bluuebunny/crossref_metadata_2025_split huggingface dataset:
A feasibility randomised controlled trial of pre-operative occupational therapy to optimise recovery for patients undergoing primary total hip replacement for osteoarthritis (PROOF-THR)
Authors: Jepson Paul , Sands Gina , Beswick Andrew D , Davis Edward T , Blom Ashley W , Sackley Catherine M 
Published: March 2015

Objective: To assess the feasibility of a pre-operative occupational therapy intervention for patients undergoing primary total hip replacement. Design: Single blinded feasibility randomised controlled trial, with data collection prior to the intervention, and at 4, 12, and 26 weeks following surgery. Setting: Recruitment from two NHS orthopaedic outpatient centres in the West Midlands, UK. Subjects: Patients awaiting primary total hip replacement due to osteoarthritis were recruited. Following pre-operative assessment, patients were individually randomised to intervention or control by a computer-generated block randomisation algorithm stratified by age and centre. Interventions: The intervention group received a pre-surgery home visit by an occupational therapist who discussed expectations, assessed home safety, and provided appropriate adaptive equipment. The control group received treatment as usual. Outcomes: The study assessed the feasibility of recruitment procedures, delivery of the intervention, appropriateness of outcome measures and data collection methods. Health related quality of life and resource use were recorded at 4, 12 and 26 weeks. Results: Forty-four participants were recruited, 21 were randomised to the occupational therapy intervention and 23 to usual care. Analysis of 26 week data included 18 participants in the intervention group and 21 in the control. The intervention was delivered successfully with no withdrawals or crossovers; 5/44 were lost to follow-up with further missing data for participation and resource use. Conclusions: The feasibility study provided the information required to conduct a definitive trial. Burden of assessment would need to be addressed. A total of 219 patients would be required in an efficacy trial.
PET/CT findings for tumors in the base of the skull: comparison of 18 F-FDG with 11 C-methionine
Authors: Tomura Noriaki , Mizuno Yasuaki , Saginoya Toshiyuki 
Published: March 2015

Background Positron emission tomography/computed tomography (PET/CT) using 18 F-fluorodeoxyglucose (FDG) has been used to characterize various malignancies. There are few reports regarding the use of 11 C-methionine (MET)-PET/CT to characterize tumors in the skull base. Purpose To compare MET-PET/CT with FDG-PET/CT in cases of tumors of the skull base. Material and Methods Both MET-PET/CT and FDG-PET/CT were performed in 27 patients with tumors of the skull base. In all cases, pathology was determined by surgery or biopsy. The images were visually and independently reviewed by two reviewers. For qualitative analysis, the inter-rater agreement between two reviewers was measured. For semi-quantitative evaluation, the tumor-to-normal brain uptake ratios (T/N ratios) were calculated by dividing the maximum of standardized uptake value (SUVmax) for the tumor by the SUVmax of the normal contra-lateral cerebellar hemisphere. Difference in T/N ratios between FDG-PET/CT and MET-PET/CT was analyzed for statistical significance. Results On qualitative evaluation, the inter-rater agreement of MET-PET/CT was superior than that of FDG-PET/CT. MET uptake was interpreted as positive in every tumor by both reviewers. MET-PET/CT had a significantly higher T/N ratio than FDG-PET/CT (2.96 ± 1.25 vs. 1.02 ± 0.54, respectively; P < 0.001). Conclusion MET-PET/CT showed superior inter-rater agreement and had higher uptake for tumors at the skull base than FDG-PET/CT. The present study suggests that MET-PET/CT has superior potential for imaging of tumors of the skull base.
CT findings after lipiodol marking performed before video-assisted thoracoscopic surgery for small pulmonary nodules
Authors: Miura Hiroshi , Yamagami Takuji , Tanaka Osamu , Yoshimatsu Rika , Ichijo Yusuke , Kato Daishiro , Shimada Junichi 
Published: March 2015

