bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, Causes, and Survival Trends From Cardiovascular-Related Sudden Cardiac Arrest in Children and Young Adults 0 to 35 Years of Age
Authors: Meyer Lauren , Stubbs Benjamin , Fahrenbruch Carol , Maeda Chris , Harmon Kimberly , Eisenberg Mickey , Drezner Jonathan 
Published: August 2012

Background—
Sudden cardiac arrest is a leading cause of death in children and young adults. This study determined the incidence, cause, and outcomes of cardiovascular-related out-of-hospital cardiac arrest (OHCA) in individuals <35 years of age.

Methods and Results—

A retrospective cohort of OHCA in children and young adults from 1980 through 2009 was identified from the King County (Washington) Division of Emergency Medical Services' Cardiac Arrest Database. Incidence was calculated from population census data and causes of arrest determined by review of autopsy reports and all available medical records. A total of 361 cases (26 cases 0–2 years of age, 30 cases 3–13 years of age, 60 cases 14–24 years of age, and 245 cases 25–35 years of age) of OHCA were treated by emergency medical services responders, for an overall incidence of 2.28 per 100 000 person-years (2.1 in those 0–2 years of age, 0.61 in those 3–13 years of age, 1.44 in those 14–24 years of age, and 4.40 in those 25–35 years of age). The most common causes of OHCA were congenital abnormalities in those 0 to 2 years of age (84.0%) and 3 to 13 years of age (21%), presumed primary arrhythmia in those 14 to 24 of age (23.5%), and coronary artery disease in those 25 to 35 years of age (42.9%). The overall survival rate was 26.9% (3.8% in those 0–2 years of age, 40.0% in those 3–13 years of age, 36.7% in those 14–24 years of age, and 27.8% in those 25–35 years of age). Survival increased throughout the study period from 13.0% in 1980 to 1989 to 40.2% in 2000 to 2009 (
P
<0.001).

Conclusions—
The incidence of OHCA in children and young adults is higher than previously reported, and a more specific understanding of the causes should guide future prevention programs. Survival trends support contemporary resuscitation protocols for OHCA in the young.
Aortic Regurgitation Quantification Using Cardiovascular Magnetic Resonance
Authors: Myerson Saul G. , d'Arcy Joanna , Mohiaddin Raad , Greenwood John P. , Karamitsos Theodoros D. , Francis Jane M. , Banning Adrian P. , Christiansen Jonathan P. , Neubauer Stefan 
Published: August 2012

Background—
Current indications for surgery in patients with significant aortic regurgitation (AR) focus on symptoms and left ventricular dilation/dysfunction. However, prognosis is already reduced by this stage, and earlier identification of patients for surgery could be beneficial. Quantifying the regurgitation may help, but there are limited data on its link with outcome. Cardiovascular magnetic resonance (CMR) can accurately quantify AR, and we examined whether this was associated with the future need for surgery.

Methods and Results—

One hundred thirteen patients with echocardiographic moderate or severe AR were monitored for up to 9 years (mean 2.6±2.1 years) following a CMR scan, and the progression to symptoms or other indications for surgery was monitored. AR quantification identified outcome with high accuracy: 85% of the 39 subjects with regurgitant fraction >33% progressed to surgery (mostly within 3 years) in comparison with 8% of 74 subjects with regurgitant fraction ≤33% (
P
<0.0001); the area under the curve on receiver operating characteristic analysis was 0.93 (
P
<0.0001). This ability remained strong on time-dependent Kaplan–Meier survival curves. CMR-derived left ventricular end-diastolic volume >246 mL had good, although lower, discriminatory ability (area under the curve 0.88), but the combination of this measure with regurgitant fraction provided the best discriminatory power.

