bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in the Mechanical Properties of Calcaneal Artificial Specimens, Fresh Frozen Specimens, and Embalmed Specimens in Experimental Testing
Authors: Zech Stefan , Goesling Thomas , Hankemeier Stefan , Knobloch Karsten , Geerling Jens , Schultz-Brunn Kristof , Krettek Christian , Richter Martinus 
Published: January 2017

Background. Artificial calcanei, fresh-frozen cadaver specimens, and embalmed cadaver specimens were compared in experimental testing under biocompatible loading to clarify the biocompatibility of artificial calcaneal specimens for implant testing. Methods. Two different artificial calcaneal bone models (Sawbone™, Pacific Research Laboratories, Vashon, WA, and Synbone™, Synbone Inc., Davos, Switzerland), embalmed cadaver calcaneal specimens (bone density, 313.1 ± 40.9 g/cm 2 age, 43.8 ± 7.9 years), and fresh-frozen cadaver calcanei (bone density, 238.5 ± 30.0 g/cm 2 age, 44.4 ± 8.2 years) were used for testing. Seven specimens of each model or cadaver type were tested. A mechanical testing machine (Zwick Inc., Ulm, Germany) was used for loading and measurements. Cyclic loading (preload 20 N, load was increased every 100 cycles by 100 N from 1,000 to 2,500 N, 0.5 mm/s) and load to failure (0.5 mm/s) were performed. The loads were applied through an artificial talus in a physiological loading direction. The displacement of the posterior facet in the primary loading direction was measured. Results. The four different specimen groups showed different stability and different displacement in the primary loading direction during cyclic loading. The variation of the maximal displacement in the primary loading direction for the entire cyclic loading was higher in artificial specimens than in the cadaver specimens. Conclusions. Artificial calcanei (Sawbone™, Synbone™) showed different biomechanical characteristics than cadaver bones (embalmed and fresh-frozen) in this experimental setup with biocompatible cyclic loading. These results do not support the use of artificial calcanei for biomechanical implant testing. Fresh-frozen and embalmed specimens seem to be equally adequate for mechanical testing. The low variation of mechanical strength in the unpaired cadaver specimens suggests that the use of paired specimens is not necessary.
Assessing long-term prognosis improvement as a consequence of treatment pattern changes in MS
Authors: Capra Ruggero , Cordioli Cinzia , Rasia Sarah , Gallo Fabio , Signori Alessio , Sormani Maria Pia 
Published: January 2017

Objective: To assess whether the age at which multiple sclerosis (MS) patients reach Expanded Disability Status Scale (EDSS) milestones changed as long as new drugs for the treatment of MS became available. Methods: We evaluated the long-term impact of therapies on disability progression assessing whether there is a detectable delay in the age at which patients reached EDSS milestones in more recent years. We used data collected over more than 30 years in the Center of Brescia, Italy. We compared the age at EDSS = 6 among patients diagnosed with relapsing-remitting MS in different time periods, adjusting for age at diagnosis and median interval among EDSS visits, by a multivariate Cox model. Results: A total of 1324 MS patients were included. Patients diagnosed in more recent periods reached EDSS = 6 at an older age: the rate at which patients reached EDSS = 6 in those diagnosed in 1991–1995 was similar to those diagnosed in 1980–1990 (hazard ratio ( HR) = 1.09, p = 0.68) and to those diagnosed in 1996–2000 ( HR = 0.85, p = 0.44), it was reduced by 37% in patients diagnosed in 2001–2005 ( HR = 0.63, p = 0.05), by 46% in patients diagnosed in 2006–2010 ( HR = 0.54, p < 0.02). Conclusion: A clear modification of MS course is observed after 2000; among other causes, this can be associated to the changes in the treatment patterns experienced in those years.
Role of Digital Artery Adrenoceptors in Raynaud's Disease
Authors: Cooke John P , Creager Shelly J , Scales Kathleen M , Ren Christine , Tsapatsaris Nicholas P , Beetham William P , Creager Mark A 
Published: January 2017

