bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pure‐tone Audiometry in Otosclerosis: Insufficient Evidence for the Diagnostic Value of the Carhart Notch
Authors: Wegner Inge , Bittermann Arnold J. N. , Hentschel Mayke A. , van der Heijden Geert J. M. , Grolman Wilko 
Published: July 2013

ObjectiveTo evaluate whether the Carhart notch on pure‐tone audiometry is reliable as a diagnostic test for predicting otosclerosis in patients with conductive hearing loss.Data SourcesPubMed, Embase, the Cochrane Library, CINAHL, and Scopus.MethodsA systematic search was conducted. Studies reporting original study data were included. After assessment of directness of evidence and risk of bias of the selected articles, the prevalences and the positive and negative predictive values were extracted.ResultsA total of 1402 unique studies was retrieved. Three of these satisfied the eligibility criteria. One study provided direct evidence, while all studies carried moderate to high risk of bias. One study with moderate directness of evidence and high risk of bias was not further analyzed. In a study with a high directness of evidence, a high risk of bias, and a low prevalence of otosclerosis (8%) in patients with conductive hearing loss, the presence of a Carhart notch at 2000 Hz increased the risk of otosclerosis with 33%. In a second study with moderate directness of evidence, moderate risk of bias, and a high prevalence of otosclerosis (72%) in patients with a surgically confirmed congenital ossicular anomaly or otosclerosis, the presence of a Carhart notch at 2000 Hz increased the risk of otosclerosis with 2%.Conclusion and RecommendationAlthough there is insufficient high‐quality evidence regarding the diagnostic value of the Carhart notch, it seems it is a useful hint for the presence of otosclerosis, but it cannot be used to confirm a diagnosis of otosclerosis.
Transcatheter aortic valve implantation: implications for Asian patients
Authors: Tay Edgar LW , Yip James Wei-Luen , Teoh Kristine LK , Ang Sophia , Poh Kian Keong , Teo Lynette LS , Yeo Tiong Cheng , Lee Chuen Neng , Tan Huay Cheem , Hon Jimmy KF 
Published: July 2013

Background: transcatheter aortic valve implantation is now an accepted therapy for patients with severe aortic valve stenosis who are deemed inoperable, and it is a reasonable alternative for patients with high surgical risk. This study assessed the clinical outcomes of this procedure and the implications of transcatheter aortic valve implantation for such patients. Methods: 14 consecutive patients with severe aortic valve stenosis, who underwent transcatheter aortic valve implantation, were assessed. Baseline clinical characteristics, procedural information, and clinical outcomes and complications were compared at baseline and at follow-up. Thirty-day mortality was also assessed. Results: the mean age of the patients was 81 ± 8 years (35% females). The mean Society of Thoracic Surgeons score was 6.8 ± 3.7. Most patients had chronic kidney disease with an estimated glomerular filtration rate of 44.5 ± 14.9 mL·kg−1·min−1. The mean annulus diameter was 21.9 ± 1.7 mm, and 8 (57%) patients received 23-mm valves. After transcatheter aortic valve implantation, the mean transaortic gradient and aortic valve area improved from 42.9 ± 19.4 to 8.9 ± 3.1 mm Hg ( p < 0.001) and 0.7 ± 0.1 to 1.5 ± 0.3 cm2 ( p < 0.001), respectively. The 30-day mortality for this cohort was 7%. Conclusion: transcatheter aortic valve implantation can be performed successfully in carefully selected Asian patients. The decision to undertake this procedure should be guided by the surgical team.
Trends in coronary artery bypass surgery: impact on early outcomes
Authors: Salick Muhammad Musa , Qadir Irfan , Perveen Shazia , Furnaz Shumaila , Sharif Hasanat 
Published: July 2013

