bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contemporary Risk Estimates of Three HbA1c Variables for Myocardial Infarction in 101,799 Patients Following Diagnosis of Type 2 Diabetes
Authors: Olsson Marita , Schnecke Volker , Cabrera Claudia , Skrtic Stanko , Lind Marcus 
Published: May 2015

OBJECTIVEThis study evaluated the risk of myocardial infarction (MI) by impaired glycemic control in a contemporary large cohort of patients with type 2 diabetes followed from diagnosis.RESEARCH DESIGN AND METHODSPatients with type 2 diabetes diagnosed between 1995 and 2011 were retrieved from the Clinical Practice Research Datalink in the U.K., and followed from diagnosis until event of MI or end of study in 2013. Two subcohorts were defined: an early cohort with those diagnosed from 1997 to 2004 and a recent cohort with those diagnosed from 2004 to 2011. Association between each of three HbA1c metrics and MI was estimated using adjusted proportional hazards models.RESULTSIn the overall cohort (n = 101,799), the risk increase for MI per 1% (10 mmol/mol) increase in HbA1c was higher for updated latest and updated mean HbA1c of 1.11 (95% CI 1.09–1.13) and 1.15 (1.13–1.18) than for baseline HbA1c of 1.05 (1.03–1.06). In the early subcohort, the corresponding risk estimates were greater than those in the recent subcohort. When categorized, the updated latest variable showed an increased risk for HbA1c &lt;6% (42 mmol/mol), relative category 6–7%, in the recent but not in the early subcohort, with hazard ratios of 1.23 (1.08–1.40) and 1.01 (0.84–1.22), respectively.CONCLUSIONSThe two time-updated HbA1c variables show a stronger relation with MI than baseline HbA1c. The risk association between HbA1c and MI has decreased over time. In recently diagnosed patients with type 2 diabetes, an increased risk of MI exists at a current HbA1c of &lt;6.0% (42 mmol/mol).
Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients
Authors: Bohn Barbara , Herbst Antje , Pfeifer Martin , Krakow Dietmar , Zimny Stefan , Kopp Florian , Melmer Andreas , Steinacker Jürgen M. , Holl Reinhard W. 
Published: May 2015

OBJECTIVE
Physical activity (PA) can improve cardiovascular risk in the general population and in patients with type 2 diabetes. Studies also indicate an HbA1c-lowering effect in patients with type 2 diabetes. Since reports in patients with type 1 diabetes are scarce, this analysis aimed to investigate whether there is an association between PA and glycemic control or cardiovascular risk in subjects with type 1 diabetes.

RESEARCH DESIGN AND METHODS
A total of 18,028 adults (≥18 to &lt;80 years of age) from Germany and Austria with type 1 diabetes from the Diabetes-Patienten-Verlaufsdokumentation (DPV) database were included. Patients were stratified according to their self-reported frequency of PA (PA0, inactive; PA1, one to two times per week; PA2, more than two times per week). Multivariable regression models were applied for glycemic control, diabetes-related comorbidities, and cardiovascular risk factors. Data were adjusted for sex, age, and diabetes duration. P values for trend were given. SAS 9.4 was used for statistical analysis.

RESULTS
An inverse association between PA and HbA1c, diabetic ketoacidosis, BMI, dyslipidemia (all P &lt; 0.0001), and hypertension (P = 0.0150), as well as between PA and retinopathy or microalbuminuria (both P &lt; 0.0001), was present. Severe hypoglycemia (assistance required) did not differ in PA groups (P = 0.8989), whereas severe hypoglycemia with coma was inversely associated with PA (P &lt; 0.0001).

CONCLUSIONS
PA seemed to be beneficial with respect to glycemic control, diabetes-related comorbidities, and cardiovascular risk factors without an increase of adverse events. Hence, our data underscore the recommendation for subjects with type 1 diabetes to perform regular PA.
Clinical prediction model for acute inpatient complications after traumatic cervical spinal cord injury: a subanalysis from the Surgical Timing in Acute Spinal Cord Injury Study
Authors: Wilson Jefferson R. , Arnold Paul M. , Singh Anoushka , Kalsi-Ryan Sukhvinder , Fehlings Michael G. 
Published: May 2015

Object
While the majority of existing reports focus on complications sustained during the chronic stages after traumatic spinal cord injury (SCI), the objective in the current study was to characterize and quantify acute inpatient complications. In addition, the authors sought to create a prediction model using clinical variables documented at hospital admission to predict acute complication development.

