bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microscopic Examination of Iatrogenic Subglottic Tracheal Stenosis
Authors: Welkoborsky Hans-J. , Hinni Michael L. , Moebius Hartmut , Bauer Lothar , Ostertag Helmut 
Published: February 2014

Objectives: The histopathologic origin of iatrogenic subglottic tracheal stenosis (ISTS) remains unclear. The purpose of this study was to use detailed operative microscopy to systematically examine the operative en bloc specimens of patients with ISTS and to observe the histologic and morphological changes in the hopes that these observations will provide insight into the histopathologic origin of these devastating injuries. Methods: The operative specimens of 18 patients who underwent open tracheal or laryngotracheal resection for ISTS were examined. Precise morphological characteristics were investigated for each tissue layer, including the adventitia, the outer surface of the perichondrium, the cartilage, the inner surface of the perichondrium, the submucosa, and the mucosa. Each tissue layer was evaluated independently and in relationship to the other layers. The cartilaginous airway was further evaluated relative to the pars membranacea. Results: The most common morphological finding in the epithelium was squamous metaplasia with occasional intense inflammation visible in the underlying mucosa, including cicatrization. The underlying cartilage demonstrated ossific metaplasia with sequestration in many cases. By far the most pronounced changes were found in the outer perichondrium and overlying adventitia and included diffuse paucicellular or hyperplastic fibrosis with intense hyperplastic scar formation or hyaline cicatrization. In the pars membranacea, severe scar formation and hyperplastic fibrosis were predominant. Ossific metaplasia was particularly severe in the lateral or outer parts of the tracheal ring, particularly in the vicinity of the adventitia and outer perichondrium. These changes were much more pronounced than the relatively minor changes observed in the submucosa and mucosa. Conclusions: The most severe pathologic observations occurred in the lateral tissue layers, ie, the outer perichondrium and adventia. Given that an injury occurs from the tracheal lumen, these tissue layers have the greatest distance from the site of injury. As only minor changes occurred in the inner tissue layers, we hypothesize that these tissues have a greater regenerative capacity than the outer layers. This study supports the theory that the depth of the airway injury is more critical to the development of ISTS than is the extent or length of the injury.
Lipomas of the Internal Auditory Canal and Cerebellopontine Angle
Authors: Bacciu Andrea , Di Lella Filippo , Ventura Elisa , Pasanisi Enrico , Russo Alessandra , Sanna Mario 
Published: February 2014

Objectives: Lipomas of the internal auditory canal (IAC) and cerebellopontine angle (CPA) are exceedingly rare lesions. The purpose of this report was to describe our experience with lipomas of the IAC and CPA and perform a review of the literature. Methods: We report 8 cases of lipomas involving the IAC and/or the CPA that were managed at Gruppo Otologico between April 1987 and October 2012. Results: Four cases of entirely intracanalicular lipomas were radiologically misinterpreted as vestibular schwannomas and underwent tumor removal by a translabyrinthine approach. Two of these patients experienced postoperative facial nerve palsy. Lipomas were suspected in 4 patients on the basis of imaging findings and were managed conservatively. Of these 4 cases, 3 did not show any growth after an average period of 28 months, and 1 case demonstrated tumor growth on follow-up imaging. Conclusions: Neuroimaging represents an extremely important tool for this diagnosis. Attempts to achieve complete resection may result in severe neurologic sequelae, especially in large lesions. Observation with repeated imaging in order to detect growth of the lesion is usually recommended. Debulking of the tumor, mainly aimed at brain stem and cranial nerve decompression, should be considered in cases of disabling and uncontrolled neurologic symptoms and signs.
Effect of Uvulopalatopharyngoplasty on Leptin and Endothelial Function in Sleep Apnea
Authors: Lin Ching-Chi , Wang Ying-Piao , Lee Kuo-Sheng , Liaw Shwu-Fang , Chiu Chung-Hsin 
Published: February 2014

