 11 of the 15 dimensions. The mean total 15D score among patients scheduled for bariatric surgery was 0.844 compared to 0.934 in the control group (P < 0.001). Conclusion: The Finnish patients awaiting bariatric surgery suffer from a very poor HRQoL compared with age- and gender-standardized general population.
Preliminary Study Comparing the Effects of Locally and Systemically Applied L-Carnitine on the Healing of Full-Thickness Skin Defects
Authors: Karsidag T. , Asensio J. A. , Kabukcuoglu F. , Tuzun S. 
Published: January 2017

Background and Aims: L-carnitine as an endogenous cofactor has a role in the regulation of energy flow between different oxidative sources. The purpose of this study is to investigate that the clinical and histopathologic effects of L-carnitine locally and systemically on secondary healing in wounds of full thickness defects. We also measured the effects of L-carnitine on wound tensile strength as mechanical. Material and Methods: Sixty adult male Sprague—Dawley rats were divided into three groups randomly; group 1 (control group, n = 20), group 2 (local experimental group, n = 20), group 3 (systemic experimental group, n = 20). Group 1 was not given any pharmacologic agents. L-carnitine was administered locally in the group 2, and systemically in group 3 for a total of 14 days. The healing days of all groups were recorded. On the 7th, 10th,14th and 21st postoperative days, biopsy specimens, including tissue samples both from healing wound sites and surrounding healthy skin were evaluated for neovascularization, inflammation, the amount of collagen deposit, fibroblast migration and re-epithelization. Tensile strength was measured in the samples which completed healing on the 30th day. The results were evaluated by nonparametric Kruskall-Wallis test followed by Mann Whitney-U test. Results: The mean clinical healing days were 18.25 days, 16.5 days, 15 days for the control group, local experimental and systemic group, respectively. The differences between groups were statistically significant (p < 0.005). Mean tensile strength values were 762.10 centinewton (cN), 801.69 cN and 786.13 cN for the control group, local experimental group and systemic experimental group, respectively. There were no statistically significant differences between groups (p > 0.05). There was no statistically significant difference in the histopathologic examination on the 7th, 10th, 14th and 21st days in the neovascularization, inflammation and fibroblast migration. Collagen deposit was most prevalent in the systemic experimental group and was least in the control group. Complete wound closure rate was observed on the 7th day in the systemic administration group, on the 10th day in local administration group and on the 14th day in the control group. Re-epithelization thickness in the systemic carnitine group was more than the other groups. Conclusions: L-carnitine administered locally or systemically has positive effects on wound healing rate and tensile strength in rats.
Incidence and Risk Factors of Surgical Wound Infection in Children: A Prospective Study
Authors: Varik K. , Kirsimägi Ü. , Värimäe E.-A. , Eller M. , Lõivukene R. , Kübarsepp V. 
Published: January 2017

Background and Aims: To establish the incidence and risk factors of surgical site infection (SSI) in children operated in the Department of Paediatric Surgery of the Clinic of Surgery of Tartu University Hospital. Material and Methods: The data of wound healing were obtained for 589 children operated between 15 March 2003 and 31 March 2005. The operations were divided into general surgical (451), orthopaedic (70) and urological (68). The surgical wounds were classified as clean (442), clean-contaminated (96), contaminated (36) and dirty-infected (15). Univariate and multivariate analyses were performed to identify risk factors. Results: There were 7 SSI cases, overall rate being 1.2%. Superficial wound infection occurred in 5 cases and deep wound infection occurred in 2 cases. There was no organ/space infection. SSI was significantly more frequent in the case of contaminated and dirty-infected compared with clean or clean—contaminated operations, 7.8% and 0.6%, respectively (p = 0.0008). Wound infection endangered more children who had operation related complications compared with non-complicated cases, 11.1% and 0.4%, respectively (p < 0.0001).
Elevated levels of adipokines predict outcome after acute myocardial infarction: A long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort
Authors: Ritsinger Viveca , Brismar Kerstin , Malmberg Klas , Mellbin Linda , Näsman Per , Rydén Lars , Söderberg Stefan , Tenerz Åke , Norhammar Anna 
Published: January 2017

