bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sharing the Gift of Life: An Intervention to Increase Organ and Tissue Donation for American Indians
Authors: Fahrenwald Nancy L. , Belitz Christine , Keckler Arliss , Sharma Manoj 
Published: January 2017

Context Growing waiting lists for organ transplantation require attention to populations with a high demand for organs but a low donation rate. American Indians experience a high demand for kidney transplantation because of an epidemic of type 2 diabetes, yet donation consent rates are low in this group. Objective To design and evaluate an educational intervention to increase the intention to serve as an organ or tissue donor among American Indians. Intervention Sharing the Gift of Life was designed for reservation-dwelling American Indians living in the Northern Plains area of the United States. The intervention addressed important cultural traditions and was derived from the Transtheoretical Model of behavior change. Design A 2-stage descriptive evaluation design was used. Setting and Participants Two evaluation groups were included. American Indian members of a project advisory council served as cultural expert evaluators (stage 1). Northern Plains reservation–dwelling American Indian adults were community member evaluators (stage 2). Measures Stage 1 used an Educational Materials Review Form. Stage 2 used an adapted community member evaluation tool. Results The cultural expert evaluation was strong. All items met the <3.0 mean acceptability criterion (range 1.93–2.89). Content validity indices met criterion of 0.80 for the overall evaluation and for all items. Cultural specific changes to the materials were suggested. After revision, community member evaluation was favorable. Mean evaluation scores met criterion and content validity indices were acceptable. Pronunciation of traditional language was corrected in the video. Sharing the Gift of Life is a promising intervention that should undergo efficacy testing.
An Analysis of Critical Care Staff's Attitudes to Donation in a Country with Presumed-Consent Legislation
Authors: Pelleriaux Béatrice , Roels Leo , Van Deynse Dominique , Smits Jacqueline , Cornu Olivier , Delloye Christian 
Published: January 2017

Context Lack of knowledge and confidence among critical care staff in identifying potential donors and communicating with donor families may explain missed organ and tissue donations. Objectives To elucidate attitudes of critical care staff toward donation and their knowledge, involvement, and self-reported skills and confidence levels with donation-related tasks. Methods Between January 2004 and May 2006, Donor Action Foundation's Hospital Attitude Survey was used to collect data from staff members in critical care units in our university hospital (study group) and 2 other Belgian university hospitals (control group). In total, 92 physicians, 433 nurses, and 26 other staff members participated. Results The 2 groups did not differ significantly with regard to donation-related attitudes. The study group had a significantly lower perception of the public's approval of organ donation than did the control group ( P <.001). Nurses reported significantly less involvement than did physicians ( P <.001) in caring for potential donors, communicating severe brain damage, explaining brain death, requesting donation, and contacting procurement staff. Probably because of previous training, physicians in the study group reported less need for additional training on donation-related issues than did control physicians. However, compared with physicians, nurses in the study group requested significantly more training on a number of donation tasks. Nurses with more than 5 years of critical care experience were consistently more confident with donation-related tasks. Conclusion Support rates for donation are high overall, and previous training is associated with improved attitudes and decreased educational needs. Educational efforts tailor-made for nurses should increase nurses' confidence levels when confronted with potential donors and their next of kin.
Teaching Organ and Tissue Donation in Medical and Nursing Education: A Needs Assessment
Authors: Anker Ashley E. , Feeley Thomas Hugh , Friedman Erica , Kruegler Joan 
Published: January 2017

Context Research on organ donation education is limited by its reliance on convenience samples (ie, small sample sizes and local schools) and its failure to assess methods of instruction on the topic. Objective To describe medical and nursing students' training in organ donation by examining curriculum content and methods of instruction by using a national sample of medical schools and a statewide sample (New York) of nursing schools. Design Self-report online survey. Participants Nursing and medical deans responsible for curriculum development and evaluation. Main Outcome Measure Participants provided information on the inclusion of specific topics in organ donation, skills related to organ donation, and the declaration of personal donation intentions within their respective educational programs. Methods of instruction on such topics (eg, standardized patients, lectures, small groups) also were assessed. Results Although many educational programs include an organ donation component, a significant proportion of schools failed to provide instruction on donation consent processes, definitions of brain and cardiac death, and the discussion of organ donation during a routine health care visit. Most schools rely on lectures as the sole method of instruction. Recommendations are made for how deficits in instruction might be addressed through future interventions and education.
Intraaneurysmal Embolization for Wide-Necked Aneurysms Remodeling Technique, Combined Neck-Clipping and Coiling Therapy, Scaffolding Technique
Authors: Nakahara T. , Hidaka T. , Kutsuna M. , Yamanaka M. , Sakoda K. 
Published: January 2017

