bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical features of sarcomatoid renal cell carcinoma causing bilateral urinary tract obstruction
Authors: Stabellini N. , Orlandi V. , Sartori S. , Tombesi P. , Fabbian F. , Baglio V. , Galeotti R. , Catizone L. 
Published: January 2018

We report on a 52-year-old female patient hospitalized because of uremia due to bilateral urinary tract obstruction caused by bilateral sarcomatoid renal cell carcinoma (SRCC). Abdominal computed tomography with contrast showed a large mass on the left side, infiltrating the left kidney, while the right kidney was described as enlarged. The latter was investigated with sonographic angiography using contrast and selective arteriography of the renal arteries, demonstrating a pseudonodular area at the inferior pole of the right kidney. The patient underwent bilateral nephrectomy and chronic hemodialysis treatment; unfortunately, after one month she died from cachexia. To the best of our knowledge this is the first case to be reported on bilateral SRCC causing bilateral urinary tract obstruction. (Int J Artif Organs 2008; 31: 910–12)
Application of fuzzy logic to predicting erythropoietic response in hemodialysis patients
Authors: Gaweda A.E. , Jacobs A.A. , Brier M.E. 
Published: January 2018

Objective The purpose of this study was to demonstrate how fuzzy sets can be used in a pharmacodynamic model to represent the uncertainty about the classification of an end-stage renal disease patient's response to erythropoietin. Methods A pharmacodynamic model was developed to predict future hemoglobin response to administered erythropoietin for a population of 186 patients with end-stage renal failure and anemia. The prediction was performed by a weighted linear combination of past hemoglobin, transferrin saturation, and erythropoietin dose. Patients were classified based on their response to administered erythropoietin into (i) all patients into 1 group (population approach), (ii) all patients into either a poor or normal responder group (subpopulation approach - traditional classification), and (iii) all patients by partial membership into the poor and normal responder groups (subpopulation approach - fuzzy classification). One half of the data set was randomly selected to estimate the model parameters, and the second half was used to test the estimated model. This randomization was repeated 100 times for both males and females. Results Mean square error decreased significantly through the incorporation of hemoglobin response categorization from the control group (1.32 ± 0.07), to crisp coding (1.23 ± 0.07), to fuzzy coding (1.20 ± 0.07) with an overall p value < 0.001. Conclusion Uncertainty in the categorization of subjects into 2 erythropoietin response groups of poor or normal response has been shown to benefit from the use of fuzzy categories, with a significant improvement in model performance.
Application of a user-friendly comprehensive circulatory model for estimation of hemodynamic and ventricular variables
Authors: Ferrari G. , Kozarski M. , Gu Y.J. , De Lazzari C. , Di Molfetta A. , Palko K.J. , Zieliński K. , GÓRczyńska K. , Darowski M. , Rakhorst G. 
Published: January 2018

Purpose Application of a comprehensive, user-friendly, digital computer circulatory model to estimate hemodynamic and ventricular variables. Methods The closed-loop lumped parameter circulatory model represents the circulation at the level of large vessels. A variable elastance model reproduces ventricular ejection. The circulatory model has been modified embedding an algorithm able to adjust the model parameters reproducing specific circulatory conditions. The algorithm reads input variables: heart rate, aortic pressure, cardiac output, and left atrial pressure. After a preliminary estimate of circulatory parameters and ventricular elastance, it adjusts the amount of circulating blood, the value of the systemic peripheral resistance, left ventricular elastance, and ventricular rest volume. Input variables and the corresponding calculated variables are recursively compared: the procedure is stopped if the difference between input and calculated variables is within the set tolerance. At the procedure end, the model produces an estimate of ventricular volumes and Emaxl along with systemic and pulmonary pressures (output variables). The procedure has been tested using 4 sets of experimental data including left ventricular assist device assistance. Results The algorithm allows the reproduction of the circulatory conditions defined by all input variable sets, giving as well an estimate of output variables. Conclusions The algorithm permits application of the model in environments where the simplicity of use and velocity of execution are of primary importance. Due to its modular structure, the model can be modified adding new circulatory districts or changing the existing ones. The model could also be applied in educational applications.
Combined Indomethacin/Gentamicin Eyedrops to Reduce Pain after Traumatic Corneal Abrasion
Authors: Alberti M.M. , Bouat C.G. , Allaire C.M. , Trinquand C.J. 
Published: January 2018

