bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesenchymal Stem Cells From a Hypoxic Culture Improve and Engraft Achilles Tendon Repair
Authors: Huang Tung-Fu , Yew Tu-Lai , Chiang En-Rung , Ma Hsiao-Li , Hsu Chih-Yuan , Hsu Shan-Hui , Hsu Yuan-Tong , Hung Shih-Chieh 
Published: March 2013

Background: Bone marrow–derived mesenchymal stem cells (MSCs) from humans cultured under hypoxic conditions increase bone healing capacity. Hypothesis: Rat MSCs cultured under hypoxic conditions increase the tendon healing potential after transplantation into injured Achilles tendons. Study Design: Controlled laboratory study. Methods: Biomechanical testing, histological analysis, and bromodeoxyuridine (BrdU) labeling/collagen immunohistochemistry were performed to demonstrate that augmentation of an Achilles tendon rupture site with hypoxic MSCs increases healing capacity compared with normoxic MSCs and controls. Fifty Sprague-Dawley rats were used for the experiments, with 2 rats as the source of bone marrow MSCs. The cut Achilles tendons in the rats were equally divided into 3 groups: hypoxic MSC, normoxic MSC, and nontreated (vehicle control). The uncut tendons served as normal uncut controls. Outcome measures included mechanical testing in 24 rats, histological analysis, and BrdU labeling/collagen immunohistochemistry in another 24 rats. Results: The ultimate failure load in the hypoxic MSC group was significantly greater than that in the nontreated or normoxic MSC group at 2 weeks after incision (2.1 N/mm2 vs 1.1 N/mm2 or 1.9 N/mm2, respectively) and at 4 weeks after incision (5.5 N/mm2 vs 1.7 N/mm2 or 2.7 N/mm2, respectively). The ultimate failure load in the hypoxic MSC group at 4 weeks after incision (5.5 N/mm2) was close to but still significantly less than that of the uncut tendon (7.2 N/mm2). Histological analysis as determined by the semiquantitative Bonar histopathological grading scale revealed that the hypoxic MSC group underwent a significant improvement in Achilles tendon healing both at 2 and 4 weeks when compared with the nontreated or normoxic MSC group via statistical analysis. Immunohistochemistry further demonstrated that the hypoxic and normoxic MSC groups had stronger immunostaining for type I and type III collagen than did the nontreated group both at 2 and 4 weeks after incision. Moreover, BrdU labeling of MSCs before injection further determined the incorporation and retention of transplanted cells at the rupture site. Conclusion: Transplantation of hypoxic MSCs may be a better and more readily available treatment than normoxic MSCs for Achilles tendon ruptures. Clinical Relevance: The present study provides evidence that transplantation of hypoxic MSCs may be a promising therapy for the treatment of Achilles tendon ruptures.
Complications of Medial Patellofemoral Ligament Reconstruction in Young Patients
Authors: Parikh Shital N. , Nathan Senthil T. , Wall Eric J. , Eismann Emily A. 
Published: March 2013

Background: The medial patellofemoral ligament (MPFL) has been recognized as the primary restraint to lateral subluxation of the patella. Reconstruction of the MPFL for patellar instability has demonstrated early clinical success, but postoperative complications have rarely been reported, especially in young patients. Purpose: To assess early complications (<3 years) of MPFL reconstruction in young patients. Study Design: Case series; Level of evidence, 4. Methods: The charts and radiographs of all patients who underwent MPFL reconstruction between 2005 and 2011 were retrospectively reviewed to identify postoperative complications. A complication was considered major if the patient required hospitalization or further surgery. Each complication was analyzed to identify the technical factors related to it. Results: A total of 179 knees underwent MPFL reconstruction during the study period. There were 38 complications in 29 knees (16.2%), with 34 major and 4 minor. Major complications included recurrent lateral patellar instability (8 patients), knee motion stiffness with flexion deficits (8 patients), patellar fractures (6 patients), and patellofemoral arthrosis/pain (5 patients). Eighteen of 38 (47%) complications were secondary to technical factors and were considered preventable. Female sex and bilateral MPFL reconstructions were risk factors associated with postoperative complications. Conclusion: Complications occurred in 16.2% of MPFL reconstruction surgeries for patellar instability in young patients, with almost half resulting from technical problems. Patients should be counseled preoperatively on the risk of potential complications.
Hepatoprotective potential of Lavandula coronopifolia extracts against ethanol induced oxidative stress-mediated cytotoxicity in HepG2 cells
Authors: Farshori Nida Nayyar , Al-Sheddi Ebtsam S , Al-Oqail Mai M , Hassan Wafaa HB , Al-Khedhairy Abdulaziz A , Musarrat Javed , Siddiqui Maqsood A 
Published: March 2013

