bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inefficiencies in Computed Tomography Sinus Imaging for Management of Sinonasal Disease: Results of a Tertiary Care Center
Authors: Sharma Giriraj K. , Foulad Allen , Shamouelian David , Bhandarkar Naveen D. 
Published: January 2017

ObjectiveA subset of patients with sinonasal disease who obtain a diagnostic computed tomography (CT) sinus scan may require repeat preoperative CT due to the inadequacy of diagnostic CT for image‐guided sinus surgery (IGSS). This leads to increased CT utilization, health care costs, and patient exposure to ionizing radiation. The objective of this study is to determine the frequencies of diagnostic CT sinus studies that were inadequate for IGSS and repeat CT studies for purposes of IGSS.Study DesignA retrospective chart study was performed between May 2012 and August 2013.SettingTertiary care rhinology practice.Subjects and MethodsNew patients with any sinonasal diagnosis who presented with CT sinus scans acquired from outside institutions were included. CT scans were considered inadequate for IGSS for any of the following reasons: >1.5‐mm slice thickness, oblique axial planes due to gantry tilt, and incompletely defined or missing IGSS anatomic landmarks.ResultsOf 183 patients, 85 (46%) presented with diagnostic CT sinus scans that were inadequate for IGSS. Seventy‐one patients met indications for IGSS, of which 37 (52%) required repeat CT due to an IGSS‐inadequate diagnostic scan.ConclusionThe frequency of repeat preoperative CT sinus imaging may be high at tertiary care centers where IGSS is performed. A standardized IGSS‐adequate CT sinus protocol may avoid the need for repeat preoperative scans. Potential advantages include improved efficiency, decreased health care costs, and reduced ionizing radiation exposure to the patient.
Therapeutic Management of Pyriform Sinus Cancer: Results of a Single‐Center Study of 122 Patients
Authors: Donnadieu Jérôme , Klopp‐Dutote Nathalie , Biet‐Hornstein Aurélie , Strunski Vladimir , Mortuaire Geoffrey , Page Cyril 
Published: January 2017

ObjectiveTo analyze the survival rate of a nonselected pyriform sinus cancer population.Study DesignCase series with chart review.SettingUniversity hospital.Subjects and MethodsA total of 122 patients were included in this study covering the 2002‐2008 period. All patients had squamous cell carcinoma originating from the pyriform sinus. Survival and prognostic factors were analyzed.ResultsThe 3‐ and 5‐year overall survival rates were 39.7% and 2.4%, respectively. The 3‐ and 5‐year survival rates without recurrence were 34% and 27%, respectively. The median survival rates by UICC stage were as follows: stage 1 and 2 patients, 60 months; stage 3, 40 months; stage 4, 19 months. Stage 4 patients had a lower median survival rate than other stages (P =. 039). The 5‐year survival rate was 46% for patients having T3‐T4 operable cancers treated by surgery vs 45% for patients treated by laryngeal conservation protocol (not significant). The 5‐year survival rate for patients having nonoperable T4 cancers was 17.2%. The 3‐ and 5‐year overall survival rates of N0 patients was significantly higher than N1 patients (P =. 042). N2 and N3 patients had 100% 5‐year mortality.ConclusionThis study showed that overall survival and therapeutic management depend on the initial stage of pyriform sinus cancer, notably on the N status. In particular, nonoperable T4 pyriform sinus cancer and N2 and N3 patients had a very poor prognosis. A laryngeal conservation protocol seemed as effective as surgical management in terms of survival.
Long-term consequences of atrial fibrillation after aortic valve replacement
Authors: Kohno Hiroki , Ueda Hideki , Matsuura Kaoru , Tamura Yusaku , Watanabe Michiko , Matsumiya Goro 
Published: January 2017

