bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wedge resection verses lobectomy for stage 1 non-small-cell lung cancer
Authors: Warwick Richard , Mediratta Neeraj , Shackcloth Michael , Page Richard , McShane James , Shaw Matthew , Poullis Michael 
Published: July 2013

Background Lobectomy remains the gold standard with regard to potentially curative resection of non-small-cell lung carcinoma. We aimed to investigate whether there is a survival difference in stage 1 non-small-cell lung cancer patients who undergo lobectomy compared to a wedge resection. Methods We retrospectively analyzed a prospective database of 1283 patients who had potentially curative resection for stage 1 non-small-cell lung cancer. Only patients with adenocarcinoma, squamous or adenosquamous carcinoma were included. We benchmarked our 5-year survival against the 6th International Association for the Study of Lung Cancer results. Three techniques were used to assess the effect of a lobectomy compared to a wedge resection with regard to long-term survival: Cox multivariate regression analysis, neuronal network analysis, and propensity matching. Results Benchmarking failed to reveal any significant difference compared to the 6th International Association for the Study of Lung Cancer results. Crude analysis demonstrated superiority of lobectomy compared to wedge resection, p = 0.02. Cox regression analysis confirmed that age, body mass index, female sex, being a current smoker, tumor diameter, and preoperative forced expiratory volume in 1 s were all significant factors determining long-term survival. Wedge resection was not a significant factor. Neuronal network analysis concurred with the Cox regression analysis. Propensity matching with 1:1 matching demonstrated that wedge resections was not inferior to a lobectomy, p = 0.10. Conclusions Cox regression analysis, neuronal network analysis, and propensity matching in stage 1 non-small-cell lung cancer demonstrate no difference in long-term survival after wedge resection compared to lobectomy.
Long-term survival after pneumonectomy for non-small-cell lung cancer
Authors: Kalathiya Rohan J , Davenport Daniel , Saha Sibu P 
Published: July 2013

Objective to investigate long-term survival in patients who underwent pneumonectomy for non-small-cell lung cancer at the University of Kentucky Medical Center. Methods we retrospectively reviewed 100 consecutive pneumonectomy cases from 1998 to 2009 at the University of Kentucky. We were able to obtain follow-up data on 99 of 100 patients. Results overall 1-, 2-, and 5-year survival was 66%, 48%, and 32%, respectively. The 1-, 2-, and 5- survival for left pneumonectomy was 76%, 55%, and 40%, respectively, compared to 56%, 44%, and 22%, respectively, for right pneumonectomy. The median survival for left pneumonectomy was 2.4 years compared to 1.2 years for right pneumonectomy ( p = 0.056). The 5-year survival for patients diagnosed with stage I disease was 34%, compared to 19% for stage II disease, and 38% for stage III disease. The 5-year survival for patients who underwent neoadjuvant therapy was 31% compared to 39% for patients who received adjuvant therapy and 29% for patients who received surgery alone. These results were also not statistically significant. Conclusion neoadjuvant therapy did not adversely affect long-term survival in our study. When compared to left pneumonectomy, right pneumonectomy for non-small-cell lung cancer is associated with adverse postoperative outcomes as well as poorer long-term survival.
Chest wall deformity found in patients with primary spontaneous pneumothorax
Authors: Saita Kosuke , Murakawa Tomohiro , Kawano Hirotaka , Sano Atsushi , Nagayama Kazuhiro , Nakajima Jun 
Published: July 2013

Background the current consensus is that primary spontaneous pneumothorax frequently occurs in young male patients who are tall and thin. However, upon careful observation, many chest wall deformities have been recognized in primary spontaneous pneumothorax patients. We investigated the distinctive features of the chest wall configuration of primary spontaneous pneumothorax patients by comparing them with controls (normal and Marfan syndrome patients). Methods the anteroposterior and transverse diameters of the bilateral hemithoraxes of each patient at predetermined levels were measured by computed tomography. The asymmetry, which was based on the right/left anteroposterior and right/left transverse diameter ratio, and thickness based on the anteroposterior/transverse ratio, were examined. Results severe anteroposterior asymmetry and transverse asymmetry were observed in Marfan syndrome patients, and moderate anteroposterior asymmetry and transverse asymmetry were observed in primary spontaneous pneumothorax patients in comparison with normal control patients. Primary spontaneous pneumothorax and Marfan patients showed flatter thoraxes than normal control patients. Conclusions primary spontaneous pneumothorax patients tend to have asymmetric and flat thoraxes. Subclinical thoracic wall deformity observed in the primary spontaneous pneumothorax group may partly contribute to alveolar pressure heterogeneity, and may be related to subpleural bleb formation.
Novel emboli protection cannula during cardiac surgery: first animal study
Authors: Shani Liran , Cohen Oved , Beckerman Ziv , Nir Rony-Reuven , Bolotin Gil 
Published: July 2013