The present investigations were carried out to study the protective potential of four extracts (namely petroleum ether extract (LCR), chloroform extract (LCM), ethyl acetate extract (LCE), and alcoholic extract (LCL)) of Lavandula coronopifolia on oxidative stress-mediated cell death induced by ethanol, a known hepatotoxin in human hapatocellular carcinoma (HepG2) cells. Cells were pretreated with LCR, LCM, LCE, and LCL extracts (10–50 μg/ml) of L. coronopifolia for 24 h and then ethanol was added and incubated further for 24 h. After the exposure, cell viability using (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and neutral red uptake assays and morphological changes in HepG2 cells were studied. Pretreatment with various extracts of L. coronpifolia was found to be significantly effective in countering the cytotoxic responses of ethanol. Antioxidant properties of these L. coronopifolia extracts against reactive oxygen species (ROS) generation, lipid peroxidation (LPO), and glutathione (GSH) levels induced by ethanol were investigated. Results show that pretreatment with these extracts for 24 h significantly inhibited ROS generation and LPO induced and increased the GSH levels reduced by ethanol. The data from the study suggests that LCR, LCM, LCE, and LCL extracts of L. coronopifolia showed hepatoprotective activity against ethanol-induced damage in HepG2 cells. However, a comparative study revealed that the LCE extract was found to be the most effective and LCL the least effective. The hepatoprotective effects observed in the study could be associated with the antioxidant properties of these extracts of L. coronopifolia.
Children With Epilepsy in Africa
Authors: Wilmshurst Jo M. , Cross J. Helen , Newton Charles , Kakooza Angelina M. , Wammanda Robinson D. , Mallewa Macpherson , Samia Pauline , Venter Andre , Hirtz Deborah , Chugani Harry 
Published: March 2013

This article presents key findings from the International Child Neurology Association/African Child Neurology Association Workshop. The viability of international guidelines for the management of children with epilepsy should be reviewed within each African country, and adapted to comply with the regional capacity. Such recommendations can be used to lobby for resources. More training centers should be developed in Africa, so that specialists can be trained within Africa, in skills relevant to the continent, in collaboration with “out of Africa” visiting-specialists to develop the concept of “train the trainers.” At least 1 child neurology specialist per 100 000 of the population is required. Specific to Africa are the challenges from stigma, prejudice, and misconceptions. “Epilepsy teams,” inclusive of the traditional healers, would enable management of increased numbers of children, and challenge policy such that it is the right of the child with epilepsy to have reliable access to appropriate antiepileptic drugs, support, and health care equity between the rural and urban settings.
Vertical and Lateral Workplace Bullying in Nursing
Authors: Waschgler Kathrin , Ruiz-Hernández José Antonio , Llor-Esteban Bartolomé , Jiménez-Barbero José Antonio 
Published: March 2013

Healthcare staff is one of the professional groups that suffers the highest exposure to sources of occupational stress such as hostility from coworkers and superiors. In order to contribute to the assessment of bullying behaviors in the healthcare sector and to obtain a brief and manageable instrument for the assessment of this psychosocial risk, we developed the Hospital Aggressive Behaviour Scale–version Co-workers-Superiors (HABS-CS). By means of thorough qualitative analysis, an initial pool of 166 items was obtained, which were reviewed according to precise criteria until concluding with a total of 57 items, which were administered to a sample of 1,484 healthcare professionals from 11 public hospitals. The analyses concluded with the selection of 17 items distributed in two subscales. The internal 5-factor structure is the result of exploratory and confirmatory factor analysis conducted in two samples. Both the resulting questionnaire and the factors identified present adequate psychometric properties: high-internal consistency (Cronbach’s α of .86) and adequate criterion validity, analyzed by means of significant correlations between the HABS-CS and job satisfaction, burnout components, and psychological well-being. This instrument may be of great utility for the assessment and prevention of psychosocial risks.
Virtual Reality Cue Reactivity Assessment
Authors: Bordnick Patrick S. , Yoon Jin H. , Kaganoff Eili , Carter Brian 
Published: March 2013