We reported the results of the endovascular treatment using Guglielmi detachable coil (GDC) for wide-necked aneurysms. Fourteen aneurysms were treated with remodeling technique. One aneurysm was performed endovascular treatment followed by partial neck clipping. The other was treated with scaffolding technique. All aneurysms could not be performed by conventional GDC treatment initially because of coil protrusion into the parent artery due to wide neck of these aneurysms. These aneurysms sited at anterior circulation system in 10 cases, and at posterior circulation system in 6 cases. Immediately after the procedure, the obliteration rate could be obtained complete occlusion in 3 cases, > 95% occlusion in 7 cases, > 90% occlusion in 3 cases and < 90% occlusion in 3 cases. In 14 patients follow-up angiography or magnetic resonance image (MRI) was carried out. The angiographic follow-up period is range from 2 to 19 months (mean: 10 months). The results of angiographical follow-up indicated increasing obliteration rate with all aneurysms except for 2 cases. In these 2 cases, the reembolization was needed for recanalization of the aneurysm. The clinical follow-up period is range form one to 26 months (mean: 15 months). There is no evidence of aneurysmal rupture and all cases have been survival without any permanent neurological deficits. The GDC treatment with additional technique (remodeling technique, combined neck-clipping and coiling therapy, scaffolding technique) provides safety and effectiveness, even if there are wide-necked aneurysms.
Embolic Complications of Endovascular Surgery for Cerebrovascular Diseases Evaluation with Diffusion-Weighted MR Imaging
Authors: Sakai H. , Sakai N. , Nakahara I. , Shimozuru T. , Higashi T. , Takahashi J.C. , Ohta H. , Kokuzawa J. , Manaka H. , Morizane A. , Kawabata Y. , Nagata I. , Kikuchi H. 
Published: January 2017

The purpose of this study was to evaluate asymptomatic embolisms during cerebral endovascular surgery for cerebrovascular diseases with diffusion-weighted magnetic resonance imaging (DWI) which allowed sensitive and early detection of cerebral ischemic lesions. 71 patients who underwent a total of 74 cerebral endovascular procedures were subjected to DWI screening study. MR imaging was performed on a 1.5T system by using single-shot SE echo-planar imaging (EPI) with b value of 1100 seconds per mm2 in pre- and post-treatment periods (between day 2 and 5 after procedures). In 38 (51.3%) of 74 procedures, new high intensity lesions, as recent infarctions related to procedures, were detected on post-procedural DWI. In 18 Of the patients (47.4%), symptomatic infarctions occurred and resulted in TIAs (n = 4), RINDs (n = 8), minor strokes (n = 6) and no major strokes and no death. 20 (52.6%) of the recent infarctions detected by DWI were asymptomatic lesions. Most of the asymptomatic ischemic lesions were likely to be distributed in watershed border areas. On the other hand, symptomatic lesions tended to be distributed in cortical and/or perforator regions and to be multiple. Thus, DWI is a useful method that can detect neurologically silent and asymptomatic ischemic lesions. It can be used to help to evaluate the safety and efficacy of neurovascular intervention.
Follow-up of Large Aneurysms Treated with Coil Embolization at an Acute Stage in Patients with Poor-Grade Subarachnoid Hemorrhage
Authors: Hagiwara S. , Tanaka N. , Tani S. , Nakamura S. , Ohbuchi H. , Hirota K. , Iwabuchi S. , Kasuya H. 
Published: January 2017