Methods
Analyses were based on data from the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) data registry, which contains prospective information on adult patients with cervical SCIs who were enrolled at 6 North American centers over a 7-year period. All patients who underwent a standardized American Spinal Injury Association (ASIA) neurological examination within 24 hours of injury and whose follow-up information was available at the acute hospital discharge were included in the study. For purposes of classification, complications were divided into 5 major categories: 1) cardiopulmonary, 2) surgical, 3) thrombotic, 4) infectious, and 5) decubitus ulcer development. Univariate statistical analyses were performed to determine the relationship between complication occurrence and individual demographic, injury, and treatment variables. Multivariate logistic regression was subsequently performed to create a complication prediction model. Model discrimination was judged according to the area under the receiver operating characteristic curve.

Results
Complete complication information was available for 411 patients at the acute care discharge. One hundred sixty patients (38.9%) experienced 240 complications. The mean age among those who experienced at least one complication was 45.9 years, as compared with 43.5 years among those who did not have a complication (p = 0.18). In the univariate analysis, patients with complications were less likely to receive steroids at admission (p = 0.01), had a greater severity of neurological injury as indicated by the ASIA Impairment Scale (AIS) grade at presentation (p < 0.01), and a higher frequency of significant comorbidity (p = 0.04). In a multivariate logistic regression model, a severe initial AIS grade (p < 0.01), a high-energy injury mechanism (p = 0.07), an older age (p = 0.05), the absence of steroid administration (p = 0.02), and the presence of comorbid illness (p = 0.02) were associated with a greater likelihood of complication development during the period of acute hospitalization. The area under the curve value for the full model was 0.75, indicating acceptable predictive discrimination.

Conclusions
These results will help clinicians to identify patients with cervical SCIs at greatest risk for complication development and thus allowing for the institution of aggressive complication prevention measures.
Incidence and severity of acute complications after spinal cord injury
Authors: Grossman Robert G. , Frankowski Ralph F. , Burau Keith D. , Toups Elizabeth G. , Crommett John W. , Johnson Michele M. , Fehlings Michael G. , Tator Charles H. , Shaffrey Christopher I. , Harkema Susan J. , Hodes Jonathan E. , Aarabi Bizhan , Rosner Michael K. , Guest James D. , Harrop James S. 
Published: May 2015

Object
The aim of this multicenter, prospective study was to determine the spectrum, incidence, and severity of complications during the initial hospitalization of patients with spinal cord injury.

Methods
The study was conducted at 9 university-affiliated hospitals that comprise the clinical centers of the North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury. The study population comprised 315 patients admitted to NACTN clinical centers between June 25, 2005, and November 2, 2010, who had American Spinal Injury Association (ASIA) Impairment Scale grades of A–D and were 18 years of age or older. Patients were managed according to a standardized protocol.

Results
The study population was 79% male with a median age of 44 years. The leading causes of injury were falls (37%) and motor vehicle accidents (28%). The distribution of initial ASIA grades were A (40%), B (16%), C (15%), and D (29%). Fifty-eight percent of patients sustained 1 or more severe, moderate, or mild complications. Complications were associated with more severe ASIA grade: 84% of patients with Grade A and 25% of patients with Grade D had at least 1 complication. Seventy-eight percent of complications occurred within 14 days of injury. The most frequent types of severe and moderate complications were respiratory failure, pneumonia, pleural effusion, anemia, cardiac dysrhythmia, and severe bradycardia. The mortality rate was 3.5% and was associated with increased age and preexisting morbidity.

