bluuebunny/crossref_metadata_2025_split huggingface dataset:
Videofluoroscopy of deglutition in children after repair of esophageal atresia
Authors: Hörmann M. , Pokieser P. , Scharitzer M. , Pumberger W. , Memarsadeghi M. , Partik B. , Ekberg O. 
Published: September 2013

Purpose: To evaluate the functional disorders of the oral and pharyngeal phases of deglutition after repair of esophageal atresia in children. Material and Methods: 19 children (10 girls, 9 boys, mean age 22 months) underwent videofluoroscopy of deglutition after repair of esophageal atresia. The videofluoroscopic studies were assessed according to functional and morphological changes in the oral, pharyngeal and esophageal phases. The persistence of radiologic findings on videofluoroscopy was determined. Results: The oral phase was normal in all patients. The main functional disorder of the pharyngeal phase was aspiration in 7 (37%) children. A completely normal deglutition in the pharyngeal and esophageal phases was not seen in any patient. Conclusion: Videofluoroscopy after repair of esophageal atresia is helpful in differentiation of functional and morphological disorders that can lead to prandial aspiration and have an influence on the decision about continued therapy.
Partial and complete tear of the anterior cruciate ligament: Direct and indirect MR signs
Authors: Chen W.-T. , Shih T. T.-F. , Tu H.-Y. , Chen R.-C. , Shau W.-Y. 
Published: September 2013

Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109°±20°) had a tendency to be less than in chronic partial ACL tear cases (119±18°). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear.
Computer-aided preoperative diagnosis of microcalcifications on mammograms
Authors: Kouskos E. , Markopoulos C. , Revenas K. , Koufopoulos K. , Kyriakou V. , Gogas J. 
Published: September 2013

Purpose: To evaluate of a computer-aided method for differentiating malignant from benign clustered microcalcifications. Material and Methods: Our material was 350 suspicious microcalcifications on mammograms from 330 female patients who underwent breast biopsy (after hook wire localization and under mammographic guidance). The histologic findings were malignant in 140 cases (40%) and benign in 210 cases (60%). Those clusters were manually detected, computer-aided analyzed and quantitatively estimated. Besides computer analysis, 3 physicians-observers (2 radiologists and 1 breast surgeon) evaluated the malignant or benign nature of the clustered microcalcifications. The performance of the artificial network, each observer and the three observers as a group was evaluated by receiver operating characteristics (ROC) curves. Results: Comparison of the ROC curves revealed the following AUC values (area under the curve): computer – 0.950, physician 1 – 0.815, physician 2 – 0.830, physician 3 – 0.830, and physicians as a group – 0.825. The results, compared by the student t-test for paired data, showed a statistically significant difference between computer analysis and physicians' performance, independently and as a group. Conclusion: Our study showed that computer analysis achieved statistically significantly better performance than that of physicians in the classification of malignant and benign calcifications.
Patient positioning after fine needle lung biopsy-effect on pneumothorax rate
Authors: Tanisaro K. 
Published: September 2013

Purpose: To evaluate the efficacy of precautionary positioning in preventing the development of pneumothorax and reducing the rate of chest tube placement after fluoroscopy-guided transthoracic needle biopsy (TTNB). Material and Methods: One hundred and seven patients who underwent TTNB were randomly assigned to one of two postbiopsy treatment groups: patients were placed with (precautionary positioning group) and without (non-precautionary positioning group) recumbent puncture site either down (n = 59 and 48, respectively) for at least 30 min. Results: The overall pneumothorax rate was 8.4% (n = 9). Four of the 9 patients needed chest tube insertion. Pneumothorax rate was 8.33% (4/48) and 8.47% (5/59) in the precaution and non-precaution groups, respectively. Rate of chest tube insertion was 6.25% (n = 3) and 1.85% (n = 1) in the precaution and non-precaution groups, respectively. There was no statistically significant difference in the rate of pneumothorax and chest tube insertion between the two groups. Conclusion: Precautionary positioning after TTNB does not reduce the incidence of postbiopsy pneumothorax and rate of chest tube insertion.
Preoperative right portal vein embolization in patients with metastatic liver disease: Metastatic liver volumes after RPVE
Authors: Barbaro B. , Di Stasi C. , Nuzzo G. , Vellone M. , Giuliante F. , Marano P. 
Published: September 2013