Conclusions—
High degrees of CMR-quantified AR were associated with the development of symptoms or other indications for surgery. Quantifying AR showed slightly better discriminatory ability than “gold standard” CMR ventricular volume assessment. This could provide a new paradigm for the timing of surgical intervention but requires confirmation in a clinical trial.
Targeting Mannose-Binding Lectin Confers Long-Lasting Protection With a Surprisingly Wide Therapeutic Window in Cerebral Ischemia
Authors: Orsini Franca , Villa Pia , Parrella Sara , Zangari Rosalia , Zanier Elisa R. , Gesuete Raffaella , Stravalaci Matteo , Fumagalli Stefano , Ottria Roberta , Reina José J. , Paladini Alessandra , Micotti Edoardo , Ribeiro-Viana Renato , Rojo Javier , Pavlov Vasile I. , Stahl Gregory L. , Bernardi Anna , Gobbi Marco , De Simoni Maria-Grazia 
Published: August 2012

Background—
The involvement of the complement system in brain injury has been scarcely investigated. Here, we document the pivotal role of mannose-binding lectin (MBL), one of the recognition molecules of the lectin complement pathway, in brain ischemic injury.

Methods and Results—

Focal cerebral ischemia was induced in mice (by permanent or transient middle cerebral artery occlusion) and rats (by 3-vessel occlusion). We first observed that MBL is deposited on ischemic vessels up to 48 hours after injury and that functional MBL/MBL-associated serine protease 2 complexes are increased. Next, we demonstrated that (1) MBL
−/−
mice are protected from both transient and permanent ischemic injury; (2) Polyman2, the newly synthesized mannosylated molecule selected for its binding to MBL, improves neurological deficits and infarct volume when given up to 24 hours after ischemia in mice; (3) anti-MBL-A antibody improves neurological deficits and infarct volume when given up to 18 hours after ischemia, as assessed after 28 days in rats.

Conclusions—
Our data show an important role for MBL in the pathogenesis of brain ischemic injury and provide a strong support to the concept that MBL inhibition may be a relevant therapeutic target in humans, one with a wide therapeutic window of application.
Cardiovascular Risk of High- Versus Moderate-Intensity Aerobic Exercise in Coronary Heart Disease Patients
Authors: Rognmo Øivind , Moholdt Trine , Bakken Hilde , Hole Torstein , Mølstad Per , Myhr Nils Erling , Grimsmo Jostein , Wisløff Ulrik 
Published: August 2012

Background—
Exercise performed at higher relative intensities has been found to elicit a greater increase in aerobic capacity and greater cardioprotective effects than exercise at moderate intensities. An inverse association has also been detected between the relative intensity of physical activity and the risk of developing coronary heart disease, independent of the total volume of physical activity. Despite that higher levels of physical activity are effective in reducing cardiovascular events, it is also advocated that vigorous exercise could acutely and transiently increase the risk of sudden cardiac death and myocardial infarction in susceptible persons. This issue may affect cardiac rehabilitation.

Methods and Results—
We examined the risk of cardiovascular events during organized high-intensity interval exercise training and moderate-intensity training among 4846 patients with coronary heart disease in 3 Norwegian cardiac rehabilitation centers. In a total of 175 820 exercise training hours during which all patients performed both types of training, we found 1 fatal cardiac arrest during moderate-intensity exercise (129 456 exercise hours) and 2 nonfatal cardiac arrests during high-intensity interval exercise (46 364 exercise hours). There were no myocardial infarctions in the data material. Because the number of high-intensity training hours was 36% of the number of moderate-intensity hours, the rates of complications to the number of patient-exercise hours were 1 per 129 456 hours of moderate-intensity exercise and 1 per 23 182 hours of high-intensity exercise.

Conclusions—
The results of the current study indicate that the risk of a cardiovascular event is low after both high-intensity exercise and moderate-intensity exercise in a cardiovascular rehabilitation setting. Considering the significant cardiovascular adaptations associated with high-intensity exercise, such exercise should be considered among patients with coronary heart disease.
Auditory Imagery Modulates Frequency-specific Areas in the Human Auditory Cortex
Authors: Oh Jihoon , Kwon Jae Hyung , Yang Po Song , Jeong Jaeseung 
Published: August 2012

Abstract
Neural responses in early sensory areas are influenced by top–down processing. In the visual system, early visual areas have been shown to actively participate in top–down processing based on their topographical properties. Although it has been suggested that the auditory cortex is involved in top–down control, functional evidence of topographic modulation is still lacking. Here, we show that mental auditory imagery for familiar melodies induces significant activation in the frequency-responsive areas of the primary auditory cortex (PAC). This activation is related to the characteristics of the imagery: when subjects were asked to imagine high-frequency melodies, we observed increased activation in the high- versus low-frequency response area; when the subjects were asked to imagine low-frequency melodies, the opposite was observed. Furthermore, we found that A1 is more closely related to the observed frequency-related modulation than R in tonotopic subfields of the PAC. Our findings suggest that top–down processing in the auditory cortex relies on a mechanism similar to that used in the perception of external auditory stimuli, which is comparable to early visual systems.
Beliefs about causes, symptoms, and stigma associated with severe mental illness among ‘highly acculturated’ Chinese-American patients
Authors: Lin Susan Y 
Published: August 2012