Conclusions
Knowledge of the type, frequency, time of occurrence, and severity of specific complications that occur after spinal cord injury can aid in their early detection, treatment, and prevention. The data are of importance in evaluating and selecting therapy for clinical trials.
Quality of life in persons with spinal cord injury: comparisons with other populations
Authors: Boakye Maxwell , Leigh Barbara C. , Skelly Andrea C. 
Published: May 2015

Object
The aim of this study was to identify the quality of life (QOL) measures commonly used to assess patients with spinal cord injury (SCI) and to summarize studies using common QOL measures that have been validated in SCI populations to compare scores in persons with SCI with those in a control population.

Methods
A systematic search of PubMed was conducted to identify studies using common QOL measures in persons with SCI and those comparing scores for QOL measures in an SCI population with scores in other populations. The authors sought comparative studies utilizing QOL measures for which validity and reliability analyses had been done.

Results
Of 28 QOL measures found, validity and reliability studies had been conducted in patients with SCI for 5 measures. Twelve comparative studies compared QOL in SCI patients with QOL in healthy controls or in patients with other disabilities, or with normative data. The 36-Item Short Form Health Survey (SF-36) and the short version of the WHOQOL (WHOQOL-BREF) were the most widely used QOL instruments. Patients with SCI had a decreased QOL as compared with that in healthy controls or normative data, with the most pronounced deficits in the domains of physical functioning and physical role limitations. In 3 studies, patients with tetraplegia had a lower physical domain QOL than did those with paraplegia. Overall, however, the impact of injury level and injury completeness on QOL after SCI remains unclear due to a lack of longitudinal studies.

Conclusions
The SF-36 and WHOQOL-BREF are validated instruments that should be considered for use in SCI QOL studies. Future analysis of deficits in QOL among patients with SCI would benefit from the development of a QOL instrument specifically targeted to SCI. Longitudinal studies to assess the impact of injury level and injury completeness on SCI QOL are also needed.
What do we currently know about thoracic spinal cord injury recovery and outcomes? A systematic review
Authors: Bransford Richard J. , Chapman Jens R. , Skelly Andrea C. , VanAlstyne Ellen M. 
Published: May 2015

Object
The purpose of this paper was to systematically review and critically appraise the evidence for whether there are differences in outcomes or recovery after thoracic spinal cord injuries (SCIs) based on the spinal level, the timing of intervention, or cause of SCI.

Methods
Systematic searches were conducted using PubMed/MEDLINE through January 5, 2012. From 486 articles identified, 10 included data on the population of interest. Included studies were assigned a level of evidence (LOE) rating based on study quality, and an overall strength of evidence was assessed. To estimate the effect of injury level on patient outcomes, the relative risk and risk difference were calculated when data were available.

Results
From 486 citations identified, 3 registry studies and 7 retrospective cohort studies met the inclusion criteria. All were rated as being of poor quality (LOE III). Limited literature exists on the epidemiology of traumatic and nontraumatic SCI. Few studies evaluated outcomes based on SCI level within the thoracic spine. Pulmonary complications and thromboembolic events were less common in persons with lower thoracic SCI (T7–12) than in those with higher thoracic SCI (T1–6) in 2 large studies, but no differences were found in functional outcomes in 4 smaller studies. Patients undergoing earlier surgery (< 72 hours) may have fewer ventilator, ICU, and hospital days than those undergoing later surgery. One small study of SCI during repair of aortic aneurysm compared with traumatic SCI reported similar outcomes for both groups. There are substantial deficiencies in the scientific literature on thoracic SCI in regard to assessment, outcomes ratings, and effectiveness of therapy.