Objective: Adiponectin and leptin are associated with insulin resistance and cardiovascular disease. Information on the prognostic value after an acute myocardial infarction is still conflicting. Methods: Patients (n = 180) without known diabetes and with admission glucose of <11 mmol/L admitted for an acute myocardial infarction in 1998–2000 were followed for mortality and cardiovascular events (first of cardiovascular mortality/acute myocardial infarction/stroke/heart failure) until the end of 2011 (median: 11.6 years). Plasma adiponectin and leptin were related to outcome in Cox proportional-hazard regression analyses. Results: Median age was 64 years and 69% were male. Total mortality was 34% (n = 61) and 44% (n = 80) experienced a cardiovascular event. Adiponectin at discharge predicted cardiovascular events (hazard ratio; 95% confidence interval; 1.45; 1.02–2.07, p = 0.038), total mortality (2.53; 1.64–3.91, p < 0.001) and cancer mortality (3.64; 1.51–8.74, p = 0.004). After adjustment for age, sex, body mass index, previous myocardial infarction and heart failure, adiponectin predicted total mortality (1.79; 1.07–3.00, p = 0.027) but not cardiovascular events. High levels of leptin were associated with cardiovascular events during the first 7 years, after which the association was attenuated. Leptin did not predict total mortality. Conclusion: In patients with acute myocardial infarction but without previously known diabetes, high levels of adiponectin at discharge predicted total mortality. The present results support the hypothesis that high rather than low levels of adiponectin predict mortality after acute myocardial infarction.
Endothelial dysfunction in normoglycaemic first-degree relatives of type 2 diabetes mellitus complicated with hyperuricaemia
Authors: Zhang Junxia , Xiang Lin , Zhang Bilin , Cheng Yangyang 
Published: January 2017

Objective: To reveal the effect of hyperuricaemia on endothelial function in normoglycaemic first-degree relatives of type 2 diabetes mellitus. Methods: In all, 40 first-degree relatives of type 2 diabetes mellitus with hyperuricaemia, 40 first-degree relatives of type 2 diabetes mellitus with normouricaemia and 35 healthy subjects without diabetic family history were recruited in this study. Anthropometric parameters as well as blood pressure, blood lipids, fasting blood glucose, fasting insulin, C-reactive protein, tumour necrosis factor-α and interleukin-6 were measured. Insulin resistance was assessed with homoeostasis model assessment index-insulin resistance index. To assess endothelial function, high-resolution ultrasonography was used for measuring flow- and nitroglycerine-mediated brachial artery vasodilation. Results: When compared with control, flow-mediated dilation was lower in first-degree relatives with or without hyperuricaemia (both p < 0.001). When compared with first-degree relative subjects with normouricaemia, there were lower flow-mediated dilation ( p < 0.001) and higher levels of uric acid ( p < 0.001), fasting blood glucose ( p < 0.001), C-reactive protein ( p = 0.001), tumour necrosis factor-α ( p < 0.001) and interleukin-6 ( p < 0.001) in first-degree relative subjects with hyperuricaemia. Flow-mediated dilation was found to be negatively related to uric acid ( r = −0.597, p < 0.001). Stepwise multiple regressions demonstrated that uric acid was a significant determinant of flow-mediated dilation independent of other variables in first-degree relatives of type 2 diabetes mellitus (β = −0.677, p < 0.001; confidence interval: −0.010 to −0.006). Conclusion: Further endothelial dysfunction is found in normoglycaemic first-degree relatives of type 2 diabetes mellitus complicated with hyperuricaemia.
Lifestyle and Health Status Differ over Time in Long-Term Heart Transplant Recipients
Authors: Flattery Maureen P. , Salyer Jeanne , Maltby Megan C. , Joyner Pamela L. , Elswick R. K. 
Published: January 2017

Objective To describe differences in lifestyle and health status across 5 posttransplant periods. Methods The sample consisted of 126 heart transplant recipients (87% men) grouped by time after transplantation: group 1, 12 to 24 months (n = 13); group 2, 25 to 48 months (n = 19); group 3, 49 to 72 months (n = 24); group 4, 72 to 96 months (n = 27); and group 5, ≥ 97 months (n = 43). Data were obtained using demographic and health status evaluation forms and the Lifestyle Profile-II, which measures physical activity, nutrition, health responsibility, interpersonal relationships, stress management, and spiritual growth. Results Most often reported lifestyle attributes were spiritual growth and interpersonal relationships. Least often reported was physical activity. Pairwise comparisons revealed that groups 3 (χ2= 16.4; SD = 4.8; P = .03) and 4 (χ2 = 16.6; SD = 5.8; P = .04) had lower physical activity than group 2 (χ2 = 21.3; SD = 5.2). Health status evaluation revealed that there were no group differences in systolic ( P = .46) or diastolic ( P = .77) blood pressure. Although creatinine was elevated, there were no group differences ( P = .86). High-density lipoprotein was higher than 42 mg/dL in all groups, but there were differences across groups in low-density lipoprotein ( P = .003). Groups 1 (χ2 = 139.2; SD = 38.5) and 2 (χ2 = 141.0; SD = 47.8) were different than group 5 (χ2 = 112.9; SD = 36.1; P = .05). There were group differences in cholesterol ( P = .002), with lower levels in groups 4 (χ2 = 190.5; SD = 38.6) and 5 (χ2 = 186.3; SD = 37.7) as compared to group 2 (χ2 = 230.8; SD = 66.5). Conclusions Identifying posttransplant periods in which healthy behaviors and health status may be vulnerable to decline is important for providing ongoing education and psychological support to transplant recipients who manage a complex regimen.
Internal Carotid Artery Pseudoaneurysm after Tonsillectomy Treated by Endovascular Approach
Authors: Raffin C.N. , Montovani J.C. , Neto J.M.P. , Campos C.M.S. , Piske R.L. 
Published: January 2017

Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm. We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions.
Stability of Microcatheter for Cerebral Aneurysm Embolization after Steam Shaping
Authors: Abe T. , Hirohata M. , Tanaka N. , Uchiyama Y. , Morimitsu H. , Fujimura N. , Takeuchi Y. , Kojima K. , Hayabuchi N. 
Published: January 2017

To compare the performance of stability after steam shaping on 4 types of microcatheters, which are commonly used for cerebral aneurysm embolization, an experimental simulation was performed. Distal portion of the microcatheters were shaped into the 90 degree with length of 5 mm with the steam under the instruction of each catheter. In the temperature kept water bath, the change of the angle of the catheter tips were recorded and measured. Several stresses were added to the tips with coaxially passing through the guiding catheter, using guidewire and Guglielmi detachable coil (GDC). The degree of straightening was prominent on braided microcatheters and on the short length of shaping. The degree of recover of the primary shaping was prominent on non-braided catheter. The most influence factor of straightening of shaped catheter tip was the stress from the manipulation of guidewire. The influence from the inserting GDC was less than the guidewire manipulation. It was shown that the decreased angle after large stress was recovered under the situation of without or with small stress. Our study shows that the non-braided microcatheter was suitable when stability of microcatheter tip after steam shaping was requested for aneurysm coiling.
Clinical Results of Percutaneous Transluminal Angioplasty and Stenting for Intracranial Vertebrobasilar Atherosclerotic Stenoses and Occlusions
Authors: Tsuura M. , Terada T. , Masuo O. , Tsumoto T. , Yamaga H. , Itakura T. , Matsumoto H. , Hyoutani G. , Hayashi S. 
Published: January 2017

Eighteen patients with intracranial vertebrobasilar stenosis and occlusion were treated by PTA or stenting. In 11 of 18 cases, only PTA was performed and in seven of 18 cases, we used stents. The mean stenosis before and after PTA/stenting was 82.8% and 22.3%, respectively. In 11 cases of PTA only, the stenotic rate decreased from 81.8% to 29.6%, while 85.0% of the stenotic rate remarkably reduced to 6.0% in seven cases of stenting. The 30 days morbidity and 30 days mortality rate were 5.5% and 5.5%, respectively. There was only one haemorrhagic complication (cerebellar haemorrhage) in cases of stenting, and no ischemic events during or after the procedures. Restenosis (more than 50% stenosis) occurred in four of 18 cases (22.2%) during mean follow-up period of 12 months. Two patients with VA occlusion before treatment, developed restenosis and reocclusion. Complete total occlusion seems to be a high-risk lesion and strict follow-up is required. In this study, PTA/stenting for intracranial vertebrobasilar artery stenosis or occlusion is an effective treatment, but strict indications may be required because procedure-related 30 days morbidity rate was 5.5% in addition to unclear natural history.
Efficacy and Limitations of the Neuroform Stent System for Intracranial Aneurysms
Authors: Handa A. , Abdo G. , Yilmaz H. , Lovblad K.O. , Lylyk P. , Rüfenacht D.A. 
Published: January 2017

We performed aneurysm embolization in seven patients using a self-expandable Neuroform stent (Boston Scientific/Target, Fremont, CA) and coils to cover the aneurysm neck and fill the aneurysm sac. Seven patients with an average age of 45 were treated in the period from October 2002 to July 2003. The aneurysm lesions involved the basilar trunk in one case, the basilar-superior cerebellar artery in one case, the internal carotid artery in four cases, and the middle cerebral artery in one case. The ruptured lesions involved the internal carotid artery in one case and the middle cerebral artery in one case. We used a Neuroform stent measuring 4.5 × 20 mm in four cases, 4.5 × 15 mm in two cases, 3.5 × 20 mm in one case, and 3.5 × 15 mm in one case. We performed aneurysm coil embolization after Neuroform stenting in all cases without development of neurological deficits caused by the interventional procedure. In performing these procedures, we investigated the efficacy and limitations of the Neuroform stent system for intracranial aneurysms. The advantages of Neuroform self-expanding stents include better flexibility and adaptability to different vessel sizes, but this stent system presents various technical difficulties during delivery.
The Dual Catheter Technique for Coiling of Wide-Necked Cerebral Aneurysms: An Under-Reported Method
Authors: Horowitz M. , Gupta R. , Jovin T. 
Published: January 2017

Aneurysms with wide necks can be difficult to manage due to inability to contain the coil mass within the lesion. When standard devices will not suffice the use of two catheters delivering coils simultaneously into the aneurysm can often provide excellent results in terms of aneurysm obliteration. We report two cases of wide-necked aneurysms coiled successfully using the dual catheter technique. Both aneurysms were successfully treated using the dual catheter technique with coil retention within the aneurysm fundus and excellent flow throngh the afferent and efferent vessels. The dual catheter technique is an under-reported method for treating wide-necked aneurysms. Successful performance, however, relies upon considerations of coil type and delivery, coil deployment, catheter removal, and anticoagulation therapy.