bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of contrast-enhanced ultrasound with MRI in the diagnosis of complex cystic renal masses: a meta-analysis
Authors: Zhou Linli , Tang Lemin , Yang Tao , Chen Wei 
Published: January 2018

Background The differential diagnosis of cystic renal masses still faces great challenges. There has been no systematically assessment to compare the value of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) in the diagnosis of cystic renal masses. Purpose To perform a meta-analysis to compare the diagnostic efficacy of CEUS with that of MRI for cystic renal masses. Material and Methods A systematic search was performed for literature evaluating the diagnostic performance of CEUS or MRI in cystic renal masses. Quality assessment of diagnostic studies 2 (QUADAS-2) was used to evaluate the quality of each study included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the areas under the summary receiver operating characteristic (AUCs-SROC) curve for CEUS and MRI were calculated, respectively. Results Seventeen studies with 1142 lesions were included. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS /MRI were 0.95/0.92, 0.84/0.91, 5.62/6.74, and 0.09/0.13, respectively. The AUCs-SROC curves for the two methods were 95.66% and 94.65%. The subgroup analysis indicated that the scanning slice thickness may influence the diagnostic efficacy of MRI. Conclusion Both CEUS and MRI have good diagnostic performance for cystic renal masses and can provide the reference for clinicians. CEUS is more sensitive but less specific than MRI.
Effect of Hip-Focused Injury Prevention Training for Anterior Cruciate Ligament Injury Reduction in Female Basketball Players: A 12-Year Prospective Intervention Study
Authors: Omi Yorikatsu , Sugimoto Dai , Kuriyama Setsurou , Kurihara Tomohisa , Miyamoto Kenji , Yun Songjo , Kawashima Tatsuhiro , Hirose Norikazu 
Published: January 2018

Background: Programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players are scarce. Also, ACL injury prevention training that focuses on hip joint function has not been reported. Purpose: To determine the effectiveness of a hip-focused ACL injury prevention program in female basketball players. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective intervention study was conducted for 12 years. Incidence rates of ACL injuries were collected in the first 4 years (observation period) from college female basketball players. After the observation period, a hip-focused ACL injury prevention program was implemented for 8 years (intervention period). A total of 309 players (mean ± SD age, 19.6 ± 1.2 years; height, 163.7 ± 5.6 cm; weight, 59.1 ± 5.1 kg; body mass index, 22.0 ± 1.4) were tracked in the observation period and compared with 448 players (age, 19.6 ± 1.1 years; height, 162.6 ± 5.8 cm; weight, 58.0 ± 5.7 kg; body mass index, 21.9 ± 1.5) who participated in the intervention period. Athlete-exposures (AEs), ACL numbers and mechanisms of injury (MOIs), relative risk (RR), absolute risk reduction (ARR), numbers needed to treat (NNT), and compliance were analyzed. Results: There were 16 ACL injuries (13 noncontact MOIs) in the 4-year observation period, whereas 9 ACL injuries (8 noncontact MOIs) were recorded in the 8-year intervention period. The overall ACL injury incidence was 0.25/1000 AEs in the 4-year observation period compared with 0.10/1000 AEs in the 8-year intervention period, respectively. Compared with the 4-year observation period, significant RR reduction was observed (0.38; 95% CI, 0.17-0.87; P = .017) with ARR and NNT of 0.032 (95% CI, 0.027-0.037) and 31.6 (95% CI, 27.1-37.7), respectively, in the 8-year intervention period. The noncontact ACL injury incidence was 0.21 per 1000 AEs during the 4-year observation period compared with 0.08/1000 AEs in the 8-year intervention period, which also showed significant RR reduction (0.37; 95% CI, 0.15-0.92; P = .026), with ARR and NNT of 0.024 (95% CI, 0.020-0.029) and 41.3 (95% CI, 34.6-51.3), respectively. The mean compliance rate during the intervention periods (8 years) was 89%. Conclusion: A hip-focused injury prevention program demonstrated significant reduction in the incidence of ACL injury in female collegiate basketball players.
Vascular Calcifications as a Footprint of Increased Calcium Load and Chronic Inflammation in Uremic Patients: A Need for a Neutral calcium Balance during Hemodialysis?
Authors: Tetta C. , Gallieni M. , Panichi V. , Brancaccio D. 
Published: January 2018