Raynaud's disease is characterized by excessive cutaneous vasoconstriction in response to ambient cold. A functional disturbance in the local regulation of digital vasomotion has been proposed. The purpose of this study was to determine whether there is an alteration in the postjunctional adrenergic receptors in the digital circulation of patients with Raynaud's disease. Furthermore, we sought to determine whether this abnormality was responsible for the excessive cold-induced vasoconstriction in these patients. Finger blood flow was measured by strain-gauge venous occlusion plethysmography in 10 patients with Raynaud's disease and in 10 normal volunteers in a 22 °C room. Measurements of finger blood flow and mean systemic arterial pressure were made during intra-arterial infusions of the alpha1-adrenergic antagonist, prazosjn, or the alpha2-adrenergic antagonist, yohimbine, at room temperature and during local cooling of the hand. Basal finger blood flow in normal subjects was significantly greater than that of patients (8.6 ± 2.7 vs 1.7 ± 0.5 ml/100 ml per min; normal vs Raynaud's subjects; p < 0.05). In normal subjects, either prazosin or yohimbine induced dose-dependent increases in finger blood flow. The maximal increase in finger blood flow induced by prazosin was significantly greater than that in response to yohimbine (29.2 ± 10.1 vs 2.8 ± 2.1 ml/100 ml per min; prazosin vs yohimbine; p < 0.05). By contrast, in the Raynaud's patients, prazosin or yohimbine induced maximal increases in finger blood flow that were not significant (7.1 ± 1.8 vs 5.0 ± 2.2 ml/100 ml per min; prazosin vs yohimbine; p = NS). The response to prazosin in Raynaud's patients was significantly less than that of the normal volunteers ( p < 0.05). In normal subjects, during intra-arterial infusion of vehicle alone, cooling induced a 52.6 ± 5.8% reduction in finger blood flow. This cold-induced vasoconstriction was blunted, but not qualitatively altered, by either adrenergic antagonist. In the Raynaud's patients, during the intra-arterial infusion of the vehicle, cooling induced a 68.2 ± 7.8% reduction in finger blood flow. Infusion of either adrenergic antagonist blunted, but did not qualitatively alter, the response to cold. Finger blood flow is less in patients with Raynaud's disease than in normal subjects when studied in a 22 °C room. In normal subjects, postjunctional alpha1-adrenergic receptors appear to predominate in the control of digital vasoconstriction. Postjunctional alpha1- and alpha2- adrenoceptors play an equal role in adrenergic regulation of finger blood flow in patients with Raynaud's disease. In both normal and Raynaud's subjects, selective antagonism of alpha1- or alpha2-adrenergic receptors does not abolish local cold-induced vasoconstriction. Therefore, it is likely that a nonadrenergic mechanism contributes to local cold-induced vasoconstriction.
The Endothelin System in Cardiovascular Physiology and Pathophysiology
Authors: Parris Richard J , Webb David J 
Published: January 2017

Endothelin-1, a member of a novel family of regulatory peptides, is the most potent vasoconstrictor and pressor substance known. Endothelin-1 is a 21-amino-acid endothelium-derived peptide causing uniquely sustained vasoconstriction. In addition, endothelin-1 has pronounced effects on the coronary, renal and cerebral circulations, enhances responses to other vasoconstrictors, and is comitogenic. Recent studies have shown that the endothelins are essential for normal fetal development, and that endothelin-1 plays an important physiological role in the regulation of basal vascular tone and blood pressure in healthy humans. There is now also a wealth of evidence suggesting that endothelin-1 is a key mediator in a range of cardiovascular diseases associated with sustained vasoconstriction, such as chronic heart failure, and with vasospasm, such as subarachnoid haemorrhage. In addition, endothelin-1 appears to act in opposition to nitric oxide to promote the atherosclerotic process. There are a large number of oral and intravenously active endothelin antagonists entering clinical development and a number of clinical studies, particularly with endothelin receptor antagonists, are now under way. Such studies are beginning to define the role of the endothelins in cardiovascular disease and to confirm the potential of the endothelin system as an important new therapeutic target.
Multiple Small Bowel Ligation Compared to Conventional Primary Repair after Abdominal Gunshot Wound with Haemorrhagic Shock
Authors: Olofsson P. , Vikström T. , Nagelkerke N. , Wang J. , Abu-Zidan F. M. 
Published: January 2017

