bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Correlates and Prognostic Significance of Change in Standardized Left Ventricular Mass in a Community‐Based Cohort of African Americans
Authors: Fox Ervin R. , Musani Solomon K. , Samdarshi Tandaw E. , Taylor Jared K. , Beard Walter L. , Sarpong Daniel F. , Xanthakis Vanessa , McClendon Eric E. , Liebson Philip R. , Skelton Thomas N. , Butler Kenneth R. , Mosley Thomas H. , Taylor Herman , Vasan Ramachandran S. 
Published: February 2015

Background

Though left ventricular mass (
LVM
) predicts cardiovascular events (
CVD
) and mortality in African Americans, limited data exists on factors contributing to change in
LVM
and its prognostic significance. We hypothesized that baseline blood pressure (
BP
) and body mass index (
BMI
) and change in these variables over time are associated with longitudinal increases in
LVM
and that such increase is associated with greater incidence of
CVD
.

Methods and Results

We investigated the clinical correlates of change in standardized logarithmically transformed‐
LVM
indexed to height2.7 (log‐
LVMI
) and its association with incident
CVD
in 606 African Americans (mean age 58±6 years, 66% women) who attended serial examinations 8 years apart. Log‐
LVMI
and clinical covariates were standardized within sex to obtain z scores for both visits. Standardized log‐
LVMI
was modeled using linear regression (correlates of change in standardized log‐
LVMI
) and Cox proportional hazards regression (incidence of
CVD
[defined as coronary heart disease, stroke, heart failure and intermittent claudication]). Baseline clinical correlates (standardized log‐
LVM
,
BMI
, systolic
BP
) and change in systolic
BP
over time were significantly associated with 8‐year change in standardized log‐
LVMI
. In prospective analysis, change in standardized
LVM
was significantly (P=0.0011) associated with incident
CVD
(hazards ratio per unit standard deviation change log‐
LVMI
1.51, 95%
CI
1.18 to 1.93).

Conclusions

In our community‐based sample of African Americans, baseline
BMI
and
BP
, and change in
BP
on follow‐up were key determinants of increase in standardized log‐
LVMI
, which in turn carried an adverse prognosis, underscoring the need for greater control of
BP
and weight in this group.
Regional Availability of Mechanical Embolectomy for Acute Ischemic Stroke in California, 2009 to 2010
Authors: Choi Jay Chol , Hsia Renee Y. , Kim Anthony S. 
Published: February 2015

Background and Purpose—
We sought to assess the geographic proximity of patients with stroke in California to centers that performed specific threshold volumes of mechanical embolectomy procedures each year.

Methods—
We identified all patients who were hospitalized for acute ischemic stroke at all nonfederal acute care hospitals in California from 2009 to 2010, and all hospitals that performed any mechanical embolectomy procedures by case volume during the same period, using nonpublic data from the Office of Statewide Health Planning and Development. We computed geographic service areas around each hospital on the basis of prespecified ground transport distance thresholds. We then calculated the proportion of hospitalized patients with stroke who lived within service areas for centers that performed a low volume and high volume of mechanical embolectomy procedures each year.

Results—
During the 2-year study period, 15% (53/360) of hospitals performed at least 1 mechanical embolectomy for acute stroke, but only 19% (10/53) performed >10 cases per year. Most hospitalized patients with stroke (94%) lived within a 2-hour transport time (65 miles) to a hospital that performed ≥1 procedure during the 2-year period. Approximately 93% of the patients with stroke who received mechanical embolectomy lived within 20 miles from an embolectomy-capable hospital compared with 7% of those who lived >20 miles.

Conclusions—
In California, most patients with stroke lived within reasonable ground transport distances from centers that performed ≥1 mechanical embolectomy in a 2-year period. The probability of receiving mechanical embolectomy for acute ischemic stroke was associated with living in close geographic proximity to these hospitals.
Relevance of Blood–Brain Barrier Disruption After Endovascular Treatment of Ischemic Stroke
Authors: Renú Arturo , Amaro Sergio , Laredo Carlos , Román Luis San , Llull Laura , Lopez Antonio , Urra Xabier , Blasco Jordi , Oleaga Laura , Chamorro Ángel 
Published: February 2015

Background and Purpose—
Computed tomographic (CT) high attenuation (HA) areas after endovascular therapy for acute ischemic stroke are a common finding indicative of blood–brain barrier disruption. Dual-energy CT allows an accurate differentiation between HA areas related to contrast staining (CS) or to brain hemorrhage (BH). We sought to evaluate the prognostic significance of the presence of CS and BH after endovascular therapy.