Background: improvements in nonsurgical revascularization have left a group of higher-risk patients presenting for operation in a later stage of coronary artery disease. We undertook this study to analyze temporal changes in demographic and clinical profiles and outcomes of cardiac surgical patients. Methods: we identified and retrieved preoperative, intraoperative, and postoperative variables for 3064 consecutive patients who underwent myocardial revascularization at the Aga Khan University Hospital between 2006 and 2011. Mortality and morbidity outcomes were compared using univariate and multivariate analyses. Results: mean age, prevalence of left ventricular systolic dysfunction, unstable angina, mean number of occluded vessels, and arrhythmias at presentation increased steadily over time. The prevalence of diabetes, chronic lung disease, peripheral vascular disease, prior stroke, prior myocardial infarction, and left main disease declined. Operative mortality did not change significantly (3.5% vs. 3.8%, p = 0.512). Determinants of operative mortality included older age, female sex, renal insufficiency, left ventricular systolic dysfunction, and longer bypass and crossclamp times. Conclusion: coronary operations are increasingly performed in higher-risk patients with greater comorbidities. Despite this, operative mortality has not increased.
Does removal of steel wires relieve post-sternotomy pain after cardiac surgery?
Authors: Rashidi Sargul , Elenbaas Ted WO , Hamad Mohamed A Soliman , van Suijlekom Hans J , van Straten Albert HM 
Published: July 2013

Background: Post-sternotomy pain in the absence of cardiac ischemia and sternal instability is most commonly due to the sternal wire sutures or a protruding wire. We performed a retrospective study to investigate the effect of removal of the steel wires for relief of post-sternotomy pain. Methods: All 206 patients who underwent sternal wire removal in our institution from January 2003 through August 2011 were included in this study. Alive patients were contacted by telephone to inquire about the fate of their pain. Accordingly, patients were classified into 4 groups: group 1 were free of symptoms; group 2 were satisfied, significantly better than before wire removal; group 3 had unchanged symptoms; and group 4 had worsening of pain after wire removal. Results: After excluding patients who died during the follow-up and those who had sternal instability and wound infection, 186 patients were available for the questionnaire. Complete relief of pain occurred in 83% of these patients, and 10% had improvement of their symptoms. Conclusions: We recommend removal of the steel wires in patients with persistent chest pain after median sternotomy, when sternal instability, mediastinitis, and cardiac causes such as ischemia are excluded.
Minimally invasive pediatric surgery in uncomplicated congenital heart disease
Authors: Cingoz Faruk , Tavlasoglu Murat , Sahin Mehmet Ali , Kurkluoglu Mustafa , Guler Adem , Günay Celalettin , Arslan Mehmet 
Published: July 2013

Background: We aimed to highlight the use of a minimally invasive approach in uncomplicated congenital heart surgery. Patients and methods: We investigated retrospectively 32 children below 10 years of age who underwent elective closure of ostium secundum type ( n = 27), sinus venosus type ( n = 4) and ostium primum type ( n = 1) atrial septal defects through a limited skin incision and partial lower sternotomy between August 2001 and December 2008. All patients had cannulation through the same incision for cardiopulmonary bypass. Results: A pericardial patch was used to close the defect in 8 patients and direct suturing in 24. The mean time from the skin incision to cannulation was 56 ± 23 min. Total bypass time was 27 ± 12 min, and crossclamp time was 15 ± 8 min. Mean length of hospital stay was 4 ± 2 days. We did not encounter any complications or mortality. Conclusions: A minimally invasive approach, consisting of a limited skin incision and partial lower sternotomy, is a safe, reliable, and cosmetically advantageous method in uncomplicated congenital heart disease surgery, which can be performed widely, and may replace the standard approach without increasing mortality and morbidity.
Effect of a local vibration stimulus training programme on postural sway and gait in chronic stroke patients: a randomized controlled trial
Authors: Lee Se-Won , Cho Ki-Hun , Lee Wan-Hee 
Published: July 2013

