bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Room Arteriography: An Updated Digital Technology
Authors: Ball C. G. , Nicol A. J. , Beningfield S. J. , Navsaria P. H. 
Published: January 2017

Background: Emergency room arteriography (ERA) is a safe, accurate, simple and cost-effective method of defining arterial injuries. Limitations include the difficulty of evaluating limb vasculature distal to the suspected site of injury. Statscan is a novel, low-dose digital X-ray machine that can rapidly obtain a whole body image in a single scan. Our goal was to evaluate the role of Statscan technology in ERA. Methods: A 24 month retrospective review of all patients who underwent a Statscan assisted ERA at the Groote Schuur Hospital Trauma Unit was completed. Indications for ERA included a hemodynamically stable patient with hard signs of a vascular injury in conjunction with the clinical assessment of a threatened limb. Contraindications encompassed instability, massive bleeding or a rapidly expanding hematoma. Results: Ten patients underwent Statscan assisted ERA of their lower limbs. Eight had cold, pulseless limbs with impaired neurological examinations. Common femoral, superficial femoral and popliteal artery lacerations were displayed. Three patients had no identifiable injury and were observed. Seven patients underwent operative management for threatened limbs. Two had Statscan evidence of arterial emboli distal to the site of injury leading to further exploration and distal embolectomy. Conclusions: Statscan ERA is safe, rapid, simple and accurate. It has the advantage of providing arteriography distal to the site of injury. This directly altered patient care in 20% of cases, primarily by detecting distal arterial emboli. Thirty percent of patients with normal ERA also avoided an unnecessary operation. This study demonstrates a new role for Statscan technology.
Continuous Retention Suture for the Management of Open Abdomen: A High Rate of Delayed Fascial Closure
Authors: Gäddnäs F. , Saarnio J. , Ala-Kokko T. , Laurila J. , Koivukangas V. 
Published: January 2017

Background and Aims: Open abdomen is most often a consequence of damage control surgery, abdominal decompression or intra-abdominal infections. Ventral hernia after unsuccessful closure of open abdomen causes marked disability to the patient. Several methods for delayed fascial closure have been developed. Patients treated with continuous retention suture were evaluated to find out how often fascial closure was achieved, and what complications were related to the technique. Method: A retrospective analysis of 16 open abdomen patients treated with continuous retention suture. Results: The most common cause of open abdomen was abdominal infection. Complete fascial closure was achieved in nine of the eleven surviving patients. Closure failed in one patient. Partial closure was also achieved in one patient. The median time between leaving the abdomen open and starting the process of closure was twelve days. The longest period of open abdomen before successful fascial closure was 29 days. Five patients died before the process of closure was complete. Conclusion: Delayed fascial closure can be accomplished by using the retention suture method described here.
Vasopressin, When Added to Norepinephrine, Was Not Associated with Increased Predicted Mortality after Cardiac Surgery
Authors: Suojaranta-Ylinen R. T. , Vento A. E. , Pätilä T. , Kukkonen S. I. 
Published: January 2017

Background and Aims: Arginin vasopressin (AVP) is a potent vasoconstrictor which has been used in vasodilatory shock when therapy with catecholamines and fluids has failed. In this study we evaluated the association of AVP with organ failure and mortality in cardiac surgical patients suffering from vasodilatory shock refractory to norepinephrine (NE) treatment. Material and Methods: Cardiac surgical patients who received AVP in addition to NE (N=33, AVP-group) and 33 control patients (NE group) who were treated with an equal dose of NE compared with AVP patients when AVP infusion started. Data on preoperative risk factors according to EuroSCORE and predicted mortality calculated by logistic EuroSCORE were collected preoperatively. Data on hemodynamics, organ dysfunctions, length of intensive care unit stay and mortality were collected. Results: EuroSCORE did not differ between the groups, AVP:10,4 ± 3,9 vs NE 8,9 ± 4.0. Observed 30 day mortality was lower than predicted in both groups, AVP: 7 (21,7%) vs. predicted mortality 25.9% and NE: 2 (6.1%) vs. 16.0%, respectively. There were more renal complications (36.4% vs. 9.1%, p=0,008) and infections (30.3% vs. 3.0%, p=0.003) in patients receiving AVP. Cardiovascular complications did not differ between the groups. Conclusions: In this prospectively observed cohort of cardiac surgical patients, AVP did not increase mortality predicted by Euroscore. Anyhow renal and infection complications were common.
Oblong Cup in the Management of Aseptic Loosening of the Acetabular Component in Total Hip Replacement
Authors: Fousek J. , Vašek P. 
Published: January 2017