Background Stroke after open heart surgery is a major cause of morbidity and mortality. Up to 60% of intraoperative cerebral events are caused by emboli generated by manipulations of the aorta during surgery. This is the first animal study evaluating the safety and efficacy of a novel aortic cannula designed to extract solid and gaseous emboli during cardiac surgery. Methods Seven domestic pigs were connected to cardiopulmonary bypass using a CardioGard 24F aortic cannula. Three pigs that were cannulated with a standard aortic cannula were defined as controls. Several main flow and suction regimens were carried out. Osseous particles of different sizes were injected into the proximal aorta to simulate emboli. Results The CardioGard cannula demonstrated an overall emboli retrieval rate of 77%. A rate of 88.45% was demonstrated during the low-flow regimen used clinically during aortic manipulation. Gaseous and solid emboli were eliminated by suction, as demonstrated by epi-carotid ultrasound. No significant changes were observed in hemodynamic and laboratory parameters. Conclusions The CardioGard cannula is as simple to use as a regular commercially available aortic cannula, having a similar safety profile and proven efficacy in capturing intraoperative emboli.
Botulinum toxin for prevention of delayed gastric emptying after esophagectomy
Authors: Bagheri Reza , Fattahi Seyed Hossein , Haghi Seyed Ziaollah , Aryana Kamran , Aryanniya Ali , Akhlaghi Saeed , Riyabi Fateme Naghavi , Sheibani Shima 
Published: July 2013

Background Esophageal cancer is among the most common gastrointestinal cancers for which the main treatment is surgery. This study was undertaken to analyze the results of Botox injection in preventing gastric stasis in these patients. Patients and methods 60 patients with esophageal cancer in the middle and lower third parts were included in our study between 2010 and 2011, and were randomly divided into two groups. In group A, 30 patients underwent pyloroplasty, and in group B, injection of botulinum toxin into the pyloric sphincter muscle was used in 30 patients. Results The mean age of these patients was 61 ± 10.7 years and the male/female ratio was 33:27. Isotope scans 3 weeks after surgery showed that 5 patients in group A and 3 in group B had delayed gastric emptying; there was no significant difference between the 2 groups, and the success rate of Botox injection was 90%. Conclusion Considering the fact that there was no significant difference between pyloroplasty and Botox injection on gastric emptying after surgery, and given the need to use less-aggressive techniques and facilitate greater use of endoscopic methods, botulinum toxin injection may be used instead of pyloroplasty as a simple, effective, and complication-free method to prevent delayed gastric emptying.
Validation of 7th TNM staging system for lung cancer, based on surgical outcomes
Authors: Yoshida Yukihiro , Murayama Tomonori , Sato Yasunori , Suzuki Yoshio , Saito Haruhisa , Tanaka Nobutaka 
Published: July 2013

Background Validation of the clinical classification for lung cancer of the 7th edition of the TNM staging system among surgical cases has not been reported previously. Methods Data of 489 males and 246 females, with a mean age of 67.6 years, who underwent surgical resection for non-small-cell lung cancer were analyzed retrospectively. Results The 5-year survival rate of these patients was 72.2% for clinical stage IA ( n = 365), 58.4% for IB ( n = 158), 51.2% for IIA ( n = 77), 49.1% for IIB ( n = 42), 36.8% for IIIA ( n = 86), 80% for IIIB ( n = 5) and 50% for IV ( n = 2). The 5-year survival rate of patients was 100% for pathological stage 0 ( n = 2), 86.1% for IA ( n = 216), 73.8% for IB ( n = 173), 46.1% for IIA ( n = 97), 47.2% for IIB ( n = 69), 33.3% for IIIA ( n = 155), 33.3% for IIIB ( n = 3) and 30.9% for IV ( n = 20). Prognostic factors included female sex and 70 years of age or younger, as well as adenocarcinoma histology. Conclusions Deterioration in patient survival was indicated with the exception of stages IIIB and IV, each of which included only a small number of patients. Our study validated the current TNM staging system in surgical cases with regard to both clinical and pathological classifications.
EuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons risk algorithm
Authors: Qadir Irfan , Alamzaib Sardar Muhammad , Ahmad Mohammad , Perveen Shazia , Sharif Hasanat 
Published: July 2013