Methods—
A prospective cohort of 132 patients treated with endovascular therapy was analyzed. According to dual-energy CT findings, patients were classified into 3 groups: no HA areas (n=53), CS (n=32), and BH (n=47). The rate of new hemorrhagic transformations was recorded at follow-up neuroimaging. Clinical outcome was evaluated at 90 days with the modified Rankin Scale (poor outcome, 3–6).

Results—
Poor outcome was associated with the presence of CS (odds ratio [OR], 11.3; 95% confidence interval, 3.34–38.95) and BH (OR, 10.4; 95% confidence interval, 3.42–31.68). The rate of poor outcome despite complete recanalization was also significantly higher in CS (OR, 9.7; 95% confidence interval, 2.55–37.18) and BH (OR, 15.1; 95% confidence interval, 3.85–59.35) groups, compared with the no-HA group. Patients with CS disclosed a higher incidence of delayed hemorrhagic transformation at follow-up (OR, 4.5; 95% confidence interval, 1.22–16.37) compared with no-HA patients.

Conclusions—
Blood–brain barrier disruption, defined as CS and BH on dual-energy CT, was associated with poor clinical outcomes in patients with stroke treated with endovascular therapies. Moreover, isolated CS was associated with delayed hemorrhagic transformation. These results support the clinical relevance of blood–brain barrier disruption in acute stroke.
An Ecological Perspective on Diabetes Self-care Support, Self-management Behaviors, and Hemoglobin A1C Among Latinos
Authors: Soto Sandra C. , Louie Sabrina Y. , Cherrington Andrea L. , Parada Humberto , Horton Lucy A. , Ayala Guadalupe X. 
Published: February 2015

Purpose The purpose of this study was to examine the role of self, interpersonal (ie, family/friend), and organizational (ie, health care) support in performing diabetes-related self-management behaviors and hemoglobin A1C (A1C) levels among rural Latinos with type 2 diabetes. Methods Cross-sectional data from baseline interviews and medical records were used from a randomized controlled trial conducted in rural Southern California involving a clinic sample of Latinos with type 2 diabetes (N = 317). Self-management behaviors included fruit and vegetable intake, fat intake, physical activity, glucose monitoring, daily examination of feet, and medication adherence. Multivariate linear and logistic regression models were used to assess the relationships of sources of support with self-management behaviors and A1C. Results Higher levels of self-support were significantly associated with eating fruits and vegetables most days/week, eating high-fat foods few days/week, engaging in physical activity most days/week, daily feet examinations, and self-reported medication adherence. Self-support was also related to A1C. Family/friend support was significantly associated with eating fruits and vegetables and engaging in physical activity most days/week. Health care support was significantly associated with consuming fats most days/week. Conclusions Health care practitioners and future interventions should focus on improving individuals’ diabetes management behaviors, with the ultimate goal of promoting glycemic control. Eliciting family/friend support should be encouraged to promote fruit and vegetable consumption and physical activity.
Evaluating the Safety of Harmonic Scalpel in Thyroidectomy
Authors: Seo Min Young , Son Young‐Ik , Baek Chung Hwan , Park Ki‐Nam , Kim Dohun 
Published: February 2015

ObjectiveHarmonic scalpel (HS) is widely used in thyroidectomy because of its multiple advantages. However, there are concerns on thermal damage to the adjacent lateral. This study aimed to compare the incidence of EBSLN or cricothyroid muscle injury, and patterns of voice discomfort between thyroidectomy using HS and classic knot‐tie ligation.MethodThirty‐four patients with papillary thyroid microcarcinoma completed the study. Patients were randomly divided into 2 groups; knot‐tying group (KT, n = 18) and harmonic scalpel group (HS, n = 16).ResultsSubjective voice assessment with questionnaires, acoustical analyses including voice range profile, and stroboscopic laryngeal evaluation were performed before and 3 months after surgery.ConclusionWhen compared to conventional knot‐tying method, using HS does not increase SLN injury, subjective voice discomfort or perturbation parameters of acoustic voice analyses. Regardless of using HS, thyroidectomy may result in subjective voice discomfort until the third month after surgery, which usually recovers to the preoperative level during 6 months.
Facial Nerve Palsy following Parotidectomy
Authors: Amin Nikul , Dixon Hannah , Gibbins Nicholas , Lew‐Gor Simione 
Published: February 2015