Purpose To evaluate the analgesic action of combined indomethacin 0.1% / gentamicin eyedrops in traumatic corneal abrasion. Methods We evaluated 123 patients presenting traumatic corneal abrasion in a multicentre, randomised, double-masked study comparing two parallel treatment groups: indomethacin / gentamicin (group 1) or gentamicin alone (group 2). Study treatments were administered four times daily for 5–6 days. Pain (visual analogue scale), associated symptoms and safety were assessed. Results Starting from a comparable level, pain was reduced by 30% in group 1 and 15% in group 2, one hour after the first instillation, and by 59% and 42% respectively after the second. The global difference in pain relief from day 0 to day 4/5 was significantly better in group 1 (p = 0.015). Associated ophthalmic symptoms showed a greater decrease in group 1 after the first instillation (p = 0.007). Both treatments were well tolerated. Conclusions Combined indomethacin/gentamicin eyedrops were effective and well tolerated in reducing the pain and discomfort associated with traumatic corneal abrasion.
Tamoxifen Side Effects, Age-Related Macular Degeneration (AMD) or Cancer Associated Retinopathy (CAR)?
Authors: Sadowski B. , Kriegbaum C. , Apfelstedt-Sylla E. 
Published: January 2018

Purpose Differential diagnosis of maculopathies can be difficult but is important if patients also suffer from other diseases such as breast cancer treated with antiestrogens. The main possible diagnoses, especially in the elderly, are age-related macular degeneration, tamoxifen and cancer-associated retinopathy (CAR). Methods We describe an 84-year-old patient with breast and colon cancer, who complained of a decrease in visual acuity after treatment with low-dose antiestrogens. She underwent a general ophthalmological investigation, perimetry and electroretinographic examination with multifocal (m-ERG) and flash-electroretinogram (flash-ERG). Results Visual acuity was reduced to 1/50 and 0.3. The ophthalmological examination was normal, except for extensive bilateral maculopathy with shining crystalline deposits, central and peripheral visual field defects, slightly affected scotopic and photopic potentials in the flash-ERG, and an abnormal m-ERG. Conclusions The findings are expected with age-related macular degeneration with crystalline drusen, but also with CAR. Even if the single and total dosage of antiestrogens given to the patient is sufficient to cause tamoxifen retinopathy, this diagnosis can be excluded because, in tamoxifen retinopathy unlike in the case presented here, the deposits are not distributed in all retinal layers.
Central Retinal Artery Occlusion Associated with Severe Ovarian Hyperstimulation Syndrome
Authors: Turkistani I.M. , Ghourab S.A. , Al-Sheikh O.H. , Abu El-Asrar A.M. 
Published: January 2018

Purpose Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovulation induction. It is a potentially lethal condition, with severe complications which include ovarian enlargement, and massive fluid redistribution from the vascular system into free spaces resulting in ascites, pleural effusion, electrolyte imbalance, hemoconcentration, hypovolemia, oliguria, and adult respiratory distress syndrome. Thromboembolism is a rare but extremely serious complication. Case Report We report a case of severe OHSS, presenting with central retinal artery occlusion (CRAO). Discussion This combination has not been reported previously.
Friction in Hip Hemiendoprostheses. Review of Literature and Own Model Using Cadaveric Acetabula
Authors: Müller L.P. , Degreif J. , Hely H. , Mehler D. , Otto M. , Rommens P.M. 
Published: January 2018

