bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pericardiectomy for treatment of neoplastic constrictive pericarditis
Authors: Buyukbayrak Fuat , Aksoy Eray , Dedemoglu Mehmet , Kirali Kaan , Alp Hizir Mete 
Published: October 2013

Objective To share our results of a case series of 8 patients who underwent pericardiectomy for constrictive pericarditis that developed secondary to a known neoplastic disease. Patients and methods The underlying neoplasia was lung cancer in 5 (62.5%) patients, malignant pleural mesothelioma in 2 (25%), and Hodgkin lymphoma in 1 (12.5%). A diagnosis of constrictive pericarditis was made primarily by echocardiography, and right heart catheterization was performed in 6 (75%) patients. Total pericardiectomy was defined as wide excision of the anterior pericardium. Follow-up information was obtained by telephone interview and the civil registry database. Results Time from initial diagnosis of the neoplastic disease ranged from 1 to 15 years. Total pericardiectomy was performed in 6 (75%) patients. Histopathological examination revealed atypical cells in evacuated fluid and pericardial material in 6 patients. Nonspecific inflammation and fibrosis were observed in the other 2 cases. Hospital death occurred in 1 (12.5%) patient. Postoperative low cardiac output syndrome occurred in 7 (87.5%) patients. Follow-up ranged from 2.92 to 26.78 months. Mean survival was 14.82 ± 4.4 months. Conclusion Pericardial constriction may develop a long time after the initial presentation of certain neoplastic diseases, and the prognosis after pericardiectomy is poor.
Dying at home: A qualitative study of the perspectives of older South Asians living in the United Kingdom
Authors: Venkatasalu Munikumar R , Seymour Jane E , Arthur Antony 
Published: October 2013

Background: South Asians constitute the single largest ethnic minority group in the United Kingdom, yet little is known about their perspectives on, and experiences of, end-of-life care. Aim: To explore beliefs, attitudes and expectations expressed by older South Asians living in East London about dying at home. Design: A qualitative study using focus groups and semi-structured interviews. Data were analysed using a constructivist grounded theory approach. Setting/participants: Five focus groups and 29 in-depth semi-structured interviews were conducted with a total of 55 older adults (24 men and 31 women) aged between 52 and 78 years. Participants from six South Asian ethnic groups were recruited via 11 local community organisations. Results: Two key themes were identified. The theme of ‘reconsidering the homeland’ draws on the notion of ‘diaspora’ to help understand why for many participants, the physical place of death was perceived as less important than the opportunity to carry out cultural and religious practices surrounding death. The second theme ‘home as a haven’ describes participants’ accounts of how their home is a place in which it is possible to perform various cultural and religious rituals. Cultural and religious practices were often seen as essential to achieving a peaceful death and honouring religious and filial duties. Conclusions: Older people of South Asian ethnicity living in East London perceive home as more than a physical location for dying relatives. They make efforts to adhere, and also adapt, to important social and cultural values relating to death and dying as part of the wider challenge of living in an emigrant society.
Measurement of muscle architecture concurrently with muscle hardness using ultrasound strain elastography
Authors: Chino Kentaro , Akagi Ryota , Dohi Michiko , Takahashi Hideyuki 
Published: October 2013

Background The B-mode ultrasound image that can measure muscle architecture is displayed side by side with the ultrasound strain elastogram that can assess muscle hardness. Consequently, muscle architecture can be measured concurrently with muscle hardness using ultrasound strain elastography. Purpose To demonstrate the measurement of muscle architecture concurrently with muscle hardness using ultrasound strain elastography. Material and Methods Concurrent measurements of muscle architectural parameters (muscle thickness, pennation angle, and fascicle length) and muscle hardness of the medial gastrocnemius were performed with ultrasound strain elastography. Separate measurements of the muscle architectural parameters were also performed for use as reference values for the concurrent measurements. Both types of measurements were performed twice at 20° dorsiflexion, neutral position, and 30° plantar flexion. Results Coefficients of variance of the muscle architectural parameters obtained from the concurrent measurements (≤7.6%) were significantly higher than those obtained from the separate measurements (≤2.4%) (all P < 0.05). Intraclass correlation coefficients of the architectural parameters were lower in the concurrent measurements (≥0.74) than in the separate measurements (≥0.97). However, there were no significant differences in any muscle architectural parameters between the concurrent and separate measurements (all P > 0.05). Conclusion The use of ultrasound strain elastography for the concurrent measurement of muscle architecture and muscle hardness is feasible.
Diagnostic accuracy of 64-slice multidetector CT angiography for detection of in-stent restenosis of vertebral artery ostium stents: comparison with conventional angiography
Authors: Lee Youn Joo , Lim Yeon Soo , Lim Hyun Wook , Yoo Won Jong , Choi Byung Gil , Kim Bum Soo 
Published: October 2013