Purpose: To quantify liver metastases and future remnant liver (FRL) volumes in patients who underwent right portal vein embolization (RPVE) and to evaluate the effects of this procedure on metastase growth. Material and Methods: Nine patients with liver metastases from primary colon (n = 5), rectal lesions (n = 1) and carcinoid tumors (n = 3) underwent spiral CT to evaluate the ratio of the non-tumorous parenchymal volume of the resected liver to that of the whole liver volume (R2). Hand tracing was used to isolate the entire liver, the resected liver and metastase volumes. All patients with R2 > 60% underwent RPVE. Results: FRL exhibited a 101–336 cm3 (average 241 cm3) increase in volume 1 month after RPVE. One patient refused surgery for 2 months and before surgery the increase in volume of the FRL was similar to that of other patients (180.64 cm3). Percent metastases volume from colorectal carcinoma in embolized liver parenchyma increased from 62.4% to 138.4% at 1 month and to 562% at 2 months after RPVE. Metastase volume from carcinoid tumors was unchanged. Conclusion: One month after RPVE, hypertrophy of the FRL is evident. In the embolized liver, there was a progressive increase in metastase volume from colorectal carcinoma while metastase volume from carcinoid tumor was unchanged in embolized and non-embolized liver.
Drug-Eluting Stents for Acute Coronary Syndrome: A Meta-Analysis of Randomized Controlled Trials
Authors: Wang Lishan 
Published: September 2013

Background
Drug-eluting stents (DES) are increasingly used for treatment of acute coronary syndrome (ACS). However, clinical efficacy and safety of various types of DES is not well established in these subjects. We therefore evaluated clinical utility of second-generation and first-generation DES in patients with ACS by conducting a meta-analysis.

Methods
A search of Medline, Embase, the Cochrane databases, and Web of Science was made. Randomized controlled trials (RCTs) which compared second-generation DES (everolimus-eluting stents [EES] or zotarolimus-eluting stents [ZES]) versus first-generation DES (sirolimus-eluting stents [SES] or paclitaxe-eluting stents [PES]) in patients with ACS and provided data on clinical efficacy or safety endpoints were included. Pooled estimates were calculated using random-effects model.

Result
A total of 2,757 participants with ACS in 6 RCTs were included. Compared with first-generation one, second-generation DES trended to be associated with the decreased incidence of definite or probable stent thrombosis in ACS patients (risk ratio [RR]  = 0.60, 95% confidence intervals [CI] 0.33 to 1.07, p = 0.09). However, the rate of target lesion revascularization (TLR) significantly increased in second-generation DES (RR = 2.08, 95%CI 1.25 to 3.47, p = 0.005). There were no significant differences in the incidence of major adverse cardiac events (MACEs), all-cause death, cardiac death, and recurrent myocardial infarction between the two arms (all p>0.10). The second-generation EES showed a tendency towards lower risk of MACEs (p = 0.06) and a beneficial effect on reducing stent thrombosis episodes (p = 0.009), while the second-generation ZES presented an increased occurrence of MACEs (p = 0.02) and TLR (p = 0.003).

