bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhalation injury and burn trauma: an experimental investigation of oxidative stress and histopathology
Authors: Eshak Ghada A. , Nasef Khaled A. 
Published: October 2013

ABSTRACT
Smoke inhalation injury is associated with high incidence of pulmonary complications as it represents a major cause of mortality after
major burn injury. Burn is associated with release of inflammatory mediators which ultimately cause local and distant pathophysiological
effects. The present study investigated the effect of smoke inhalation or\and burn injury on the antioxidants status in the lungs in a
rat model to simulate an inhalation injury as might be encountered by firefighters and burn victims. Seventy five rats were equally
randomized to five groups: Sham group, smoke inhalation injury group, burn group, sham burn group, and smoke burn group. At
the end of the exposure protocol rats were killed by cervical decapitation and the lungs were removed completely and processed for
histopathological and biochemical analysis by measuring lung antioxidant enzyme activities: Malondialdehyde (MDA), superoxide
dismutase (SOD) and glutathione peroxidase (GPs) level, as an index of lipid peroxidation. Grossly, results showed that rats´lungs in
the smoke inhalation group and the smoke burn group showed multiple hemorrhagic spots. Light microscopic examination showed
localized and diffuse alveolar hemorrhage. Two rats in the burn group had evidence of pneumonia and lung abscesses. Biochemically,
results showed that both smoke inhalation and burn injury significantly elevated lung MDA and glutathione peroxidase levels when
compared with controls. The combined smoke and burn group resulted in a more significant rise in both antioxidant levels indicating
a higher level of lipid peroxidation. SOD level was significantly lowered on exposure to both conditions when compared to control.
SOD level was significantly lower in the combined injury group when compared to either smoke or burn alone. In conclusion; the
above data provide evidence that inhalation injury with and without burn decrease tissue antioxidant capacity and increase tissue
peroxidative injury.
Finger lengths and behavior: Is the 2D:4D index of interest in forensic medicine?
Authors: Schwarz Walsted Anne 
Published: October 2013

ABSTRACT
The relationship between the second and the fourth digit in the human hand, the 2D:4D index, is considered a putative marker
of exposure to prenatal testosterone. Much research has been done in the attempt to associate the 2D:4D index and physical
characteristics as well as cognitive skills and behavioral patterns. It has been suggested that these characteristics and behavioral
patterns may be linked to high levels of testosterone. The basis for considering the 2D:4D index a marker of prenatal exposure to
testosterone, and the influence of prenatal and circulating testosterone on behavior are reviewed. Furthermore, it is discussed whether
forensic medicine may benefit from identification of a marker of behavioral predispositions. It seems that it is not possible to derive any
valid information on predispositions from finger length ratio, however the field of 2D:4D research might benefit from forensic studies.
Estimation of Sensitivity and Specificity of Brain Magnetic Resonance Imaging and Single Photon Emission Computed Tomography in the Diagnosis of Olfactory Dysfunction after Head Traumas
Authors: Atighechi Saeid , Zolfaghari Aliasghar , Baradaranfar Mohammadhossein , Dadgarnia Mohammadhossein 
Published: October 2013

Background Olfactory dysfunction has an incidence of 5–10% after head injury. Several objective and subjective tests had been proposed. Recent studies showed that brain single photon emission computed tomography (SPECT) and brain magnetic resonance imaging (MRI) have good diagnostic value in this era in which the most common sites of involvement were olfactory bulb and olfactory nerve in MRI and frontal lobe in SPECT. This study aimed to estimate the sensitivity and specificity of brain MRI and brain SPECT in the diagnosis of traumatic hyposmia and anosmia. Methods From February 2009 to March 2011, 63 patients with head injury and smell complaint were selected for this study. Using an identification test and a threshold smell test, 28 were anosmic and 27 had hyposmia and the remaining 8 were normosmic. All of them underwent brain MRI and SPECT. Results The sensitivity of SPECT was 81.5 and 85.7% in hyposmia and anosmia, respectively. Its specificity was 87.5% in anosmia and 87.7% in anosmia. MRI sensitivity was 66.7% in hyposmia but 82.1% in anosmia. Its specificity was 85.7% in anosmia and 87.7% in anosmia. If MRI and SPECT were considered together, the sensitivity was 92.3% in hyposmia and 92% in anosmia, but the specificity was 87% in both cases. Conclusion According to our study, both brain MRI and SPECT have high sensitivity and specificity in the diagnosis of traumatic anosmia, although brain SPECT is slightly superior to MRI. If the two techniques are applied together, the accuracy will be increased.
Differential Expression of Adhesion Molecules by Sinonasal Fibroblasts among Control and Chronic Rhinosinusitis Patients
Authors: Oyer Samuel L. , Nagel Whitney , Mulligan Jennifer K. 
Published: October 2013