Aims: The aim of this study was to evaluate the effects of early rapid control of multiple bowel perforations on cardiovascular function in combined abdominal missile trauma and haemorrhagic shock compared with conventional surgery. Methods: Eighteen anesthetised pigs were injured with a standardised abdominal missile trauma. The animals were bled to a mean arterial pressure of 50 mm Hg for 30 minutes, after which they were resuscitated and had laparotomy. They were divided into conventional surgery group (n=9) with primary resection and anastomosis of bowel injuries and early rapid multiple bowel ligation group (n=9). Repeated measurement analysis of variance was used for analysis. Results: There was profound hypotension, reduced cardiac output, increased vascular resistance and lactic acidaemia in both groups. Lactic acidaemia persisted longer in the early rapid multiple bowel ligation group. There were no significant differences in mean arterial pressure, cardiac output, stroke volume or systemic vascular resistance between the groups. The mean operation time was significantly shorter in the early rapid multiple bowel ligation group (13.3 (1.5) (SEM) minutes, compared with 116.4 (1.74) (SEM) minutes in the conventional surgery group, p =<0.001). Conclusions: Damage control principles have shortened the operating time in our model but did not improve the cardiovascular function and caused more lactic acidaemia than conventional repair.
Combination of Paracetamol, Codeine and Lidocaine for Pain Relief during Transrectal Ultrasound Guided Biopsy of the Prostate
Authors: Visapää H. , Taari K. 
Published: January 2017

Background and Aim: Transrectal ultrasound (TRUS)-guided prostate biopsy is often a painful procedure. The aim of this study was to evaluate the effectiveness of combining oral paracetamol and codeine with periprostatic nerve block in relieving prostate biopsy-related pain. Material and Methods: In this prospective study we compared the pain associated with prostate biopsy between two groups of patients. Group 1 consists of 25 men who were given paracetamol 500 mg and codeine 30 mg orally before the biopsy, and group 2 consists of 25 men who received no oral analgesics. All patients received periprostatic nerve block with 1% lidocaine before the biopsy. The pain associated with the biopsy procedure was evaluated on a visual analogue scale. Results and Conclusions: The mean pain score ± SD in group 1 was 1.4 ± 0.80 on the scale of 0 to 10, and the mean pain score ± SD in group 2 was 2.4 ± 1.69. The difference in the pain scores between the two groups was statistically significant (p = 0.01). The combination of oral paracetamol, codeine and periprostatic nerve block before TRUS-guided prostate biopsy is an effective method for relieving biopsy-related pain.
Inadequate Preoperative Colonic Evaluation for Synchronous Colorctal Cancer
Authors: Achiam M. P. , Burgdorf S. K. , Wilhelmsen M. , Alamili M. , Rosenberg J. 
Published: January 2017

Background and Aims: Synchronous cancers (SC) are well known (2–11%) in patients with colorectal carcinoma (CRC). One study has shown that intraoperative palpation can miss up to 69% of the SC while other studies have shown altered planned surgical procedure due to preoperatively diagnosed synchronous lesions in 11–44%. The purpose of this study was to review all patients having surgery for CRC in our department since 2001, and to evaluate the extent of the perioperative colonic evaluation. Materials and Methods: The records of all patients operated for CRC between Jan. 2001 and Dec. 2007 in our department were reviewed. Only patients with CRC were included. Information regarding pre-, per- and postoperative colonic evaluation were obtained and occurrences of SC were evaluated. Results: Of the 534 patients included 124 (23%) patients had an impassable stenosis. Full preoperative colonic evaluation (FPCE) were done in 305 (26%) patients without stenosis. In 36 patients 39 SC were diagnosed. Seven SC were diagnosed postoperatively, of which five patients never had a FPCE. Three of these five patients had an inoperable SC, one patient died due to anastomosis leakage following re-operation and one patient had pulmonary embolism as a complication to re-operation. Conclusions: The results show that many patients (78%) never underwent FPCE, but also that many of these patients never had a full postoperative colonic evaluation. SC being overlooked can lead to increased morbidity and the possibility of advanced staging of the cancer which is also exemplified in this study.
Percutaneous Removal of a Tiny Needle Fracture From the Right Ventricle of the Heart in a Drug Abuser
Authors: Bompotis Georgios , Karkanis Georgios , Chatziavramidis Angelos , Konstantinidis Iordanis , Dokopoulos Petros , Pyriochos Panagiotis , Lazaridis Ioannis 
Published: January 2017