Objectives: This study evaluated the effects of uvulopalatopharyngoplasty (UPPP) on serum leptin levels and endothelial function in patients with obstructive sleep apnea syndrome (OSAS). Methods: Fifteen healthy subjects and 35 patients with moderate to severe OSAS who desired UPPP were prospectively enrolled. The serum levels of leptin and nitric oxide derivative (NOx) from their peripheral blood samples were measured by enzyme-linked immunosorbent assay. All subjects participated in sleep studies, which were repeated 3 months after UPPP in the patients with OSAS. Results: Before UPPP, the patients with OSAS had a higher serum level of leptin and a lower NOx level than did the control subjects. The serum leptin levels in the 17 of the 35 patients with OSAS who were surgical responders decreased from 24.2 ± 6.1 ng/mL before operation to 15.9 ± 6.0 ng/mL after operation. The serum NOx levels in these 17 patients increased from 18.5 ± 7.5 µmol/L before operation to 27.3 ± 8.2 µmol/L after operation. In the 18 patients who were unresponsive to surgery, the serum leptin and NOx levels remained impaired after the UPPP. Conclusions: Successful treatment of OSAS with UPPP leads to the normalization of serum leptin and NOx levels.
Alternative to Canal Wall–Down Mastoidectomy for Sclerotic Mastoid Cavities
Authors: Heo Kyung Wook , Kang Myung Koo , Park Jae Yeong 
Published: February 2014

Objectives: Surgical procedures for chronic ear disease can be grossly divided into two tympanoplasty procedures: canal wall–up and canal wall–down (CWD) mastoidectomies. The choice depends on the surgeon’s preference. Epitympanoplasty with mastoid obliteration (EMO) has shown postoperative results similar to those of CWD mastoidectomy with long-term follow-up. In this study, we compared the outcomes of EMO and CWD mastoidectomy in preoperatively sclerotic mastoid cavities with cholesteatoma, chronic otitis media with poor eustachian tube function, or adhesive otitis media. The operations were performed by the same surgeons in order to eliminate any effect of surgeon preference on the surgical outcomes. Methods: We reviewed the medical records of patients who underwent tympanoplasty with EMO (EMO group) or CWD mastoidectomy (CWD group) and followed them for more than 28 months. The postoperative outcomes were analyzed and compared. Results: The EMO and CWD groups comprised 132 and 110 ears, respectively. In both groups, the air-bone gaps were significantly reduced after operation. The relapse rates of the groups were similar. Cavity problems were the most common complication in the CWD group. The overall complication rate in the EMO group was significantly lower than that in the CWD group (p = 0.044). Conclusions: Epitympanoplasty with mastoid obliteration can be considered an alternative procedure to CWD mastoidectomy in patients with preoperatively sclerotic mastoid cavities. It gives similar surgical results and has fewer complications.
OK432 Versus Doxycycline for Treatment of Macrocystic Lymphatic Malformations
Authors: Motz Kevin M. , Nickley Katherine B. , Bedwell Joshua R. , Yadav Bhupender , Guzzetta Philip C. , Oh Albert K. , Bauman Nancy M. 
Published: February 2014

Objectives: A variety of sclerotherapy agents are used to treat macrocystic lymphatic malformations (LMs). This retrospective study at a single institution was performed to compare the outcomes of pediatric macrocystic LMs of the head and neck that were treated with doxycycline or with OK432. Methods: The outcomes measured included early response to therapy, number of treatments required, operating room time, and adverse events. Results: The rates of clinical success for OK432 and doxycycline were similar (83% and 82%, respectively; p > 0.05), although OK432-treated patients required more treatments than did doxycycline-treated patients (1.9 versus 1.0 injections; p = 0.01; 95% confidence interval, 1.57 to 0.27). The average operating room time for a single OK432 injection was significantly shorter than that for doxycycline (53.2 versus 98.1 minutes; p < 0.001); however, when the total number of treatments administered was considered, the overall times in the operating room were similar. Adverse events in the early postoperative period were more common in OK432-treated patients, who experienced marked postoperative swelling compared to doxycycline-treated patients. Conclusions: OK432 and doxycycline are both effective sclerosants for the treatment of predominantly macrocystic LMs. The administration time for OK432 is shorter than that for doxycycline, but OK432 required more treatments overall to achieve clinical success. Early adverse events were more common in OK432-treated patients, but longer follow-up is necessary to determine whether rates of recurrence and adverse events are similar, particularly in light of the risk of tooth discoloration in doxycycline-treated patients.
Results of Anterior Facial Nerve Rerouting Procedures for Removing Skull Base Tumors
Authors: Yi Jong Sook , Lim Hyun Woo , Chang Young Soo , Choi Seung Hyo , Cho Yang-Sun , Chung Jong Woo 
Published: February 2014

