bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Survival and Repeat Coronary Revascularization in Dialysis Patients After Surgical and Percutaneous Coronary Revascularization With Drug-Eluting and Bare Metal Stents in the United States
Authors: Shroff Gautam R. , Solid Craig A. , Herzog Charles A. 
Published: April 2013

Background—
Few published data describe long-term survival of dialysis patients undergoing surgical versus percutaneous coronary revascularization in the era of drug-eluting stents (DES).

Methods and Results—

Using United States Renal Data System data, we identified 23 033 dialysis patients who underwent coronary revascularization (6178 coronary artery bypass grafting, 5011 bare metal stents, 11 844 DES) from 2004 to 2009. Revascularization procedures decreased from 4347 in 2004 to 3344 in 2009. DES use decreased by 41% and bare metal stent use increased by 85% from 2006 to 2007. Long-term survival was estimated by the Kaplan-Meier method, and independent predictors of mortality were examined in a comorbidity-adjusted Cox model. In-hospital mortality for coronary artery bypass grafting patients was 8.2%; all-cause survival at 1, 2, and 5 years was 70%, 57%, and 28%, respectively. In-hospital mortality for DES patients was 2.7%; 1-, 2-, and 5-year survival was 71%, 53%, and 24%, respectively. Independent predictors of mortality were similar in both cohorts: age >65 years, white race, dialysis duration, peritoneal dialysis, and congestive heart failure, but not diabetes mellitus. Survival was significantly higher for coronary artery bypass grafting patients who received internal mammary grafts (hazard ratio, 0.83;
P
<0.0001). The probability of repeat revascularization accounting for the competing risk of death was 18% with bare metal stents, 19% with DES, and 6% with coronary artery bypass grafting at 1 year.

Conclusions—
Among dialysis patients undergoing coronary revascularization, in-hospital mortality was higher after coronary artery bypass grafting, but long-term survival was superior with internal mammary grafts. In-hospital mortality was lower for DES patients, but the probability of repeat revascularization was higher and comparable to that in patients receiving a bare metal stent. Revascularization decisions for dialysis patients should be individualized.
Reducing Inconsistencies in Point Observations of Maximum Flood Inundation Level
Authors: Parkes Brandon L. , Cloke Hannah L. , Pappenberger Florian , Neal Jeff , Demeritt David 
Published: April 2013

Abstract
Flood simulation models and hazard maps are only as good as the underlying data against which they are calibrated and tested. However, extreme flood events are by definition rare, so the observational data of flood inundation extent are limited in both quality and quantity. The relative importance of these observational uncertainties has increased now that computing power and accurate lidar scans make it possible to run high-resolution 2D models to simulate floods in urban areas. However, the value of these simulations is limited by the uncertainty in the true extent of the flood. This paper addresses that challenge by analyzing a point dataset of maximum water extent from a flood event on the River Eden at Carlisle, United Kingdom, in January 2005. The observation dataset is based on a collection of wrack and water marks from two postevent surveys. A smoothing algorithm for identifying, quantifying, and reducing localized inconsistencies in the dataset is proposed and evaluated showing positive results. The proposed smoothing algorithm can be applied in order to improve flood inundation modeling assessment and the determination of risk zones on the floodplain.
Satellite Detection of Spatial Distribution and Temporal Changes of Surface Soil Moisture at Three Gorges Dam Region from 2003 to 2011
Authors: Du Jinyang , Liu Qiang 
Published: April 2013

Abstract
Knowledge of the spatial distribution and temporal changes of the land surface parameters at the Three Gorges Dam (TGD) region is essential to understanding the changes of hydrological processes and climate systems possibly brought by TGD. Based on accumulated observations for years from a spaceborne passive microwave radiometer, this study presents and analyzes the spatial and temporal distribution of soil moisture in the TGD region. Major drought and flood events are identified from the satellite-derived soil moisture products. Moreover, the areas around the largest freshwater lakes of China, the Dongting and Poyang Lakes, are frequently subjected to drought events, which might be partially related to the impoundment of TGD since the year 2006. Data analysis further reveals a statistically significant drying trend in May in the middle and lower reaches of the Yangtze River over the years 2003–11. These analyses indicate that water shortage becomes a realistic challenge for the once water abundant Yangtze River region, and more considerations on the possible consequences brought by climate changes are needed for the operation of TGD.
Comparison of PMP-Driven Probable Maximum Floods with Flood Magnitudes due to Increasingly Urbanized Catchment: The Case of American River Watershed
Authors: Yigzaw Wondmagegn , Hossain Faisal , Kalyanapu Alfred 
Published: April 2013