Background In preoperative lipiodol marking for small pulmonary nodules, lipiodol has a potential risk of distribution in the surrounding lung structure. There are no reports about the detailed accumulation and distribution of lipiodol. Purpose To evaluate computed tomography (CT) findings after lipiodol marking before thoracoscopic surgery for pulmonary nodules. Material and Methods Sixty-four consecutive CT-guided lipiodol markings for 103 nodules were performed in 55 patients. Lipiodol (0.2–0.4 mL) was injected using a 21-gauge needle near the nodule. The appearance of lipiodol spots was classified into the following three types on CT: type 1, dense; type 2, punctate; and type 3, unclear. The distribution of lipiodol was also investigated. Statistical analyses were performed on the accumulation and distribution related to nodule factors. Incidences of complications were also investigated. Results A total of 110 markings were performed because of seven additional procedures due to insufficient marking. All nodules were successfully resected on the same day. The appearances of the lipiodol spots were type 1 (82%), type 2 (11%), and type 3 (7.3%). The areas of distribution were lung parenchyma (54%), central bronchus (39%), peripheral bronchovascular bundle (24%), needle tract (20%), pleural space (19%), another segment of ipsilateral lung (5.5%), and contralateral lung (0.9%). Distribution into pleural space and central bronchus was frequently seen in the shallow nodules ( P < 0.05). Complications were pneumothorax (61%) and pulmonary hemorrhage (35%). There were no serious symptoms. Conclusion The appearance of the lipiodol spot was dense in most cases, despite frequent distribution in the surrounding lung structures without serious complications.
White matter microstructure abnormalities in pediatric migraine patients
Authors: Messina Roberta , Rocca Maria A , Colombo Bruno , Pagani Elisabetta , Falini Andrea , Comi Giancarlo , Filippi Massimo 
Published: March 2015

Background Diffusion tensor (DT) magnetic resonance imaging (MRI) provides several quantities with the potential to disclose white matter (WM) microstructural abnormalities. We explored alterations of WM architecture in pediatric migraine patients using DT MRI and two different methods of analysis. Methods Dual-echo and DT MRI scans were acquired from 15 pediatric migraine patients and 15 age-matched controls. Whole-brain voxel-wise comparisons of WM DT MRI abnormalities were performed using tract-based-spatial-statistics (TBSS). A DT probabilistic tractography analysis was also run. Results Both TBSS and DT tractography analysis showed that, compared to controls, pediatric migraine patients had significant lower mean (MD), axial (AD) and radial (RD) diffusivity of WM tracts located in the brainstem, thalamus and fronto-temporo-occipital lobes, bilaterally. Patients also experienced increased fractional anisotropy (FA) of the optic radiations. No correlation was found between WM tract abnormalities and disease duration and attack frequency. Conclusions Pediatric migraine patients harbor diffuse brain WM microstructural abnormalities. High FA and low MD, AD and RD in these patients might be explained by repeated neuronal activation, which may lead to cell swelling and stimulate activity-dependent myelin-modulation, or by increased fiber and dendritic densities. Both these mechanisms might reflect a hyperexcitability of the brain in migraineurs.
The Preventive Effect of the Nordic Hamstring Exercise on Hamstring Injuries in Amateur Soccer Players
Authors: van der Horst Nick , Smits Dirk-Wouter , Petersen Jesper , Goedhart Edwin A. , Backx Frank J.G. 
Published: March 2015

Background: Hamstring injuries are the most common muscle injuries in soccer, and they have a high rate of recurrence. Eccentric hamstrings strength is recognized as an important modifiable risk factor. This led to the development of prevention exercises such as the nordic hamstring exercise (NHE). The effectiveness of the NHE on hamstring injury prevention has never been investigated in amateur soccer. Purpose: To investigate the preventive effect of the NHE on the incidence and severity of hamstring injuries in male amateur soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Male amateur soccer players (age, mean ± SD, 24.5 ± 3.8 years) from 40 teams were randomly allocated to an intervention (n = 20 teams, 292 players) or control group (n = 20 teams, 287 players). The intervention group was instructed to perform 25 sessions of NHE in a 13-week period. Both the intervention and control groups performed regular soccer training and were followed for hamstring injury incidence and severity during the 2013 calendar year. At baseline, personal characteristics (eg, age, injury history, field position) were gathered from all participants via a questionnaire. Primary outcome was injury incidence. Secondary outcomes were injury severity and compliance with the intervention protocol. Results: A total of 38 hamstring injuries were recorded, affecting 36 of 579 players (6.2%). The overall injury incidence rate was 0.7 (95% CI, 0.6-0.8) per 1000 player hours, 0.33 (95% CI, 0.25-0.46) in training, and 1.2 (95% CI, 0.82-1.94) in matches. Injury incidence rates were significantly different between the intervention (0.25; 95% CI, 0.19-0.35) and control groups (0.8; 95% CI, 0.61-1.15), χ2(1, n = 579) = 7.865; P = .005. The risk for hamstring injuries was reduced in the intervention group compared with the control group (odds ratio, 0.282; 95% CI, 0.110-0.721) and was statistically significant ( P = .005). No statistically significant differences were identified between the intervention and control groups regarding injury severity. Compliance with the intervention protocol was 91%. Conclusion: Incorporating the NHE protocol in regular amateur training significantly reduces hamstring injury incidence, but it does not reduce hamstring injury severity. Compliance with the intervention was excellent.
Trajectory of Externalizing Child Behaviors in a KEEP Replication
Authors: Uretsky Mathew C. , Lee Bethany R. , Greeno Elizabeth J. , Barth Richard P. 
Published: March 2015