This study evaluated the clinical and angiographic outcome of large aneurysms treated with coil embolization at an acute stage in patients with poor-grade subarachnoid hemorrhage (SAH). Between July 1, 2001 and June 30, 2004, eight consecutive WFNS grade 5 patients with large aneurysms (15!23mm) were treated with endovascular coil embolization within two days and followed for at least 30 months. There were three middle cerebral and five internal carotid artery aneurysms. No patients were treated by craniotomy and none survived without treatment. Two patients died of primary brain damage or cerebral vasospasm within one month. One patient died of pneumonia at 24 months. Four patients were alive with good recovery or moderate disability at the time of final follow-up (30!66 months). Angiography immediately after the procedure showed complete occlusion in three, neck remnant in four, and body filling in one patient. No complication was seen related to the procedure. Three aneurysms that were initially neck remnant developed body filling due to coil compaction. Two were re-treated with coils at six and 12 months and resulted in neck remnant. One patient refused re-treatment and died of re-bleeding. Endovascular coil embolization can be selected at an acute stage for the treatment of aneurysms in patients with poor-grade SAH without intraparenchymal hematoma even if the aneurysm is large. Serial follow up by MRA/angiography is necessary for at least 12 months.
Treatment of Intracranial Aneurysms Using Flow-Diverting Silk Stents (BALT): A Single Centre Experience
Authors: Leonardi M. , Cirillo L. , Toni F. , Dall'Olio M. , Princiotta C. , Stafa A. , Simonetti L. , Agati R. 
Published: January 2017

The Silk stent (Balt, Montmorency, France) is a retractable device designed to achieve curative reconstruction of the parent artery associated with an intracranial aneurysm. We present our initial experience with the Silk flow-diverting stent in the management and follow-up of 25 patients presenting with intracranial aneurysms. Twenty-five patients (age range, 34–81 years; 24 female) were treated with the Silk flow-diverting device. Aneurysms ranged in size from small (5), large (10) and giant (10) and included wide-necked aneurysms, multiple, nonsaccular, and recurrent intracranial aneurysms. Nine aneurysms were treated for headache, 14 for mass effect. None presented with haemorrhage. All patients were pretreated with dual antiplatelet medications for at least 72 hours before surgery and continued taking both agents for at least three months after treatment. A total of 25 Silk stents were used. Control MR angiography and/or CT angiography was typically performed prior to discharge and at one, three, six and 12 months post treatment. A follow-up digital subtraction angiogram was performed between six and 19 months post treatment. Complete angiographic occlusion or subtotal occlusion was achieved in 15 patients in a time frame from three days to 12 months. Three deaths and one major complication were encountered during the study period. Two patients, all with cavernous giant aneurysms, experienced transient exacerbations of preexisting cranial neuropathies and headache after the Silk treatment. Both were treated with corticosteroids, and symptoms resolved completely within a month. In our experience the Silk stent has proven to be a valuable tool in the endovascular treatment of intracranial giant partially thrombosed aneurysms and aneurysms of the internal carotid artery cavernous segment presenting with mass effect. The time of complete occlusion of the aneurysms and the risk of the bleeding is currently not predictable.
Bleeding Source Identification and Treatment in Brain Arteriovenous Malformations
Authors: Mjoli N. , Le Feuvre D. , Taylor A. 
Published: January 2017