Abstract
Since historical (predam) data are traditionally the sole criterion for dam design, future (postdam) meteorological and hydrological variability due to land-use and land-cover change cannot be considered for assessing design robustness. For example, postdam urbanization within a basin leads to definite and immediate increase in direct runoff and reservoir peak inflow. On the other hand, urbanization can strategically (i.e., gradually) alter the mesoscale circulation patterns leading to more extreme rainfall rates. Thus, there are two key pathways (immediate or strategic) by which the design flood magnitude can be compromised. The main objective of the study is to compare the relative contribution to increase in flood magnitudes through direct effects of land-cover change (urbanization and less infiltration) with gradual climate-based effects of land-cover change (modification in mesoscale storm systems). The comparison is cast in the form of a sensitivity study that looks into the response to the design probable maximum flood (PMF) from probable maximum precipitation (PMP). Using the American River watershed (ARW) and Folsom Dam as a case study, simulated peak floods for the 1997 (New Year's) flood event show that a 100% impervious watershed has the potential of generating a flood that is close to design PMF. On the other hand, the design PMP produces an additional 1500 m3 s−1 peak flood compared to the actual PMF when the watershed is considered 100% impervious. This study points to the radical need for consideration future land-cover changes up front during the dam design and operation formulation phase by considering not only the immediate effects but also the gradual climatic effects on PMF. A dynamic dam design procedure should be implemented that takes into account the change of land–atmospheric and hydrological processes as a result of land-cover modification rather than relying on historical records alone.
Treatment of chronic venous disease with flavonoids: recommendations for treatment and further studies
Authors: Rabe E , Guex J-J , Morrison N , Ramelet A-A , Schuller-Petrovic S , Scuderi A , Staelens I , Pannier F 
Published: April 2013

Objectives: A variety of studies have suggested that flavonoids are effective for the treatment of CVD. However, many questions remain about their mechanism of action and when, how, and for what signs and symptoms they should be used. Method: A panel of experts in CVD met in Budapest, Hungary in December 2011 to discuss the current state of knowledge of CVD and the role of flavonoids in its treatment. The discussion was based on a literature search in the current databases. The goals of this paper are recommendations for further studies on the use of flavonoids in the treatment of CVD. Results: There is good evidence to recommend the use of flavonoids in the treatment of CVD. However, because of the poor quality of some older clinical trials, inadequate reporting, and insufficient information, much work is still needed to firmly establish their clinical efficacy and to determine when and how they should be employed. In particular, long-term randomized, placebo-controlled, double-blind studies are needed to establish the efficacy and safety of flavonoids. Additional studies are also needed to establish their mechanism of action, pharmacokinetics, toxicity, and cost-effectiveness. Conclusions: Aside from good evidence for the use of flavonoids in CVD further studies are indicated to establish long term treatment in this indication.
Comparison of endovenous laser ablation and high ligation and stripping for varicose vein treatment: a meta-analysis
Authors: Pan Y , Zhao J , Mei J , Shao M , Zhang J 
Published: April 2013