Background Chronic rhinosinusitis (CRS) is characterized by inflammatory cell migration into sinus tissue with resultant inflammation fueled by a milieu of cytokines. Fibroblasts may contribute to inflammation through expression of leukocyte adhesion molecules such as vascular cell adhesion molecule (VCAM) and intercellular adhesion molecule (ICAM). VCAM attracts eosinophils and mast cells contributing to Th2 skewing, and ICAM attracts neutrophils and to a lesser degree, eosinophils, and contributes to mixed Th1/Th2 skewing. The purpose of this study was to compare sinus fibroblast adhesion molecule expression ex vivo among CRS subtypes and in vitro after cytokine stimulation. Methods Sinus biopsy specimens were taken from control patients (n = 13), CRS without nasal polyposis (CRSsNP, n = 6), and CRS with nasal polyposis (CRSwNP, n = 15). Ex vivo levels of VCAM and ICAM were measured by flow cytometry from single cell suspensions of tissue biopsy specimens. Changes in VCAM and ICAM expression to cytokine exposure were assessed using in vitro cultured sinonasal fibroblasts treated with tumor necrosis factor (TNF)-α, interleukin (IL)-4, or interferon (IFN)-γ. Results Ex vivo VCAM expression was lowest in controls, higher in CRSsNP, and highest in CRSwNP. In vitro stimulation with TNF-α and IL-4, but not IFN-γ, increased VCAM among CRSsNP, while expression in CRSwNP remained elevated with all treatments except IFN-γ. Ex vivo ICAM expression was elevated in both CRS subtypes. In vitro stimulation with TNF-α and IFN-γ, but not IL-4, increased ICAM expression in all patients with the largest effects among the CRSsNP subgroup. Conclusion Sinonasal fibroblast expression of adhesion molecules in sinusitis varies by disease state and is selectively influenced by exposure to inflammatory cytokines.
Increased Expression of YKL-40 in Mild and Moderate/Severe Persistent Allergic Rhinitis and its Possible Contribution to Remodeling of Nasal Mucosa
Authors: Park Se Jin , Jun Young Joon , Kim Tae Hoon , Jung Jong Yoon , Hwang Gyu Ho , Jung Kwang Jin , Lee Seung Hoon , Lee Heung Man , Lee Sang Hag 
Published: October 2013

Background Prominent expression of YKL-40 has been associated with pathological conditions characterized by tissue remodeling. We determined the expression level and distribution pattern of YKL-40 in allergic nasal mucosa and evaluated the effect of YKL-40 on the proliferation and migration of fibroblasts, the production of the mediators related to tissue remodeling, and collagen production. Additionally, the cytokine-driven regulation of YKL-40 expression was evaluated in cultured epithelial cells. Methods The expression of YKL-40 in normal, mild, and moderate/severe allergic nasal mucosa was evaluated using real-time polymerase chain reaction (PCR), Western blot, and immunohistochemistry. Fibroblast migration was observed using a scratch wound method, and proliferation was determined by the MTT methods. Expression of proteoglycans, transforming growth factor (TGF) beta1, MMP2, MMP9, TIMP1, TIMP2, and collagen concentration were analyzed in fibroblasts treated with YKL-40. The expression levels of YKL-40 in cultured epithelial cells were examined after stimulation with mediators including Th2 cytokines, interferon (IFN)gamma, and TNF-alpha with real-time PCR and ELISA. Results The expression of YKL-40 was up-regulated in allergic rhinitis and distributed in superficial epithelium, submucosal glands, and vascular endothelium, in addition to infiltrating cells. TGF-beta1, TIMP1, MMP9, and biglycan were up-regulated in fibroblasts on stimulation with YKL-40, accompanying increased proliferation and migration, and collagen production. IL-13, IFN-gamma, and TNF-alpha induced the increased production of YKL-40 in cultured epithelial cells. Conclusion YKL-40 is up-regulated in mild and moderate/severe persistent allergic rhinitis, and its expression can be regulated differentially by different cytokines, possibly contributing to the remodeling of nasal mucosa in allergic rhinitis.
Prognosis for Sixth Nerve Palsy Arising from Paranasal Sinus Disease
Authors: Miller Craig , Suh Jeffrey D. , Henriquez Oswaldo A. , Schlosser Rodney J. , Ramakrishnan Vijay R. , Chiu Alexander G. 
Published: October 2013