Background and Aims: At present, revision surgery of a total hip replacement is a major problem that must be dealt with by all orthopedic facilities. Aseptic loosening of the acetabular component is often associated with destruction of the original spherical shape of the acetabulum and the formation of bone defects. An orthopedist faces the challenge of acetabular revision and stable fixation of the new acetabular component in an effort to re-establish the functioning of the hip replacement. Material and Methods: The authors evaluated a group of 74 patients in whom they implanted an oblong revision cup due to aseptic loosening of the acetabular component from August 2000 until December 2003. The mean duration of the follow-up period was 63 months (ranging from 38 to 78 months). Results and Conclusions: The authors reported very good results from the use of this implant, where osteointegration and good functional outcome evaluated according to the Harris Hip Score (HHS) were achieved in 95% of cases. The long-term outcome should be the subject of further investigation.
Feasibility of Comparing Core Data from Existing Trauma Registries in Scandinavia. Reaching for a Scandinavian Major Trauma Outcome Study (MTOS)
Authors: Ringdal K. G. , Lossius H. M. ,   The SCANTEM ad hoc group on Scandinavian MTOS and Trauma Registry
Published: January 2017

Background: The organisation of trauma care in Scandinavia has several similarities, including trauma registries, but so far there are limited amount of research on efficiency and outcome. Data and results from trauma outcome studies like the US MTOS are not fully applicable to the Scandinavian trauma population. Aims: To reveal the feasibility of using data from existing trauma registries of major hospitals in Scandinavia, for a minimal common dataset, in a joint, prospective Scandinavian MTOS. Material and Methods: We collected data points, data point definitions, and inclusion/exclusion criteria, from the major trauma registries of the Swedish trauma registry standard, three university hospitals in Denmark, one university hospital in Finland, and the Norwegian National Trauma Registry. The collected material was compared to reveal common data points, inclusion criteria, and the compatibility of data point definitions. Results: The median number of data points was 147 (range 71–257; interquartile range = 90–205). Most registries lacked precise data definition catalogues. Only 16 data points could be considered as common, of which just a few were core trauma data. Four data points had the same data category options but were not considered having the same data point definitions. The inclusion criteria were not uniform. Conclusions: Trauma registries in Scandinavia have few common core data and data point definitions. There were data points for calculating the Trauma and Injury Severity Score (TRISS) but the inclusion criteria varied too much to ensure a valid comparison. A consensus process for a joint trauma core data set will be initiated by the Scandinavian Networking Group for Trauma and Emergency Management (SCANTEM) to increase research on trauma efficiency and outcome.
A Clinical Evaluation of Endoscopicallyplaced Self-Expanding Metallic Stents in Patients with Acute Large Bowel Obstruction
Authors: Pommergaard H.-C. , Vilmann P. , Jakobsen H. L. , Achiam M. P. 
Published: January 2017

