bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistent incompetent truncal veins should not be treated immediately
Authors: Pittaluga P , Chastanet S 
Published: March 2015

Background The traditional attitude for the treatment of chronic venous disorder is to systematically treat incompetent truncal veins. We wanted to evaluate the outcomes of not treating all incompetent truncal veins with regard to our experience of focusing the treatment to the varicose tributaries. Methods Retrospective study on all procedures of surgical treatment consecutively performed for varicose veins by single phlebectomy with preservation of a refluxing great saphenous vein (GSV), according to the principles of the ambulatory selective varices ablation under local anesthesia (ASVAL) during four years of practice. The clinical and hemodynamic outcomes have been evaluated at eight days, one year, and once a year. Results We have included 1212 lower limbs (LLs) that underwent consecutive ASVAL procedures in 816 patients (611 women and 205 men) aged between 19 and 93 years (mean age 53.7 years). The CEAP Class C classification was C0–C1 = 0%; C2 = 85.6%; C3 = 5.4%; C4 = 7.8%; C5 = 0.7%; C6 = 0.7%. Symptoms were present in 854 cases (70.5%). A thrombosis of the GSV was diagnosed at eight days postoperative in 13 cases (1.1%). A total of 1010 LLs were followed after the first postoperative year (mean follow-up of 44.5 months). A secondary major procedure was done in 30 cases during the follow-up: a striping of the GSV in nine cases and a redo phlebectomy in 21 cases. The cumulative incidence of a persistent or recurrent GSV reflux, of a varicose recurrence, and of secondary major procedure at five years after life table analysis was 33.8%, 13%, and 4.5%, respectively. A GSV reflux extended above plus below the knee and multiple connections of the varicose tributaries to the GSV at the calf were associated with a varicose recurrence (respectively 66.7% versus 55.3% p < 0.05 and 46.7% versus 12.8% p < 0.05). Conclusion A treatment limited to the varicose tributaries by phlebectomy is safe and efficient at midterm with preservation of the main veins of the superficial venous system. It can be performed in a large group of patients thanks to a proper exclusion of cases with advanced chronic venous disorder. Therefore, the systematic treatment of an incompetent truncal vein is not relevant in the majority of the cases.
Position of the European College of Phlebology
Authors: Onida S , Shalhoub J , Davies AH 
Published: March 2015

Chronic venous disease is a common condition, bearing significant morbidity to patients. It is predicted that the population suffering from this disease will significantly increase in the coming years, with a growing demand for specialists in the field of phlebology. Training and delivery of services are highly heterogeneous in the European Union. The establishment of the European College of Phlebology marks the opportunity to address these differences from a European perspective, with the aim of providing all patients with standardised, high-quality, accessible medical care. In this paper, we review the current status of phlebology from a European and an international perspective, as well as highlighting the current and future roles of the European College of Phlebology.
Embolization is not essential in the treatment of leg varices due to pelvic venous insufficiency
Authors: Rabe E , Pannier F 
Published: March 2015

Aim To consider if it is essential to perform embolization in the treatment of leg varices due to pelvic venous insufficiency. Methods Review of the current literature concerning treatment options of leg varicose veins of pelvic origin. Results Pelvic venous insufficiency, vulvar and pudendal varicose veins as well as pelvic congestive syndrome are under diagnosed entities. Embolization of ovarian and pelvic veins is well established in patients with pelvic congestive syndrome. In varicose veins of pelvic origin but without pelvic congestive syndrome, comparative studies comparing the outcome of embolization or treatment of varicose veins by sclerotherapy or phlebectomy alone are missing. Foam sclerotherapy or phlebectomy shows good results in patients with varicose veins of pelvic origin. Conclusions Embolization is not essential in the treatment of leg varices of pelvic origin without pelvic congestive syndrome. Foam sclerotherapy or phlebectomy shows good results in patients with vulvar or pudendal varicose veins. Randomized comparative studies using embolization of incompetent pelvic veins or sclerotherapy of varicose veins with pelvic origin should be performed.
Quality-of-life in interventionally treated patients with post-thrombotic syndrome
Authors: Catarinella FS , Nieman FHM , de Wolf MAF , Toonder IM , de Graaf R , Wittens CHA 
Published: March 2015

