bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Various Percutaneous Interventions for In-Stent Restenosis
Authors: Sethi Ankur , Malhotra Gurveen , Singh Sukhchain , Singh Param P. , Khosla Sandeep 
Published: November 2015

Background—
In-stent restenosis (ISR) remains a difficult problem in interventional cardiology. The relative efficacy and safety of available interventions is not clear. We aimed to perform a network meta-analysis using both direct evidence and indirect evidence to compare all available interventions.

Methods and Results—
We systematically searched electronic databases for randomized trials comparing ≥2 treatments for ISR. A network meta-analysis was performed using a Bayesian approach. Eleven treatments were compared in 31 studies with 8157 patient-years follow-up. Compared with balloon angioplasty, everolimus-eluting stent (hazard ratio [95% credibility interval], 0.13 [0.048–0.35]), paclitaxel-eluting balloon (0.32 [0.20–0.49]), paclitaxel-eluting cutting balloon (0.054 [0.0017–0.5]), paclitaxel-eluting stent (0.39 [0.24–0.62]), and sirolimus-eluting stent (0.32 [0.18–0.50]) are associated with lower target vessel revascularization. Balloon angioplasty is not different from cutting balloon (0.73 [0.31–1.5]), excimer laser (0.89 [0.29–2.7]), rotational atherectomy (0.96 [0.53–1.7]), and vascular brachytherapy (0.60 [0.35–1.0]). In drug-eluting stent ISR, balloon angioplasty was inferior to everolimus-eluting stent (0.19 [0.049–0.76]), paclitaxel-eluting balloon (0.43 [0.18–0.80]), paclitaxel-eluting stent (0.35 [0.13–0.76]), and sirolimus-eluting stent (0.36 [0.11–0.86]) for target vessel revascularization. There was no difference between treatments in probable or definitive stent thrombosis. The results of binary restenosis and target lesion revascularization were similar. Paclitaxel-eluting cutting balloon, everolimus-eluting stent, and paclitaxel-eluting balloon have the highest probability of being in the top 3 treatments based on low target lesion revascularization, but there was no statistical significant difference between them.

Conclusions—
Balloon angioplasty is inferior to all drug-eluting treatments for ISR, including drug-eluting stent ISR. Drug-eluting stent, particularly everolimus-eluting stent, or paclitaxel-eluting cutting balloon and paclitaxel-eluting balloon should be preferred for treating ISR.
Importance of Implantable Cardioverter‐Defibrillator Back‐Up in Cardiac Resynchronization Therapy Recipients: A Systematic Review and Meta‐Analysis
Authors: Barra Sérgio , Providência Rui , Tang Anthony , Heck Patrick , Virdee Munmohan , Agarwal Sharad 
Published: November 2015

Background

It remains to be determined whether patients receiving cardiac resynchronization therapy (
CRT
) benefit from the addition of an implantable cardioverter‐defibrillator (
ICD
).

Methods and Results

We performed a literature search looking for studies of patients implanted with
CRT
s. Comparisons were performed between patients receiving
CRT
‐defibrillator (
CRT
‐D) versus
CRT
‐pacemaker (
CRT
‐P). The primary outcome was all‐cause mortality. Data were pooled using a random‐effects model. The relative risk (
RR
) and hazard ratio (
HR
, when available) were used as measurements of treatment effect. Nineteen entries were entitled for inclusion, comprising 12 378 patients (7030 receiving
CRT
‐D and 5348 receiving
CRT
‐P) and 29 799 patient‐years of follow‐up. Those receiving
CRT
‐D were younger, were more often males, had lower
NYHA
class, lower prevalence of atrial fibrillation, higher prevalence of ischemic heart disease, and were more often on beta‐blockers. Ten studies showed significantly lower mortality rates with the
CRT
‐D device, while the remaining 9 were neutral. The pooled data of studies revealed that
CRT
‐D patients had significantly lower mortality rates compared with
CRT
‐P patients (mortality rates:
CRT
‐D 16.6% versus
CRT
‐P 27.1%;
RR
=0.69, 95%
CI
0.62–0.76;
P
<0.00001). The number needed to treat to prevent one death was 10. The observed I
2
values showed moderate heterogeneity among studies (I
2
=48%). The benefit of
CRT
‐D was more pronounced in ischemic cardiomyopathy (
HR
=0.70, 95%
CI
0.59–0.83,
P
<0.001, I
2
=0%), but a trend for benefit, albeit of lower magnitude, could also be seen in non‐ischemic dilated cardiomyopathy (
HR
=0.79, 95%
CI
0.61–1.02,
P
=0.07, I
2
=36%).