The science of tribology concerning hip arthroplasty has mainly dealt with total endoprosthesis, whereas measurement values of hemiendoprosthetic implants are rare. The small amount of experimental tribologic data concerning hemiendoprosthetic implants in the form of pendulum trials, animal experiments, in vivo measurements on human hip joints and pin on disc studies will be reviewed in the following work. The reported frictional coefficients in these studies were between 0.014–0.57. In order to test the friction coefficients of different femur head hemiendoprostheses (unipolar ceramic- and metal heads) against fresh cadaveric acetabula, the HEPFlEx-hip simulator (Hemi-EndoProsthesis Flexion Extension) was developed. In the simulator, the various hemiendoprosthetic heads are placed on a special cone and tested against a cadaver acetabulum cast in MCP 47 woodmetal. The plane of movement of the apparatus is uniaxial with a flexion-extension movement of ± 35 degrees. The force is produced pneumatically with amounts of up to 5 kN. Newborn calf serum serves as a lubricant. A PC collects the data from torque-, force-, and angle-sensors on-line and allows the simultaneous processing and visualization of the data. The frictional coefficients produced by the different head materials and the relevance of the play between the hemiendoprothesis head size and acetabulum can be determined. Preliminary results showed that the mean friction coefficient at 1 kN loading was μ=0.024–0.063 for ceramic against cartilage and μ=0.033–0.075 for metal against cartilage.
The Optimal Depth for Femoral Cement Insertion in Total Hip Replacement. An Anatomical and Clinical Study into Cementing Technique in the Proximal Femur
Authors: Owers K.L. , Leaver A.A. , Bannister G.C. 
Published: January 2018

In retrograde cementing, blood often rises proximally on the surface of injected cement. This blood contamination weakens the cement-bone interface. The major source of bleeding into the proximal femoral medullary canal is the severed nutrient artery. The aims of this study were to define the clinically relevant anatomy of the nutrient artery supplying the proximal femur and establish the optimum depth of cement insertion to minimise blood contamination. Sixty cadaveric femora were radiographed with a wire placed in the nutrient foramen to assess the distance from the tip of the greater trochanter to its entry into the proximal femoral medullary canal. The nutrient artery entered the medullary canal at an average of 13.9 cm from the tip of the greater trochanter and never more proximal than 10.3cm. In 30 patients undergoing primary total hip replacement, cement was inserted retrogradely at 7.5cm, 10 cm or 15 cm from the tip of the greater trochanter and blood contamination recorded. There was blood in significantly fewer cases when cement was inserted at 10cm. Cement insertion 10cm distal to the tip of the greater trochanter appears to occlude the bleeding nutrient artery and should give a stronger proximal cement-bone interface.
Growth and Remodelling of the Dysplastic Hip after Conservative Reduction in Congenital Dislocation
Authors: Wierusz-Kozłowska M. , łempicki A. , Kruczyński J. 
Published: January 2018

This study presents the development and remodelling of 78 dysplastic hips treated conservatively The hip joints were observed from the end of conservative treatment, during growth until maturity, up to the age of 18 years and beyond. We used 9 radiological parameters of hip structure. The parameters described the status of the acetabulum, proximal end of the femur and the joint congruity. The values of these parameters were compared with the norms established for healthy hips. The material was divided into groups with regard to the parameter values. It was found that hip congruity at the age from 2 to 5 years or from 2 to 7 years is the most important factor that determines the development of both the acetabulum and the whole joint. Based on the values of three radiological parameters, describing hip congruity at this period of life, it was found that the remodelling of a dysplastic hip follows one of three definable models. If we attribute the development of a given hip to a given model, then the status of this hip at maturity is predictable. What makes the prediction of the final condition of the hip feasible is the observation of the hip remodelling process from age 2 to 5 or 7 years. This also permits a decision regarding surgery to eliminate any dysplastic elements from the hip during the child's optimal age for operative treatment.
Safety and Efficacy of Intra-Articular Injection of the Hip
Authors: Waseem M. , Sadiq S. , Gambhir A.K. , Lim J. , Maxwell S. , Bamford D.J. 
Published: January 2018