Objectives: The cue-reactivity paradigm has been widely used to assess craving among cigarette smokers. Seeking to replicate and expand on previous virtual reality (VR) nicotine cue-reactivity research on nontreatment-seeking smokers, the current study compared subjective reports of craving for cigarettes when exposed to smoking (proximal and contextual) and neutral cues using VR in treatment-seeking and nontreatment-seeking cigarette smokers. Methods: Data from two previously published studies in nontreatment seekers from our group (Bordnick et al., 2004; Bordnick, Graap, Copp, Brooks, & Ferrer, 2005) were compared to results with 82 newly enrolled treatment-seeking smokers. Results: Overall, VR cues produced similar levels of craving for both treatment seekers and nontreatment seekers across the different cue environments. Specifically, craving was greater for both groups in smoking environments (paraphernalia and party) than those in the neutral environments. Conclusions: These findings provide strong evidence that VR is a useful tool that may be used by social workers and other clinical professionals to present smoking (proximal and contextual) cues for assessment and treatment and illustrate the utility of standardizing VR procedures to compare craving between different groups.
Pilot Evaluation of a Home Visit Parent Training Program in Disadvantaged Families
Authors: Leung Cynthia , Tsang Sandra , Heung Kitty 
Published: March 2013

Objectives: The study reported the pilot evaluation of the Healthy Start Home Visit Program for disadvantaged Chinese parents with preschool children, delivered by trained parent assistants. Home visiting was used to make services more accessible to disadvantaged families. Method: The participants included 21 parent–child dyads. Outcome measures included parent report, teacher report, and direct assessment of children. Results: Paired samples t-test results indicated significant increase in child cognitive measures, child school readiness, child oral health practices; decreases in child sedentary activities, child home injury, and hospital visits; decreases in parenting stress and child behavior problems and increases in social support. The parent assistants delivering the program reported significant decreases in child behavior problems and parenting stress from pretraining to posttraining and completion of home visits. Conclusion: There was promising evidence that the Healthy Start Home Visit Program was effective in addressing the needs of disadvantaged families with preschool children.
Electrodiagnostically Confirmed Posttraumatic Neuropathy and Associated Clinical Exam Findings With Lisfranc Injury
Authors: Pourcho Adam Michael , Liu Yongmin Harry , Milshteyn Michael Alexander 
Published: March 2013

Background: Patients with a Lisfranc injury often complain of persistent pain radiating from the Lisfranc joint up or down the first dorsal web space, accompanied by decreased sensation. We hypothesized that these symptoms were related to a posttraumatic neuropathy of the terminal medial branch of deep fibular (peroneal) nerve (MBDFN) and that by recognizing this symptom an earlier diagnosis of Lisfranc injury may be possible. Methods: Twelve patients with diagnosis of subtle unilateral Lisfranc injury, confirmed by standing X-ray, CT, or bone scan, were enrolled. Standardized antidromic sensory nerve conduction studies of MBDFN were performed bilaterally within 2 months postinjury and prior to surgical intervention. The contralateral, normal side was used as a control. All patients were tested for decreased 2-point discrimination in the first dorsal web space on both lower extremities. Results: Sensory nerve action potential of the MBDFN was absent, with decreased 2-point discrimination on the injured side in all patients. Conclusion: Lisfranc injuries were associated with a posttraumatic neuropathy of the MBDFN and decreased 2-point discrimination in the first dorsal web space. The finding of altered sensation in the first dorsal web space may help the practitioner to earlier diagnosis of a Lisfranc injury. Level of Evidence: Level III, case control study.
Endoscopy-Assisted Percutaneous Repair of Acute Achilles Tendon Tears
Authors: Chiu Chih-Hao , Yeh Wen-Lin , Tsai Min-Chien , Chang Shih-Sheng , Hsu Kuo-Yao , Chan Yi-Sheng 
Published: March 2013