Cardiovascular complications caused by an accelerated atherosclerotic disease represent the largest single cause of mortality in chronic renal failure patients. The rapidly developing atherosclerosis of the uremic syndrome appears to be caused by a synergism of different mechanisms, such as malnutrition, oxidative stress and genetic factors. Recent studies provide evidence that chronic inflammation plays an important role in the pathogenesis of cardiovascular diseases. Hyperphosphatemia and an increased calcium-phosphate ion product have also been associated with an increased risk of death. Cardiovascular calcifications secondary to increases in phosphate and calcium load in dialysis patients might exert an important contribution to the excess cardiovascular mortality and morbidity in dialysis patients. Elevated serum levels of plasma C-reactive protein (CRP) are associated with the extent and severity of the atherosclerotic processes as well as with an increased risk of experiencing myocardial infarction and sudden cardiac death in apparently healthy subjects. In patients affected by pre-dialytic renal failure increased levels of CRP and IL-6 were recorded in 25% of our population; CRP and IL-6 were inversely related with renal function. These data suggest the activation - even in the predialytic phase of renal failure - of mechanisms known to contribute to the enhanced cardiovascular morbidity and mortality of the uremic syndrome. In recent years we have investigated the hypothesis that the chronic inflammatory state of the uremic patient could be at least in part due to the dialytic technique. We have shown that the increase of CRP in stable dialysis patients may be due to the stimulation of monocyte/macrophage by backfiltration of dialysate contaminants. During conventional dialysis, a positive calcium balance and a concomitant inflammatory state may act as cofactors in the development of cardiovascular calcifications. We suggest that this hypothesis should be verified by clinical studies. A reevaluation of the ideal calcium levels in the dialysate is warranted: a neutral intradialytic calcium balance is probably more appropriate, although not easily attainable.
Effects of the Infusion Mode on Bicarbonate Balance in On-Line Hemodiafiltration
Authors: Pedrini L.A. , De Cristofaro V. , Pagliari B. 
Published: January 2018

Background Electrolyte and acid-base balance may be differently affected by the infusion mode in on-line hemodiafiltration (HDF). We studied the effects of the different infusion modes on bicarbonate transport across the dialyzer membrane, and thus on the final bicarbonate balance of the HDF sessions. Methods Instantaneous HCO3− transfer across the dialyzer membrane, blood bicarbonate profile and the total balance of the sessions were studied in six dialysis patients under the same operating conditions over 36 HDF sessions, in order to compare the effects of predilution HDF (pre-HDF), postdilution HDF (post-HDF), and mixed HDF on the final bicarbonate balance. Results The final HCO3− balance was more positive in post-HDF vs pre-HDF (142 ± 36 vs 99 ± 41 mmol/session, p<0.05), with a final blood HCO3− concentration of 26.6 ± 1.0 vs 25.4 ± 1.1 mmol/L, (p<0.05). Mixed HDF yielded intermediate results (balance: 119 ± 42 mmol/session, final HCO3− 26.2 (1.2 mmol/L). These differences were seen to result from the increased HCO3- concentration of blood entering the filter in predilution, due to the infused HCO3−, enhancing convective loss and reducing the driving force for diffusive HCO3− gain. Conclusions Bicarbonate concentration in dialysate-reinfusate is critical in order to obtain an adequate end of session HCO3− balance in on-line HDF. The predilution method produced the lowest cumulative net HCO3− gain between the three studied infusion modes. Our data suggest that, under the same operating conditions and excluding the effect of ultrafiltration, dialysate HCO3− should be increased by about 2 mmol/L in pre-HDF, and 1 mmol/L in mixed HDF, to yield the same final balance as in post-HDF.
The Effect of Chronic Flow Changes on Brachial Artery Diameter and Shear Stress in Arteriovenous Fistulas for Hemodialysis
Authors: Dammers R. , Tordoir J.H.M. , Welten R. J.T.H.J. , Kitslaar P. J.E.H.M , Hoeks A.P.G. 
Published: January 2018

Background Vessel wall adaptation to acute or chronic flow changes is regulated by shear stress (SS) at the endothelium. This hypothesis was tested in the brachial artery (BA) of patients receiving an arteriovenous fistula (AVF) for hemodialysis vascular access. Methods The acute and sustained effects were evaluated in 13 patients. Pre-operatively and postoperatively on predetermined time-points BA diameter and shear rate (SR) were measured. SS was calculated from whole blood viscosity and SR. Analysis was performed with Wilcoxon's test and ANCOVA multivariate analysis. Results Acutely, mean SS increased (475%, p<0.05), peak-to-peak SS decreased (37%, p<0.05) and peak SS remained constant. BA diameter increased (15%, p<0.05). After one year a further increase was observed (r=0.59, p<0.001), plus an increase in mean SS (r=0.78, p<0.001). Peak-to-peak SS remained constant. Conclusion Our results indicate that after AVF placement an acute increase in SS results in an acute increase of vessel diameter. However, one year of sustained high blood flow does not result in restoration of mean SS.
Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction: A Prospective Randomized Study on the Timing of Perioperative Intraaortic Balloon Pump Support
Authors: Marra C. , De Santo L.S. , Amarelli C. , Corte A. Della , Onorati F. , Torella M. , Nappi G. , Cotrufo M. 
Published: January 2018