Background There are very few reports assessing in-stent restenosis (ISR) after vertebral artery ostium (VAO) stents using multidetector computed tomography (MDCT). Purpose To compare the diagnostic accuracy of computed tomography angiography (CTA) using 64-slice MDCT with digital subtraction angiography (DSA) for detection of significant ISR after VAO stenting. Material and Methods The study evaluated 57 VAO stents in 57 patients (39 men, 18 women; mean age 64 years [range, 48–90 years]). All stents were scanned with a 64-slice MDCT scanner. Three sets of images were reconstructed with three different convolution kernels. Two observers who were blinded to the results of DSA assessed the diagnostic accuracy of CTA for detecting significant ISR (≥50% diameter narrowing) of VAO stents in comparison with DSA as the reference standard. The sensitivity, specificity, positive and negative predictive values, and accuracy were calculated. Results Of the 57 stents, 46 (81%) were assessable using CTA, while 11 (19%) were not. No stents with diameters ≤2.75 mm were assessable. DSA revealed 13 cases of significant ISR in all stents. The respective sensitivity, specificity, positive and negative predictive values, and accuracy were 92%, 82%, 60%, 97%, and 84% for all stents. On excluding the 11 non-assessable stents, the respective values were 88%, 95%, 78%, 97%, and 93%. Of the 46 CTA assessable stents, eight significant ISRs were diagnosed on DSA. Seven of eight patients with significant ISR by DSA were diagnosed correctly with CTA. The area under the receiver-operating characteristic curve (AUC) was 0.87 for all stents and 0.91 for assessable stents, indicating good to excellent agreement between CTA and DSA for detecting significant ISR after VAO stenting. Conclusion Sixty-four-slice MDCT is a promising non-invasive method of assessing stent patency and can exclude significant ISR with high diagnostic values after VAO stenting.
Impact of the Fracture Risk Assessment on Patient and Physician Behavior in Osteoporosis Prevention
Authors: McConaha Jamie L. , Berdine Hildegarde J. , Skomo Monica L. , Laux Robert V. , Higginbotham Suzanne K. , O'Neil Christine K. 
Published: October 2013

Objective: To evaluate the impact of a pharmacist-directed osteoporosis screening program utilizing the fracture risk assessment (FRAX) tool on patient and physician behavior. Methods: Postmenopausal women 45 to 65 years with Achilles T score <−1.0 not receiving bisphosphonate therapy were randomly assigned to a control or intervention group. All participants received a heel ultrasound and pharmacist education on risks of low bone mass. The intervention group received the FRAX and shared their results with their physician. Three months after screening, a telephonic questionnaire was administered to all participants. Results: A total of 749 patients were screened, with 87 meeting the enrollment criteria (43 control and 44 intervention). Physician behavior was not different between the groups with respect to ordering vitamin D levels, prescription medication, or dual-energy x-ray absorptiometry scan. A significant difference in vitamin D supplementation occurred between the 2 groups ( P = .024). At follow-up, 72.2% of responding participants increased daily calcium intake and 76.4% started or increased physical activity. Conclusion: Physician behavior was not influenced by FRAX results in the intervention group; however, positive patient behavior changes occurred in both groups. Primary prevention efforts conducted through heel ultrasound screening and pharmacist consultation led women to follow-up; however, awareness still needs to be raised of the value of FRAX in osteoporosis prevention.
Early recognition of anti-N-methyl D-aspartate (NMDA) receptor encephalitis presenting as acute psychosis
Authors: Tidswell Jessica , Kleinig Timothy , Ash David , Thompson Philip , Galletly Cherrie 
Published: October 2013