Introduction New developments in the treatment of complex deep venous disease have become available in the last decade. Besides analysing patencies as a surrogate outcome for these treatments we analysed the Quality-of-Life (QoL) changes for successful and failed deep venous treatments. Materials and methods Patients with proven venous occlusive disease, referred to our department of Venous Surgery at the Maastricht University Medical Centre, were included. After inclusion patients were treated by percutaneous transluminal angioplasty and stenting and when indicated endophlebectomy with an arteriovenous fistula. QoL was assessed with the disease specific VEINES-QOL/Sym and the generic Short-Form (SF)-36 questionnaires preoperatively at baseline and post-operatively after 3, 12 and 24 months. Results One hundred fifty-three interventions were analysed, showing a primary, assisted primary and secondary patency of respectively 65%, 78% and 89% at 24 months. The VEINES-QOL and Sym scores improved at 3, 12 and 24 months. The overall improvement at 24 months is 22.7 for QoL and 18.18 for Sym with respective p values of 0.013 and 0.016. The improvement of the VEINES-QOL and Sym scores after a successful (patent) treatment remained highly significant (QoL: p < 0.001, Sym: p = 0.004). Also the generic QoL (Short-Form 36v2) shows significant improvement after 12 months for physical functioning ( p = 0.004) and role physical ( p = 0.004) scales. Conclusions The overall patencies of interventions for deep venous pathology are exceptionally good after two years. Concomitantly the VEINES-Sym and VEINES-QOL scores improve significantly for 3, 12, and 24 months when compared to the baseline (T0) after treatment. Successful interventions showed, as expected, a significant greater QoL improvement between T0 and T3, T12, T24 for both VEINES-QOL and VEINES-Sym scores when compared to the failed interventions. The one-year linear improvement of two SF-36 scales (PF and RP) is also significant.
Debate: Should persistent incompetent truncal veins be treated immediately? The case in support of the statement
Authors: Smith P Coleridge 
Published: March 2015

Background Debate continues as to the best method of treating patients with varicose veins and which will lead to durable clinical outcomes. Many modern techniques of treating varicose veins rely on ablation of the saphenous vein alone or in combination with phlebectomy or sclerotherapy of varices. However, it has been suggested that methods which leave the saphenous trunk untreated may result in similar outcomes. Methods A search of medical databases was made for literature which compared the outcomes of saphenous vein stripping, sclerotherapy and modern methods of vein ablation. Synthesis Surgical methods which have been used range from simple phlebectomy, ligation of the saphenous trunk to stripping of the saphenous vein. Systematic comparison of striping of the saphenous vein in addition to ligation of the sapheno-femoral junction appears to improve the outcome of varicose veins surgery compared to saphenous ligation alone. The 21st century endovenous treatments for varicose veins all rely on ablating the saphenous trunk. Duplex ultrasound studies show some variation in the efficacy of saphenous ablation with these methods. However, a randomised clinical trial shows similar patient reported outcomes with all endovenous techniques and surgical stripping of the saphenous vein. A clinical series shows that after endovenous thermal ablation recurrent varices arise in residual sections of saphenous trunk, accessory veins and residual tributaries. Conclusions Studies based on clinical criteria require follow-up of about six years to yield reliable data. Before this time varices may be forming but cannot be detected clinically and over-optimistic results of treatment are reported. Data from surgical and endovenous treatment studies suggest that the more extensive and effective the ablation of saphenous trunks, accessory veins and tributaries, the better the long-term outcome that is achieved.
Hemodynamic significance of collateral blood flow in chronic venous obstruction
Authors: Kurstjens RLM , de Wolf MAF , van Laanen JHH , de Haan MW , Wittens CHA , de Graaf R 
Published: March 2015