Background: Literature about experiences of mental illness among ethnic minority has tended to focus on first-generation migrants. This study fills that gap by exploring experiences among highly acculturated Chinese-American patients with mental illness. Materials: Twenty-nine participants completed semi-structured interviews based on Kleinman’s explanatory model, which were audio-taped, transcribed and coded for qualitative analysis. Discussion: Beliefs about the causes of mental illness included biological factors, head trauma and personal losses. Issues relating to stigma and shame were also discussed. Conclusion: Highly acculturated ethnic minority patients may ascribe to a biomedical model at the same time as ascribing to culture-specific beliefs.
The Reach and Boundaries of Moral Concerns: Which Way for British Aid in Africa?
Authors: Sarpong Sam 
Published: August 2012

The British government’s recent threat to withhold aid from African governments that do not reform legislation banning homosexuality has generated a lot of resentment from African countries where homosexuality is still illegal. With supposedly different social norms and values, Africa’s anti-gay stance is largely seen as being precipitated by its cultural values. Whilst Britain and, more recently, the US and Canada, have all determined that the issue of homosexuality lies at the heart of human rights, many African countries have stressed that it boils down to cultural values and social norms, a notion which many Africans believe Western governments have failed to appreciate. The purpose of this paper is to provide an insight into this issue. It examines whether patterns of particular culture are really incompatible with admitted standards of human rights. The paper also dwells on the debate raging over universal human rights and cultural differences. It concludes that the culture of transnational modernity, one that specifies procedures for collaborative decision-making, conceptions of global social justice, and definitions of gender and sexual roles, stands at risk if it fails to take into account cultural specificity in some regions.
Supracricoid Partial Laryngectomy
Authors: Pinar Ercan , Imre Abdulkadir , Calli Caglar , Oncel Semih , Katilmis Huseyin 
Published: August 2012

ObjectiveThe aim of this study was to analyze the functional and oncologic results of supracricoid partial laryngectomy.Study DesignCase series with chart review.SettingKatip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.Subject and MethodsThe medical records of 56 patients, who underwent supracricoid partial laryngectomy between March 2002 and December 2010, were reviewed in this study. Forty‐three patients underwent supracricoid partial laryngectomy with cricohyoidopexy, and 13 patients underwent cricohyoidoepiglottopexy. The overall and disease‐specific survival, local control rates, and the mean time of decannulation and nasogastric tube removal were evaluated. Association of type of surgery with the functional and oncologic outcomes was evaluated and statistically compared.ResultsThe median follow‐up period was 58 months. The 1‐, 3‐, and 5‐year overall survival rates were 100%, 96.4%, and 82.1%, respectively. The 1‐, 3‐, and 5‐year local control rates were 100%, 96.1%, and 92.5%, respectively. Type of surgery did not show any significant difference in survival and local control rates (P =. 546, P =. 455). The mean (SD) decannulation and nasogastric feeding tube removal time was 11.43 (2.03) and 16.79 (3.51) days, respectively. The mean time of decannulation and nasogastric tube removal was significantly longer in patients who underwent cricohyoidopexy when compared with those who underwent cricohyoidoepiglottopexy (P =. 002, P =. 000).ConclusionAlthough delaying deglutition functions could be termed a disadvantage of supracricoid laryngectomy, especially with cricohyoidopexy, supracricoid laryngectomy has reliable oncologic and functional results for locally advanced laryngeal cancers while maintaining laryngeal functions.
Chronic Pharyngitis: Role of Atypical Organisms
Authors: Naina P. , Anandan Shalini , Mathews Suma Susan , Job Anand , Albert Rita Ruby 
Published: August 2012