ObjectiveTo determine the incidence of temporary and permanent facial nerve dysfunction in patients following parotidectomy in a UK teaching hospital.MethodAll parotidectomies performed between January 1, 2009, and January 1, 2012, were analyzed using patients’ clinical and operative records. The grade of the surgeon, the operation, and the presence of a facial nerve monitor were recorded. House‐Brackmann scores were recorded preoperatively and postoperatively. The length of time until recovery of facial nerve function was recorded.ResultsSixty‐five parotidectomies were performed. The indications for surgery included pleomorphic adenoma 31%, warthin 23%, malignant disease 34%, and other 15%. Overall postoperative palsy rate was 43% (28/65). The most commonly affected branch was the marginal mandibular, 25% (16/65 %). Six were permanent and 22 temporary. The rate of facial nerve palsy was 44% for benign disease and 41% for malignant. Of the 6 permanent facial nerve palsies, 4 (67%) facial nerves were sacrificed because of preoperative disease involvement. MM was the branch commonly involved in these cases often due to Level 1 nodal clearance. In patients with temporary facial nerve palsy, mean recovery time was 4.3 months (range, 24 hours‐12 months).ConclusionFacial nerve palsy is a distressing and debilitating complication of parotidectomy, not only functionally but also emotionally and socially. Informed consent is an important part of preoperative assessment and accurate facial nerve palsies incidence rates should be discussed with patients.
Hereditary Head and Neck Paragangliomas
Authors: Crockett David , Bentz Brandon G. 
Published: February 2015

ObjectiveParagangliomas are rare neuroendocrine tumors derived from the extra‐adrenal paraganglia of the autonomic nervous system. Little information has been accumulated describing the differences in clinical expression between hereditary versus nonhereditary paraganglia. We examined the differences in clinical characteristics, presenting symptoms, and tumor types of hereditary head and neck paragangliomas.MethodA retrospective review of the medical records was performed in order to formulate a database of patients with head and neck paragangliomas. Clinical characteristics, tumor type and location, presentation, and genetic results of each patient were included. Hereditary paragangliomas were compared to the general database of head and neck paragangliomas.ResultsEighty patients with the diagnosis of a head and neck paraganglioma were evaluated at the University of Utah during the years of 2000 to 2010. Thirteen of the 80 were confirmed to be hereditary paragangliomas through genetic testing or through family history. Patients with a known hereditary component presented earlier in life than those of the general paraganglioma population. Over half of the patients who presented under the age of 30 years were confirmed to be hereditary. The most common presenting symptom was a neck mass (54%). A genetic mutation was found in all those tested under the age of 30 years.ConclusionOur study evaluates a large population of hereditary paragangliomas. We found that patients who present at a younger age may be at an increased risk of possessing a genetic mutation. Further research will determine if genetic testing is necessary in all patients who present under the age of 30 years.
Improved Outcomes in Primary Prosthesis Placement during Tracheoesophageal Puncture
Authors: Fowler Nicole M. , Kmiecik Joann , Khan Mumtaz J. , Scharpf Joseph , Lorenz Robert R. , Burkey Brian B. 
Published: February 2015