Conclusions

The addition of the
ICD
associates with a reduction in the risk of all‐cause mortality in
CRT
patients. This seems to be more pronounced in patients with ischemic cardiomyopathy.
Evaluation of Simulated Clinical Breast Exam Motion Patterns Using Marker-Less Video Tracking
Authors: Azari David P. , Pugh Carla M. , Laufer Shlomi , Kwan Calvin , Chen Chia-Hsiung , Yen Thomas Y. , Hu Yu Hen , Radwin Robert G. 
Published: November 2015

Objective: This study investigates using marker-less video tracking to evaluate hands-on clinical skills during simulated clinical breast examinations (CBEs). Background: There are currently no standardized and widely accepted CBE screening techniques. Methods: Experienced physicians attending a national conference conducted simulated CBEs presenting different pathologies with distinct tumorous lesions. Single hand exam motion was recorded and analyzed using marker-less video tracking. Four kinematic measures were developed to describe temporal (time pressing and time searching) and spatial (area covered and distance explored) patterns. Results: Mean differences between time pressing, area covered, and distance explored varied across the simulated lesions. Exams were objectively categorized as either sporadic, localized, thorough, or efficient for both temporal and spatial categories based on spatiotemporal characteristics. The majority of trials were temporally or spatially thorough (78% and 91%), exhibiting proportionally greater time pressing and time searching (temporally thorough) and greater area probed with greater distance explored (spatially thorough). More efficient exams exhibited proportionally more time pressing with less time searching (temporally efficient) and greater area probed with less distance explored (spatially efficient). Just two (5.9 %) of the trials exhibited both high temporal and spatial efficiency. Conclusions: Marker-less video tracking was used to discriminate different examination techniques and measure when an exam changes from general searching to specific probing. The majority of participants exhibited more thorough than efficient patterns. Application: Marker-less video kinematic tracking may be useful for quantifying clinical skills for training and assessment.
Randomized comparison trial of gait training with and without compelled weight-shift therapy in individuals with chronic stroke
Authors: Sheikh Mania , Azarpazhooh Mahmoud Reza , Hosseini Hossein Asghar 
Published: November 2015

Objective: To compare the effects of gait training combined with compelled weight-shift therapy and gait training alone on velocity and gait symmetry in patients with chronic stroke. Design: Single-blind randomized controlled trial. Participants: Patients ( N=28) with chronic stroke and stance asymmetry toward the non-paretic side. Interventions: Six weeks of gait training combined with compelled weight-shift therapy via a shoe lift applied under the non-paretic leg (experimental group, n=14) or gait training alone (control group, n=14). Main measures: Percentage of total body weight carried by the paretic limb, gait velocity and gait spatiotemporal symmetry ratios including step symmetry, stance symmetry, swing symmetry and overall temporal symmetry. Results: When comparing the two groups, weight bearing on the affected side increased more significantly in experimental group than in control group (40.14±3.77, 38.28±4.06) after the end of treatment and also after a three-month follow-up (44.42±3.5, 38.5±3.77) (P<0.05). Among the experimental and control groups, there were no significant differences of gait velocity (cm/s) after six weeks of treatment (49.82±16.82, 42.66±18.75) and also after a three-month follow-up (50.94±16.27, 41.66±17.58) ( P>0.05). There were no significant differences of gait spatiotemporal symmetry ratios including step symmetry, stance symmetry, swing symmetry and overall temporal symmetry between the two groups after six weeks of treatment and also at three-month follow-up ( P>0.05). Conclusions: This study did not confirm that the effect of gait training combined with compelled body weight shift therapy was better than gait training alone on improving velocity and gait symmetry in patients with chronic stroke.
Small-Diameter Awls Improve Articular Cartilage Repair After Microfracture Treatment in a Translational Animal Model
Authors: Orth Patrick , Duffner Julia , Zurakowski David , Cucchiarini Magali , Madry Henning 
Published: November 2015