Objectives: The purpose of this study was to estimate the rates of functional recovery of the facial nerve and of total tumor resection in patients who undergo short anterior rerouting and long anterior rerouting of the facial nerve in removal of skull base tumors. Methods: We retrospectively collected data on 37 patients with skull base tumors who underwent facial nerve rerouting during the procedure for tumor removal. Information on the rerouting technique, the completeness of tumor resection, and changes in facial nerve function were obtained from the medical records. Rerouting techniques were classified as short anterior rerouting or long anterior rerouting. Results: Ten of 16 patients (62.5%) in the group with short anterior rerouting showed postoperative facial palsy, and all completely recovered within 1 year. In the group with long anterior rerouting, 18 of 21 patients (85.7%) showed postoperative facial palsy, and recovery to a preoperative level of facial function was found in 10 patients at 1 year of follow-up. Total tumor resection was possible in 94% and 81% of patients with short rerouting and long rerouting, respectively. The mean operation time was not significantly related to the postoperative recovery of facial function. Conclusions: Short rerouting techniques, when appropriately chosen on the basis of tumor and patient characteristics, offer excellent preservation of facial function and tumor resection, comparable to those of long rerouting techniques.
The Swedish Version of the Breastfeeding Self-Efficacy Scale–Short Form
Authors: Gerhardsson Emma , Nyqvist Kerstin Hedberg , Mattsson Elisabet , Volgsten Helena , Hildingsson Ingegerd , Funkquist Eva-Lotta 
Published: February 2014

Background: Among Swedish mothers, breastfeeding duration has been declining in recent years. An instrument for early identification of women at risk for shorter breastfeeding duration may be useful in reversing this trend. Objectives: The aims of this study were to translate and psychometrically test the Swedish version of the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF), examine the relationship between breastfeeding self-efficacy and demographic variables, and evaluate associations with breastfeeding continuation plans in Swedish mothers. Methods: The BSES-SF was translated into Swedish using forward and back translation. The sample consisted of 120 mothers who, during the first week postpartum, came for a routine follow-up visit at the postnatal unit in a university hospital. The mothers were compared based on demographic data and their future breastfeeding plans. Results: The Cronbach’s alpha coefficient for internal consistency for the BSES-SF was 0.91 and the majority of correlation coefficients exceeded 0.3. A 1-factor solution was found that explained 46% of the total variance. There was no difference in confidence in breastfeeding between mothers with early hospital discharge and mothers who received postnatal care at the hospital. Primiparas who stayed longer at the hospital were less confident in breastfeeding than primiparas who had a shorter hospital stay. Breastfeeding mothers who planned to partially breastfeed in the near future had lower BSES-SF scores, compared to those who planned to continue exclusive breastfeeding. Conclusion: The Swedish version of the BSES-SF has good reliability, validity, and agreement with mothers’ plans regarding breastfeeding continuation and exclusivity.
Collective bargaining for paid parental leave in Australia 2005–2010: A complex context effect
Authors: Baird Marian , Murray John 
Published: February 2014

AbstractIn the period leading up to the federal government’s May 2009 announcement of a paid parental leave scheme, there was a surge in community and media debate about the absence of such a scheme in Australia. This article explores whether this context had some bearing on bargaining outcomes during that time. We analyse data from the Australian Workplace Agreements Database to determine the incidence and length of paid parental leave in collective agreements registered between 2005 and 2010. The results show an increase in the number of agreements that included paid parental leave clauses in the period, with just over 14% of all current agreements including a paid parental leave clause by 2010. Moreover, 18% of all agreements lodged in 2010 included a paid parental leave clause, suggesting an increase in bargaining outcomes over time. We also find a slight increase in the average duration of paid parental leave in collective agreements. A leave of 14 weeks is most common in public sector agreements but less than 3% of agreements in the private sector provide for 14 weeks or more. These marked differences between the public and private sectors suggest minimal change in private sector bargaining outcomes. We conclude that the legislative context does influence bargaining outcomes, but that this effect is felt more in public sector than private sector bargaining.
Cell Therapy in Joint Disorders
Authors: Counsel Peter D. , Bates Daniel , Boyd Richard , Connell David A. 
Published: February 2014