Background Atrial fibrillation is a common complication after cardiac surgery, but the risk factors and long-term outcome after primary isolated aortic valve replacement remains to be clarified. Methods A single-center retrospective study was conducted on 157 patients who underwent first-time isolated aortic valve replacement between April 1999 and February 2015. Fifty-eight patients developed new-onset atrial fibrillation within 6 months postoperatively, and they were compared with patients who remained in sinus rhythm. Multivariate analyses, which incorporated the propensity score patient matching technique, were conducted to evaluate the long-term outcome of new-onset postoperative atrial fibrillation and identify patients at risk of developing this arrhythmia. Results At a mean follow-up of 52.4 months (range 8.4–200.7 months), mortality was significantly higher in patients who developed atrial fibrillation compared to those who remained in sinus rhythm (2.8%/patient-year vs. 0.2%/patient-year, respectively; p < 0.05). Patients developing atrial fibrillation were also at an independently increased risk of stroke and readmission during follow-up. Risk analysis revealed that advanced age (>70 years) and absence of a postoperative β-blocker were predictors of atrial fibrillation. Conclusions New-onset atrial fibrillation after first-time isolated aortic valve replacement correlated significantly with late morbidity and mortality. Advanced age and absence of a postoperative β-blocker may increase the incidence of atrial fibrillation.
Clinical implications of the anatomical variation of deep venous thrombosis
Authors: El-Menyar Ayman , Asim Mohammad , Jabbour Gaby , Al-Thani Hassan 
Published: January 2017

Introduction Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT. Methods A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations. Results A total of 637 patients with DVT were included with a mean age of 50 ± 17 years (51%; females). The most frequently thrombosed segments were popliteal, posterior tibial and profunda femoris veins. DVT was more common at the left side, with a left-to-right ratio of 1.5:1. Bilateral DVT cases (38.5%) had more prior history of DVT as compared to left- (20.3%) and right-sided DVTs (22.6%); p = 0.01. Bilateral DVT was complicated more with post-thrombotic syndrome (leg ulcer) ( p = 0.02). The rates of pulmonary embolism (25%) and mortality (23.1%) were significantly higher for bilateral DVT in comparison to left- and right-sided DVT. Abnormal coagulation profile was significantly associated with posterior tibial DVT (81% vs. 71.4%; p = 0.01) as compared to patients with normal coagulation profile. Conclusion Lower limb DVTs are more common at the left side; however, patients with bilateral DVT have higher frequency of recurrence, post-thrombotic syndrome, pulmonary embolism and mortality. The anatomic segments of DVT show specific distribution depending on the predisposing factors. These findings could improve our understanding of the pathophysiology and management of DVT patients.
Comparison of Strain-Gauge and Photocell Venous Function Testing with Invasive Pressure Measurements. A Prospective Study in Deep Venous Insufficiency
Authors: van den Broek Theodore A.A. , Rauwerda John A. , Kuijper Caroline F. , Bakker Fred C. , van Rij Gerhard L. 
Published: January 2017

Of noninvasive venous function tests two are well known: photoplethysmography (PPG) and strain-gauge plethysmography (SGP). Their effectiveness in assessment of insufficiency in candidates for venous reconstructive surgery however, is debated. The two methods were studied in these patients, and compared to invasive measurements. Nineteen limbs of patients with deep venous disease, and seven limbs of healthly volunteers were evaluated. Measurements were taken in standing, as well as in the more patient-compliant sitting position. Venous reflux time (RT) proved to be significantly different in patients vs. controls. Differences between expelled volume of controls and patients were only significant for invasive measurements in any position ( p < 0.01), but not with one of the noninvasive methods. RT invasively and non-invasively measured were well correlated in both positions with PPG ( R = 0.83 – 0.86), and with SGP ( R = 0.85 — 0.92). The percentage residual pressure however, showed in both methods a poor correlation of < 0.50. The studied noninvasive techniques offer no alternative to invasive measurements in the evaluation of patients with deep venous disease, considered for venous reconstructive surgery.
Injection Sclerotherapy for Varicose Veins — A Comparison of Materials for Applying Local Compression
Authors: Stanley Paul R. W. , Bickerton David R. , Campbell William B. 
Published: January 2017