Conclusions
The overall strength of evidence for all outcomes reported is low. Definitive conclusions should not be drawn regarding the prognosis for outcome and recovery after thoracic SCI. From a physiological standpoint, additional methodologically rigorous studies that take into consideration various levels of injury in more anatomically and physiologically relevant form are needed. Use of validated, comprehensive outcomes tools are important to improve our understanding of the impact of thoracic SCI and aid in examining factors in recovery from thoracic SCI.
Intraorbital meningioma: resection through modified orbitozygomatic craniotomy
Authors: Cohen-Gadol Aaron A. 
Published: May 2015

Intraorbital meningiomas are challenging lesions to excise because of their location and the restricted surgical corridor available due to the presence of important neighboring structures. Lesions located in the posterior one-third of the orbit require skull base approaches for their exposure and safe resection.
Frontoorbital and modified orbitozygomatic (OZ) craniotomies may facilitate the exposure and resection of masses in the posterior intraorbital space. Specifically, the one-piece modified OZ craniotomy provides many advantages of the “full” OZ craniotomy (which includes a more extensive zygomatic osteotomy). The modified OZ approach minimizes the extent of frontal lobe retraction and provides ample amount of space for the surgeon to exploit all the working angles to resect the tumor.
The following video presentation discusses the nuances of technique for resection of an intraorbital meningioma through modified OZ approach and optic nerve decompression. The nuances of technique will be discussed.
The video can be found here: http://youtu.be/fP5X2QNr5qk.
Endoscopic endonasal transplanum transtuberculum approach for resection of retrochiasmatic craniopharyngioma
Authors: Liu James K. , Eloy Jean Anderson 
Published: May 2015

Retrochiasmatic craniopharyngiomas are formidable cranial base tumors to resect because of their intimate relationship with neighboring critical neurovascular structures, particularly the undersurface of the optic chiasm and hypothalamus. Radical resection offers the best chance of minimizing tumor recurrence, although this may be associated with significant surgical morbidity. Although various transcranial approaches have been utilized (transbasal subfrontal, frontobasal interhemispheric, pterional, orbitozygomatic, and petrosal) for resection of retrochiasmatic craniopharyngiomas, each is associated with some degree of brain retraction, and direct visualization of the retrochiasmatic region is often incomplete, therefore resulting in blind dissection. The endoscopic endonasal transplanum transtuberculum approach provides the most direct route to the retrochiasmatic region while affording unmatched visualization of the undersurface of the optic chiasm, third ventricle, and hypothalamus. This advantage allows for direct bimanual tumor dissection off of these critical structures by using microsurgical principles. The endonasal route also has the advantage of avoiding brain retraction and risk of cerebral edema that can be associated with transcranial approaches. In this operative video atlas report, the authors demonstrate their step-by-step techniques for resection of a suprasellar retrochiasmatic craniopharyngioma using a purely endoscopic endonasal transplanum transtuberculum approach. They describe and illustrate the operative nuances and surgical pearls to safely and efficiently perform the approach, tumor resection, and multilayered reconstruction of the cranial base defect.
The video can be found here: http://youtu.be/ZIbJvAyRxYU.
Laser-assisted microsurgical resection of thoracic intramedullary spinal cord ependymoma
Authors: Liu James K. 
Published: May 2015

The surgical management of intramedullary spinal cord ependymomas remains a formidable challenge amongst neurosurgeons because of the potential risk of surgical morbidity. From on an oncological perspective, complete resection—if technically feasible—should be the goal of surgery, since this can result in excellent local control and progression-free survival. Advances in microsurgical techniques, intraoperative neurophysiological monitoring, and the use of lasers have contributed to our ability to achieve gross-total resection. This is also largely dependent on the presence of an identifiable surgical plane of dissection between the tumor and spinal cord, which appears to have a positive prognosis with overall neurological improvement. In this operative video manuscript, the author demonstrates an illustrative step-by-step technique for microsurgical resection of a thoracic intramedullary spinal cord ependymoma (T-3 to T-5) associated with an extensive cervicothoracic syrinx. The application of a handheld non-contact CO2 laser for performing the midline myelotomy is also highlighted. The operative technique and surgical nuances, including the surgical approach, intradural tumor removal, and closure, are illustrated in this video atlas.
The video can be found here: http://youtu.be/itE2tuBFmgw.
Thoracoscopic transdiaphragmatic approach for ventral decompression and reconstruction of metastatic spine disease
Authors: Schmidt Meic H. 
Published: May 2015