Objectives: To evaluate the efficiency and safety of endovenous laser ablation (EVLA) for primary lower extremity varicosities compared with high ligation and stripping (HLS). Method: Prospective non-randomized studies and randomized control trials on comparison of EVLA and HLS in treating varicose vein were included in this study. A meta-analysis on the data of suitable 13 clinical trials was performed using the Mantel–Haenszel method and the risk ratio was calculated. Thirteen studies including a total of 2245 limbs were eligible for inclusion. Among them, 1128 limbs were treated with endovenous laser ablation, whereas 1117 were treated with high ligation and stripping. Primary outcome measures were technical success rates and recurrence rates at different follow-up duration and complication rates. Results: No significant difference in initial technical success rates, Procedural failures were more common following EVLA compared with conventional surgery at one- and two-year follow-up. However, the duplex-detected and clinical recurrence rate was similar between conventional surgery and EVLA after one and two years. No statistical significance was found in postoperative phlebitis and bruise in EVLA and HLS (17.9% versus 21.5%). However, fewer complications were observed in EVLA compared with HLS, including bleeding and haematoma (1.28% versus 4.83%), wound infection (0.33% versus 1.91%) and paraesthesia (6.73% versus 11.27%). Conclusions: EVLA for varicose veins is safe and effective compared with HLS in a two-year range. More randomized controlled studies follow-up results are needed to clarify longterm recurrence (5 years).
Deep venous thrombosis among disaster shelter inhabitants following the March 2011 earthquake and tsunami in Japan: a descriptive study
Authors: Shibata M , Hanzawa K , Ueda S , Yambe T 
Published: April 2013

Objectives A retrospective analysis of data collected during subject screening following Japan's March 2011 earthquake and tsunami was performed. We aimed to determine the incidence of deep venous thrombosis (DVT) among screened subjects and to identify risk factors associated with the development of DVT as independent variables. Methods Calf ultrasonography was undertaken in 269 subjects living in 21 shelters in Miyagi prefecture during the one-month period immediately following the March 2011 disaster. Information regarding the health and risk factors of subjects was collected by questionnaire and assessment of physical signs. Results Of the 269 evacuees screened, 65 (24%) met the criteria for calf DVT. We found lower limb trauma, reduced frequency of urination and sleeping in a vehicle to be independent positive predictors of DVT. Conclusions Evacuees had an increased risk of developing DVT, associated with tsunami-related lower limb injury, immobility and dehydration.
Compression and venous ulcers
Authors: Stücker M , Link K , Reich-Schupke S , Altmeyer P , Doerler M 
Published: April 2013

Compression therapy is considered to be the most important conservative treatment of venous leg ulcers. Until a few years ago, compression bandages were regarded as first-line therapy of venous leg ulcers. However, to date medical compression stockings are the first choice of treatment. With respect to compression therapy of venous leg ulcers the following statements are widely accepted: (1) Compression improves the healing of ulcers when compared with no compression; (2) Multicomponent compression systems are more effective than single-component compression systems; (3) High compression is more effective than lower compression; (4) Medical compression stockings are more effective than compression with short stretch bandages. Healed venous leg ulcers show a high relapse rate without ongoing treatment. The use of medical stockings significantly reduces the amount of recurrent ulcers. Furthermore, the relapse rate of venous leg ulcers can be significantly reduced by a combination of compression therapy and surgery of varicose veins compared with compression therapy alone.
Dose-saving isolation procedure in percutaneous ethanol sclerotherapy for venous malformations
Authors: Kishi K , Morita N , Terada T , Sato M 
Published: April 2013

Objectives: To evaluate the feasibility and effectiveness of an isolation technique during ethanol injection sclerotherapy for venous malformations (VMs) in the head and neck region. Methods: The subjects were 23 patients with 35 VM lesions in the head and neck, treated between 1999 and 2012. The mean lesion area was 3.75 ± 3.09 cm2 (± standard deviation). We confirmed the contour of the lesions to be treated on a fully filled image on direct injection cisternography, and observed patterns of communicating drainage to systemic veins. The cisterns were evacuated by squeezing and were isolated by manual compression of the communicators. Ethanol (94.5%) with a contrast agent was then injected into both isolable and unisolable lesions, up to a total volume of 1 mL/cm2, avoiding complications. We investigated the relationship between lesion size and injected ethanol dose, and also dose per unit area. Results: Both manual evacuation by compression and isolation were performed in 20 (57.1%) isolable lesions, but not in 15 unisolable lesions. The mean injected ethanol dose was 0.65 ± 0.31 mL/cm2 overall, 0.70 ± 0.32 in isolable and 0.59 ± 0.30 in unisolable lesions (NS). However, the injected ethanol dose was significantly lower for lesions sized >6 cm. Complete to near-complete shrinkage was observed in all isolable lesions, and in 60% of unisolable lesions ( P < 0.05). Clinical outcome seemed unrelated to the injected ethanol dose or the dose per unit area. There was one case of recurrence and one complication in the unisolable lesions. No further relapses or complications were observed during the follow-up period of 38.6 ± 12.3 months. Conclusions: Clinical outcome was related to the isolability not to the injected dose. The isolation appears useful for improving the safety and effectiveness of ethanol sclerotherapy for VM.
Reflux time estimation on air-plethysmography may stratify patients with early superficial venous insufficiency
Authors: Lattimer C R , Kalodiki E , Azzam M , Geroulakos G 
Published: April 2013