Conclusion
Second-generation DES, especially EES, appeared to present a lower risk of stent thrombosis, whereas second-generation ZES might increase the need for repeat revascularization in ACS patients. During coronary interventional therapy, DES class should be adequately considered in order to maximize clinical benefit of DES implantation in these specific subjects.
Vitamin D increases circulating IGF1 in adults: potential implication for the treatment of GH deficiency
Authors: Ameri Pietro , Giusti Andrea , Boschetti Mara , Bovio Marta , Teti Claudia , Leoncini Giovanna , Ferone Diego , Murialdo Giovanni , Minuto Francesco 
Published: September 2013

ObjectivesPrevious studies suggested that vitamin D modulates circulating IGF1. We investigated this effect in adults and its clinical relevance in the management of GH deficiency (GHD).Design and methodsIGF1 levels were prospectively measured before and after 12 weeks of treatment with oral vitamin D3(5000 or 7000 IU/week) vs no intervention in 39 subjects 61.9±7.9 years old. The frequency of IGF1 values ≥50th age- and sex-specific percentile in relation to vitamin D status, as determined by the concentration of 25-hydroxyvitamin D (25(OH)D), was retrospectively assessed in 69 GHD patients (57.4±16.6 years) on stable hormone replacement and with 25(OH)D and IGF1 concurrently measured.ResultsTreatment with 5000 and 7000 IU vitamin D3/week significantly raised 25(OH)D by 12.7±8.4 and 13.1±6.5 ng/ml respectively (bothP<0.001 vs baseline). In the 7000 IU group, IGF1 levels also significantly increased by 31.3±36.7 ng/ml (P=0.01). Neither 25(OH)D nor IGF1 significantly varied in controls. IGF1 was ≥50th percentile more frequently in GHD patients with 25(OH)D levels ≥15 than <15 ng/ml (65.9 vs 40.0%,P<0.05). Logistic regression with adjustment for recombinant human GH (rhGH) dose, vitamin D supplements, gender, use of thyroid hormones, corticosteroids or estrogen/testosterone, and season revealed a significant positive association between ≥15 ng/ml 25(OH)D and IGF1 ≥50th percentile (OR 4.4, 95% CI 1.0–18.8,P<0.05). A significant negative correlation between 25(OH)D concentrations and rhGH dose was found after correcting for age and IGF1 (β−0.042,P<0.01), but not after further adjusting for sex, thyroid, adrenal or gonadal replacement, and season (β−0.037,P=0.06).ConclusionsVitamin D increases circulating IGF1 in adults. As a result, a better vitamin D status may ease the achievement of normal IGF1 values in GHD.
Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy
Authors: Gosse Emily , Newsom Richard , Hall Peter , Lochhead Jonathan 
Published: September 2013

Background/Aims:
The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy.

Methods:
Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher’s exact and chi-square tests.

Results:
Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50).

Conclusion:
Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.
“Is This Really What I Voted For?” – On The Legitimacy Of European Integration
Authors: Kerikmäe Tanel , Nyman-Metcalf Katrin , Papageorgiou Ioannis 
Published: September 2013

ABSTRACT
This paper discusses the problems and dangers of proceeding with European integration without facing a transparent constitutional debate. The crucial issue demanding clarity is whether the current integration in the form of the EU shall be seen within the framework and concepts of public international law or within those of constitutional law. The authors argue that more intensive integration cannot be achieved on the basis of undermining rule of law and democracy by vacillating between different international law or constitutional law models of proceeding without taking any clear standpoint.
Initial Findings of Breast Cancer Risk Factors from a Survey Conducted at Pauls Stradins Clinical University Hospital
Authors: Dzervite Agnese , Pranka Maruta , Lace Tana , Rungule Ritma , Gardovskis Janis , Miklasevics Edvins 
Published: September 2013