Introduction This study presents a validation series for EuroSCORE II compared with the previous additive and logistic EuroSCORE and the Society of Thoracic Surgeons risk prediction algorithm. Patients and methods Clinical data of 2004 patients undergoing isolated coronary artery bypass surgery between 2006 and 2010 were retrospectively collected and individual expected risks of death were calculated by all 3 risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration. Results There were 76 deaths (3.8%) among 2004 patients. The mean EuroSCORE II predicted mortality was 3.72% ± 5.11%, additive EuroSCORE was 4.35% ± 3.65% and logistic EuroSCORE was 6.41% ± 10.06%. The additive EuroSCORE was better than EuroSCORE II in terms of both discrimination and calibration (C-statistic 0.866 and Hosmer-Lemeshow p value 0.230 vs. C-statistic 0.836 and Hosmer-Lemeshow p value 0.013 for EuroSCORE II). In a subset of 380 patients, we compared EuroSCORE II with the Society of Thoracic Surgeons risk prediction. Actual mortality was 2.89%. Predicted mortality by EuroSCORE II was 4.27% ± 5.22% and Society of Thoracic Surgeons risk prediction was 2.30% ± 4.16%. The area under the curve was 0.759 for EuroSCORE II and 0.898 for the Society of Thoracic Surgeons risk prediction, whereas the Hosmer-Lemeshow p value was 0.267 for EuroSCORE II and 0.981 for Society of Thoracic Surgeons risk prediction. Conclusion The Society of Thoracic Surgeons risk prediction algorithm is a better risk assessment tool compared to additive and logistic EuroSCORE and EuroSCORE II in Pakistani patients.
Endovenous laser ablation and sclerotherapy for incompetent vein of Giacomini
Authors: Guzelmansur Ismail , Oguzkurt Levent , Koca Nihal , Andic Cagatay , Gedikoglu Murat , Ozkan Ugur 
Published: July 2013

Purpose To retrospectively evaluate the feasibility and effectiveness of endovenous laser ablation or ultrasound-guided foam sclerotherapy for Giacomini vein insufficiency. This is the largest cohort of patients treated for Giacomini vein insufficiency with endovenous laser ablation or ultrasound-guided foam sclerotherapy. Material and methods Over a three-year period, 23 females and nine males (age range, 19–67 years) treated for Giacomini vein insufficiency with or without saphenous vein insufficiency were retrospectively reviewed. Diagnosis of venous insufficiency was made by color Doppler ultrasonography. Symptomatic insufficiency of the Giacomini vein or the saphenous veins was treated with endovenous laser ablation. Ultrasound-guided foam sclerotherapy was used for tortuous incompetent Giacomini veins. The venous disease was categorized according to the clinical, etiological, anatomical, and pathological classification, and clinical severity was graded with the venous clinical severity score. Follow-up included clinical examination and color Doppler ultrasonography. Results Thirty-nine limbs in 32 patients were treated (25 endovenous laser ablation and seven ultrasound-guided foam sclerotherapy). All procedures were technically successful. One patient in the ultrasound-guided foam sclerotherapy group had a recurrence with successful repeated treatment. Recurrence was not seen in the endovenous laser ablation group. No complications were observed. All patients had resolution and improvement in 100% of their symptoms at 12 months of follow-up. Conclusion Giacomini vein insufficiency is mostly seen with insufficiency of the great saphenous vein and can be effectively treated with endovenous laser ablation or ultrasound-guided foam sclerotherapy.
Pregnancy outcomes of day 5 embryo transfer in patients at high risk of developing ovarian hyperstimulation syndrome and analysis of factors affecting blastocyst formation
Authors: Xin Zhi-min , Zhu Hong , Jin Hai-xia , Song Wen-yan , Sun Ying-pu 
Published: July 2013