In this prospective trial the results of preoperative and intraoperative IABP in coronary artery bypass graft (CABG) patients with low left ventricular ejection fraction (LVEF) were compared. Sixty CABG patients with preoperative LVEF ≤0.30 were enrolled: in group A patients (n=30) IABP was started within 2 hours preoperatively; in group B (n=30) it was instituted intraoperatively before weaning from cardiopulmonary bypass. Cardiac performance was assessed through Swan-Ganz catheter monitoring and daily echocardiography. Hospital survival, length of IABP support, intubation, ICU and hospital stay, need for postoperative inotropic drugs and incidence of myocardial infarction were compared between the two groups. Survival in group A patients proved significantly higher (P=0.047). Cardiac performance after myocardial revascularization improved in both groups with significantly better outcomes in group A patients (p<0.001). Doses of inotropic drugs (dobutamine, enoximone) were lower in group A (P=0.001; P=0.004) and duration shorter (p<0.001; p<0.001). No major IABP-related complication was observed.
Long-Term Control of Hypertension in Dialysis Patients by Low Dose Atenolol
Authors: Vlassopoulos D. A. , Mentzikof D. G. , Hadjiyannakos D. K. , Noussias C. V. , Karras S. M. , Hadjiconstantinou V. E. 
Published: January 2018

Hypertension in dialysis patients is considered a major factor in cardiovascular mortality. We investigated long-term efficacy of intermittent atenolol (AT) administration in 10 (7M/3F) hypertensive dialysis patients, age 60.5 (38–72), on dialysis for 56.5 months (8–156) thrice per week (10.5–13.5 h/w) (A). A similar group of 11 normotensive patients served as controls (B). Hypertension was defined as BP>140/90 (day) and >120/80 mmHg (night) by a 44-h ambulatory BP monitoring (ABPM) after the mid-week session. Dialysis ultrafiltration, hematology, biochemistry were similar in A and B. Atenolol was started on an alternate day, 37.5 mg/w and increased as needed. After 34 days (6–80) and a dose of 68.75 (37.5–450) mg/w, BP dropped (ABPM: MAP 104±11.5 to 95.6±10.4 mmHg, P=0.0025) similar to controls and daytime HR dropped: 84.6±9.2 to 69.3±8.2, P=0.0008 and at night: 79.5±7.6 to 68.6±8.6 b/1' becoming lower than in B: 83±10.8/69.3±8.2, P=0.009 and 80.5±11.7/68.6±8.6 b/1' (P=0.02). Six months later ABPM in A as well as echocardiography in A and B remained unchanged. Moderate, volume independent hypertension in stable dialysis patients is easily controlled during the interdialytic period by small intermittent atenolol doses.
Improving the Fixation of an Artificial Intervertebral Disc
Authors: Eijkelkamp M.F. , Hayen J. , Veldhuizen A.G. , Van Horn J.R. , Verkerke G.J. 
Published: January 2018

The fixation of an artificial intervertebral disc has been studied especially with respect to the dimensions, the convexity of the endplates and the size of the fixation elements. From literature and cadaveric vertebrae, the dimensions and shape of the lumbar vertebral endplates were determined and the dimensions of fixation ribs for the artificial intervertebral disc were calculated. To withstand shear forces and prevent dislocation, two sagittal ribs, each 3.5 mm in height and at least 20 mm in length and four transversal ribs, each 1.5 mm in height and with a total length of 60 mm are sufficient. A range of five different sagittal diameters was selected as sufficient for all patients. At least 72.6 % of the endplate of the vertebrae is covered. A convexity with a radius of 140 mm limits the gap to 0.62 mm.
Vitamin E as an Antioxidant Agent in CAPD Patients
Authors: Mydlík M. , Derzsiová K. , Rácz O. , Šipulová A. , Boldizsár J. , Lovásová E. , Hríbiková M. 
Published: January 2018