Background: Microfracture is the most commonly applied arthroscopic marrow stimulation procedure. Hypothesis: Articular cartilage repair is improved when the subchondral bone is perforated by small-diameter microfracture awls compared with larger awls. Study Design: Controlled laboratory study. Methods: Standardized rectangular (4 × 8 mm) full-thickness chondral defects (N = 24) were created in the medial femoral condyle of 16 adult sheep and debrided down to the subchondral bone plate. Three treatment groups (n = 8 defects each) were tested: 6 microfracture perforations using small-diameter awls (1.0 mm; group 1), large-diameter awls (1.2 mm; group 2), or without perforations (debridement control; group 3). Osteochondral repair was assessed at 6 months in vivo using established macroscopic, histological, immunohistochemical, biochemical, and micro–computed tomography analyses. Results: Compared with control defects, histological cartilage repair was always improved after both microfracture techniques ( P < .023). Application of 1.0-mm microfracture awls led to a significantly improved histological overall repair tissue quality (7.02 ± 0.70 vs 9.03 ± 0.69; P = .008) and surface grading (1.05 ± 0.28 vs 2.10 ± 0.19; P = .001) compared with larger awls. The small-diameter awl decreased relative bone volume of the subarticular spongiosa (bone volume/tissue volume ratio: 23.81% ± 3.37% vs 30.58% ± 2.46%; P = .011). Subchondral bone cysts and intralesional osteophytes were frequently observed after either microfracture treatment. Macroscopic grading, DNA, proteoglycan, and type I and type II collagen contents as well as degenerative changes within the adjacent cartilage remained unaffected by the awl diameter. Conclusion: Small-diameter microfracture awls improve articular cartilage repair in the translational sheep model more effectively than do larger awls. Clinical Relevance: These data support the use of small microfracture instruments for the surgical treatment of cartilage defects and warrant prolonged clinical investigations.
Epidemiology of Sports-Related Concussions in National Collegiate Athletic Association Athletes From 2009-2010 to 2013-2014
Authors: Wasserman Erin B. , Kerr Zachary Y. , Zuckerman Scott L. , Covassin Tracey 
Published: November 2015

Background: Limited data exist among collegiate student-athletes on the epidemiology of sports-related concussion (SRC) outcomes, such as symptoms, symptom resolution time, and return-to-play time. Purpose: This study used the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) to describe the epidemiology of SRC outcomes in 25 collegiate sports. Study Design: Descriptive epidemiology study. Methods: SRC data from the NCAA ISP during the 2009-2010 to 2013-2014 academic years were analyzed regarding symptoms, time to resolution of symptoms, and time to return to play. Findings were also stratified by sex in sex-comparable sports (ie, ice hockey, soccer, basketball, lacrosse, baseball/softball) and whether SRCs were reported as recurrent. Results: Of the 1670 concussions reported during the 2009-2010 to 2013-2014 academic years, an average (±SD) of 5.29 ± 2.94 concussion symptoms were reported, with the most common being headache (92.2%) and dizziness (68.9%). Most concussions had symptoms resolve within 1 week (60.1%); however, 6.2% had a symptom resolution time of over 4 weeks. Additionally, 8.9% of concussions required over 4 weeks before return to play. The proportion of SRCs that required at least 1 week before return to play increased from 42.7% in 2009-2010 to 70.2% in 2013-2014 (linear trend, P < .001). Within sex-comparable sports analyses, the average number of symptoms and symptom resolution time did not differ by sex. However, a larger proportion of concussions in male athletes included amnesia and disorientation; a larger proportion of concussions in female athletes included headache, excess drowsiness, and nausea/vomiting. A total of 151 SRCs (9.0%) were reported as recurrent. The average number of symptoms reported with recurrent SRCs (5.99 ± 3.43) was greater than that of nonrecurrent SRCs (5.22 ± 2.88; P = .01). A greater proportion of recurrent SRCs also resulted in a long symptom resolution time (14.6% vs 5.4%, respectively; P < .001) and long return-to-play time (21.2% vs 7.7%, respectively; P < .001) compared with nonrecurrent SRCs. Conclusion: Trends in return-to-play time may indicate changing concussion management practices in which team medical staff members withhold players from participation longer to ensure symptom resolution. Concussion symptoms may differ by sex and recurrence. Future research should continue to examine the trends and discrepancies in symptom resolution time and return-to-play time.
Evaluating the organising model of trade unionism: An Australian perspective
Authors: Barnes Alison , Markey Raymond 
Published: November 2015