The management of metastatic spine disease is complex, but usually involves radiation therapy and/or surgical treatment. Surgery followed by radiation has a significant role in select patients presenting with metastatic spinal cord compression. Ventral decompression can be achieved through several surgical approaches including posterior, posterolateral, and anterior surgical approaches. Although open thoracotomy is the most common approach for ventral decompression, it is associated with significant spinal access morbidity. This video illustrates a thoracoscopic transdiaphragmatic approach for symptomatic L-1 metastatic spinal cord compression. This approach allows for a minimal incision in the diaphragm to expose the thoracolumbar junction and allows for corpectomy, spinal canal decompression, vertebral body replacement, and spinal stabilization via four small incisions along the chest wall. The step-by-step technique illustrates operative nuances and surgical pearls to safely perform this approach in a patient with thoracolumbar L-1 metastatic spinal cord compression.
The video can be found here: http://youtu.be/w8fanV9bq-E.
Minimally invasive lumbar intradural extramedullary tumor resection
Authors: Lee Brian , Hsieh Patrick C. 
Published: May 2015

Intradural, extramedullary schwannomas have long been treated with open midline incision, laminectomy, and dural opening to expose and resect the lesion. While this technique is well established, today new surgical techniques can be utilized to perform the same procedure while minimizing pain, size of incision, and trauma to adjacent tissues. In cases of intradural surgery, minimally invasive surgery limits the degree of soft tissue disruption. As a result, there is significant decreased dead space within the surgical cavity that may decrease the rate of CSF leak complications. Minimally invasive techniques have continuously improved over the years and have reached a point where they can be used for intradural surgeries. In this case presentation, we demonstrate a minimally invasive approach to the lumbar spine with resection of an intradural schwannoma. Surgical techniques and the nuances of the minimally invasive approach to intradural tumors compared to the standard open procedure will be discussed.
The video can be found here: http://youtu.be/XXrvAIq_H48.
Resection of an anterior spinal cord AVM through a far-lateral approach
Authors: Michael L. Madison , Sorenson Jeffrey M. 
Published: May 2015

A small arteriovenous malformation near the craniocervical junction with contributions from the anterior spinal artery was discovered in a young developmentally-delayed woman after she presented with altered mental status and evidence of subarachnoid hemorrhage. The malformation could not be completely treated with endovascular therapy, so it was resected through a far-lateral approach. This stereoscopic video demonstrates how to gain the exposure needed to address a lesion in this area.
The video can be found here: http://youtu.be/ByjPGm_eXLc.
Endoscopic endonasal craniopharyngioma resection
Authors: Kenning Tyler J. , Beahm D. David , Farrell Christopher J. , Schaberg Madeleine R. , Rosen Marc R. , Evans James J. 
Published: May 2015

The authors present the case of a 21-year-old female with a progressive bitemporal hemianopsia. Cranial MR imaging revealed a large cystic suprasellar, retrochiasmatic lesion consistent with craniopharyngioma. The lesion was fully resected through an endoscopic endonasal transsphenoidal and transplanum approach. Closure of the resultant dural defect was performed with a bilayer fascia lata button and autologous mucoperichondrial nasoseptal flap. Each portion of this procedure was recorded and is presented in an edited high-definition format.
The video can be found here: http://youtu.be/i3-qieLlbVk.
Endoscopic endonasal repair of spontaneous CSF fistulae
Authors: Tormenti Matthew J. , Paluzzi Alessandro , Pinheiro-Neto Carlos D. , Fernandez-Miranda Juan C. , Snyderman Carl H. , Gardner Paul A. 
Published: May 2015

The authors present a fully endoscopic endonasal repair of a spontaneous CSF leak caused by a defect in the anterior fossa floor. Patients were positioned supine in a Mayfield headholder in slight extension. A complete ethmoidectomy was performed to expose the defect. The middle turbinate was removed to increase visualization and allow for more working room. The defect was identified and exposed. A nasoseptal flap was raised and placed over the defect. A free-mucosal graft fashioned from the removed middle turbinate was placed on the nasoseptal donor site.
The video can be found here: http://youtu.be/gAN2cvQVXCE.