One-hundred-and-two patients undergoing sclerotherapy for varicose veins were randomized for the use of adhesive Molefoam (Scholl®) or traditional Sorbo pads (STD®) under the compression bandage. A total of 413 injections were performed. Molefoam was found to offer practical advantages over Sorbo pads and was associated with a lower incidence of minor skin irritation, which was seen only in patients sensitive to Elastoplast®. The use of Molefoam provides a helpful modification in compression sclerotherapy for lower limb varicose veins.
A Methodological Study of Venous Valvular Insufficiency and Musculovenous Pump Function of the Lower Leg
Authors: Rosfors S. 
Published: January 2017

Objective: To assess venous valvular function of the lower limb using Duplex scanning and descending phlebography, and compare the results obtained with clinical examination and other methods of monitoring venous function of the lower limb, including venous photoplethysmography, strain-gauge phlethysmography, foot volumetry and intramuscular pressure readings. Design: Non-randomised, retrospective study of patients referred for investigation of venous disease. Patients investigated included a group of 20 who had previously undergone fasciotomy of the lower limb, and a group of healthy controls. Setting: Patients referred to St Goran's Hospital, Stockholm, Sweden. Intervention: Venous photoplethysmography, foot volumetry, strain-gauge plethysmography, photoplethysmography, Dopplex/Duplex ultrasound, phlebography, intravenous pressure and intramuscular pressure readings in various sub-groups. Main outcome measures: Determination of sites of venous reflux in the lower limb using Duplex/Doppler and phlebography, and correlation of the results obtained with other methods of investigation of lower limb venous function. Results: Poor correlation was found between descending phlebography and Duplex scanning, although good correlation was found between the number of segments with reflux and clinical condition. PPG recovery time was very variable, depending on transducer position, numbers of dorsiflexions performed, and reflux in superficial veins.
Light Microscopy, Immunohistochemistry and Electron Microscopy of the Valves of the Lower Limb Veins and Jugular Veins
Authors: Butterworth D. M. , Rose S. S. , Clark P. , Rowland P. , Knight S. , Haboubi N. Y. 
Published: January 2017

Objectives: To demonstrate the light, electron microscopy and immunohistochemistry appearances of the valves of lower limb veins and jugular veins of subject with evidence of venous disease. Design: A prospective study of saphenous veins obtained at post mortem examination and jugular vein obtained at time of surgery. Setting: Health Service district general hospital. Patients: Patients with no evidence of venous disease being treated in the hospital for unrelated conditions, or examined at autopsy in the Department of Pathology. Interventions: Sections of saphenous vein from the lower limb and jugular vein were examined using conventional histology, immunohistochemical staining and electron microscopy. Main outcome measures: Microscopic and electron microscopic appearances of histological sections of venous valves. Results: The valve agger contains an increased amount of fibrous tissue compared with the vein wall and saphenous and jugular veins. However, in saphenous veins the muscle layer of the wall could be traced across the base of the agger, but this was deficient in jugular valves. Electron microscopic examination showed that most of the valve cusp was composed of collagen fibrils, aggregated in irregularly arranged bundles. Elastic fibre material was present in the subendothelial zones. Nerve and muscle fibres were not present in the cusp. Conclusions: Valve cusps in both high and low pressure systems are similar, and the authors suggest that cusp/agger/vein wall complex is important for valve function.
Prevention of Post-Thrombotic Syndrome with Hidrosmina: A Prospective Pilot Study
Authors: Monreal M. , Callejas J. M. , Martorell A. , Sahuquillo J. C. , Contel E. 
Published: January 2017