Purpose: To demonstrate the successful percutaneous removal of a tiny needle fracture from the heart with the use of a guide wire with a magnet at its distal end and two snares through both femoral veins. Case Report: We report a rare case of a tiny needle fracture in the apex of the right ventricle of the heart in a drug abuser after its migration from the neck through the lumen of the right internal jugular vein. The procedure of the percutaneous approach and removal of this tiny foreign body was extremely difficult and dangerous due to its location and tiny size. Conclusion: This percutaneous technique for the removal of a tiny foreign body from the heart was proven to be both effective and safe for the patient, and it provides a good therapeutic option for removal of intracardiac foreign bodies.
Treatment of Traumatic Carotid-Cavernous Fistula
Authors: Wu Z. , Zhang Y. , Wang C. , Yang X. , Li Y. 
Published: January 2017

From 1986 to the end of 1998, 482 cases of traumatic carotid-cavernous fistula (TCCF) were treated by means of intravascular embolisation technique. The experience is overviewed in this article. Many kinds of detachable balloon catheters (including Chinese made detachable balloon catheters), coils and cyanoacrylate were used as embolic materials. Transcervical, transfemoral, anterior communicating artery, posterior communicating artery approach, or transvenous approach were selected according to conditions. A combination of different approaches or materials was used for complex TCCF. We found that the special sign, named “bileakage sign”, indicated multileakage of TCCF and was not mentioned before. All 482 cases of TCCF were embolised successfully, of which 405 cases maintained the patency of internal carotid artery (ICA). No death related to the treatment occurred in our group and the symptoms or signs in 462 cases were relieved after embolisation. Emergency embolisation was needed in some conditions such as serious epistaxis, delayed or repeatedly subdural haematoma and rapid visual impairment. Endovascular treatment of TCCF is a safe and efficient method. The time of operation, approach, and materials for embolisation must be carefully selected in order to obtain the best result.
GDC Embolisation of Cavernous Internal Carotid Artery Aneurysms with Parent Artery Preservation
Authors: Kim S.J. , Choi I.S. 
Published: January 2017

We evaluated the clinical and angiographic results of endosaccular treatment with Guglielmi detachable coils (GDCs) in 19 cases of cavernous internal carotid artery (ICA) aneurysms. The size of the aneurysms ranged from 10 to 30 mm (mean 18.4 mm) and neck size ranged from 2 to 15 mm (mean 6.7 mm). Intraluminal thrombosis was found in ten cases. Main presenting symptoms were related to mass effect in 17 cases including cranial nerve palsy, headache and vomiting. On initial GDC embolisation, total occlusion was obtained in two cases, subtotal in eight, and incomplete in nine. In two cases with incomplete occlusion, parent arteries were occluded with balloons or GDCs during or just after the procedure because of underlying diseases. A higher rate of initial occlusion was obtained in smaller and non-thrombosed aneurysms. Symptoms resolved or improved in all cases except one after initial treatment. No complication occurred related to the procedure. Follow-up angiography was obtained in 15 cases among which ten cases (66.7%) showed luminal recanalisation. Symptoms recurred in one case with luminal recanalisation. Incidence of recanalisation was similar in both large and giant aneurysms but higher in the thrombosed than non-thrombosed group. Retreatment was done in five cases with success. In conclusion, although embolisation of cavernous ICA aneurysms with GDCs was safe and effective in relieving symptoms, the incidences of initial incomplete occlusion and follow-up recanalisation were high. Therefore, we think judicious selection of the cases is necessary for endosaccular GDC embolisation in cavernous ICA aneurysms.
Arteriovenous Malformation Model in Swine: A Natural History Study
Authors: Klisch J. , Yin L. , Requejo F. , Schumacher M. 
Published: January 2017