Objectives To investigate the effects of day 5 embryo transfer (D5ET) compared with day 3 embryo transfer (D3ET) in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS); to analyse factors affecting blastocyst formation. Methods Patients at high risk of developing OHSS underwent either D3ET or D5ET. Results A total of 253 patients received D3ET; 263 received D5ET. The number of embryos transferred was lower in the D5ET group than in the D3ET group. There were no between-group differences in pregnancy or live birth rates. Implantation rate was higher, and multifetation rate lower, in the D5ET group compared with the D3ET group. In addition, the incidence of moderate or severe OHSS was lower in the D5ET group than in the D3ET group. The woman’s age, gonadotrophin dosage and insemination method were associated with the quality of blastocyst formation. Conclusions In patients with a high risk of developing OHSS, compared with D3ET, D5ET decreased the multifetation rate and the incidence of moderate or severe OHSS, but did not affect the pregnancy or live birth rate. Women of a younger age, who have had an appropriate gonadotrophin dose and insemination by in vitro fertilization, are suitable candidates for blastocyst transfer.
Headache in children: Effectiveness of multidisciplinary treatment in a tertiary paediatric headache clinic
Authors: Soee Ann-Britt L , Skov Liselotte , Skovgaard Lene Theil , Thomsen Lise L 
Published: July 2013

Aim The aim of this article is to evaluate the effectiveness of a specific multidisciplinary treatment programme for children with headache and to describe the concept and settings of the Children’s Headache Clinic in Denmark. Method All new patients were included and evaluations were conducted after six and 12 months. Pharmacological and non-pharmacological treatments were offered by a team of specialists (physicians, headache nurses, a physiotherapist and a psychologist). Patients The subjects comprised 169 children (mean age 11.7 (range 4–17), 91 females, 78 males), 39% of whom suffered from chronic headache (≥15 days/month). All children were diagnosed according to the International Classification of Headache Disorders, second edition; 20% had migraine, 34% tension-type headache, 27% mixed headache, 4% medication-overuse headache, and 15% were diagnosed with other types of headaches. Results Fifty per cent of the children had an improvement in headache frequency above 50% at six months. By the use of repeated measurement analysis, we found a significant decrease in headache frequency in all of the six headache groups, whereas the increase in quality of life (PedsQL™ 4.0) was significant for the group as a whole. Conclusion Though preliminary, the results show a good outcome for multidisciplinary treatment programmes for children who suffer from frequent or chronic headache.
T1ρ Imaging Demonstrates Early Changes in the Lateral Patella in Patients With Patellofemoral Pain and Maltracking
Authors: Thuillier Daniel U. , Souza Richard B. , Wu Samuel , Luke Anthony , Li Xiaojuan , Feeley Brian T. 
Published: July 2013

Background: Patellofemoral pain (PFP) is a common condition and often presents without evidence of arthritis on radiographs. Magnetic resonance imaging (MRI) has shown good correlation between T1ρ and T2 relaxation times and changes in the cartilage matrix, but as of yet, there are limited data in the literature utilizing these modalities to evaluate the patellofemoral joint. Hypothesis: Patients with PFP and patellar tilt will show longer T1ρ relaxation times in the lateral facets of their patella but no difference in T2 values. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 20 patients aged 18 to 45 years with anterior knee pain, patellar tilt, and no evidence of osteoarthritis were identified and consented to undergo MRI including axial T1ρ and T2 relaxation time mapping sequences. Knee cartilage was segmented on spoiled gradient recalled acquisition in steady state (SPGR) images using a spline-based algorithm. These results were then compared with those of 10 age-matched controls. Results: The mean T1ρ values of the lateral facets were significantly elevated in patients with PFP compared with controls (46.33 ± 4.92 ms vs 42.32 ± 3.67 ms, respectively; P = .031), while no significant difference was observed in the medial facets (42.20 ± 5.55 ms vs 41.42 ± 4.09 ms, respectively; P = .69). Significantly higher mean T1ρ values were noted in the lateral facets of the patients with PFP (46.33 ms) compared with the medial facets (42.20 ms) ( P = .0001), while no significant differences in T1ρ values were observed between the medial and lateral facets of the controls ( P = .502). No significant differences were noted in T2 relaxation times. A high correlation was noted between the mean T1ρ values of the whole patella of patients with PFP and the degree of patellar tilt ( r = 0.72). Conclusion: There were significantly higher T1ρ values in the lateral facets of patients with PFP and patellar tilt that were not seen in control patients. These higher values approach the numbers seen in patients with early osteoarthritis.
In Vitro Comparison of Popliteus Tendon and Popliteofibular Ligament Reconstruction in an External Rotation Injury Model of the Knee
Authors: Zhang Hui , Zhang Jin , Liu Xin , Shen Jie Wei , Hong Lei , Wang Xue Song , Feng Hua 
Published: July 2013