Background The abducens nerve, cranial nerve VI (CNVI), is the medial-most nerve in the cavernous sinus. Its close proximity to the sphenoid sinus makes it susceptible to injury, invasion, or compression from a sphenoid pathology leading to horizontal gaze diplopia. A wide range of literature describes myriad causes for CNVI palsy, but there is a lack of references that point to paranasal sinus pathology as an etiology, as well as the prognosis and timeline for resolution. Here, we describe a series of patients that presented with CNVI palsy, their management, and prognosis for recovery. This study was designed to evaluate and understand prognostic factors predicting disease course and likelihood of resolution in patients with abducens nerve palsy. Methods A multi-institutional retrospective review was performed of all patients presenting with CNVI palsy between 2009 and 2012. The demographic data, radiological features, treatment regimens, and disease courses were analyzed. Results Fifteen patients at four institutions were identified. Seven patients had neoplasms originating from the paranasal sinuses, three suffered from allergic fungal sinusitis, three patients had invasive fungal sinusitis, one patient had fibrous skull base dysplasia, and one had chronic bacterial sinusitis. The average follow-up time from presentation was 9 months (range, 1–16 months). Thirteen patients underwent surgery, three received chemotherapy, and four had radiation therapy. CNVI palsy resolved in 50% of the cases, with an average time to resolution of 6 weeks (range, 2–12 weeks). Conclusion Paranasal sinus pathology is a rare cause of CNVI palsy. A number of factors may help to predict prognosis in these patients. Masses compressing, but not destroying or invading, the cavernous sinus had optimal posttreatment outcomes with full resolution occurring as early as 2 weeks. Destructive lesions that invaded CNVI and its vasculature, i.e., invasive fungus, were negative indicators for recovery. Knowledge of factors that affect recovery can help clinicians predict disease course and prognosis for resolution of the defect.
Assessing the Relationship between Serum Resistin and nasal Obstruction in Children with Allergic Rhinitis
Authors: Zicari Anna Maria , Occasi Francesca , Marcelli Azzurra Cesoni , Lollobrigida Valeria , Carbone Maria Palma , Galandrini Ricciarda , Giuffrida Anna , Duse Marzia 
Published: October 2013

Background Nasal obstruction has been reported as a “key symptom” of allergic rhinitis (AR) because it is deeply associated with impaired quality of life and it reflects more directly the allergic inflammation in the nasal mucosa. Resistin is known to be involved in inflammatory processes exerting an important role in the regulation of cytokine production even though its effective proinflammatory activity at nasal level has never been fully established. This study investigates the relationship between resistin levels and nasal obstruction assessed by an objective method such as active anterior rhinomanometry. Methods Fifty-three children between 4 and 10 years of age affected by persistent allergic rhinitis (PAR) were enrolled and subdivided in two groups. Serum resistin levels were detected in all children. The same day patients underwent rhinomanometry, which was considered negative (no nasal obstruction) when the fraction of predicted values (p.v.'s) was between 71 and 100% and it was considered positive when the fraction of p.v. was ≤70%. Results The serum resistin levels were significantly higher in children with moderate–severe PAR than in patients with mild PAR (p < 0.03). Furthermore, serum resistin levels were significantly higher in children with positive rhinomanometry compared with negative rhinomanometry (p < 0.03). The fraction of p.v.'s of nasal flows in patients with nasal obstruction had a significant negative correlation with serum resistin levels (p < 0.001). Conclusion This study provides evidence that resistin levels are increased in children with severe nasal obstruction measured by an objective and quantitative approach.
Comparison of Ropivacaine, Bupivacaine, Prilocaine, and Lidocaine in the Management of Pain and Hemorrhage during Nasal Pack Removal
Authors: Gencer Zeliha Kapusuz , Özkiriş Mahmut , Gencer Muzaffer , Saydam Levent 
Published: October 2013