ObjectiveTracheoesophageal prosthesis facilitates esophageal speech in postlaryngectomy patients. The vocal prosthesis can be placed either during tracheoesophageal puncture (TEP) or, more commonly, in a delayed fashion. Our objectives were to: 1) analyze the voice outcomes and 2) compare the pain and emergency care, following primary versus delayed prosthesis placement.MethodA 2011 cohort study. A tracheoesophageal puncture occurred in conjunction with, or within 3 months of, total laryngectomy. Nine patients underwent primary and 11 patients underwent delayed prosthesis placement. The primary outcome was voice production at the first postoperative appointment. Secondary outcomes included pain and perioperative emergency room visits.ResultsAll patients (100%) with prostheses placed at the time of the TEP had voice production at the first postoperative clinic visit, in comparison to only 45% (5/11) of patients with prostheses placed in delayed fashion. Significant pain with vocalization occurred in zero primary placement prosthesis patients, but in 55% (6/11) of delayed placement prosthesis patients. Only one primary placement prosthesis patient (11%) sought emergency medical care related to their stoma or voice prosthesis versus 7 (64%) delayed placement prosthesis patients.ConclusionPrimary prosthesis placement during TEP has significantly improved voice and quality of life outcomes with earlier voice production, reduced postoperative pain and the virtual elimination of perioperative emergency room visits. This significant modification of the standard technique represents a highly successful and cost‐effective approach to vocal rehabilitation in post‐laryngectomy patients.
Innate Immune Reactions in Locally Early Tonsillar Cancer
Authors: Kuratomi Yuichiro , Kusano Kenichiro , Shimazu Rintaro , Inokuchi Akira 
Published: February 2015

ObjectiveThe palatine tonsil contains innate immune cells such as natural killer (NK) cells and macrophages. Tonsillar cancers often present locally early tumors with cervical metastases. This study was performed to clarify the possibility that the growth of primary tumors might be inhibited by innate immune cells in the palatine tonsil.MethodNK cells and macrophages were immunohistochemically identified using anti‐HNK‐1 and anti‐CD68 antibodies. The degree of the immune cell infiltration in tonsillar cancers, tongue cancers, and normal tonsils was estimated by counting the number of NK cells and macrophages in formalin‐fixed, paraffin‐embedded blocks. Phagocytosis of the tumor cells was also studied.ResultsThere was a significant increase in the number of NK cells in locally early tonsillar cancers (a median of 100 in 8 patients) in comparison to locally early tongue cancers (a median of 8 in 15 patients) and 5 normal tonsils (a median of 35; P <. 0001). The number of macrophages was also significantly increased in tonsillar cancers (a median of 247) in comparison to tongue cancers (a median of 81) and normal tonsils (a median of 82; P <. 0001). Phagocytosis of tumor cells by macrophages was observed significantly more frequently in tonsillar cancers than in tongue cancers (P <. 01).ConclusionThe innate immune reactions were observed to significantly increase and they might therefore inhibit the growth of the primary tumor in locally early tonsillar cancer. In addition, these inhibitory immune reactions against the primary tumor in the palatine tonsil might be part of the etiology of developing primary‐unknown cervical metastasis.
Intraoperative Hyperkalemia: Death in Renal Parathyroidectomy
Authors: Zahoor Tosief , Bajaj Yogesh , Roberts S. , England James 
Published: February 2015

ObjectiveRecognize potential life‐threatening complications of intraoperative hyperkalemia during parathyroid surgery to control secondary hyperparathyroidism in renal patients. We present a case of a 20‐year‐old renal patient who died from VF arrest intraoperatively during elective surgery for secondary hyperparathyroidism. Understand the importance of intraoperative potassium monitoring.MethodProspective analysis of intraoperative monitoring of potassium levels in patients with CRF undergoing total parathyroidectomy from April 2006 to July 2009 at Hull Royal Infirmary (UK). All patients had postdialysis preoperative potassium levels checked, at least 2 intraoperative levels, and 1 postoperative level.ResultsTwenty‐nine patients underwent total parathyroidectomy. A total of 17 out of 29 had intraoperative potassium rises, 55% (95% CI 38‐71%) had intraoperative potassium rise above the normal limit (5.3 mM). Six patients (21% (95% CI 10‐38%)) required intraoperative treatment with dextrose‐insulin infusion. Active intervention was taken for patients who had rises greater than 0.5 mM or active ECG changes. Four patients had increasing potassium levels despite treatment indicating that without treatment these could potentially have been very high. Comparative results of postinduction and first intraoperative potassium levels were a good indicator of potassium rise later and the need for treatment (P =. 003).ConclusionHyperkalemia is a recognized complication within the first 24 hours postparathyroidectomy; however, it can occur more commonly intraoperatively in renal patients with potential devastating effects. Our unfortunate mortality complication has led us to change practice and we advocate active intraoperative monitoring and treatment to prevent such complications.
Laryngeal Cancer: A 2‐Year Follow‐up Study
Authors: Smith Matthew D. , Fleming Jason , Lew‐Gor Simione , Simcock Richard , Weighill John , Harries Meredydd L. 
Published: February 2015