Summary
Introduction. Several risk factors for breast cancer have been documented based on epidemiological studies conducted over the last several decades - familial history of breast cancer, particular gene mutations, early menarche, late menopause, late age at first childbirth, use of oral contraceptives and hormone replacement therapy, absence of breastfeeding, alcohol use, smoking, obesity and physical inactivity.
Aim of the study. Register data on breast cancer risk factors among the Latvian population and analyze it in relation to age of diagnosis.
Materials and methods. This paper presents quantitative survey data collected from April 2010 to June 2011 at the Pauls Stradins Clinical University hospital from 150 patients undergoing breast cancer treatment.
Results. A small correlation could be seen between age and patient menarche (0.1541; p=0.0749), as well as menopause onset (0.1286; p<0.0001). Hormonal replacement did not show any correlation with age, yet hormonal contraceptives had a moderate correlation with a statistical significance (-0.4988; p=0.0001). Lifestyle risk factors had higher correlations with age of diagnosis than reproductive factors. A moderate correlation could be seen for age and smoking (-0.37289; p<0.0001). A similar moderate correlation existed for age and use of alcohol (-0.31095; p=0.0012). Our survey found that no significant correlation exists between age of diagnosis and number of pregnancies, number of births and number of abortions. We found no significant correlation between age and length of breast feeding.
Conclusions. From current available data gathered in our study it can be concluded that for the Latvian population breast cancer risk is more associated with lifestyle factors than reproductive
Variations in Lower Limb Deep Venous Anatomy in Latvia
Authors: Krievins Dainis , R Regina Zarina , Savlovskis Janis , Dombure Polina 
Published: September 2013

Summary
Introduction. During the last several decades there have been many new methods introduced for the treatment of lower limb chronic venous insufficiency (laser, foam, subendothelial and thermal coagulation methods). Venous system of lower limbs often presents anatomic variations including venous duplications. Knowledge of venous system variations in the lower limb area is of particular importance due to correct interpretation of imaging in relation to deep vein thrombosis (DVT). There was only a small number of studies published on anatomic variations of venous system in the lower limbs. To the best of our knowledge there have been no previous studies on anatomic variations of lower limb deep venous system performed in Latvia.
Aim of the study. To retrospectively review of 216 patients (432 lower limbs) phlebograms in order to establish deep venous system anatomic variations in Latvian population and compare our results to other publications.
Materials and methods. Retrospective analysis of 432 lower limb phlebograms performed at Pauls Stradins Clinical University Hospital (Riga, Latvia) of 216 patients treated in different ortopedic centers of Latvia during 2009 and 2012. Assessment made using DICOM Synedra view personal software. Study protocol was developed for definition of veins and assessment of phlebogram images in accordance with anatomic definitions used in previous studies. Two independent radiologists assessed data. Visualised duplications in the deep venous system of both lower limbs in patients were registered (common iliac vein, external iliac vein, common femoral vein, femoral vein, deep femoral vein, popliteal vein). Blood vessels have been listed as single, double or triple / complex. The presence of DVT was recorded upon assessment of phlebograms. Statistical analysis performed using SPSS 20.0 software (IBM). Parametric data comparison performed using Student t-test and ANOVA. Non-parametric data comparison performed using chi-square and Mann Whitney tests. Data comparison type was assessed using Kolmogorova-Smirnovs test. The results are presented as the average ± standard deviation.
Results. Retrospective analysis of 432 lower limb phlebograms was performed in 216 patients. Average age of the patients was 34.4 years (range 19-90). 101 patients were female (47%) and 115 (53%) were male with no statistical venous variation differences found between two genders, which is explained by both age and gender (p > 0.05). Analysis of calf vein, popliteal vein and femoral venous variations provided a strong correlation between larger number of duplications in one limb and possibility of such variations in the other limb of the same patient (all p < 0.001).
Conclusion. We conclude that there are frequent anatomic variations in SFV and popliteal veins seen in Latvian population. All patients included in this study had high DVT risk, much higher than in the average Latvian population. In almost every sixth Latvian person there is some form of deep veins hypoplasia found.
Orphan Drugs in Surgery
Authors: Logviss Konstantins , Krievins Dainis , Purvina Santa 
Published: September 2013