Background This study investigates the effects of local anesthetics application on pain and hemorrhage caused by nasal pack removal. Methods The study included 140 patients. Of these, 72 were women and 68 were men. The mean age and weight of the patients were 33.67 ± 10.2 years (range, 21–63 years) and 69.6 ± 13.6 kg. The patients were divided randomly into four groups. Three of the four groups received one of the local anesthetics studied in our trial (lidocaine + adrenaline, 0.25% bupivacaine, or 2% prilocaine) before removal of the nasal packing material and the control group received saline solution. Local anesthetics and 0.9% saline solution were applied to Merocel nasal packs 15 minutes before removal. Each patient was given a questionnaire where verbal analog score and amount of postoperative hemorrhage was noted. Results The mean pain score was 3.5 ± 1.2 (median, 4; range, 3–5) in the lidocaine group, 4.5 ± 1.2 (median, 4; range 3–5) in the prilocaine group, 4.7 ± 1.3 (median, 6; range, 3–5) in the bupivacaine group, and 6.35 ± 1.2 (median, 6; range, 5–7) in the saline group during nasal packing removal. The lidocaine group had significantly better pain scores versus other groups (p < 0.05). Bupivacaine and prilocaine had significantly better pain scores versus the control group, respectively. Analysis of bleeding scores after pack removal showed that all three study groups had significantly better bleeding scores versus the control saline group (p < 0.05). The lidocaine group had significantly less bleeding score than bupivacaine and prilocaine groups (p < 0.05). Conclusion Topical lidocaine application before removal of nasal packs in patients who undergo nasal septal surgery can decrease discomfort and bleeding and improve patient tolerance.
Rhinology Fellowship Training and its Scholarly Impact
Authors: Svider Peter F. , Blake Danielle M. , Setzen Michael , Folbe Adam J. , Baredes Soly , Eloy Jean Anderson 
Published: October 2013

Background Previous examination of the impact of fellowship training on scholarly productivity among otolaryngologists found that head and neck surgeons and otologists had a higher mean h–index than fellowship-trained rhinologists. Because fellowship training in rhinology is a historically newer trend, the objectives of the present analysis were to further characterize research productivity among fellowship-trained academic rhinologists, including geographic and temporal trends, to gain insight into the future direction of scholarly pursuits within the field. Methods Fellowship-trained rhinologists in academic practices were identified from the American Rhinologic Society online listings and organized by academic rank, number of years in practice, location, and h-index, as calculated using the Scopus database. Results Mean h-index rose with increasing years in practice after fellowship. The h-index, number of publications, and the E-factor (a newly described bibliometric) increased with successive academic rank. The E-factor for rhinologists in this current analysis was not statistically different from the values calculated for other otolaryngology subspecialties (p > 0.05). Conclusion Fellowship-training in rhinology is a relatively recent development, with half of the academic rhinologists included in this analysis having completed fellowship training within the past 5 years. Scholarly productivity among academic rhinologists increases with academic seniority. As the current cohort of fellowship-trained rhinologists progress in their academic careers, previously described deficits in scholarly productivity relative to other subspecialties are expected to diminish.
The use of Postoperative Topical Corticosteroids in Chronic Rhinosinusitis with Nasal Polyps: A Systematic Review and Meta-Analysis
Authors: Marcela Fandiño C , Macdonald Kristian I. , Lee John , Witterick Ian J. 
Published: October 2013