Objectives It has been suggested that quantification of haemodynamic parameters of venous disease may complement clinical assessment and may help identify a group of patients with severe venous disease or alternatively patients with early venous disease. However, there has been very little work to prove this hypothesis. The venous filling index (VFI) of air-plethysmography (APG) can quantify severity and treatment effect but has limited discriminatory value. However, the components of the VFI, total venous volume (VV) and time to reach 90% of VV (VFT90), have never been fully studied. The aim was to investigate the contribution of VV and VFT90 to an elevated VFI and determine their relationship to great saphenous vein (GSV) diameter and clinical severity scoring. Method Ninety-three consecutive patients/legs (22–78 years) with primary GSV reflux (>0.5 seconds) awaiting endovenous treatment were recruited. CEAP (clinical, aetiological, anatomical and pathological elements) assessments were: 33 (35.5%) C2, 14 (15.0%) C3, 29 (31.2%) C4a, 5 (5.4%) C4b, 7 (7.5%) C5 and 5 (5.4%) C6. The median venous clinical severity score (VCSS) was 6 (2–20) and the averaged GSV diameter at three sites was 7.5 mm (4–12). The VFI, VV and VFT90 were recorded using APG. Results There was no correlation between the VV and the VFT90 ( r = −0.103, P = 0.324). The VFI, VV and VFT90 significantly correlated ( P < 0.0005, Spearman) with the GSV diameter: r = 0.623, r = 0.567, r = −0.432, respectively, and the C of CEAP ( P < 0.05): r = 0.4, r = 0.225, r = −0.343, respectively. None of the 25 (26.9%) patients with a VFT90 > 25 seconds were among the 17 (18.3%) patients in categories C4b–6 or with a VCSS > 9 ( P = 0.005, Fisher's exact test, corrected odds ratio: 17.3). Conclusions The VFT90 complements the VFI as a marker of severe superficial venous insufficiency. However, in contrast to the VFI, it may have discriminatory value in stratifying patients with early disease into two groups based on the severity of haemodynamic impairment.
Short-term gain for long-term pain? Which patients should be treated and should we ration?
Authors: Lane T R A , Dharmarajah B , Kelleher D , Franklin I J , Davies A H 
Published: April 2013

Objectives: Treatments of common conditions which do not affect mortality often become sidelined in the drive to improve efficiency and reduce costs. The rationing of patients is a divisive but crucial component to universal health care. How should this be accomplished? Methods and Results: In this article we examine the outcomes of various rationing methods in varicose veins. Conclusions: No method is perfect and treatment of symptoms and complications should remain the target for all physicians.
Patterns of reflux in the great saphenous vein system
Authors: Chastanet S , Pittaluga P 
Published: April 2013

Objective: To report the patterns of reflux in the great saphenous vein as well as to investigate the correlations between patterns of reflux, the demographics and the clinical findings in the population studied. Methods: A total of 1882 limbs were assessed by duplex ultrasound examination in 1449 patients (348 men and 1101 women). Ages ranged from 21 to 94 years (mean 51.8). The presence of symptoms of venous disease (aching, heaviness, night cramps, swelling, itching, burning, tingling and throbbing) and clinical signs were recorded. Results: Varicose veins without saphenous reflux occurred at a younger age (43 versus 55.6 years P < 0.05). The presence of incompetence at the saphenofemoral junction occurred in older patients (58.5 versus 54.1 years P < 0.05). Venous reflux to the ankle also occurred in older patients (mean 64.0 years P < 0.05). Saphenous vein reflux without clinical varices was associated with more advanced signs (C4–C6: 20.3% P < 0.05). A younger age was associated with less advanced signs (C0–C2:49.4 versus C4–C6: 60.1 years P < 0.05). Presence of symptoms was associated with advancing patient age (51.1 versus 49.1 years P < 0.05). Conclusions: A significant correlation between the extent of great saphenous vein reflux and the patient age and the clinical stage of SVI has been observed in this study. The authors hypothesize that these findings support the concept of early treatment of venous insufficiency before symptomatic and physiological deterioration occurs.
Microcirculatory changes in venous disease
Authors: Huisman L C , Den Bakker C , Wittens C H A 
Published: April 2013