Objective: To investigate the effect of a local vibration stimulus training programme on postural sway and gait in stroke patients. Design: A randomized controlled trial with two groups: a local vibration stimulus training programme group and a sham group. Setting: Inpatient rehabilitation centre. Subjects: Thirty-one chronic stroke patients. Interventions: Both groups underwent a standard rehabilitation programme. The local vibration stimulus training programme group ( n = 16) participated in the local vibration stimulus training programme for 30 minutes a day, five times a week, for six weeks. The sham group ( n = 15) participated in a sham local vibration stimulus training programme for 30 minutes a day, five times a week, for six weeks. Main measures: A forceplate was used to measure postural sway under two conditions: standing with eyes open and eyes closed. Gait ability was measured using the GAITRite system. Results: In postural sway, greater improvements in the postural sway distance with eyes-open (–11.91 vs. 0.80) and eyes-closed (–20.67 vs. –0.34) conditions and postural sway velocity with eyes-open (–0.40 vs. 0.03) and eyes-closed (–0.69 vs. –0.01) conditions were observed in the local vibration stimulus training programme group, compared with the sham group ( P < 0.05). In gait ability, greater improvement in gait speed (15.06 vs. 2.85), cadence (8.46 vs. 1.55), step length (7.90 vs. 3.64), and single limb support time (0.12 vs. 0.01) were observed in the local vibration stimulus training programme group, compared with the sham group ( P < 0.05). Conclusions: These findings suggest that local vibration stimulus training programme is an effective method for improvement of the postural sway and gait ability of chronic stroke patients.
Toll-like receptor 9 (TLR9) gene polymorphisms associated with increased susceptibility of human papillomavirus-16 infection in patients with cervical cancer
Authors: Lai Zeng-Zhen , Ni-Zhang  , Pan Xiao-Ling , Song Liang 
Published: July 2013

Objectives To investigate the association between toll-like receptor 9 ( TLR9) single nucleotide polymorphisms (SNPs) and human papillomavirus (HPV) infection among Chinese Han women with cervical cancer. Methods TLR9 –1486 and 2848 SNPs were investigated in patients with cervical cancer and controls using polymerase chain reaction (PCR)-restriction fragment length polymorphism. HPV16 E6 and E7 infections were assessed using PCR. Results Of 120 patients with cervical cancer and 100 controls, there was a significant association between TLR9 2848 SNP and cervical cancer risk, but there was no such association with TLR9 –1486 SNP. Frequency of the TLR9 2848 GA genotype was significantly higher in patients with cervical cancer than in controls. There was no statistically significant between-group difference in presence of HPV16 infection. Presence of HPV infection with TLR9 2848 (rs352140) GA/AA genotype increased the risk of cervical cancer 13.8-fold compared with the GG genotype. Conclusions The TLR9 2848 G/A polymorphism in Chinese Han women was associated with increased risk of cervical cancer in the presence of HPV16 infection. Further studies are necessary to uncover the functional aspect of this TLR9 2848 polymorphism.
Neuroendocrine and haemodynamic changes in single-lead atrial pacing and dual-chamber pacing modes
Authors: Zhang Ying-ying , Wu Dong-yan , Fu Nai-kuan , Lu Feng-min , Xu Jing 
Published: July 2013

Objectives Neuroendocrine and haemodynamic changes were compared between single-lead atrial (AAI) or dual-chamber (DDD) pacing modes in patients with sick sinus syndrome, in a crossover study. Methods Inpatients scheduled for their first pacemaker implantation were screened for the following inclusion criteria: sick sinus syndrome; intact atrioventricular conduction; normal QRS interval. All study patients were implanted with a dual-chamber pacemaker, programmed for AAI or DDD pacing mode. Patients were allocated randomly to AAI followed by DDD pacing or to DDD followed by AAI pacing, each mode being applied for 72 h. Echocardiographic, electrocardiographic and neuroendocrine parameters were tested at the end of each pacing mode. Results From 152 inpatients screened for inclusion, 28 were selected for treatment. Plasma levels of atrial natriuretic peptide (ANP), endothelin, aldosterone and angiotension II were significantly lower, and aortic flow velocity–time integral was significantly higher, in AAI mode than in DDD mode. Aortic pre-ejection interval, interventricular mechanical delay and QRS duration were significantly higher in DDD than in AAI mode. Conclusions In patients with sick sinus syndrome, DDD pacing mode can induce neuroendocrine system activation, and left ventricular dysfunction and dyssynchrony. These findings discourage the routine use of DDD pacing in patients with sick sinus syndrome.
Factors associated with the anonymous reporting of lifetime domestic violence in a genitourinary medicine clinic: a patient self-reported questionnaire study
Authors: Sanmani L , Sheppard Z A , Chapman C 
Published: July 2013