Oxidative stress, increased lipid peroxidation and decreased activity of antioxidant systems may contribute to the accelerated development of atherosclerosis in chronic renal failure patients during renal replacement therapy. The aim of the study was to investigate the influence of vitamin E (400 mg/day) on some antioxidant defense parameters in CAPD patients. In fourteen CAPD patients, erythrocyte antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase (CAT), the concentration of plasma malondialdehyde (MDA), vitamin A, vitamin C and vitamin E were investigated. The study was divided into two periods. Each period lasted six weeks. In the first period patients received orally vitamin E 400 mg/day, in the second period they did not receive vitamin E or other antioxidant drugs. Each parameter was determined at the beginning of the study and at the end of each period. Six CAPD patients were treated by erythropoietin (EPO) and received orally pyridoxine 20 mg/day and the others without EPO treatment received pyridoxine 5 mg/day. Six-week treatment by vitamin E (400 mg/day) led to the significant increase of serum vitamin E (from 33.6±9.0 to 49.3±15.5 μmol/L) and to the significant decrease of MDA (from 2.62±0.5 to 2.36±0.4 μmol/L). The mean values of erythrocyte enzymes were in or under the lower margin of normal range and were not influenced by vitamin E in CAPD patients. The results of our study showed that orally administered vitamin E is a very important antioxidant agent for CAPD patients.
Filtration Fluid for Hemodialysis Treatment
Authors: Ikonomov V. , Haase G. , Stefanidis I. , Melzer H. , Mann H. 
Published: January 2018

Bacterial contamination of dialysis fluid has long been recognized as a problem in hemodialyis. Cytokines released as a consequence of contaminated dialysis fluid are believed to be responsible for many acute and chronic side effects in patients undergoing renal replacement therapy. For several years now, attempts have been made to eliminate pyrogenic substances and ensure a sterile and endotoxin-free dialysis fluid. A recent dialysis fluid filter known as DIASAFE®, containing a membrane based on Polysulfone® (Fresenius), was tested for a period of 1,000 hours (approx. 14 weeks). Dialysis fluid samples were collected once weekly before and behind the filter and cultivated for detection of microorganisms and endotoxins. Additionally, starting after the fourth week of the study, serum samples were collected weekly and the ß2-microglobulin concentration was determined. The filter reduced microorganisms at a rate of at least 105 and in the majority of cases (86% of samples) by more than 106. Under clinical conditions the stability and microbiological functionality of the filters could be demonstrated for more than 1,000 hours and 150 disinfecting cycles. In four cases of endotoxin burden (>0.5 IU/ml) in the dialysis fluid in front of the filter the concentration behind the filter was lower than 0.1 IU/ml, indicating effective reduction of endotoxins. A tendency to a reduction of ß2-microglobulin in serum from 32.5 ± 3.9 mg/L to 21.5± 5.3 mg/L was observed. These results indicate that the dialysis fluid filter used was effective, dramatically reducing the bacterial contaminants in dialysis fluid, thus protecting patients from the potentially harmful acute and long-term life-threatening consequences of contaminated dialysis fluid.
Dialysis in Adults in Year 2000 in the Republic of Macedonia
Authors: Polenakovic M.H. ,   the Dialysis Working Group, Sikole A. , Grozdanovski R. , Amitov V. , Stojkovski Lj. , Oncevski A. , Grcevska L. , Dzikova S. , Cakalaroski K. , Bogdanovska S. , Gerasimovska V. , Gerasimovska B. , Milovanceva M. , Stojceva-Taneva O. , Krstanovski B. , Kovaceski S. , Serijat M. , Mustafa Z. , Capova O. , Bajalska A. , Nikolovski A. , Filipovic R. , Neskovski J. , Selja Lj. , Janakievska P. , Lamova K. , Hristova V. , Sarajlija E. Karceva , Romeo M. , Mitrevski Z. , Ivanovski K. , Dimitrov S. , Velinova B. , Panova B. 
Published: January 2018