Objective: We present a case of anti-N-methyl D-aspartate (NMDA) receptor encephalitis that illustrates the dilemma that psychiatrists face in evaluating patients with first episode psychosis. Conclusions: The discovery that acute psychosis can be the presenting feature of autoimmune encephalitis (in particular encephalitis caused by anti-NMDA receptor antibodies) has both practical and theoretical consequences. First, this condition is an important, but often overlooked, differential diagnosis of first episode psychosis. Antibody testing is not currently part of routine screening, though delayed (or missed) diagnosis can lead to prolonged hospital stay, medical complications and incomplete or delayed recovery. Widespread screening of patients with first presentation psychosis for anti-NMDA receptor and anti-voltage-gated potassium channel (anti-VGKC) antibodies is warranted for a number of reasons: to expedite appropriate treatment, to determine the true proportion of patients with these conditions presenting as psychosis, and to help elucidate the neurochemical causes of psychosis.
Comparison of Medical Costs of Patients With Atrial Fibrillation Unsuitable for Warfarin Treatment With Apixaban or Aspirin Based on AVERROES Trial
Authors: Amin Alpesh , Deitelzweig Steve , Jing Yonghua , Makenbaeva Dinara , Wiederkehr Daniel , Lin Jay , Graham John 
Published: October 2013

Background: The AVERROES trial name is the following: The Apixaban Versus Acetylsalicylic Acid (ASA) to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment (AVERROES) trial demonstrated that apixaban reduced the risk of stroke relative to aspirin, without significantly increasing major bleeding risk in patients with atrial fibrillation (AF) considered unsuitable for warfarin therapy. Based on AVERROES trial results, this study compared the medical costs for clinical end points among patients with AF treated with either apixaban or aspirin. Methods: Medical costs per patient-year for clinical events were determined. Based on clinical event rates for patients in the AVERROES trial, medical costs excluding drug costs were estimated for apixaban- and aspirin-treated patient groups. Results and Conclusions: Based on AVERROES trial results, among patients with AF unsuitable for warfarin therapy, apixaban use was estimated to be associated with a mean medical cost avoidance of US$735 in a patient-year relative to aspirin. The primary driver was the significant reduction in ischemic stroke rate. The medical cost reduction associated with apixaban use was consistent in sensitivity analyses.
Predictors and dynamics of postpartum relapses in women with multiple sclerosis
Authors: Hughes Stella E , Spelman Tim , Gray Orla M , Boz Cavit , Trojano Maria , Lugaresi Alessandra , Izquierdo Guillermo , Duquette Pierre , Girard Marc , Grand’Maison Francois , Grammond Pierre , Oreja-Guevara Celia , Hupperts Raymond , Bergamaschi Roberto , Giuliani Giorgio , Lechner-Scott Jeannette , Barnett Michael , Edite Rio Maria , van Pesch Vincent , Amato Maria Pia , Iuliano Gerardo , Slee Mark , Verheul Freek , Cristiano Edgardo , Fernández-Bolaños Ricardo , Poehlau Dieter , Saladino Maria Laura , Deri Norma , Cabrera-Gomez Jose , Vella Norbert , Herbert Joseph , Skromne Eli , Savino Aldo , Shaw Cameron , Moore Fraser , Vucic Steve , Petkovska-Boskova Tatjana , McDonnell Gavin , Hawkins Stanley , Kee Frank , Butzkueven Helmut ,   for the MSBase study group, Paolicelli Damiano , Lucchese Guglielmo , Iaffaldano Pietro , Zwanikken Cees , De Luca Giovanna , Di Tommaso Valeria , Travaglini Daniela , Pietrolongo Erika , di Ioia Maria , Farina Deborah , Mancinelli Luca , Marriott Mark , Kilpatrick Trevor , King John , van der Walt Anneke , Skibina Olga , Haartsen Jodi , Chamorro Beatriz , Petersen Thor , Cartechini Elisabetta , Pucci Eugenio , William David , Dark Lisa , Fiol Marcela , Correale Jorge , Ysrraelit Celica , Den Braber-Moerland Leontien , Jaacks Gonzalo , Laffue Alfredo , Fernanda Páez María , Muñoz Daniel , Oleschko Arruda Walter , Paine Mark , Vella Malcolm , Vetere Santiago 
Published: October 2013