The aim of the present study was twofold: a) to establish the therapeutic efficacy of the hip injection with marcaine and steroid; (b) to establish the safety of the procedure with respect to possible bacterial contamination at the time of passage of needle into the hip joint. Thirty-five patients with osteoarthritis of the hip were injected. All patients were admitted as day cases and the procedure was performed in a laminar flow theatre under full aseptic conditions. The hip was aspirated before injection. Aspirate and injecting needles were sent for microbiological examination. Both aerobic and anaerobic cultures were performed. All patients were followed up for three months after hip injection. Microbiology results were not revealed to reviewing clinicians. All patients were reviewed at two weeks and at twelve weeks. Thirty-three patients (94.3%) had no growth in the samples. Two cases out of thirty-five hips had a positive culture but none of the patients went on to develop clinical sepsis. Patient response for pain in the hip was graded using a 10 point visual analogue scale (VAS) with 10 point as maximum pain and 0 points as no pain. Pre-injection the patient VAS for pain was a mean value of 6.4 ±0.77 (median, 6). The mean value of VAS score at 2 weeks dropped to 2.6 ±2.7 with median of 2. This difference was highly significant (p=0.003). At 12 weeks mean VAS score was 2.7 ± 2.5 with median value of 2 (p=001). Three patients were worse after the injection. We found the hip injection to be safe. The risk of bacterial contamination is low provided a strict aseptic protocol is observed. In this study, one third of the patients had excellent pain relief for 3 months after the injection but in two thirds of cases it failed to provide complete, long-term pain relief (> 3 months).
The Importance of the Thickness of the Femoral Cement Mantle
Authors: Harris W.H. 
Published: January 2018

The importance of mantle thickness in the long-term survival of cemented femoral components remains controversial. One complexity in evaluating mantle thickness alone is the dominating fact that so many other factors can influence the incidence of failure. Nonetheless, a cement grading system has been applied to the assessment of the intermediate and long-term follow-up series of the following cemented femoral stem designs HD-2 (Howmedica, Rutherford, NJ), CAD (Howmedica, Rutherford, NJ), Precoat (Zimmer, Warsaw, IN), Iowa (Zimmer, Warsaw, IN), Ti32 (Zimmer, Warsaw, IN), and DF80 (Zimmer, Warsaw, IN). In each series, a statistically significant increased risk of failure was found in those cases with cement mantles that were thin or deficient. While these data do not mean that all such cases fail, the data strongly support the concept of avoiding such deficiencies in the cement mantle of these stem designs.
Metallurgical considerations in the wear of metal-on-metal hip bearings
Authors: Nevelos J. , Shelton J.C. , Fisher J. 
Published: January 2018

Metal-on-metal bearings offer one possible solution to problems of osteolysis associated with ultra high molecular weight polyethylene (UHMWPE) wear debris generated during articulation in total joint replacements. Designs using larger bearing diameters are also possible with associated improvements in both range of motion and stability. There has been considerable debate as to the optimum metallurgical structure of the cobalt chrome alloys used in these metal-on-metal bearings. This review addresses the main metallurgical design issues in metal-on-metal bearing design and reviews some recent studies from two independent academic centres. Cobalt chrome alloys with a low carbon content, when paired against themselves, have been shown to have poor wear properties under both simple configuration and simulator testing. Other cobalt chrome alloy couples with higher carbon content, whether wrought, cast or cast and heat-treated, appear to have similar performance in clinically relevant wear simulation studies.
Medium-Term DEXA Analysis of an Uncemented Femoral Component
Authors: Ahrens P.M. , Gibbons C.E.R. , Peace K.A.L. , Healy J.C. , Scott J.E. 
Published: January 2018

We investigated the bone remodelling around the AML uncemented femoral component using DEXA analysis and plain radiography in 19 patients at a mean of 89 months from operation. All patients had previously been analysed at a mean of 32 months after surgery. We found a decrease in bone mineral density around the AML implant between the two scans in Gruen zones 1,2 and 6 of up to 8%, but an increase in zones 4,5 and 7 of up to 36%. The increase in zones 4 and 5 were statistically significant (P<0.05). The relative difference between the operated and unoperated hips also showed a reduction in the bone density ratio with time, except in zones 4 and 5 where an increase was seen. We confirm the results of previous studies of proximal stress shielding and distal loading around the AML implant and demonstrate that bone remodelling continues in the medium term.
Osteochondritis Dissecans of the Femoral Head
Authors: Siebenrock Klaus A. , Powell James N. , Ganz Reinhold 
Published: January 2018