BackgroundBacteria including Chlamydophila pneumoniae, Mycoplasma pneumoniae, and anaerobic bacteria such as Fusobacterium necrophorum have been implicated as etiological agents of chronic pharyngitis in Western literature. Because there are no data regarding this from India, the authors undertook this study.Study DesignProspective case‐control study.SettingTertiary‐level medical college and hospital.MethodIn total, 343 consecutive adults with persistent throat pain and/or irritation (duration ≥3 months) were screened for known causes of pharyngitis by a thorough clinical and endoscopic examination. In 71 patients, the evaluation performed was unable to determine any cause, and these were considered cases. An enzyme‐linked immunosorbent assay test to detect IgA and IgG antibodies to C pneumoniae and M pneumoniae was performed on 66 of these cases and 62 controls. The posterior pharyngeal swabs taken from both the cases and controls were subjected to aerobic and anaerobic culture.ResultsIndividuals with chronic pharyngitis had a 3.43 times odds of being seropositive for C pneumoniae as compared with controls (P =. 001; odds ratio = 3.43). Aerobic organisms and M pneumoniae did not seem to be significant etiological agents for chronic pharyngitis. On the contrary, isolation of Fusobacterium spp was found to be significantly more in controls as compared with cases.ConclusionThis study suggests an association between IgA antibodies to C pneumoniae and chronic pharyngitis. Further studies using more specific tests combined with long‐term follow‐up are needed to confirm these findings.
Superior Semicircular Canal Dehiscence in Patients with Spontaneous Cerebrospinal Fluid Otorrhea
Authors: Allen Kyle P. , Perez Carlos L. , Isaacson Brandon , Roland Peter S. , Duong Thao T. , Kutz J. Walter 
Published: August 2012

ObjectiveTo determine the prevalence of superior semicircular canal dehiscence (SCD) in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.Study DesignCase series with chart review.SettingTertiary care referral center.Subjects and MethodsPatients included have undergone a middle fossa craniotomy for repair of spontaneous CSF otorrhea between January 2007 and December 2011. The main outcome measure is the presence or absence of SCD observed during spontaneous CSF leak repair. Computed tomography (CT) imaging was also reviewed to determine the diagnostic accuracy of this modality.ResultsThirty‐three ears in 31 patients underwent surgical repair for spontaneous CSF otorrhea via a middle fossa craniotomy. The average age at the time of repair was 60.5 years, and 80.6% of patients were female. A dehiscence of the superior canal was observed in 15.2% of ears (16.1% of individuals). No significant difference in age, body mass index, or sex was noted between those patients with or without a superior canal dehiscence. For the diagnosis of SCD, coronal CT was 100% sensitive and 91.7% specific. The positive predictive value and negative predictive value of CT were 66.7% and 100%, respectively.ConclusionThe prevalence of superior semicircular canal dehiscence in ears with spontaneous otorrhea is 15.2%. This prevalence is greater than the 0.5% reported in a temporal bone study of ears not selected for CSF otorrhea.
Incentive Spirometry for the Tracheostomy Patient
Authors: Goldstein Gregg H. , Iloreta Alfred Marc , Ojo Bukola , Malkin Benjamin D. 
Published: August 2012

ObjectiveTo determine the feasibility of developing and using a customized incentive spirometer device for patients who have undergone a tracheostomy procedure.Study DesignThe authors performed a prospective case series approved by the institutional review board.SettingAcademic medical center.Subjects and MethodsPatients were eligible for participation if they were older than 18 years and had a new tracheostomy. Spirometry exercises were performed using a protocol adapted from the American Academy of Respiratory Care guidelines. Patient data were recorded, including age, sex, tobacco use, surgical procedure, time under general anesthesia, length of hospital stay, and time until ambulation. The details of the spirometry exercises were also recorded along with any complications that occurred.ResultsAn incentive spirometer was adapted for use with tracheostomy patients and received an investigational device exemption from the Food and Drug Administration. A total of 10 patients were enrolled (mean age 60 years). Sixty percent were current or former tobacco users, the mean anesthesia time was 9 hours, and 70% underwent a microvascular free flap reconstruction. Patients used the incentive spirometer for a mean of 1.6 days during the postoperative period, averaging 3.3 sessions per day and 6.8 breaths per session. The device was well tolerated by patients, and there were no complications associated with its use.ConclusionThis study supports the feasibility of using a customized incentive spirometer for tracheostomy patients and establishes a safety profile for the device to be used in future studies.
The Effect of Modified Broström-Gould Repair for Lateral Ankle Instability on In Vivo Tibiotalar Kinematics
Authors: Wainright William B. , Spritzer Charles E. , Lee Jun Young , Easley Mark E. , DeOrio James K. , Nunley James A. , DeFrate Louis E. 
Published: August 2012