Arteriovenous malformation (AVM) patients who initially present with intracerebral haemorrhage may have an identifiable source of bleeding on angiogram, which can be a treatment target. Previous work suggests that the re-bleed rate may be lowered if a weak area is eliminated. A retrospective cohort study was conducted on patients who presented over a six-year period with a bled AVM. Cases were reviewed looking for the source of the hemorrhage by correlating haematoma location on CT or MRI and any angio-architectural weakness seen on digital subtraction angiography (DSA). Neuroendovascular notes were reviewed to identify the treatment targets. One hundred patients presented with a brain AVM with a 1.7:1 male: female ratio, 41 patients had an initial presentation of hemorrhage. The source of hemorrhage was identified in 18 subjects with 11 intranidal false aneurysms, five flow-related aneurysms, two associated aneurysms and one venous pouch. The location of haemorrhage on the presenting scan significantly correlated with the identified bleeding source using Chi-square analysis (P-value 0.039). Partial targeted embolization was used successfully in 90% with a 9% related technical complication rate not resulting in long-term morbidity or mortality. The mean follow-up period was 34 months with an annual hemorrhage rate of 0.7%. In just under half the patients with AVM bleeding a source of haemorrhage can be identified on DSA and in most cases this will be an intranidal false aneurysm. Flow-related and associated aneurysms in patients with brain AVM can cause haemorrhage and these patients are more likely to have SAH than intracerebral haemorrhage. These weak points are a good target for partial endovascular treatment, are usually accessible and may reduce the higher haemorrhage rate expected over the next two years.
Seizures after Onyx Embolization for the Treatment of Cerebral Arteriovenous Malformation
Authors: De Los Reyes K. , Patel A. , Doshi A. , Egorova N. , Panov F. , Bederson J.B. , Frontera J.A. 
Published: January 2017

Onyx embolization of cerebral arteriovenous malformations (AVM) has become increasingly common. We explored the risk of seizures after Onyx use. A retrospective review was conducted of 20 patients with supratentorial brain arteriovenous malformation (AVM) who received Onyx embolization between 2006 and 2009. Baseline demographics, clinical history, seizure history, AVM characteristics and treatment were compared between those who developed post-onyx seizure and those who did not. MRIs were reviewed for edema following Onyx treatment. Of 20 patients who underwent Onyx embolization, the initial AVM presentation was hemorrhage in 40% (N=8). The median number of embolizations was two (range 1–4) and the median final obliteration amount was 90% (range 50–100%). A history of seizure was present in 50% (N=10) of patients pre-embolization and 12 (60%) patients received seizure medications (treatment or prophylaxis) prior to embolization. Seizur post-Onyx embolization occurred in 45% (N=9). The median time to seizur post-Onyx was seven days (range 0.3–210). Four patients (20%) with seizures post-Onyx had no seizure history. Two of these patients (10%) had no other identifiable cause for seizure other than recent Onyx embolization. Seizures in these two patients occurred within 24 hours of Onyx administration. Among patients with post-Onyx seizures, there was a trend toward larger AVM size (P=0.091) and lower percent obliteration (P=0.062). Peri-AVM edema was present in 75% of MRIs performed within one month of Onyx treatment and may represent a possible etiology for seizures. New onset seizures post-Onyx embolization are not uncommon. Further study of seizure prevention is warranted.
The Efficacy of Endovascular Treatment of Ruptured Blood Blister-Like Aneurysms Using Stent-Assisted Coil Embolization
Authors: Ihn Y.K. , Kim S.H. , Sung J.H. , Kim T-G. 
Published: January 2017

We report our experience with endovascular treatment and follow-up results of a ruptured blood blister-like aneurysm (BBA) in the supraclinoid internal carotid artery. We performed a retrospective review of ruptured blood blister-like aneurysm patients over a 30-month period. Seven patients (men/women, 2/5; mean age, 45.6 years) with ruptured BBAs were included from two different institutions. The angiographic findings, treatment strategies, and the clinical (modified Rankin Scale) and angiographic outcomes were retrospectively analyzed. All seven BBAs were located in the supraclinoid internal carotid artery. Four of them were ≥ 3 mm in largest diameter. Primary stent-assisted coiling was performed in six out of seven patients, and double stenting was done in one patient. In four patients, the coiling was augmented by overlapping stent insertion. Two patients experienced early re-hemorrhage, including one major fatal SAH. Complementary treatment was required in two patients, including coil embolization and covered-stent placement, respectively. Six of the seven BBAs showed complete or progressive occlusion at the time of late angiographic follow-up. The clinical midterm outcome was good (mRS scores, 0–1) in five patients. Stent-assisted coiling of a ruptured BBA is technically challenging but can be done with good midterm results. However, as early regrowth/re-rupture remains a problem, repeated, short-term angiographic follow-up is required so that additional treatment can be performed as needed.
Endovascular Treatment of Ruptured Dissecting Posterior Inferior Cerebellar Artery Aneurysms
Authors: Ioannidis I. , Nasis N. , Andreou A. 
Published: January 2017