Summary
Introduction. Rare diseases, also called orphan diseases, are life-threatening or chronically debilitating conditions of different origin. Majority of them are genetic disorders, others being rare cancers, congenital malformations, autoimmune, toxic and infectious diseases. Rare conditions may also be related to surgery, e.g. acute sensorineural hearing loss after surgery induced acoustic trauma, scarring post glaucoma filtration surgery, and short bowel syndrome following intestinal surgery. Besides, surgery as a specific area for orphan drugs, has not been studied yet in Latvia.
Aim of the study. This study aims to determine orphan drugs associated with surgery (used pre-, during or post-surgery) and their availability and access in Latvia.
Materials and methods. European register of designated orphan medicinal products and EMA approved Summary of Product Characteristics were analyzed, to find orphan drugs with approved labeled indications related to surgery. Drug availability and access in Latvia were determined, by using data available from State Agency of Medicines of Latvia and National Health Service. A literature review was performed to compare Latvian situation in field of orphan medicines with other European countries.
Results. 15 orphan drugs were identified, 8 of them (53.3%) indicated for different kinds of tumors. 6 drugs (40%) are available in Latvia, including one drug (6.7%) included in the reimbursement list.
Conclusions. Oncology is the biggest therapeutic area of orphan drugs. Majority of orphan drugs are not available in Latvia, moreover those drugs that are available are often not accessible.
Expression of Insulin-Like Growth Factor 1 (Igf1) and its Receptor (Igfr1) in Two Extremely Pre-Term Placentas
Authors: Kreicberga Ilze , Pilmane Mara , Rezeberga Dace 
Published: September 2013

Summary
Today extremely premature children readily survive; good quality of life can be reached only with research and technology based approaches, therefore understanding of molecular processes taking place in pre-term placentas can be of practical value both for neonatology and pediatric surgery, as complications of prematurity quite often require surgical interventions. The present case report describes the expression of one of the most significant growth factors IGF1 and its receptor IGFR1 in placentas after extremely pre-term deliveries of 22 and 23 gestational weeks and their correlations with clinical findings of corresponding extremely premature children. Significantly more beneficial clinical course is represented by a child with clinically less advantageous situation: smaller gestational age (22w versus 23 w) and birthweight (540g v. 650g), born in the first vaginal delivery (v. repeated delivery) and recently ruptured membranes (v. PPROM > 72 hours). Placental cells of this child contained abundance of IGF1 and IGFR1 positive structures (v. few structures in the other one), possibly revealing better protective features of placenta, improving survival capabilities of the neonate in cases of extreme prematurity.
Application of Cervicocapital Endoprosthesis in Treatment of Pathological Fracture of the Humerus
Authors: Lolans Peteris , Vecina Rota 
Published: September 2013

Summary
Osteosarcoma is one of the most common malignant tumours of osseous tissue, where localisation of the tumour in the proximal third part of the humerus is the third most frequent (6). Prosthesing of the teenager’s right humerus after pathological fracture was done with cervicocapital or Moore endoprosthesis. This endoprothesis developed for the treatment of femoral neck fracture and using for hip hemiarthroplasty. After 10 years the patient has suffered fracture of periprosthesis, osteosynthesis has been performed. Within 2 months after osteosynthesis the patient has regained the previous functional level without complications
European Union Water Policy in Aspect of Rural Areas Development
Authors: Pierzgalski Edward 
Published: September 2013

Abstract
Agriculture and environment are among others the most important priorities of the European Union. Agriculture is strongly influenced by the state of the environment, including water resources. In addition to many other policies, the EU water policy is crucial for the sustainable development of rural areas. Directives are the main tools for implementation of water policy. This article contains an overview of the directives on aspects of quality and quantity of water resources. Within the paper three most important agricultural areas of the Directive are characterized: the Water Framework Directive, the Floods Directive and the Nitrates Directive. Presented mandatory EU action aimed at their implementation and the problems associated with it. Current proposals for changes in the EU water policy are described.