Background and Aims: Self-expanding metallic stents (SEMS) have since 1991 established themselves as an option in the treatment of large bowel obstruction. The aim of this study was to evaluate the use of SEMS in management of acute colorectal obstructions at a Danish Surgical Gastroenterology center. Material and Methods: Retrospective review of charts from all patients who, in the period Marts 2002 to December 2007 underwent insertion of a SEMS for an acute large bowel obstruction. Results: Of 45 patients included, SEMS was intended as a bridge to surgery in 20 patients and as palliation in 25 patients. For malignant etiology, the SEMS procedure was a technical and clinical success in 97.4% of the cases. Complications occurred in 21%, mortality rate 2,6%. For benign etiology, the SEMS procedure was a technical success in 85.7%, and a clinical success in 71.4%. Complications occurred in 71.4% of the benign cases with a mortality rate of 28,6%. Conclusions: placement of SEMS for acute large bowel obstruction with malignant etiology is an effective and safe procedure with low mortality and morbidity. However results for benign obstructions are questionable and more research is needed to determine the role of SEMS.
Heading for a Fall — Moped and Scooter Accidents from 2002 to 2007
Authors: Kosola S. , Salminen P. , Laine T. 
Published: January 2017

Background and Aims: Mopeds and scooters have become increasingly popular among Finnish teenagers. The aim of this retrospective study was to assess incidence of and injury patterns associated with moped and scooter accidents in adolescents. Materials and Methods: All 222 patients treated for moped and scooter-related injuries at Helsinki Children's Hospital and Töölö Trauma Centre from January 2002 to December 2007 were included. Information was drawn from patient records and compared with nation-wide Finnish data gathered from public data-bases. Results: The annual number of patients at our centres increased from 14 to 76 and the proportion of girls increased from 7% to 25%. A similar trend was found on a national level. In our material, collisions between mopeds and other motorized vehicles accounted for 52% of accidents, and 33% of patients were injured from falling. Seventy-five percent of patients were hospitalized, and 50% needed at least one procedure requiring general anaesthesia. Five percent of the patients were under the influence of alcohol. Trauma of the head occurred in 22%; helmets did not protect against severe trauma. On a national level the proportion of 15- to 17-year-old road traffic victims has doubled in five years. Among this age group, more than half of all road-traffic accidents involve mopeds and scooters. Conclusions: Over a time span of six years, moped accidents among adolescents have become very common. Our results suggest that measures should be taken to diminish the number of moped and scooter accidents and to improve driver safety.
Helicobacter Pylori in Alcohol Induced Acute Pancreatitis
Authors: Khan J. , Pelli H. , Lappalainen-Lehto R. , Järvinen S. , Sand J. , Nordback I. 
Published: January 2017

Background and Aims: The objective of this study was to measure the association of Helicobacter pylori infection with alcoholic acute pancreatitis. Material and Methods: This study comprised of 50 patients with their first alcoholic pancreatitis and 50 alcoholic controls with no history of pancreatitis but similar alcohol use recruited from an alcohol rehabilitation center. Helicobacter infection was measured using Enzygnost EIA IgG-test. Complications and length of hospital stay were also recorded in patients with alcoholic pancreatitis. Results: The seroprevalence of Helicobacter pylori was 10/50 (20%) in the pancreatitis group and 15/50 (30%) in the control group (p = NS). The median length of hospital stay of pancreatitis patients was 7 days, 11 days for those tested positive (range 6–25) and 6 days for those tested negative (range 3–47) for Helicobacter pylori, p = 0.013. As determined with the Atlanta criteria, seropositive patients tended to have more often severe pancreatitis, 4/10 (40%) vs. 6/40 (15%), OR 3.78 (95% CI 0.815–17.52), p = 0.097. Conclusions: This study suggests that Helicobacter pylori infection is not associated clinically significantly with the development of alcoholic pancreatitis. However, Helicobacter pylori infection may be associated with longer hospital stay due to more severe disease, which needs to be studied in a larger series of patients.
Long-Term Results after Anterior Sphincteroplasty for Anal Incontinence
Authors: Mevik K. , Norderval S. , Kileng H. , Johansen M. , Vonen B. 
Published: January 2017