Context: Articular cartilage possesses poor natural healing mechanisms, and a variety of non-cell-based and cell-based treatments aim to promote regeneration of hyaline cartilage. Data Sources: A review of the literature to December 2013 using PubMed with search criteria including the keywords stem cell, cell therapy, cell transplantation, cartilage, chondral, and chondrogenic. Study Selection: Forty-five articles were identified that employed local mesenchymal stem cell (MSC) therapy for joint disorders in humans. Nine comparative studies were identified, consisting of 3 randomized trials, 5 cohort studies, and 1 case-control study. Study Type: Clinical review. Level of Evidence: Level 4. Data Extraction: Studies were assessed for stem cell source, method of implantation, comparison groups, and concurrent surgical techniques. Results: Two studies comparing MSC treatment to autologous chondrocyte implantation found similar efficacy. Three studies reported clinical benefits with intra-articular MSC injection over non-MSC controls for cases undergoing debridement with or without marrow stimulation, although a randomized study found no significant clinical difference at 2-year follow-up but reported better 18-month magnetic resonance imaging and histologic scores in the MSC group. No human studies have compared intra-articular MSC therapy to non-MSC techniques for osteoarthritis in the absence of surgery. Conclusion: Mesenchymal stem cell–based therapies appear safe and effective for joint disorders in large animal preclinical models. Evidence for use in humans, particularly, comparison with more established treatments such as autologous chondrocyte implantation and microfracture, is limited.
Changes in Landing Mechanics in Patients Following Anterior Cruciate Ligament Reconstruction When Wearing an Extension Constraint Knee Brace
Authors: Butler Robert J. , Dai Boyi , Garrett William E. , Queen Robin M. 
Published: February 2014

Background: Anterior cruciate ligament (ACL) reconstruction is associated with a high incidence of second tears (graft tears and contralateral ACL tears). These secondary tears have been attributed to asymmetrical lower extremity mechanics. Knee bracing is one potential intervention that can be used during rehabilitation that has the potential to normalize lower extremity asymmetry; however, little is known about the effect of bracing on movement asymmetry in patients following ACL reconstruction. Hypothesis: Wearing a knee brace would increase knee joint flexion and joint symmetry. It was also expected that the joint mechanics would become more symmetrical in the braced condition. Objective: To examine how knee bracing affects knee joint function and symmetry over the course of rehabilitation in patients 6 months following ACL reconstruction. Study Design: Controlled laboratory study. Level of Evidence: Level 3. Methods: Twenty-three adolescent patients rehabilitating from ACL reconstruction surgery were recruited for the study. The subjects all underwent a motion analysis assessment during a stop-jump activity with and without a functional knee brace on the surgical side that resisted extension for 6 months following the ACL reconstruction surgery. Statistical analysis utilized a 2 × 2 (limb × brace) analysis of variance with a significant alpha level of 0.05. Results: Subjects had increased knee flexion on the surgical side when they were braced. The brace condition increased knee flexion velocity, decreased the initial knee flexion angle, and increased the ground reaction force and knee extension moment on both limbs. Side-to-side asymmetry was present across conditions for the vertical ground reaction force and knee extension moment. Conclusion: Wearing a knee brace appears to increase lower extremity compliance and promotes normalized loading on the surgical side. Clinical Relevance: Knee extension constraint bracing in postoperative ACL patients may improve symmetry of lower extremity mechanics, which is potentially beneficial in progressing rehabilitation and reducing the incidence of second ACL tears.
The Prevalence of Radiographic Criteria of Femoral Acetabular Impingement in Patients Undergoing Hip Arthroplasty Surgery
Authors: LaFrance Russell , Williams Richard , Madsen Wes , Maloney Michael , Drinkwater Christopher , Giordano Brian 
Published: February 2014