Background: We developed a technique for endoscopy-assisted percutaneous repair of acute Achilles tendon tears. Methods: Nineteen patients with acute Achilles tendon tears were prospectively recruited into the study. All patients (18 male, 1 female) had sports-related injuries. Preoperative diagnosis was made from patient history, physical examination, and sonography. The average patient age was 38.7 years, and follow-up averaged 24 months. All patients received endoscopy-assisted percutaneous Achilles tendon repair with modified Bunnell sutures passed by bird beak and No. 5 Ethibond under direct visualization using 4.0-mm arthroscopy. Results were evaluated by physical examination, sonography, and magnetic resonance imaging (MRI). Results: All 19 patients achieved tendon healing. All patients were evaluated by sonography, and the tendons of 16 patients were imaged using MRI to evaluate the extent of healing. Final dorsiflexion was 16 degrees and plantar flexion 26 degrees, and 95% of the patients (18/19) returned to their previous level of sporting activity. One patient developed a superficial infection, and 2 patients had postoperative sural nerve injury with numbness for 1 month. There were no other major complications. Conclusion: Endoscopy-assisted percutaneous repair of the Achilles tendon allowed good tendon healing and return to sports at 6 months. Sural nerve injury during surgery was a potential complication of this procedure. Level of Evidence: Level IV, retrospective case series.
A Biomechanical Analysis of Two Anterior Ankle Arthrodesis Systems
Authors: Kestner Christopher J. , Glisson Richard R. , Nunley James A. 
Published: March 2013

Background: An increasingly popular ankle fusion method uses plates and screws positioned on the anterior aspect of the tibiotalar joint. This study compared the mechanical properties of 2 contemporary plate systems for ankle arthrodesis, one based on a single anterior plate and the other comprising paired anteromedial and anterolateral plates. Methods: Ten matched pairs of fresh-frozen cadaver ankle joints underwent arthrodesis with a single anatomically contoured anterior plate or 2 anatomic plates applied anteromedially and anterolaterally. Each arthrodesed specimen was subjected to controlled sagittal and coronal plane bending and internal and external rotation. Tibiotalar joint bending stiffness, bending angulation, torsional stiffness, and joint rotation were documented. Results: Bending stiffness of the 2-plate system was 1.5 to 5 times greater than that of the single-plate system in plantarflexion, dorsiflexion, eversion, and inversion ( P = .005-.050). Angulation in each bending direction was several-fold greater than for the single plate ( P = .005-.014) at the peak applied moment. Torsional stiffness of the 2-plate system nearly doubled that of the single plate in both rotation directions ( P = .014, P = .005). Approximately half as much arthrodesis site rotation occurred with 2-plate fixation at the peak applied torque ( P = .005, P = .007). Conclusion: The tested 2-plate arthrodesis system has the potential to optimize arthrodesis site stiffness compared with fixation with a contemporary single plate. Clinical Relevance: Use of the stiffer 2-plate system could improve the clinical fusion rate, especially in patients with suboptimal bone quality.
Comparison of Bumetanide- and Metolazone-Based Diuretic Regimens to Furosemide in Acute Heart Failure
Authors: Ng Tien M. H. , Konopka Erica , Hyderi Alifiya F. , Hshieh Shenche , Tsuji Yuki , Kim Brian J. , Han Song Y. , Phan Duc H. , Jeng Aaron I. , Lou Mimi , Elkayam Uri 
Published: March 2013

Introduction: Limited data exist comparing the efficacy and safety of bumetanide- or metolazone-based diuretic regimens to furosemide in acute heart failure (HF). Our purpose was to evaluate the comparative effect on urine output (UO) and renal function between these regimens. Methods: A retrospective study of hospitalized HF patients treated with continuous infusion furosemide (CIF), combination furosemide plus metolazone (F + M), or continuous infusion bumetanide (CIB). Primary end points were between regimen comparisons for change in mean hourly UO versus baseline and incidence of worsening renal function. Results: Data on 242 patients with acute HF (age 58 ± 12 years, 63% male, left ventricular ejection fraction 38% ± 17%) were analyzed (160 CIF, 42 F + M, 40 CIB). The mean duration of diuretic regimens was 41 ± 32 hours. Compared to baseline, all regimens increased mean hourly UO ( P < .0001 for all), with greater increases with F + M (109 ± 171 mL) and CIB (90 ± 90 mL) compared to CIF (48 ± 103 mL; P = .009). Incidence of worsening renal function was not different between regimens; however, blood urea nitrogen (BUN) tended to increase more with F + M (4.4 ± 9.8 mg/dL) and CIB (4.3 ± 9.7 mg/dL) than CIF (1.8 ± 10.8 mg/dL), P = .09. The incidence of hyponatremia was higher with F + M and CIB. Differences in UO, BUN, and hyponatremia were retained in the subgroup analysis limited to patients with baseline serum creatinine <1.5 mg/dL, where renal function between the groups was not different. Conclusion: Compared to CIF, F + M or CIB was associated with greater increases in UO. No difference in the incidence of worsening renal function was found; however, electrolyte abnormalities may be more prevalent when furosemide is combined with metolazone or when bumetanide is used. These therapeutic differences warrant prospective study.
Determinants of Angiographic Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Tanboga Ibrahim Halil , Topcu Selim , Aksakal Enbiya , Kalkan Kamuran , Sevimli Serdar , Acikel Mahmut 
Published: March 2013