1,019 adult patients with terminal renal failure were treated with dialysis (D) in the first part of the year 2000 in the Republic of Macedonia. 1,010 patients (99%) were treated with chronic intermittent (maintenance) hemodialysis (HD) while nine patients (1%) were on continuous ambulatory peritoneal dialysis (CAPD). For the children, a special peritoneal dialysis program was developed; 509 patients per million of the population (PMP) were on dialysis. The Republic of Macedonia is, therefore, among those central and eastern European countries with a higher PMP number in the treatment of end-stage renal disease, following Croatia, the Czech Republic and Slovenia. The patients were treated at 18 Centers in a network of HD Centers at a distance of 30–50 km. from their place of residence in order to facilitate their access to treatment and to work. All patients who have had symptoms indicating need for treatment with D were accepted for treatment. The government payed all the expenses of the treatment and the salaries of the staff. 56% were male and 44% were female patients. The youngest patient was aged 9 and the oldest was 82 years old. There has been an increase in the age of the patients on D as well as an increase in their number. In 1993 we had 727 patients being treated with D, and now we have 1,019 with a constant increase in the number of patients with ESRD and a need for D and renal transplantation. Mortality per year at the different Centers ranged from 8–19% in 1999 and the average is 12%. Glomerulonephritis (GN) – both primary and secondary – is the main cause of renal failure (RF) in some Centers up to 45%. Tubulo-interstitial disease follows GN. ADPKD patients constitute 9.4% with a difference among the Centers of 3–29%, and diabetic nephropathy is found in 10%, 5–15% in different Centers. 11–61% of patients have an unknown etiology. 352 patients are on treatment with human recombinant erythropoietin (rhuEPO) – in some Centers up to 60%. The mode of application was subcutaneous and the initial dose is 20 U/kg body weight and the mean maintenance dose of EPO per patient weekly is 4,000 U. The Cimino-Brescia arteriovenous fistula is being applied as a standard vascular access. The survival rate of our patients treated with maintenance HD at 5 years was 58%. CAPD and particularly renal transplantation are to be further developed as alternative methods in treating terminal renal failure.
In vitro Bioactivity of Poly(∊-Caprolactone)-Apatite (PCL-AP) Scaffolds for Bone Tissue Engineering: The Influence of the PCL/AP Ratio
Authors: Taddei P. , Di Foggia M. , Causa F. , Ambrosio L. , Fagnano C. 
Published: January 2018

Porous poly(∊-caprolactone) (PCL) is used as long-term bioresorbable scaffold for bone tissue engineering. The bone regeneration process can be enhanced by addition of carbonated apatites (AP). This study was aimed at evaluating the influence of the PCL/AP ratio on the in vitro degradation and bioactivity of PCL-AP composites. To this purpose, PCL-AP samples were synthesised with the following PCL/AP weight/weight ratios: 50/50, 60/40 and 75/25. Vibrational IR and Raman spectroscopies coupled to thermogravimetry (TG) and differential scanning calorimetry (DSC) were used to investigate the in vitro degradation mechanism in different media: 0.01 M NaOH solution (pH = 12), saline phosphate buffer at pH 7.5 (SPB), esterase in SPB and simulated body fluid (SBF) at pH 7.5. The latter medium was used to evaluate the bioactivity of the composites. A control PCL sample was analysed before the addition of the AP component. As regards the untreated samples, the method of synthesis utilised for preparing the composite was found to enhance the crystallinity degree. The AP component revealed to be constituted of a B-type carbonated hydroxyapatite with a 3% carbonate content. After 28 days of treatment, the samples showed different degradation patterns and extents depending on the degradation medium, the starting PCL crystallinity and composite composition. Weight measurements, Raman and TG analyses revealed deposition of an apatitic phase on all the composites immersed in SBF. Therefore, all the samples displayed a good bioactivity; the sample which showed the most pronounced apatitic deposition was 50/50, i.e. that containing the highest amount of AP.
A Case Report of Fracture of Ceramic Head in Total Hip Arthroplasty: Histological and Biochemical Features of Perimplant Tissues
Authors: Stea S. , Visentin M. , Bordini B. , Traina F. , Squarzoni S. , Toni A. 
Published: January 2018

The authors analyzed the case of a patient with a non-cemented hip prosthesis with a ceramic-ceramic coupling. As a consequence of trauma the head fractured. Although the patient could feel the joint grinding, there was no pain and he continued daily living activities for nearly six months, which led to marked wearing of the ceramic head. SEM analysis with microprobe showed “planed” surfaces on the ceramic head, suggesting repeated movements between the fractured components. Inside the cone of the head, signs of TiAlV, which is an alloy of the prosthetic stem, could be seen. Periprosthetic tissues were packed with ceramic wear particles of sizes ranging between 0.2 and 10 microns, according to the harvest site. Metal and mixed particles were also found. IL1, IL6, IL8 and IL10 assays in the synovial liquid confirmed the inflammatory state and a modest induction of bone resorption, which was less than that observed in patients with loosened metal-polyethylene couplings. The humoral picture was compatible with the radiological aspect, which did not show marked signs of bone resorption. In revision surgery both ceramic components were replaced by a metal head and polyethylene liner. The clinical outcome after 12 months was very good.