Objective: To assess the long term incontinence and quality of life (Qol) results after elective anterior sphincteroplasty for anal incontinence. Materials and Methods: Short and long term follow-up included respectively 28 and 25 of the 29 patients who were operated between 1989 and 1998 in our institution. Qol was assessed with gastro intestinal quality of life index (GIQLI). Incontinence was graded according to Parks score supplied with St Mark's score at long term follow-up. Results: 21 (73%) patients had a history of obstetric sphincter tears. Mean age at operation was 45 years (range 6–77). Median time from operation to short term follow-up was 26 months (mean 38 months, range 2–113) and 84 months (mean 105, range 74–185) to long term follow-up. At short term follow-up 19 of 28 patients (68%) were continent for stool compared with nine of 25 patients (36%) at long term follow-up. Nine of 17 (53%) who were continent for stool at short term follow-up remained continent for stool at long term follow-up. Patients with a history of obstetric sphincter tear had less severe incontinence at long term follow-up compared to women with other causes of incontinence (St. Mark's score 8 and 16 respectively, p = 0,015). Patients with no incontinence or gas incontinence only, had higher quality of life score at both follow-ups than those who where incontinent for stool (p = 0,007 and p = 0,014 respectively). Conclusion: More than half of the patients remained continent for stool at long term follow-up. Continence for stool was associated with high Qol score.
Organ Donation and Transplantation: A Survey of Critical Care Health Professionals in Nontransplant Hospitals
Authors: Chernenko Susan Marie , Jensen Louise , Newburn-Cook Christine , Bigam David L. 
Published: January 2017

Context Exploration of the role of critical care professionals in improving organ donation within Canada has been limited to tertiary care centers while donor potential in smaller nontransplant hospitals remains unknown. Objective To gain an understanding of the knowledge, attitudes, and perceived barriers that healthcare professionals in 5 nontransplant hospitals in Alberta have toward organ donation and transplantation, and to identify factors that influenced participation in the donation process. Design A descriptive survey of critical care professionals. Setting Five nontransplant hospitals in Alberta, Canada. Results Of the 135 respondents, 98 were critical care nurses, 32 were physicians, and 5 were hospital administrators. Respondents were least knowledgeable about transplant statistics and religious beliefs regarding donation, although overall, attitudes reflected positive support for organ donation. Respondents exhibited reluctance in approaching a potential donor family, and believed inadequate resources were allocated for organ donation. Conclusions Educational programs are needed to increase knowledge of organ donation and transplantation as well as the development of an in-house coordinator program in nontransplant hospitals for critical care personnel.
Organ Scarcity and the Psychological Pre—Heart Transplant Evaluation: A Simulation Study Using Community Residents
Authors: Todaro John F. , Sears Samuel F. , Rodrigue James R. , Musto Kristin 
Published: January 2017

Context Although research examining medical outcomes in heart transplantation has progressed, there are few studies examining the impact of organ scarcity and wait list demand on the transplant candidate evaluation process. Objective To examine the influence of transplant knowledge pertaining to organ scarcity and wait list demand on simulated ratings of psychological distress provided by community residents participating in a simulated pre–heart transplant evaluation. Design A randomized, controlled design. We used a vignette simulation to experimentally manipulate the effect of transplant knowledge pertaining to organ scarcity in a group of community residents with no previous knowledge or experience with the transplant selection process. Participants One hundred forty-three community residents visiting a department of motor vehicles office in north central Florida were recruited. Community residents were randomly assigned to 1 of 2 experimental conditions, with either mention (n = 66) or no mention (n = 77) of organ scarcity and wait list demand statistics in their assigned vignette. Participants then served as actors and completed measures of psychological distress as part of a mock psychological pre–heart transplant evaluation. Results Participants with mention of organ scarcity reported significantly fewer symptoms of anxiety and depression compared to those with no mention of organ scarcity. This relationship remained significant even after controlling for relevant covariates, including age and simulated ratings of social desirability. Conclusion Transplant knowledge pertaining to organ scarcity and wait list demand may influence transplant candidates to report fewer symptoms of psychological distress. Clinical suggestions for dealing with underreporting of psychological distress are discussed.
Changes in Weight during the First Year after Kidney Transplantation
Authors: Cashion Ann K. , Sánchez Zoila V. , Cowan Patricia A. , Hathaway Donna K. , Costello Agnes Lo , Gaber A. Osama 
Published: January 2017