The well-known porcine arteriovenous malformation (AVM) model introduced by Massoud et al has been widely used as an acute-phase model. However, there are no data available on the patency rate in long-term follow-up. Therefore this study is dedicated to the natural history of porcine AVM model after creation. Three piglets (Yucatan micropigs, aged 12 to 14 months) were used in this study. The model was created by microsurgical anastomosis in an end-to-end fashion between the common carotid artery (CCA) and external jugular vein (EJV) on the left side, and by direct ligation of the left external carotid artery (ECA). Angiography was performed before and immediately after model creation, as well as at 44, 103, 188 and 245 days in all animals. A successful high-flow brain AVM model was established in all animals. The fistula created by end-to-end anastomosis remained intact and thus the successful AVM model maintained in all models over a follow-up period as long as more than eight months. The AVM-model in swine could be used as a chronic model to test the neurointerventional techniques of AVM treatment. We re-created the well known AVM-model by a terminal anastomosis between CCA and EJV and we hypothesize that the good long-term patency of the model is related to the type of anastomosis performed between CCA and EJV.
Reconsidering the economic impact of the EU manufacturing and export provisions
Authors: Sussell Jesse A , Tebeka Mahlet G , Jena Anupam B , Vanderpuye-Orgle Jacqueline 
Published: January 2017

Background The European Commission is considering two provisions which would permit limited generic drug production in the EU prior to supplemental protection certificate expiration. A recent study by Vicente and Simões addressed the potential economic consequences of these provisions and concluded that the provisions could result in 178, 698 million (M) new units produced, 8,890 new direct jobs, 26,670–35,560 new indirect jobs, and 37 new medium-sized pharmaceutical enterprises over the period 2014–2022. This paper assesses the accuracy of these findings through a critical review of the Vicente and Simões analysis. Methods We replicated the Vicente and Simões model and applied a series of adjustments including (1) correction of an arithmetic error, (2) introduction of a counterfactual analysis, (3) substitution of evidence-based parameters and (4) accounting for statistical uncertainty. Like Vicente and Simões, we model effects on four key outcomes: units produced, medium-sized pharmaceutical enterprises launched, and direct and indirect jobs created. Given data limitations, we were unable to replicate the Vicente and Simões export provision model. Results Our adjustments yield estimates of the economic effects that are substantially smaller than those reported by Vicente and Simões. Our revisions suggest the provisions would lead to 124,992 M new manufactured units (a 30% reduction relative to Vicente and Simões), 1,898 new direct jobs (78% reduction), 6,642 new indirect jobs (75–81% reduction), and 14 new medium-sized pharmaceutical enterprises (62% reduction). When parameter uncertainty is considered, the estimate of the number of direct and indirect jobs created is not statistically distinguishable from zero. Conclusion The Vicente and Simões analysis contains several limitations, most notably a substantial arithmetic error. While difficult to assess, the study implicitly assumes that increased demand leads to job gains in the generic sector, but that reduced demand does not lead job losses in the branded sector. Addressing these limitations substantially reduces the estimated economic effects of the proposed EU provisions.
Public perceptions of the use of gloves by healthcare workers and comparison with perceptions of student nurses
Authors: Wilson Jennie , Bak Aggie , Whitfield Andrea , Dunnett Andrew , Loveday Heather 
Published: January 2017

Introduction: There is evidence that non-sterile clinical gloves (NSCG) are over-used by healthcare workers (HCWs) and are associated with cross-contamination. This study aimed to determine attitudes of student nurses and members of the public to the use of NSCG. Methods: Third-year student nurses completed a questionnaire indicating tasks for which they would wear NSCG and influences on their decision. Correlations between tasks were identified using exploratory factor analysis. An online survey of the public was conducted using snowball sampling method. Results: Sixty-seven students completed the questionnaire; they indicated use of NSCG for low-risk tasks and reported their own judgement as the main influence on their decision to wear them. Correlated tasks included ‘perceived to be risky’ or ‘definitive indication for gloves/no gloves’ and ‘related to personal hygiene’. A total of 142 respondents completed the public survey. They reported being uncomfortable with HCW wearing gloves for some personal tasks, e.g. assisting to toilet and dressing, but 94% preferred their use for washing ‘private parts’; 29% had observed inappropriate glove use by HCWs during recent contact with healthcare. Conclusion: Student nurses reported using NSCG routinely for tasks for which they are neither required nor recommended. The public observe inappropriate glove use and are uncomfortable with their use for some personal tasks.