Objective: In a previous study we demonstrated the beneficial effect of some venoactive drugs when administered to patients with established post-thrombotic syndrome (PTS). The aim of the present study was to assess prospectively the efficacy of one of such drugs in preventing the development of PTS signs. Design: Prospective, randomized, open study. Patients: 100 consecutive patients with a first episode of deep vein thrombosis (DVT), whose diagnosis had been verified with either venography or real-time ultrasonography, were entered in the study. Interventions: In addition to anticoagulant therapy, and immediately prior to discharge, patients were randomly allocated to receive Hidrosmina (Venosmil, FAES, Spain) 600 mg daily or no additional treatment. Each patient was followed-up in our outpatient clinic at 4-monthly intervals for a 3-year period. At each visit, patients were carefully examined for the presence of oedema, pigmentation, induration and ulceration. A simple scoring system, as reported by the SVS and the ISCS, was used to assess the severity of symptoms and signs. Results: After excluding 17 patients with recurrent DVT, there remained 83 patients, 10 of whom had bilateral DVT. No signs of PTS were found during the 3-year period in 65 out of 93 limbs (70%). Class 1 signs were found in 21 out of 93 limbs (23%), class 2 in 6 out of 93 limbs (6%) and class 3 signs in one limb. PTS was more commonly found in patients in whom DVT had involved the popliteal vein (20/50 vs. 8/43; p < 0.05). Furthermore, PTS developed in 7 out of 46 limbs (15%) in patients taking Hidrosmina vs. 21 out of 47 limbs (45%) in patients not taking the drug ( p < 0.005). Conclusions: In this pilot study our findings demonstrate that long-term therapy with Hidrosmina may be useful in preventing the development of PTS signs.
Clinical characteristics and cytokine changes in children with pneumonia requiring mechanical ventilation
Authors: Nguyen Thi Dieu Thuy , Pham Nhat An , Craig Timothy J , Duong-Quy Sy 
Published: January 2017

Objective To assess clinical characteristics and cytokine levels in children with severe pneumonia who required ventilatory support. Methods In this prospective, descriptive, cross-sectional study, blood and endotracheal fluid samples were obtained from patients with severe pneumonia, aged <5 years, within 24 h following intubation. Blood samples were also obtained from age-matched healthy controls. Cytokine levels were investigated using flow cytometry-assisted immunoassay. Results Forty-five patients with severe pneumonia requiring mechanical ventilation (aged 10 ± 5 months) and 35 healthy age-matched controls were included. Patients with severe pneumonia had significantly increased serum interleukin (IL)-6, IL-8, and granulocyte/macrophage colony-stimulating factor concentrations compared with controls (80.84 pg/ml versus 2.06 pg/ml, 90.03 pg/ml versus 6.62 pg/ml, and 115.58 pg/ml versus 11.47 pg/ml, respectively). In the severe pneumonia group, serum IL-10 levels were significantly higher in patients aged <6 months versus those aged 6–12 months. Age-group differences in serum cytokine levels did not correspond to age-group differences in endotracheal-fluid cytokine levels. Serum IL-6 levels were significantly higher in patients who subsequently died versus those who survived (267.12 pg/ml versus 20.75 pg/ml, respectively). Conclusion High IL-6 concentrations were associated with mortality in patients <5 years of age with severe pneumonia requiring mechanical ventilation.
Reliability of home-based, motor function measure in hereditary neuromuscular diseases
Authors: Ruiz-Cortes Xiomara , Ortiz–Corredor Fernando , Mendoza-Pulido Camilo 
Published: January 2017

Objective To evaluate the reliability of the motor function measure (MFM) scale in the assessment of disease severity and progression when administered at home and clinic and assess its correlation with the Paediatric Outcomes Data Collection Instrument (PODCI). Methods In this prospective study, two assessors rated children with hereditary neuromuscular diseases (HNMDs) using the MFM at the clinic and then 2 weeks later at the patients’ home. Intraclass correlation coefficient (ICC) was calculated for the reliability of the MFM and its domains. The reliability of each item was assessed and the correlation between MFM and three domains of PODCI was evaluated. Results A total of 48 children (5–17 years of age) were assessed in both locations and the MFM scale demonstrated excellent inter-rater reliability (ICC, 0.98). Weighted kappa ranged from excellent to poor. Correlation of the home-based MFM with the PODCI domain ‘basic mobility and transfers’ was excellent, with the ‘upper extremity’ domain was moderate, but there was no correlation with the ‘happiness’ domain. Conclusion The MFM is a reliable tool for assessing patients with HNMD when used in a home-based setting.
Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis
Authors: Wang Xiaohu , Wei Lei , Lv Zhi , Zhao Bin , Duan Zhiqing , Wu Wenjin , Zhang Bin , Wei Xiaochun 
Published: January 2017

Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.
Management of acute Achilles tendon rupture with tendon-bundle technique
Authors: Li Chun-Guang , Li Bing , Yang Yun-Feng 
Published: January 2017

Objective * These authors contributed equally to this work. To explore tendon-bundle technique for treating Achilles tendon rupture with no defects. Methods Patients with full unilateral Achilles tendon rupture with no defects were included. The Achilles tendon medial edge surgical repair approach was used, revealing horsetail-like rupture bundles. Tendon bundles were anatomically realigned and repaired end-to-end using 5-0 sutures. Patients were followed-up for 1 year, and assessed for differences between the repaired versus healthy limb. Results Out of 24 patients (18 male, 6 female; aged 19–56 years) at 1 year following surgery, mean American Orthopaedic Foot and Ankle Society score was 92.4 ± 5.9; mean differences between the surgically repaired versus contralateral side in dorsiflexion and plantarflexion angle were 3.5 ± 2.3° and 5.6 ± 3.2°, respectively; mean difference in calf circumference between the two sides was 0.9 ± 0.5 cm; and mean increase in Achilles tendon width versus the healthy side was 0.8 ± 0.2 cm. By 1 year post-surgery, there were no significant between-side differences in dorsiflexion and plantarflexion angle, or calf circumference. Conclusions Tendon-bundle surgery resulted in good ankle function restoration and low complication rates. Tendon-bundle surgery may reduce blood supply destruction and maximally preserve Achilles tendon length, and may be effective for treating Achilles tendon rupture with no defects.
Biological Correlates of Piracetam Clinical Effects in Psychotic Patients
Authors: Kabeš J , Erban L , Hanzliček L , Skondia V 
Published: January 2017

The purpose of this controlled clinical trial was to demonstrate possible correlations between changes in bioenergetic metabolism and psychotropic drug administration in the treatment of functional psychosis. The study included twenty-six patients, eleven with schizophrenia, three with chronic atypical depression and twelve with drug-resistant endogenous depressions. All patients were kept on continuous psychotropic medication for at least 3 weeks before starting the trial, and piracetam was given additionally in a fixed dosage of 2400 mg daily; the same number of identical capsules was given during the pre- and post-treatment placebo periods. Psycho-pathological evaluation of the patients was by the BPRS; clinical and biochemical data were evaluated statistically by the analysis of regression. The results show that in schizophrenic patients an improvement was observed in those cases who had improved biochemically, i.e. where the A TP values had increased. In drug-resistant depressions there was a rapid and significant clinical improvement after piracetam co-administration, and this went in step with a significant rise in A TP levels.
Experience with Sustained-Release Oxprenolol (Slow Trasicor) in the Management of Hypertension in General Practice
Authors: Forrest W A 
Published: January 2017

One thousand two hundred and ninety-five hypertensive patients with an average blood pressure of 180/110 mm Hg currently treated with a mean daily dose of methyldopa 1025 mg were studied. In two-thirds of these patients a diuretic was also prescribed. While the dose of diuretic remained constant, the daily dose of methyldopa was reduced in a stepwise fashion over a period of six weeks, and totally withdrawn by eight weeks. Simultaneously, sustained-release (SR) oxprenolol 160 mg was introduced up to a maximum dose of 320 mg (two tablets daily). One hundred and seventeen patients (13.7% of the total) withdrew from the study, of whom sixty-eight (5.3%) were for drug-related reasons. In the 1,118 patients completing the study the average blood pressure fell steadily during the trial to a final level of 159/95 mm Hg. SR oxprenolol was very well tolerated by the majority and the incidence of the troublesome symptoms of tiredness, depression, headache and sexual problems reported initially with methyldopa, was significantly reduced. Three-quarters of the patients reported that they felt better with this new treatment. This study demonstrates the feasibility of substituting once daily SR oxprenolol in hypertensive patients whose blood pressure is inadequately controlled by methyldopa therapy, and the subsequent improvement in blood pressure is inadequately controlled by methyldopa therapy, and the subsequent improvement in blood pressure control and patient well-being.