Context Obesity frequently occurs following kidney transplantation and is of concern because of the associated risk for cardiovascular complications. Objective To examine weight gain over the first year after kidney transplantation to determine associations with gender, ethnicity, and cardiovascular risk factors. Design A retrospective analysis was completed on patients who had received transplants between January 1998 and January 2002 and who had matching baseline and 1-year follow-up data and a functional graft. Participants The sample consisted of 171 recipients (33% women, 58% African Americans, and 39% whites) with a mean age of 44 ± 12.2 years. Main Outcome Measures Outcome measures included fasting blood sugar, triglycerides, creatinine levels, and body mass index categorized as normal, overweight, or obese. Results The total group showed a significant increase in mean weight (6.2 ± 10.7 kg) and body mass index (2.1 ±3.8). Although equivalent at baseline, by 1 year after transplantation there were significantly more obese than normal-weight recipients, regardless of gender or ethnicity, with African Americans increasing more than whites and women more than men. At baseline, those characterized as obese versus normal weight were older (47 vs 41 years; P <.05), with a higher fasting blood sugar. At 1 year, differences in age and fasting blood sugar disappeared; however, the obese group had higher triglycerides (235 vs 165, P = .01). Conclusions Weight gain after transplantation was not explained by demographic and clinical factors. We speculate additional variables such as genetic factors influence weight gain and warrant study.
Medication Adherence in Successful Kidney Transplant Recipients
Authors: Ruppar Todd M. , Russell Cynthia L. 
Published: January 2017

Objective To explore the medication-taking behavior of successful kidney transplant recipients and determine what behaviors were common among this group. Methods Open-ended interviews were conducted by telephone with 19 individuals who had successfully maintained a transplanted kidney for 25 years or more. Data were coded by using a grounded theory approach to explore patterns of phenomena, common descriptions, and relationships. Results Four themes emerged as participants described the behaviors they developed to adhere successfully to the immunosuppressive medication required for maintaining their transplanted kidneys. The themes were reminder methods, obtaining medications, maintaining routines, and problem-solving strategies. Kidney transplant recipients identified the importance of developing and maintaining medication-taking skills and routines on medication adherence. Problem-solving abilities were also valuable during times of disruption of normal routines. Conclusions Interventions focusing on medication-taking skills, habit formation, and resources for problem solving may improve immunosuppressive medication adherence and clinical outcomes in kidney transplant recipients.
Relationship of Exposure to Organ Donation Information to Attitudes, Beliefs, and Donation Decisions of Next of Kin
Authors: Rodrigue James R. , Cornell Danielle L. , Howard Richard J. 
Published: January 2017

Context Public education campaigns about organ donation are common, but their association to actual attitudes, beliefs, and decisions about organ donation among family members of donation-eligible individuals is unknown. Objective To examine the sources of organ donation information identified by donor and nondonor families who participated in a large-scale study to examine factors that influence organ donation decisions. Design Semistructured telephone survey conducted after a passive recruitment strategy. Setting and Participants Participants were 285 next of kin of donor-eligible individuals (147 donors, 138 nondonors) from one organ procurement organization. Results Most (85.6%) of next of kin were exposed to at least 1 source of donation information that was important to them, although the types of donation information they were exposed to varied widely. White and educated adults were more likely to have been exposed to more donation information than had minorities and persons with less education. Favorable attitudes and beliefs about organ donation, donor designation, and sharing donation intentions with others were all associated with more exposure to different types of donation information. Donation consent was more likely when next of kin had been exposed to more donation information in the months preceding the family member's death. Conclusions When examined in the context of other recent research, these findings argue for continued development and implementation of public education campaigns for organ donation, with an emphasis on repeated exposure over time.