Objective1) To report the process of management and 2‐year disease‐free survival statistics for laryngeal cancer cases presenting to a United Kingdom tertiary cancer center. 2) To investigate which modality of treatment is the most appropriate for specific stages of laryngeal cancer.MethodA retrospective cohort study was carried out on laryngeal cancer patients presenting to a tertiary head and neck center from 2007 to 2009. Information on primary tumor staging and management was collected using the Somerset Cancer Registry. Patient notes, imaging, and histology reports were consulted to complete data retrieval.ResultsForty‐seven cases presented during the study period (2 stage‐0, 8 stage‐I, 12 stage‐II, 13 stage‐III, 12 stage‐IV). Nodal disease was present in 10.6%, and 2.1% had metastatic disease at presentation. Overall 2‐year disease‐free survival was 100% for stage‐0, 87.5% stage‐I, 69.2% stage‐II, 36.4% stage‐III, and 32.2% for stage‐IV disease. Stage‐I/II cases were treated by transoral laser (36.8%) or radiotherapy (63.2%), with 85.7% and 83.3% 2‐year disease‐free survival rates, respectively. Stage‐III/IV cases were treated by surgery (38.1%) or radiotherapy/chemoradiotherapy (61.9%) with 2‐year disease‐free survival rates of 62.5% and 21.4%, respectively.ConclusionEarly‐stage disease is equally well treated with transoral laser or radiotherapy alone in line with other studies. Larynx preservation with chemoradiotherapy demonstrates significantly poorer outcomes compared to surgery in this study. Accurate contemporary data recording is required to allow critical review of treatment modalities.
Laryngeal Hibernoma
Authors: Cain Rachel B. , Landry April M. , Hinni Michael L. 
Published: February 2015

ObjectiveRecognize hibernoma as an uncommon, benign tumor composed of brown adipose tissue that can occur in the head and neck. Learn the unique radiographic features of this rare tumor, and understand the principles of treatment.MethodA systematic review of the English literature was conducted. In addition, we present a series of 2 laryngeal hibernomas treated with transoral laser microsurgical resection at a tertiary referral center over a period of 18 years.ResultsNineteen cases of hibernoma in the cervicofacial region have been described in the literature. This includes only 2 cases of laryngeal hibernoma ever reported. We present a series of 2 laryngeal hibernomas encountered at our institution. In each case, preoperative imaging demonstrated a well‐circumscribed neoplasm with fat density compatible with lipoma, but internal heterogeneity and vascularity seen in the context of liposarcoma. Transoral laser microsurgical resection was successfully completed in each case. Grossly, the tumors had the fatty appearance of a lipoma, however final pathology revealed myxoid hibernoma. Both patients healed well with normal speech and swallowing postoperatively.ConclusionHibernoma is a tumor composed of brown adipose tissue. There have been only 2 cases of para‐glottic hibernoma reported to date. We report 2 additional cases of laryngeal hibernoma. In our experience, complete resection via transoral laser microsurgery is a safe and effective treatment modality with very little associated morbidity.
Mammary Analogue Secretory Carcinoma of the Parotid Gland
Authors: Huang Lilleen M. , Petersson Frederik , Loke David 
Published: February 2015

ObjectiveMammary analogue secretory carcinoma is a new entity in salivary gland tumors that has only been recently described. It has overlapping histopathological features with acinic cell carcinoma and low grade variants of cystadenocarcinoma. It has a distinct chromosomal translocation, t(12;15)‐(p13;q25), resulting in a fusion gene ETV6 NTRK3. The clinical course of this disease entity is uncertain at present. We present a case of MASC of the parotid gland occurring in a 34‐year‐old man and discuss the difficulties in diagnosis and subsequent treatment of this tumour.