Background: Several studies have shown that pregnancy reduces multiple sclerosis (MS) relapses, which increase in the early postpartum period. Postpartum relapse risk has been predicted by pre-pregnancy disease activity in some studies. Objective: To re-examine effect of pregnancy on relapses using the large international MSBase Registry, examining predictors of early postpartum relapse. Methods: An observational case–control study was performed including pregnancies post-MS onset. Annualised relapse rate (ARR) and median Expanded Disability Status Scale (EDSS) scores were compared for the 24 months pre-conception, pregnancy and 24 months postpartum periods. Clustered logistic regression was used to investigate predictors of early postpartum relapses. Results: The study included 893 pregnancies in 674 females with MS. ARR (standard error) pre-pregnancy was 0.32 (0.02), which fell to 0.13 (0.03) in the third trimester and rose to 0.61 (0.06) in the first three months postpartum. Median EDSS remained unchanged. Pre-conception ARR and disease-modifying treatment (DMT) predicted early postpartum relapse in a multivariable model. Conclusion: Results confirm a favourable effect on relapses as pregnancy proceeds, and an early postpartum peak. Pre-conception DMT exposure and low ARR were independently protective against postpartum relapse. This novel finding could provide clinicians with a strategy to minimise postpartum relapse risk in women with MS planning pregnancy.
Luminescent gold nanoparticles: A new class of nanoprobes for biomedical imaging
Authors: Zhou Chen , Yang Shengyang , Liu Jinbin , Yu Mengxiao , Zheng Jie 
Published: October 2013

Our fundamental understanding of cell biology and early diagnosis of human diseases have been greatly benefited from the development of fluorescent probes. Over the past decade, luminescent gold nanoparticles (AuNPs) with diverse structural parameters including particle size, surface ligands, valence state and grain size have been synthesized and have begun to emerge as a new class of fluorescent probes for bioimaging because of their great biocompatibility, robust photophysical properties and tunable emissions from the visible range to the near infrared region. In this minireview, we summarize the recent progress in applications of different-sized luminescent AuNPs as imaging probes for both in vitro and in vivo levels.
Don’t forget about the pancreas! Useful tips on ultrasound
Authors: Footitt C , Suut S , Rudralingam V 
Published: October 2013

Transabdominal ultrasound (TAUS) remains the most widely available, non-invasive and least expensive initial imaging modality of the pancreas. Awareness of a range of pancreatic pathology is imperative when determining the need for further cross-sectional imaging or increasingly, endoscopic ultrasound (EUS). Given the spectrum of pathologic processes that affect the pancreas, alongside the significant overlap in clinical presentation, the major task on the initial TAUS is to distinguish normal from abnormal and subsequently inflammatory-related pathology from underlying neoplasia. This article aims to present useful sonographic signs that demonstrate and differentiate pancreatic pathologies. These useful sonographic signs are highlighted through a series of benign and neoplastic conditions involving the pancreas and correlation is made with alternative imaging including computed tomography (CT), magnetic resonance imaging (MRI) and EUS. In conclusion, TAUS continues to have a useful role in the initial assessment of the pancreas. Recognising useful sonographic signs, as well as their limitations, is important in the avoidance of misdiagnosis and accurately triaging patients with regard to further appropriate imaging investigations.
What ranges of metacarpophalangeal joint flexion and extension are necessary to perform activities without difficulty?
Authors: Hayashi Hiroyuki , Shimizu Hideki 
Published: October 2013

Introduction: Although the goal of restoring motion is to reduce limitations imposed on activities, the necessary metacarpophalangeal joint range of motion to perform activities without difficulty remains unclear. This study of 30 healthy participants was conducted to ascertain the flexion and extension range of motion of all finger metacarpophalangeal joints necessary to perform activities without difficulty with restricted angles of all finger metacarpophalangeal joints. Methods: Flexion and extension of finger metacarpophalangeal joints of 30 participants were restricted by orthoses. Flexion was restricted to 70°, 60°, 50°, and 40°. Extension was restricted to −20°, −30°, −40°, and −50°. Participants performed 19 activities at eight different angles in random order. The perceived difficulty in performing each task was scored. Results: Statistically significant differences in difficulty were found between the results of trials performed with angles restricted to 50° and 40° of flexion, and to −40° and −50° of extension compared with those of a normal hand. No significant difference in difficulty was found between the results of trials performed with restriction angles of 70° or 60° of flexion, or −20° or −30° of extension compared with those of a normal hand. Conclusion: Difficulty in performing many activities might not be perceived for flexion or extension range of motion of more than 60° and −30° achieved by hand therapy, even if the range of motion of finger metacarpophalangeal joints is restricted. This study is expected to be useful for determining range of motion goals in patients with limited finger metacarpophalangeal joint movement.
Neurothekeoma of the Toe
Authors: Wiemeyer Stefan , Hafer Guido 
Published: October 2013