Background: Pistol grip deformity of the proximal femur has been reported as a potential cause of hip pain and early-onset arthritis. The exact incidence of patients with osteoarthritis resulting from femoral acetabular impingement (FAI) is unknown. The purpose of this study was to explore the relationship between radiographic markers of FAI in patients undergoing hip arthroplasty. Methods: We retrospectively reviewed the radiographs of patients undergoing hip arthroplasty by a single surgeon over a 2-year period. The patients were divided by age, those younger than 65 years and (group A) and those 65 years and older (group B). The radiographs were evaluated for morphology consistent with FAI including an α angle >55°, crossover sign, coxa profunda, acetabular protrusio, and ischial spine sign. Three independent reviewers evaluated all the radiographs. The incidence of CAM, Pincer, and mixed deformities were compared between the 2 groups. Results: A total of 255 patients with 258 hip arthroplasties were included in this analysis. Group A was found to have a greater number of patients with CAM morphology. Linear regression analysis revealed that the α angle was greater in younger patients. Conclusion: Patients undergoing hip arthroplasty exhibit a high incidence of radiographic abnormalities consistent with FAI. The CAM-type morphology occurs more frequently in younger patients with advanced arthritis requiring hip arthroplasty. This morphology is thought to cause a delaminating injury to the cartilage of the acetabulum. This study supports the notion that CAM-type morphology is a risk factor for early development of degenerative arthritis of the hip.
SRF is required for neutrophil migration in response to inflammation
Authors: Taylor Ashley , Tang Wenwen , Bruscia Emanuela M. , Zhang Ping-Xia , Lin Aiping , Gaines Peter , Wu Dianqing , Halene Stephanie 
Published: February 2014

Key PointsSRF is essential for neutrophil migration in part by regulation of integrin homeostasis. Several genes located on chromosome 5q are part of the SRF signaling pathway implicating dysfunction of SRF in myelodysplasia.
Factors associated with severe maternal morbidity and near miss in the São FranciscoValley, Brazil: a retrospective, cohort study
Authors: Pacheco Alvaro José Correia , Katz Leila , Souza Alex Sandro Rolland , de Amorim Melania Maria Ramos 
Published: February 2014

Abstract

Background
Maternal mortality remains a major public health issue worldwide, with persistent high rates prevailing principally in underdeveloped countries. The objective of this study was to determine the risk factors for severe maternal morbidity and near miss (SMM/NM) in pregnant and postpartum women at the maternity ward of the Dom Malan Hospital, Petrolina, in northeastern Brazil.

Methods
A retrospective, cohort study was conducted to evaluate the sociodemographic and obstetric characteristics of the women. Patients who remained hospitalized at the end of the study period were excluded. Risk ratios (RR) and their respective 95% confidence intervals (95% CI) were calculated as a measure of relative risk. Hierarchical multiple logistic regression was also performed. Two-tailed p-values were used for all the tests and the significance level adopted was 5%.

Results
A total of 2,291 pregnant or postpartum women receiving care between May and August, 2011 were included. The frequencies of severe maternal morbidity and near miss were 17.5% and 1.0%, respectively. Following multivariate analysis, the factors that remained significantly associated with an increased risk of SMM/NM were a Cesarean section in the current pregnancy (OR: 2.6; 95% CI: 2.0 – 3.3), clinical comorbidities (OR: 3.4; 95% CI: 2.5 – 4.4), having attended fewer than six prenatal visits (OR: 1.1; 95% CI: 1.01 – 1.69) and the presence of the third delay (i.e. delay in receiving care at the health facility) (OR: 13.3; 95% CI: 6.7 – 26.4).

Conclusions
The risk of SMM/NM was greater in women who had been submitted to a Cesarean section in the current pregnancy, in the presence of clinical comorbidities, fewer prenatal visits and when the third delay was present. All these factors could be minimized by initiating a broad debate on healthcare policies, introducing preventive measures and improving the training of the professionals and services providing obstetric care.