Background Topical intranasal corticosteroids (INCSs) are used to control disease symptoms in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). The evidence to recommend INCSs as part of the postoperative care is limited. This study was designed to assess the efficacy of INCSs in the postoperative care of patients undergoing functional endoscopic sinus surgery (FESS) during the 1st year postoperatively. Methods We searched the Cochrane Central Register of Controlled Trials (1995 to May 2012), MEDLINE (January 1948 to May 2012), EMBASE (January 1980 to May 2012), and the reference lists of articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Randomized controlled trials (RCT) and cohort studies comparing INCSs with placebo or comparing different types of INCSs were included. Results Eleven studies (n = 945 patients) were RCTs and one prospective cohort study (n = 32 patients). As measured by the standardized mean difference (SMD) INCSs had a beneficial effect on symptom scores (SMD, –1.35; 95% CI, –2.05 to –0.64; p = 0.0002; 3 trials; 137 patients) and polyp score (SMD, 0.53; 95% CI, –0.91 to –0.14; p = 0.007; 5 trials; 223 patients). Compared with placebo, the use of INCSs decreased the odds of polyp recurrence (odds ratio, 0.17; 95% CI, 0.06–0.51; p = 0.002; 2 trials; 74 patients). Two RCTs (n = 105) and one cohort study (n = 32) reported normal adrenocorticotropic hormone levels postintervention. Conclusion INCS use is a safe therapy in postoperative management of CRSwNP patients. INCS showed significant improvement in polyp score, patients’ symptoms and significant decrease in polyp recurrence in the first year postoperatively.
The Effect of Maxillary Sinus Irrigation on Early Prognostic Factors after Endoscopic Sinus Surgery: A Preliminary Study
Authors: Kim Seon Tae , Sung Um Hee , Jung Joo Hyun , Paik Ju Young , Woo Joo Hyun , Cha Heung Eog , Kang Il Gyu 
Published: October 2013

Background Sinus irrigation has been used to treat chronic rhinosinusitis refractory to medical and surgical treatments. The aim of this study was to evaluate the effect of maxillary sinus saline irrigation on the prevention of purulent rhinorrhea, extensive granulation formation, and polyp recurrence after endoscopic sinus surgery (ESS). Methods This prospective, controlled study was approved by the Institutional Review Board of Gachon University Gil Medical Center. Between August 1, 2011, and May 31, 2012, we recruited a total of 30 patients who underwent bilateral ESS. Group A was composed of 15 patients that were treated with bilateral maxillary sinus saline irrigation for 2 months after ESS. Group B was composed of 15 patients who were followed up during the same period after ESS. We checked for persistent purulent discharge, extensive granulation, and recurrent polyps in both groups to evaluate the effects of maxillary sinus irrigation on their prevention. Results Age, gender, and preoperative Lund-Mackay scores were not significantly different between the two groups (p > 0.05). In group A, one patient showed polyp recurrence. In group B, one patient showed extensive granulation tissue, two patients showed uncontrolled purulent discharge, three patients showed extensive granulation tissues and uncontrolled purulent discharge, and one patient showed recurrent polyps (p = 0.03). In addition, total endoscopic scores in the 3rd month were significantly different between groups A and B (p = 0.01). Conclusion Maxillary sinus saline irrigation may be effective in the prevention of poor prognostic factors, such as persistent purulent discharge, at the early stages after ESS.
Occupational Therapy for Upper Limb Post-Stroke Sensory Impairments: A Survey
Authors: Doyle Susan , Bennett Sally , Gustafsson Louise 
Published: October 2013

Purpose: Upper limb post-stroke sensory impairments have an impact on a significant number of stroke survivors. There is limited research in this area and it is unclear how occupational therapists are addressing sensory impairments in clinical practice. This study aimed to investigate the clinical practice patterns of occupational therapists, perceived barriers to providing interventions and information sources used when addressing upper limb post-stroke sensory impairments. Methods: A survey was sent to 500 randomly selected occupational therapists in the United States. Findings: The majority of the 145 respondents reported frequently assessing sensation, and half reported providing interventions for sensory impairments. Interventions primarily focused on providing passive sensory stimulation followed by compensatory strategies. Most therapists provided patient/caregiver education about safety. Therapists cited lack of knowledge and skills, patients' short length of stay and lack of time as barriers to utilizing interventions. Most therapists reported not being up to date with current research and requested continuing education to support practice. Conclusion: This survey established a profile of American occupational therapists' practice with people with upper limb post-stroke sensory impairments. Therapists have a need for information and training in all aspects of the management of upper limb post-stroke sensory impairment. Further research, evaluating the effectiveness of interventions and exploring therapists' clinical decision making when choosing interventions, is also needed.