Neurothekeomas are benign connective tissue tumors probably of nerve sheath origin. Making diagnosis is often difficult, because of many histological similar looking tumors. Immunostaining of S-100 protein is a helpful method for differentiation. We report a case of subungual neurothekeoma affecting the little toe, which is to our knowledge the first to be described in the literature. In spite of an incomplete excision of the tumor with tails reaching to the base of the specimen, no recurrence after 1-year follow-up was observed. Levels of Evidence: Therapeutic, Level IV: Case Study
Turf Toe Repair
Authors: Doty Jesse F. , Coughlin Michael J. 
Published: October 2013

Turf toe injury typically describes an injury to the metatarsosesamoid complex of the hallux generally caused by a hyperextension force to the great toe. This injury may be accompanied by pain, deformity, and decreased athletic performance. Operative treatment to repair the damaged tissue can be difficult, and we present a technique description that may help simplify the surgical reconstruction. Levels of Evidence: Level V
A specially tailored vancomycin continuous infusion regimen for renally impaired critically ill patients
Authors: Eldemiry Eman Mohamed Bahgat , Sabry Nirmeen A , Abbassi Maggie M , Abdel Shafy Sanaa S , Mokhtar Mohamed S , Abdel Bary Ahmed 
Published: October 2013

Background: Vancomycin remains the gold standard for treatment of methicillin-resistant Staphylococcus aureus. Specially designed continuous infusion of vancomycin leads to better therapy. Methodology: A total of 40 critically ill patients who suffered from pneumonia susceptible to vancomycin, had serum creatinine >1.4 mg%, and oliguria <0.5 mL/kg/h for 6 h were included in the study with respiratory culture sensitivity to vancomycin ≤2 mg/L. Patients’ clinical, microbiological, and biological data were obtained by retrospective analysis of the corresponding medical files before and after vancomycin treatment. Patients with serum creatinine level ≥4 mg% and patients who received renal replacement therapy during the treatment period were excluded. The patients were divided into two groups—group 1 (intermittent dosing) and group 2 (continuous infusion) based on the following formula: rate of vancomycin continuous infusion (g/day) = [0.0205 creatinine clearance (mL/min) + 3.47] × [target vancomycin concentration at steady state (µg/mL)] × (24/1000). Trough vancomycin serum levels were also assessed using high-performance liquid chromatographic technique. Patients’ outcomes such as clinical improvement, adverse events, and 15-day mortality were reported. Results: Group 2 showed significant reduction in blood urea nitrogen, creatinine serum levels, white blood cells, partial carbon dioxide pressure, body temperature, and Sequential Organ Failure Assessment score, while significant increase in partial oxygen pressure and saturated oxygen was also observed. A significantly shorter duration of treatment with a comparable vancomycin serum levels was also reported with group 2. Conclusion: After treatment, comparison in patients’ criteria supports the superiority of using continuous infusion of vancomycin according to this equation in renally impaired patients.
The Effect of Epinephrine on Coronary Flow in the Setting of a Systemic-to-Pulmonary Artery Shunt
Authors: DeCampli William M. , Tsai Felix W. , Argueta-Morales I. Ricardo , Smith Cathy , Munro Hamish M. 
Published: October 2013

Background: Indirect clinical evidence suggests that coronary blood flow (CBF) is altered in patients palliated with systemic-to-pulmonary artery shunts (SPSs). The addition of epinephrine may exert additional effects. Methods: A total of 11 newborn piglets underwent placement of a 3.5- to 4-mm graft between the innominate artery and the pulmonary artery. Doppler probes measured flow continuously in the aorta (aortic flow [AoF]), pulmonary artery and left coronary artery at baseline (SPS closed), SPS open, and during epinephrine administration (SPS closed and open). Each animal served as its own control. Systolic and diastolic CBF, resistance (coronary vascular resistance index [CVRI]), and myocardial oxygen supply demand ratio were calculated. Results: Opening the SPS increased AoF and decreased systolic and diastolic pressure from baseline, with and without the presence of epinephrine. The CBF and CVRI decreased on opening the SPS in the presence of epinephrine. The decrease occurred only in diastole and was proportional to pulmonary-to-systemic flow ratio (Qp/Qs). Epinephrine infusion itself reduced CVRI with SPS closed, but there was little further decrease on opening SPS. Myocardial oxygen supply–demand ratio decreased on opening SPS at baseline and with epinephrine. Conclusions: This study suggests that SPS decreases CBF, especially in the presence of a higher Qp/Qs and epinephrine. The mechanism is largely due to the decrease in diastolic pressure and the inability of the coronary arteries to compensate with vasodilation.