Introduction Complaints related to the post-thrombotic syndrome do not always correlate well with the extent of post-thrombotic changes on diagnostic imaging. One explanation might be a difference in development of collateral blood flow. The aim of this study is to investigate the hemodynamic effect of collateralisation in deep venous obstruction. Methodology Resting intravenous pressure of the common femoral vein was measured bilaterally in the supine position of patients with unilateral iliofemoral post-thrombotic obstruction. In addition, pressure in control limbs was also measured in the common femoral vein after sudden balloon occlusion in the external iliac vein. Results Fourteen patients (median age 42 years, 12 female) were tested. In eleven limbs post-thrombotic disease extended below the femoral confluence. Median common femoral vein pressure was 17.0 mmHg in diseased limbs compared to 12.8 mmHg in controls (p = 0.001) and 23.5 mmHg in controls after sudden balloon occlusion (p = 0.009). Results remained significant after correcting for non-occlusive post-thrombotic disease. Conclusion This study shows that common femoral vein pressure is increased in post-thrombotic iliofemoral deep venous obstruction, though not as much as after sudden balloon occlusion. The latter difference could explain the importance of collateralisation in deep venous obstructive disease and the discrepancy between complaints and anatomical changes; notwithstanding, the presence of collaterals does not eliminate the need for treatment.
The prevalence and correlates of syphilis and HIV among homosexual and bisexual men in Shijiazhuang, China
Authors: Zhang Shao-Hui , Liu Shu-Jun , Hu Ling-Ling , Li Jie-Fang , Liu Li-Hua , Wei Ning 
Published: March 2015

Summary Bisexual men (men who have sex with men and women) are potential epidemiological bridges responsible for the spread of HIV and other sexually transmitted infections from men who have sex with men only to the heterosexual population. We aimed to estimate the prevalence of syphilis and HIV and the factors associated with syphilis infection among men who have sex with men and women and men who have sex with men only from Shijiazhuang, China. In 2011–2013, a cross-sectional cohort of 427 men who have sex with men was recruited by a snowball sampling method and tested for syphilis and HIV. Chi square and logistic regression were performed to identify syphilis risk factors. Among the 427 men who have sex with men, 71 (16.6%) cases were syphilis-positive and 16 cases (3.7%) were HIV-positive. The proportions of men who have sex with men and women and men who have sex with men only in the total sample were 31.4% and 68.6%, respectively. Men who have sex with men and women exhibited double the syphilis prevalence of men who have sex with men only and were more likely to practice insertive anal sex. Higher education level, being married, having more male partners, and both receptive and insertive anal sex roles were associated with syphilis among men who have sex with men and women. Residing in suburban areas, being married, being HIV positive, and an absence of desire to change sexual orientation were associated with syphilis among men who have sex with men only. Therefore, men who have sex with men and women represent an important sub-group in the syphilis epidemic and further interventions should be developed to reduce risk among different sub-sets of men who have sex with men.
Venous stenosis in chronic dialysis patients with a well-functioning arteriovenous fistula
Authors: Shi Yaxue , Zhu Mingli , Cheng Jiejun , Zhang Jiwei , Ni Zhaohui 
Published: March 2015

Purpose It is not clear whether patient who is dialyzing with a well-functioning vascular access may appear venous stenosis. The aim is to see the prevalence of central or other vein stenoses/occlusions in patients with asymptomatic, normal functioning fistulas. Methods A total of 54 patients met the inclusion criteria. We performed angiography examinations for these patients and reviewed venography of the superficial and deep venous systems. Results Among these patients, 21 (39%) were detected positive cases by the angiography, the remainder was negative cases. Thirteen of 54 (24%) had mild central venous stenosis (stenosis <50% diameter with or without collateral branch), 7/54 (13%) had upper arm vein system occlusion or stenosis, another one had anastomotic stenosis. There were no differences in fistula flow dynamics between those with venous abnormalities and those without such as blood flow rate, venous pressures, brachial arterial velocity, and brachial arterial flow rate. We also observed no significant differences in other variables between these two groups (including BMI, hemoglobin, albumin, gender, primary disease, URR, spKt/V P > 0.05). Conclusion The frequency of venous lesion is not low in hemodialysis patients with a well-functioning AVF. To value the impact of these abnormalities on access, prognosis needs longer time follow-up.
Volatile organic compounds and risk of asthma and allergy: a systematic review
Authors: Nurmatov Ulugbek B. , Tagiyeva Nara , Semple Sean , Devereux Graham , Sheikh Aziz 
Published: March 2015