Dissecting aneurysms of the posterior inferior cerebellar artery (PICA) distal to its origin from vertebral artery (VA) are very rare. Although rare, they associated with a high risk of rebleeding and they present a therapeutic challenge. This study reviewed the clinical presentations, angiographic characteristics of dissecting aneurysms of the PICA and to assess the clinical and angiographic outcomes of patients who underwent endovascular treatment. Ten patients with ten dissecting aneurysms who underwent endovascular treatment were identified in the clinical records of a single medical center from January 2000 to December 2010. The mean follow-up duration was 2.8 years. All patients presented with subarachnoid hemorrhage (SAH). They all underwent endovascular treatment, which included occlusion of the dissected segment and the parent artery after detailed angiographic evaluation of the vascular anatomy, and test occlusion of the PICA. In all patients the endovascular treatment was successfully completed without procedure related complications. Long-term follow-up studies in seven out of ten patients showed complete occlusion of the aneurysm with no new neurologic deficits. The clinical outcome was good in eight cases, whereas two patients with poor clinical condition at admission died during their initial hospital stay. Endovascular occlusion of the parent vessel and the dissected segment is relatively safe treatment option for dissecting aneurysms of the PICA distal to its origin.
Endovascular Treatment of AICA Flow Dependent Aneurysms
Authors: Mahmoud M. , El Serwi A. , Habib M. Alaa , Gamrah S. Abou 
Published: January 2017

Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare, accounting for less than 1% of all cerebral aneurysms. To our knowledge 34 flow-related cases including the present study have been reported in the literature. Three patients harbouring four flow dependent aneurysms were referred to our institution. Two patients presented with subarachnoid hemorrhage, one presented with cerebellar manifestations. They were all treated by endovascular embolization of the aneurysm as well as the parent artery using liquid embolic material. Two cases were embolized using NBCA, Onyx was used in the third case. No bleeding or rebleeding were encountered during the follow-up period which ranged from five to nine months. One patient developed facial palsy, cerebellar symptoms and sensorineural hearing loss. The remaining two cases did not develop any post treatment neurological complications. Endovascular management of flow-dependent AICA aneurysms by parent artery occlusion is feasible and efficient in terms of rebleeding prevention. Post embolization neurological complications are unpredictable. This depends upon the adequacy of collaterals from other cerebellar arteries.
Dietary Recommendations in Fracture Healing in Traditional Persian Medicine: A Historical Review of Literature
Authors: Kasnavieh Seyed Mohammad Hosseini , Sadeghi Seyed Mohammad Hasan , Khameneh Seyed Mehdi Hosseini , Khodadoost Mahmood , Bazrafshan Azam , Kamalinejad Mohammad , Jaladat Amir Mohammad , Jafari Shirin , Yasinzadeh Mohammad Reza , Gachkar Latif 
Published: January 2017

Background. Fracture repair is a complex process. An inappropriate diet is a contributing risk factor for fracture nonunion. The aim of this study was to extract dietary recommendations for fracture healing according to traditional Persian medicine (TPM) literature. Method. The contents relevant to diets in fracture healing were selected from main textbooks in TPM like Al Qanon fi Al-teb ( The Canon). Other reference textbooks in traditional medicine were also used for a comprehensive study in this respect. Finally content analysis was used for summarizing and describing the results. Findings. Food stuffs are classified in TPM according to their nutritive value, their assimilability, and the quality of achieved chyme. Some light meals like chicken soup are recommended for the early days of fracture and high-nutrient and dense foods such as goat’s or sheep’s head and nuts are advised in following days for fracture healing acceleration and callus formation. Several recommendations are also provided for pacing the healing process. Conclusion. A comparison of Avicenna and other Persian sage’s recommended regimens with the recent evidence revealed the potential positive effects of their regimen for bone healing acceleration. It can shed light on a part of history of orthopedics and add to current knowledge about bone fracture and its management.