Background: In posterolateral corner (PLC) injuries in which the lateral collateral ligament (LCL) is intact, there is controversy about whether reconstructing the popliteus tendon (POP), the popliteofibular ligament (PFL), or both structures (POP + PFL) is required to restore normal external tibial rotation. Hypothesis: Three reconstruction techniques, POP, PFL, and POP + PFL, are able to restore external tibial rotation to normal. Study Design: Controlled laboratory study. Methods: Six nonpaired human knees were tested under the following states: POP and PFL intact and sectioned. The 3 different surgical techniques were used to reconstruct the sectioned structures, and the knees were retested. Each knee was subjected to a 5-N·m external rotation torque and tested at 0°, 30°, 45°, 60°, 90°, and 120° of flexion. A navigation system was used to measure motion changes of the tibia with respect to the femur. Results: There were small but significant increases in external rotation after sectioning both the POP and PFL. Sectioning of either one of these structures alone produced smaller increases that were not significant. After comparing all of the tested reconstructed states to the intact state, there were significant differences at knee flexion angles from 30° to 90°. The PFL procedure restored external tibial rotation without significant differences compared with the intact knee at 30° to 90° of flexion. The POP and POP + PFL techniques significantly overconstrained external tibial rotation at all tested angles. Conclusion: In an LCL-intact PLC injury model, the POP and PFL function as a unit in resisting external rotation. All surgical procedures described and tested were able to reduce the increased external rotational laxity found in the sectioned state. The PFL reconstruction technique was able to restore external rotation to near normal. However, the techniques involving POP reconstruction overconstrained external rotation during laxity testing.
Systemic lupus erythematosus in the multiethnic Malaysian population: disease expression and ethnic differences revisited
Authors: Jasmin R , Sockalingam S , Cheah TE , Goh KJ 
Published: July 2013

Objectives Ethnic differences in systemic lupus erythematosus (SLE) have been previously described in the multiethnic Malaysian population. However, there have since been many demographic and socioeconomic changes in the country. The aim of this study is to re-examine the clinical and immunological profiles of Malaysian SLE patients of different ethnic backgrounds. Methods Consecutive follow-up patients at the University Malaya Medical Centre (UMMC) from July 2010 until March 2011 were included in the study. Results The most common clinical manifestations were malar rash (61.3%), arthritis (52.3%), haematological disease (51.6%), oral ulcers (51%) and renal disease (40.6%). Ethnic Indians had fewer malar and discoid rashes but were at higher risk of arthritis, serositis, renal and neuropsychiatric disease compared to Malays and Chinese Malaysians. Antiphospholipid syndrome (APS) was less common in Chinese. A longer duration of SLE correlated with a lower SLEDAI score. Conclusion Overall, the spectrum disease expression was similar to the earlier Malaysian study but the frequency of the more severe disease manifestations, viz. renal, haematological, neuropsychiatric involvements and serositis, were lower. This study further emphasises differences primarily between ethnic Indians and the other races in Malaysia.
Association of serum B cell activating factor from the tumour necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) with central nervous system and renal disease in systemic lupus erythematosus
Authors: Vincent FB , Northcott M , Hoi A , Mackay F , Morand EF 
Published: July 2013

Introduction The objective of this study is to determine whether serum concentrations of B cell activating factor from the tumour necrosis factor family (BAFF) and/or a proliferation-inducing ligand (APRIL) are associated with clinical manifestations of systemic lupus erythematosus (SLE). Methods BAFF and APRIL concentrations were quantified using a commercial ELISA in serum samples obtained at the time of clinical assessment in 98 patients, and on 245 samples from 75 of these patients followed prospectively. Results Serum BAFF was significantly increased, and APRIL decreased, in patients with either renal or central nervous system (CNS) lupus. In contrast, in cross-sectional analysis, there was no correlation between disease activity (SLEDAI-2k) and serum BAFF or APRIL. In longitudinal follow-up, there was no association between changes in serum BAFF or APRIL and changes in SLEDAI-2k, or between baseline serum BAFF or APRIL and subsequent changes in SLEDAI-2k. However, between-visit changes in BAFF were significantly different in patients with increases in SLEDAI-2k ≥ 4, compared to patients whose SLEDAI-2k did not change. Conclusions Although neither serum BAFF nor APRIL correlated with disease activity in the overall population, elevated serum BAFF and reduced APRIL may be markers of renal and CNS disease in SLE patients.