Background: Lateral ankle instability leads to an increased risk of tibiotalar joint osteoarthritis. Previous studies have found abnormal tibiotalar joint motions with lateral ankle instability that may contribute to this increased incidence of osteoarthritis, including increased anterior translation and internal rotation of the talus under weightbearing loading. Surgical repairs for lateral ankle instability have shown good clinical results, but the effects of repair on in vivo ankle motion are not well understood. Hypothesis: The modified Broström-Gould lateral ligament reconstruction decreases anterior translation and internal rotation of the talus under in vivo weightbearing loading conditions. Study Design: Controlled laboratory study. Methods: Seven patients underwent modified Broström-Gould repair for unilateral lateral ankle instability. Ankle joint kinematics as a function of increasing body weight was studied with magnetic resonance imaging and biplanar fluoroscopy. Tibiotalar kinematics was measured in unstable ankles preoperatively and postoperatively at a mean follow-up of 12 months as well as in the uninjured contralateral ankles of the same patients. Results: Surgical repair resulted in statistically significant decreases (expressed as mean ± standard error of the mean) in anterior translation of the talus (0.9 ± 0.3 mm; P = .018) at 100% body weight and internal rotation of the talus at 75% (2.6° ± 0.8°; P = .019) and 100% (2.7° ± 0.8°; P = .013) body weight compared with ankle kinematics measured before repair. No statistically significant differences were detected between repaired ankles and contralateral normal ankles. Conclusion: The modified Broström-Gould repair improved the abnormal joint motion observed in patients with lateral ankle instability, decreasing anterior translation and internal rotation of the talus. Clinical Relevance: Altered kinematics may contribute to the tibiotalar joint degeneration that occurs with chronic lateral ankle instability. The findings of the current study support the efficacy of this repair in improving the abnormal ankle motion observed in these patients.
Superior Capsule Reconstruction to Restore Superior Stability in Irreparable Rotator Cuff Tears
Authors: Mihata Teruhisa , McGarry Michelle H. , Pirolo Joseph M. , Kinoshita Mitsuo , Lee Thay Q. 
Published: August 2012

Background: There have been many clinical reports of patch graft surgery for irreparable rotator cuff tears. However, the retear rate of the patch graft is relatively high because of the lack of superior stability, causing subacromial abrasions. Purpose: To compare superior stability among 3 types of patch grafting for simulated irreparable rotator cuff tears. Study Design: Controlled laboratory study. Methods: Eight cadaveric shoulders were tested in a custom shoulder testing system. Superior translation of the humerus, subacromial contact pressure, and glenohumeral joint force were quantified in the following 5 conditions: (1) when the rotator cuff was intact, (2) after cutting the supraspinatus tendon, (3) after the patch graft to reconstruct the supraspinatus tendon, (4) after the patch graft to reconstruct the superior capsule, and (5) after the patch graft to reconstruct both the supraspinatus tendon and superior capsule. While the graft was sutured to the torn tendon in condition 3, the graft was attached to the superior glenoid in condition 4. Results: Compared with values for intact rotator cuffs, cutting the supraspinatus tendon significantly increased superior translation ( P < .05), significantly increased subacromial contact pressure ( P < .05), and significantly decreased glenohumeral compression force ( P < .05). Superior translation was restored partially after the supraspinatus tendon patch graft and restored fully after the superior capsule patch graft and after both patch grafts. All patch grafts fully restored the subacromial contact pressure ( P < .05) but did not alter the glenohumeral joint force. Conclusion: When patch graft surgery is chosen for irreparable rotator cuff tears, the graft should be attached medially to the superior glenoid and laterally to the greater tuberosity to restore superior stability of the humeral head. Clinical Relevance: The superior capsule patch graft completely restored superior stability of the glenohumeral joint, while patch grafting to the supraspinatus tendon partially restored superior translation.