Summary Domestic violence (DV) occurs frequently within the UK, with one in four women and one in six men experiencing DV during their life. DV is the leading cause of morbidity for women aged 19–44 years and is associated with sexual health problems. However, few data exist on the prevalence of DV in UK genitourinary (GU) medicine settings. An anonymous questionnaire was self-completed by patients (n = 476/500) attending Bournemouth GU medicine clinic during July 2009 to explore associations between lifetime DV and sociodemographic, sexual and behavioural factors. Overall, 21% (98/472) reported that they had ever been abused by a partner (12% [27/229] of men and 29% [71/243] of women). Logistic regression highlighted that being female, having children/dependants and use of illicit drugs were the most important factors associated with lifetime DV. Regular staff training on DV is recommended to increase awareness and signposting to relevant services.
Functionalization of multiwalled carbon nanotubes for the solid-phase extraction of silver, cadmium, palladium, zinc, manganese and copper by flame atomic absorption spectrometry
Authors: Ghaedi Mehrorang , Montazerozohori M. , Nazari E. , Nejabat R. 
Published: July 2013

In the present work, multiwalled carbon nanotube (MWCNT) chemically modified with (3-mercaptopropyl) silanetriolate is efficiently used for the solid-phase extraction of Cu2+, Ag+, Cd2+, Pb2+, Zn2+ and Mn2+ ions prior to their flame atomic absorption spectrometric determination. The influences of the various analytical parameters, including pH, amounts of solid phase, sample volume and eluent conditions and so on, on the recoveries of target analytes were investigated and optimized by one at a time optimization method. The influences of alkaline, alkaline earth and some transition metals on the adsorption and elution of the analytes were also examined. The detection limits for all understudied metal ions were between 1.4 and 2.8 ng mL−1 (3Sb, n = 10). The evaluation of the thermodynamic parameters such as enthalpy (positive value), Gibbs free energy (negative value) in addition to high value of entropy shows the endothermic and spontaneous nature of sorption process. Following the optimization of variables, the adsorption process follows the intraparticle kinetic model with R2 of 0.98 and the Langmuir isotherm with high correlation coefficient ( R2 > 0.95). The procedure was applied for the analytes determination in the food samples with satisfactory results (recoveries >95% and relative standard deviation’s (RSD) lower than 4%).
Neuroprotective effects of alpha-ketoglutarate and ethyl pyruvate against motor dysfunction and oxidative changes caused by repeated 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine exposure in mice
Authors: Satpute R. , Lomash V. , Kaushal M. , Bhattacharya R. 
Published: July 2013

1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxin associated with drug abuse and causes permanent symptoms of Parkinson's disease (PD) by destroying dopaminergic neurons in the substantia nigra of the brain. In the present study, the neuroprotective effects of two carboxylic acid compounds, viz. alpha-ketoglutarate (A-KG), a Kreb’s cycle intermediate and ethyl pyruvate (EP), a lipid-soluble analogue of pyruvate, were evaluated against MPTP intoxication in mice and compared with madopar (MD; combination of levodopa plus benserazide), a standard drug. Animals received oral treatment of A-KG (500 mg/kg), EP (100 mg/kg) or MD (5 mg/kg) daily for 5 days followed by intraperitoneal administration of MPTP (20 mg/kg) and posttreatment (+10 min) of A-KG, EP or MD daily for the remaining 5 days. MPTP caused the inhibition of complex I of electron transport chain accompanied by oxidative stress in the brain. It also caused cytotoxicity in the midbrain region as characterized by histology and immunohistochemistry. Treatments of A-KG and EP were found to resolve the loss of motor coordination, oxidative stress, diminished complex I activity and tyrosine hydroxylase–positive neurons in midbrain. A-KG and EP also regressed the histological damage in the brain and minimized the accumulation of alpha-synuclein in the midbrain region. The data suggest that A-KG and EP which are nontoxic carboxylic acid compounds could be of potential therapeutic value in the treatment of PD.
Potential chemoprotective effects of selenium on diazinon-induced DNA damage in rat peripheral blood lymphocyte
Authors: Shokrzadeh M. , Ahangar N. , Abdollahi M. , Shadboorestan A. , Omidi M. , Payam S.S Hosseini 
Published: July 2013