AbstractTo mark the 20th anniversary of the Australian union movement’s Organising Works programme, this article introduces a symposium discussing potential ways forward for unions. It overviews research regarding the challenges of union organising and renewal, both in Australia and internationally. It provides a broad historical perspective on the origins and progress of the grassroots Organising Works agenda initiated by the peak union bodies, the Australian Council of Trade Unions and Unions NSW. It explores how trade unions can best generate and sustain their spirit of mobilising and organising, while also ensuring the institutional legitimacy they require to effectively represent workers. Unions have had to manage the tension between two dynamics of trade union growth – the sense of movement involved in mobilising workers, and the institutional stability and legitimacy needed to represent workers. Unions have faced both the need to confront global capital restructuring through their own restructuring, and the need to renew and maintain a strong and democratic community base. To do so, they have built new networks and campaigning approaches, in order to organise an increasingly diverse and insecure workforce and build strong community links.
Does cryostripping add anything to the treatment of the ascending thrombophlebitis of the great saphenous vein?
Authors: Balint IB , Farics A , Manfai G , Szekely I , Menyhei G , Vizsy L 
Published: November 2015

Objective To analyse the differences of outcome between cryostripping and conservative therapy in the treatment of superficial vein thrombosis. Patients and methods A retrospective analysis was performed between the October of 2001 and the October of 2014. In all, 246 cases were eligible for the study. High ligation, cryostripping and local thrombectomy was carried out on 94 patients with thrombophlebitis of the proximal part of the great saphenous vein. Thromboembolic events, the presence of residual varices and time for recovery were compared to 152 cases treated conservatively because of superficial vein thrombosis. Results Thromboembolic events were found without significant difference (mean ± SD for surgery: 1.11 ± 0.60 and conservative therapy: 1.11 ± 0.55; p = 0.988) in each group. The presence of residual varices (mean ± SD for surgery: 1.03 ± 0.52 and conservative therapy: 1.42 ± 0.99; p = 0.001) and the time for recovery (mean ± SD for surgery: 15 ± 10.50 and conservative therapy: 26 ± 12.32; p < 0.001) were more favourable in the cryostripping group. Conclusion Our analysis confirmed that cryostripping does not result in a lower risk for thromboembolic complications due to superficial vein thrombosis but can be an alternative method to treat the ascending thrombophlebitis of the great saphenous vein because it has some advantages over conservative treatment on the short term.
The outcomes of digital tip amputation replacement as a composite graft in a paediatric population
Authors: Butler D. P. , Murugesan L. , Ruston J. , Woollard A. C. , Jemec B. 
Published: November 2015

Limited studies exist on the outcome of replacing an amputated fingertip as a composite graft. We report the outcomes and predictors for composite graft survival along with the long-term morbidity. A retrospective review of all patients <16 years who underwent composite graft replacement of an amputated fingertip was performed. Long-term morbidity was evaluated through a standardized parental questionnaire. A total of 120 patients were identified, of whom 97 were eligible for inclusion. Parental questionnaires were completed for 42 (43%) patients. There was a 10% complete and 34% partial graft survival rate. Patients aged ⩽4 were significantly more likely to have complete graft take than those >4. Of the patients, 17% developed post-operative complications; 48% of patients reported a hook-nail deformity and 17% reported cold intolerance. Only 5% of patients reported any functional difficulties long term. The rate of complete composite graft survival in a paediatric population is low, although the long-term function of these patients is good. Level of evidence: 3
Long-term results of syndactyly correction by the trilobed flap technique focusing on hand function and quality of life
Authors: Widerberg A. , Sommerstein K. , Dahlin L. B. , Rosberg H.-E. 
Published: November 2015

Syndactyly is usually corrected surgically during the first years of life. The trilobed flap, a surgical method that does not require skin grafting, was developed in the 1990s and the short-term results were comparable with previously reported techniques. Here we report on long-term outcomes, focusing on how children perceive their hand function and quality of life when they grow up. A total of 19 patients (29 web spaces) were operated on between 1990 and 2000, and followed-up 16 years later with questionnaires and clinical tests. The patients reported low QuickDASH scores, normal sensibility and dexterity, and minor cold intolerance. Only two reoperations, due to early web creep, were needed. The condition minimally affected the choice of occupations, leisure activities and perceptions of appearance. The trilobed flap technique for release of syndactyly provides a good long-term outcome with good hand function and minimal impact on the quality of life. Level of evidence: IV.
Clinical and ultrasound features in patients with intersection syndrome or de Quervain’s disease
Authors: Sato J. , Ishii Y. , Noguchi H. 
Published: November 2015