Aims: We aimed to investigate the determinants of angiographic thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). Methods: The study population consisted of 662 patients with nonanemic STEMI who underwent pPCI. Clinical, laboratory, and demographic properties of the patients were recorded. Baseline hematologic indices were measured at the time of admission. Angiographic coronary thrombus burden was scored based on thrombolysis in myocardial infarction (TIMI) thrombus grades. After wiring and/or small balloon dilation, patients with thrombus burden grades 4 and 5 were defined as high thrombus burden, and patients with thrombus burden <grade 4 was defined as low thrombus burden. Result: Patients with high thrombus burden had more family history of coronary artery disease, longer pain to balloon time, higher Killip class (≥II), higher neutrophil to lymphocyte ratio, red cell distribution width (RDW), baseline creatine kinase-MB fraction (CK-MB) and baseline troponin, higher peak CK-MB, and peak troponinbut lower triglycerides. Angiographically, patients with high thrombus burden had longer lesion in the infarct-related artery, less frequent direct stenting, lower epicardial and myocardial perfusion, more frequent distal embolization, and more frequent electrocardiographic and angiographic no reflow. In multivariate logistic regression analysis, only RDW (odds ratio: 1.29, 95% confidence interval 1.19-1.39, P < .001) was determined as independent predictor. The area under the receiver–operating characteristic curve of the RDW was 0.733 (0.690-0.776, P < .001) to predict high TIMI thrombus burden. Conclusion: Present study results demonstrated that high thrombus burden in patients with STEMI was associated with impaired postprocedural epicardial and myocardial perfusion and higher no reflow and distal embolization; and increased RDW values were independent predictors of coronary thrombus burden.
The Effects of Eosinophil on the Left Atrial Thrombus in Patients With Atrial Fibrillation
Authors: Keçeoğlu Serdar , Demir Mehmet , Uyan Umut , Melek Mehmet 
Published: March 2013

Background: Atrial fibrillation (AF) is the most common cardiac rhythm disorder. Atrial fibrillation causes a 5-fold increased risk for thromboembolic stroke. It is known that eosinophils play an important role in thrombosis. We aimed to compare the number of eosinophil counts of the patients with and without thrombi in the left atrium (LA) or in the left atrial appendage (LAA) and to ascertain the association of eosinophil counts with the presence of thrombi. Method: The study included 89 patients diagnosed with persistent AF who underwent transesophageal echocardiography and designated to undergo cardioversion. The patients were divided into 2 groups: group 1 consisted of 40 patients (18 male; average age 63.27 ± 1.4) who had thrombus formation in the LA or LAA, and group 2 consisted of 49 patients (23 male; average age 66.53 ± 1.56) who did not have any thrombus in the LA or LAA. These patients underwent concurrent routine biochemical tests and eosinophil count on whole blood count was also performed. Results: Baseline characteristics of the study groups were comparable. Group 1 patients had higher eosinophil and mean platelet volume values than group 2 (233.0 ± 30.7 vs 118.9 ± 11.8 and 9.77 ± 0.20 vs 8.27 ± 0.12 fL, P < .001, respectively). In group 1, the patients’ LA diameter is higher than that in group II. Conclusion: As a result, our study revealed a relationship between eosinophil count and LA thrombus in patients with nonvalvular AF.