Volatile organic compounds (VOCs) are ubiquitous domestic pollutants. Their role in asthma/allergy development and exacerbations is uncertain. This systematic review investigated whether domestic VOC exposure increases the risk of developing and/or exacerbating asthma and allergic disorders.We systematically searched 11 databases and three trial repositories, and contacted an international panel of experts to identify published and unpublished experimental and epidemiological studies.8455 potentially relevant studies were identified; 852 papers were removed after de-duplication, leaving 7603 unique papers that were screened. Of these, 278 were reviewed in detail and 53 satisfied the inclusion criteria. Critical appraisal of the included studies indicated an overall lack of high-quality evidence and substantial risk of bias in this body of knowledge. Aromatics (i.e. benzenes, toluenes and xylenes) and formaldehyde were the main VOC classes studied, both in relation to the development and exacerbations of asthma and allergy. Approximately equal numbers of studies reported that exposure increased risks and that exposure was not associated with any detrimental effects.The available evidence implicating domestic VOC exposure in the risk of developing and/or exacerbating asthma and allergy is of poor quality and inconsistent. Prospective, preferably experimental studies, investigating the impact of reducing/eliminating exposure to VOC, are now needed in order to generate a more definitive evidence base to inform policy and clinical deliberations in relation to the management of the now substantial sections of the population who are either at risk of developing asthma/allergy or living with established disease.
Study of Benzene Hydroxylation in Liquid Phase Using Mono- and Binuclear Copper Complex Catalysts
Authors: Okemoto Atsushi , Kato Kurumi , Taniya Keita , Ichihashi Yuichi , Nishiyama Satoru 
Published: March 2015

Abstract
Mono- or binuclear copper homogeneous catalysts with similar coordination environments were used for benzene hydroxylation. The effect of multiple active sites on phenol formation was investigated. The structures of the synthesized mono- and binuclear copper catalysts were confirmed by FT-IR and EXAFS. Molecular oxygen was used as the oxidant and it was found that the binuclear copper catalyst showed better phenols formation than the mononuclear catalyst.
A simulator study of adverse wear with metal and cement debris contamination in metal-on-metal hip bearings
Authors: Halim T. , Clarke I. C. , Burgett-Moreno M. D. , Donaldson T. K. , Savisaar C. , Bowsher J. G. 
Published: March 2015

Objectives Third-body wear is believed to be one trigger for adverse results with metal-on-metal (MOM) bearings. Impingement and subluxation may release metal particles from MOM replacements. We therefore challenged MOM bearings with relevant debris types of cobalt–chrome alloy (CoCr), titanium alloy (Ti6Al4V) and polymethylmethacrylate bone cement (PMMA). Methods Cement flakes (PMMA), CoCr and Ti6Al4V particles (size range 5 µm to 400 µm) were run in a MOM wear simulation. Debris allotments (5 mg) were inserted at ten intervals during the five million cycle (5 Mc) test. Results In a clean test phase (0 Mc to 0.8 Mc), lubricants retained their yellow colour. Addition of metal particles at 0.8 Mc turned lubricants black within the first hour of the test and remained so for the duration, while PMMA particles did not change the colour of the lubricant. Rates of wear with PMMA, CoCr and Ti6Al4V debris averaged 0.3 mm3/Mc, 4.1Â mm3/Mc and 6.4 mm3/Mc, respectively. Conclusions Metal particles turned simulator lubricants black with rates of wear of MOM bearings an order of magnitude higher than with control PMMA particles. This appeared to model the findings of black, periarticular joint tissues and high CoCr wear in failed MOM replacements. The amount of wear debris produced during a 500 000-cycle interval of gait was 30 to 50 times greater than the weight of triggering particle allotment, indicating that MOM bearings were extremely sensitive to third-body wear. Cite this article: Bone Joint Res 2015;4:29–37.
Elm Street School:A Case Study of Professional Development Expenditures
Authors: Gallagher H. Alix 
Published: March 2015