We investigated the demographic characteristics of patients who were diagnosed with intersection syndrome and also investigated the dominance of the affected hand, duration of symptoms and any precipitating factor for pain of the wrist. These features were compared with patients who had de Quervain’s disease. Ultrasonography was used to confirm the clinical diagnosis. Intersection syndrome occurred more frequently in men and in the dominant hand than de Quervain’s disease when all the patients were compared and when peripartum women were excluded. It occurred at a younger age than de Quervain’s disease only when the comparison excluded peripartum women. Patients with intersection syndrome presented with a much shorter duration of symptoms. These results were consistent with previous reports about occupational factors in intersection syndrome, and might be helpful in the understanding of epidemiological difference between the two conditions. Level of evidence: Level 3.
Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications
Authors: Keeratichananont Warangkana , Thanadetsuntorn Chokchai , Keeratichananont Suriya 
Published: November 2015

Objectives: The objective of this study was to determine the performance of preoperative 6-minute walk test (6MWT) for predicting postoperative pulmonary complications (PPC) in high risk patients undergoing elective surgery under general anesthesia. Methods: A prospective cohort study was conducted in patients scheduled to undergo elective thoracic or nonthoracic surgery and indicated for preoperative pulmonary evaluation in Songklanagarind Hospital, Songkhla, Thailand. Preoperative spirometry, 6MWT were done and 30-day PPC were recorded. The multiple regression analysis and receiver operating characteristic (ROC) curves were used to analyze the variables and to compare the performance of 6MWT and spirometry tests. Results: A total of 78 participants were recruited into the study. 6MWT was done completely in all cases without any complications. Among these tests, 14 cases (17.9%) had contraindications to spirometry and two cases were unable to achieve the criteria for acceptable efforts. PPC developed in 17 cases (21%) with a high mortality (17.7%). A multiple regression analysis showed elderly, poor general health status, smoking history, low level of the mean value of forced expiratory volume in 1 second (FEV1) % predicted (by spirometry) and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. Patients developing PPC had a significantly lower preoperative 6MWD compared with patients without PPC (256.0 ± 48.0 versus 440.0 ± 117.1 meters, p < 0.001). 6MWD of ⩽325 meters was a threshold for predicting PPC with 77% sensitivity and 100% specificity, and had a good predictive value for PPC similar to that for the FEV1 %. Conclusions: Preoperative 6MWT is a very useful alternative test for predicting PPC in high risk patients scheduled to undergo surgery under GA.
Ultrasonographic Assessment of the Distal Femoral Cartilage Thickness in Patients with Homozygous Sickle Cell Disease
Authors: Yildizgoren Mustafa Turgut , Helvaci Mehmet Rami , Ustun Nilgun , Osmanoglu Kasim , Turhanoglu Ayse Dicle 
Published: November 2015

Objective To compare the distal femoral cartilage thickness of patients with sickle cell disease (SCD) with those of healthy subjects using ultrasonography. Methods The study comprised 30 patients with SCD (16 male, 14 female; mean age, 30.1 years) and 30 age- and sex-matched healthy subjects. Demographic features and medications of the patients were recorded. With the knees held in maximum flexion, the femoral cartilage thickness was measured bilaterally with a 7- to 12-MHz linear probe. Using ultrasonography, 3 midpoint measurements were taken from both knees: lateral femoral condyle (LFC), intercondylar area (ICA), and medial femoral condyle (MFC). Results Patients with SCD had thinner femoral cartilage thickness values at LFC ( P = 0.004), at MFC ( P = 0.000), and ICA ( P = 0.002) when compared with those of the healthy subjects. Patients with SCD also had lower Hb levels ( P = 0.000) levels. Weak positive correlations were determined between Hemoglobin (Hb) levels and ultrasonographic measurements in the SCD group at MFC ( r = 0.331, P = 0.010), and ICA ( r = 0.289 , P = 0.025 ). Low levels of Hb seem to affect the femoral cartilage thickness. Conclusion These preliminary findings of decreased femoral cartilage thickness in SCD patients should be complemented with future studies. The possibility of early knee joint degeneration and eventual osteoarthritis in SCD should be kept in mind.