Objective: The aim of this study was to investigate the feasibility to measure microcirculatory blood flow changes in patients with venous ulcers, by using the laser speckle imaging. Methods: Nine patients with a leg ulcer were measured with the laser speckle imager in a sitting position before and after mimicking venous hypertension, with the legs raised, by applying a blood pressure cuff and inflating it to 60 mmHg. Results: The results were inconclusive, due to the fact that a lot of practical problems interfered with the measurements, e.g. movement artefacts and inadequate wound visualisation. Conclusion: The additional value of laser speckle imaging in daily practice for wound care still remains an important question for further research. A reliable, reproducible microcirculation measurement in venous ulcers might predict venous ulcer healing and recurrence and therefore would be a valuable diagnostic tool in daily practice.
Intralesional copper wire retention and pingyangmycin injection: an effective combinational therapy for complex venous malformation in soft tissue
Authors: Yuan S-M , Hong Z-J , Jiang H-Q , Wang J , Hu X-B 
Published: April 2013

Objectives: Complex venous malformations (VMs) may extensively involve the soft tissue. The treatment remains a challenge till now. Here we introduce a combinational therapy of copper wires and pingyangmycin (bleomycin A5, PYM). Methods: Copper wires were retained in VMs by repeated penetration with a straight needle. Subsequently, PYM solution was injected into the lesion. Eight to 10 days later, copper wires were removed. The dressing was changed every day until the puncture pores healed. Magnetic resonance imaging scanning was performed to observe the change of VMs. Results: From January 2001 to December 2011,56 patients were treated. During the follow-up period, most of the VMs shrunk obviously. The symptoms were relieved or disappeared. The complications included local pain, temporary paraesthesia and moderate fever, which disappeared quickly after the removal of copper wires. Conclusions: This combinational therapy is a safe and effective approach for the complex VMs in soft tissue.
Sex steroid hormones are not altered in great saphenous veins after varicose vein treatment in male patients
Authors: Kendler M , Kratzsch J , Wetzig T , Simon J C 
Published: April 2013

Objective: The objective of this study was to assess differences in blood samples (sex steroid hormone levels and blood counts) before and after surgical treatment of incompetent great saphenous veins (GSV) in males. Methods: Antecubital vein and GSV blood samples were taken from 11 men with varicose veins and GSV reflux before and after treatment. Six patients were treated with high ligation, stripping and phlebectomy. Five patients were treated with endoluminal radiofrequency ablation and phlebectomy. After a four-year follow-up period (FU) cubital vein and GSV blood samples were taken again. Results: In men with varicose veins, significantly higher ( P < 0.05) serum testosterone (median 25.18 nmol/L, range 8.82–225.1) and oestradiol (median 179 pmol/L, range 79–941) levels were found in the saphenous vein samples before and after the FU (testosterone 18.8 nmol/L, range 7.96–83.1, oestradiol 171 pmol/L range 125–304) compared with the cubital vein samples before therapy (testosterone 15.72 nmol/L, range 8.36–23.29; oestradiol 84 pmol/L, range 41–147) and after the FU (testosterone 14.5 nmol/L, range 6.10–22.2, oestradiol 117 pmol/L, range 95–165). After the FU, one patient demonstrated recurrent varicose veins with groin neovascularization. Another presented with axial reflux of the anterior accessory saphenous vein. Further differences in blood counts and serum androstenedione levels between the upper and lower extremities were not detected. Conclusion: The differences between testosterone and oestradiol levels in the leg veins compared with the cubital veins persist after treating men with refluxing saphenous veins. These results suggest that local hormone regulation may be different between leg and arm veins in men with varicose veins.