The purpose of this study was to investigate the protective effects of selenium (Se) against genotoxicity induced by diazinon (DZN) in rat peripheral blood lymphocytes by micronucleus (MN) test. Animals were concurrently administered intraperitoneally with DZN in proper solvent (20 mg/kg body weight (b.w.)) and Se at three different doses (0.5, 1, and 2 mg/kg b.w.) for 30 consecutive days. The positive control group received DZN at the same dose without Se. After 24 h of last injection, 0.5 ml blood of each rat was received and cultured in culture medium for 44 h. The lymphocyte cultures were mitogenically stimulated with cytochalasin B to allow the evaluation of number of MNs in cytokinesis-blocked binucleated cells. Incubation of lymphocytes with DZN induced additional genotoxicity and is shown by increase in MNs frequency in human lymphocytes. Se at low dose of 0.5 mg/kg had a maximum effect and significantly reduced the MNs frequency in cultured lymphocytes ( p < 0.0001) that reduced the frequency of MN from 12.78 ± 0.24% for DZN group to 4.40 ± 0.36. The present study revealed that Se particularly at low doses has a potent antigenotoxic effect against DZN -induced toxicity in rats, which may be due to the scavenging of free radicals and increased antioxidant status.
Triketone toxicity
Authors: Boels D. , Monteil-Ganière C. , Turcant A. , Bretaudeau M. , Harry P. 
Published: July 2013

Introduction: Sulcotrione is a herbicidal agent belonging to the family of triketones. Sulcotrione herbicides are used for weed control in maize and flax crops. To date, no cases of human poisoning had been reported in the literature linked to different herbicidal agents in the triketone family. We report here on two cases of the voluntary ingestion of this substance in the form of the branded product MikadoTM, which were recorded by the Angers Poison Centre. Case report: Both cases of voluntary ingestion constituted attempted suicide, and involved two men aged 30 and 37 years. Their symptoms linked to sulcotrione were limited to vomiting, despite elevated plasma concentrations of sulcotrione. In one case, hypertyrosinemia has been demonstrated. The outcome was favourable in both patients and at follow up, no ocular disorders were observed. In the second case, hypotension and transient renal failure could be linked to the concomitant ingestion of chlorophenoxy herbicides. Discussion: In animal toxicity studies, sulcotrione inhibit 4-hydro-phenylpyruvate dioxygenase leading to hypertyrosinemia and corneal opacities. In both cases, no ocular disorders were observed despite hypertyrosinemia in one case. These case reports were consistent with the animal toxicology findings concerning triketones, and particularly their relative safety in mammals following acute poisoning. However it seems prudent to monitor plasma tyrosine concentrations and to screen prospectively for corneal deposits if further acute intoxication events occur.
An overview of the clubhouse model of psychiatric rehabilitation
Authors: Raeburn Toby , Halcomb Elizabeth , Walter Garry , Cleary Michelle 
Published: July 2013

Objective: The aim of this article is to provide an overview of the clubhouse model and its capacity to assist people with severe mental illness. Method: The paper uses a sample vignette (with all identifying information removed) and survey of literature describing clubhouses over the last 15 years. Results: Strengths of the clubhouse model include its ability to provide a safe environment, supportive relationships and supported employment activities. Criticisms include its failure to provide onsite psychiatry clinics and a risk of promoting service dependence. Conclusions: Modern clubhouses continue to provide useful models of psychiatric rehabilitation which are popular worldwide. Studying and describing the model is challenging due to its complexity. Mixed methodological approaches and recovery-orientated measurement tools may assist future research and development.