Seven patients with symptomatic osteochondritic lesions of the femoral head are presented. All were male with a mean age of 26 years (16 – 33 years). Two distinct morphologic appearances of the hip joint could be identified. Five patients presented with a coxa valga deformity, four of whom had signs of epiphyseal dysplasia. There were 2 patients whose hips appeared normal apart from the osteochondrontic lesions. In both cases an additional acetabular rim lesion due to a reproducible femoro-acetabular impingement was diagnosed at arthrotomy. This may have acted as the underlying cause of osteochondritis dissecans in these cases. All 7 patients underwent surgical treatment. An intertrochanteric osteotomy (I.O.) alone was performed in 2 patients. Follow-up of these patients at 6.5 and 8.5 years after surgery revealed that the osteochondritic lesions had not healed and one individual remained symptomatic. In the remaining 5 patients, treatment consisted of femoral head dislocation and screw fixation of the osteochondritic lesion. This was combined with an I.O. in two of these patients for coxa valga and osteoplasty of a broad femoral neck in 2 other patients. All lesions had healed at an average follow-up of 4.3 years (2 – 8.5 years). Three patients were asymptomatic and 2 patients had minor residual pain. No progressive osteoarthritic changes or signs of avascular necrosis of the femoral head were observed.
Arteriovenous Fistulas Constructed Using Side-to-Side Anastomosis with Ligation and Division of Distal Venous Arm; A Tertiary Care Hospital Experience
Authors: Ahsan Zafar-UI , Waheed Abdul , Zaeem Faisal A. , Nazir Farzana 
Published: January 2018

Background and Objective The rising prevalence of end-stage renal disease has added to the demands of renal replacement therapy in the form of hemodialysis (Hd) in lieu of unmitigated needs of renal transplants. The best available angioaccess for HD is the autogenous arteriovenous fistula. Many techniques for arteriovenous anastomosis have been reported, but there is dearth of data which study the side-to-side arteriovenous anastomosis with concomitant ligation and division of the distal venous arm. This study aimed to describe the clinical outcome of the fistulae constructed with this particular technique. Methods It is a descriptive and retrospective review in which all patients who underwent the operation with this particular technique in a certain time period were included. The data entry and analysis was done using SPSS 15. Only descriptive statistics are used. Demographic details, primary patency, end point patency and fistula survival were calculated. Results There were 77 patients, 61 males and 16 females. Radiocephalic arteriovenous anastomosis was constructed in 65 patients, brachiocephalic in 11 patients and brachiobasilic in one patient. Primary patency was 96.1% and end point patency was 90.9% with a median survival of 44 weeks at the end point. Conclusion This particular technique of fistula construction has excellent patency rates, fistula survival and lesser complications when compared to what has been reported for other methods. It is therefore recommended that the technique of angioaccess reported in this study may be considered as a first option.
Cephalic Arch Stenosis in Autogenous Brachiocephalic Hemodialysis Fistulas: Results of Cutting Balloon Angioplasty
Authors: Heerwagen Søren T. , Lönn Lars , Schroeder Torben V. , Hansen Marc A. 
Published: January 2018

Purpose Cephalic arch stenosis is a known cause of hemodialysis access failure in patients with brachiocephalic fistulas (BCFs). Outcomes of endovascular treatment are affected by resistance of the stenosis to balloon dilation, a high vein rupture rate and the development of early restenosis. The purpose of this retrospective study was to report outcomes after cutting balloon angioplasty (CBA) of cephalic arch stenosis. Methods In our vascular access database we identified 74 dysfunctional BcFs of which 30 (41%) were caused by cephalic arch stenosis. Seventeen fistulas in 17 patients (13 males and four females; median age 62 yrs; range 52–86) were treated with CBA (June 2005 to January 2008). Twenty-five procedures were performed. In 15 procedures, a cutting balloon was used alone and in 10 procedures CBA was followed by standard or high-pressure balloon angioplasty. Restenosis rates were calculated and patency rates were estimated with the Kaplan-Meier method. Results Primary patency rates (±SEE) at 3, 6, 12 and 15 months were 94% (±6%), 81% (±10%), 38% (±14%) and 22% (±15%), respectively. Assisted primary patency rates (±SEE) at the same intervals were 100% (±0%), 94% (±6%), 77% (±12%) and 63% (±13%), respectively. The mean interval between radiological interventions was 13 months (SD=8) and the mean number of interventions required per patient-year of dialysis was 0.9. Conclusion Treatment of cephalic arch stenosis with CBA did not improve patency compared to published results of conventional PTA, but our results indicate that CBA may lower the frequency of required re-interventions.