This article addresses the question of how much is spent on teachers' professional development. A review of the literature finds two problems that have frequently led to inaccurate estimates of professional development spending: 1) the accounting codes that are used in many studies provide little description of spending, and 2) studies generally focus on district or state expenditures for professional development, but do not collect data on school-level spending. These problems are compounded by the fact that studies define professional development spending differently, and thus it is difficult to compare findings across studies. In an effort to begin to address this problem, this study utilizes a detailed cost structure to analyze both district and school site expenditures on professional development across cost categories. The study found that school-level expenditures were a significant source of professional development for teachers. This has implications for the methodologies used to estimate current professional development expenditures and what level of expenditures would be necessary to generate dramatic improvements in student achievement.
Childhood and Disability in Brazil: A History of Blindness and Silencing
Authors: De Oliveira Cristina Borges 
Published: March 2015

This article is a continuation of research involving inclusive educational policies, conceptions and transmission concerning childhood and the disabled child in Brazilian physical education academic production. The aim is to understand the history of childhood in Brazil, from the colonial period to the Republic and the role of government and civil society in relation to problems in the lives of children, specifically those with disabilities, in the history of Brazilian educational policies. Bibliographic and documentary research methods were used and the conclusion was reached that the history of childhood in Brazil has been marked by abandonment and disrespect. From total anonymity in the first centuries to our days, when the child is recognized as a citizen with rights and obligations, the idea of institutional and social care for children with disabilities has been given mere lip service.
Constitutional Reform and the Opportunity for Higher Education Access in Ecuador Since 1950
Authors: Post David 
Published: March 2015

Ecuador's 2008 Constitution, and its 2009 national development plan, assign universities the role of reducing social inequality by, among other means, eliminating user fees. This article offers the first over-time assessment of the background tendencies in the accessibility to secondary and postsecondary university. Based on the analysis of 1990 and 2001 census data, and on household surveys from 1988 to the present, I find that women have overtaken men in all levels of education participation. The gaps are growing between ethnic groups, income groups, and language groups. This historic tendency will be difficult to reverse through the suspension of user fees because the main beneficiaries of free higher education are the most advantaged students in Ecuador.
Education Alignment and Accountability in an Era of Convergence: Policy Insights from States with Individual Learning Plans and Policies
Authors: Phelps L. Allen , Durham Julie , Wills Joan 
Published: March 2015

In response to the rising demand for market-responsive education reform across the U.S., since 1998 more than twenty states have created individual learning or graduation plan (ILP/IGP) state policies. Using extensive policy document analyses and stakeholder interview data from four early-adopting ILP/IGP states, the goal of this four-state case study was twofold. First, to determine the extent to which states are leveraging federal and state resources to align their ILP initiatives with other policies aimed at fostering education innovation and assisting economic recovery. The second goal was to develop policy recommendations for making intergovernmental investments to strengthen performance outcomes in education and workforce development in ILP/IGP states. The federal interest in equal protection and improving equity for special populations including youth with disabilities stimulated and animated the investigation. Several key findings emerged across the four states. First, to date limited fiscal investments in professional development and systematic data collection have constrained ILP-IGP implementation and evaluation efforts. Second, the opportunity to align and leverage the state investment with federal programs and other state employment and education initiatives was largely unexplored in these states. Recommendations for state policy improvements include aligning ILP policies with state plans for improving outcomes in federal programs for students confronting economic, language and disability challenges.