Objective: The purpose of this study is to examine the correlates of child behavior change over time in a replication of the KEEP intervention. Method: The study sample was drawn from the treatment group of the Maryland replication of KEEP (n=65). Change over time was analyzed using multilevel linear mixed modeling. Results: Parents’ use of positive reinforcement relative to discipline was associated with the rate of child behavior change among program participants; parents with the lowest initial levels of reinforcement reported the greatest decrease in child problem behaviors. Other participant characteristics were not associated with child behavior change during the study period. Conclusions: The results indicate the efficacy of an evidence-based foster parent training program for reducing child problem behaviors and underscore the utility of teaching parents to use more positive responses relative to discipline as a robust path to improved child outcomes.
The Prevalence of Neuropathic Pain in Terminally Ill Patients With Cancer Admitted to a Palliative Care Unit
Authors: Harada Shinsuke , Tamura Fumihiko , Ota Shuhei 
Published: March 2015

Objective: The primary aim of this study was to determine the prevalence of neuropathic pain (NP) in patients with cancer receiving palliative care. Methods: In this prospective observational study, terminally ill patients with cancer having NP were identified by a pain management clinician using the diagnostic algorithm of NP from the International Association for the Study of Pain on the day of admission. Results: A total of 220 patients who were hospitalized in the palliative care unit were enrolled in this study. The median survival times were 21.5 days (range, 0-173 days), and 57.7% of patients were male. Among the 220 patients, 41 (18.6%; 95% confidence interval, 13.5%-23.8%) developed NP. Conclusion: The prevalence of NP in terminally ill patients with cancer in Japanese palliative care units was 18.6%.
Mid- to Long-term Clinical Outcome and Gait Biomechanics After Realignment Surgery in Asymmetric Ankle Osteoarthritis
Authors: Nüesch Corina , Huber Cora , Paul Jochen , Henninger Heath B. , Pagenstert Geert , Valderrabano Victor , Barg Alexej 
Published: March 2015

Background: Joint-preserving, realignment surgical procedures have gained increasing popularity as treatment of asymmetric early- and mid-stage ankle osteoarthritis. The aim of the present study was to quantify bilateral gait biomechanics in patients who underwent ankle realignment surgery by supramalleolar osteotomies. Methods: Eight patients, a minimum of 7 years after realignment surgery, and 8 healthy controls were included in this study. Three-dimensional instrumented gait analysis was used to assess spatiotemporal parameters, bilateral joint angles, and moments. Furthermore, a clinical evaluation on pain, ankle function, and quality of life was performed. Results: Compared with the healthy controls, the patients walked more slowly, had a smaller sagittal hindfoot range of motion on their affected leg, and had a lower peak ankle dorsiflexion moment ( P < .05). There were no significant differences compared with controls for the ranges of motion in the foot segments of the nonaffected foot and for the knee and hip joint ranges of motion and peak moments of both legs. Additionally, patients and controls did not differ in the quality of life score. However, in the pain subscore, the patients reported significantly more pain than the healthy persons. Conclusion: Despite different gait biomechanics of the affected foot after ankle realignment surgery, the quality of life for patients was comparable to that of healthy controls. Therefore, supramalleolar osteotomies should be considered as a promising treatment option in patients with asymmetric non-end-stage ankle osteoarthritis. Level of Evidence: Level III, comparative study.
Comparative Investigation of Postoperative Complications in Patients With Gastroesophageal Junction Cancer Treated With Preoperative Chemotherapy or Surgery Alone
Authors: Achiam M. P. , Jensen L. B. , Larsson H. , Jensen L. S. , Larsen A. C. , Holm J. , Svendsen L. B. 
Published: March 2015

Background and aim: Gastroesophageal junction cancer is one of the leading causes to cancer-related death and the prognosis is poor. However, progress has been made over the last couple of decades with the introduction of multimodality treatment and optimized surgery. Three-year survival rates have improved to 50% in patients receiving neoadjuvant therapy. Only a few studies have focused on the difference of postoperative complications in patients receiving neoadjuvant therapy in relation to a comparative surgery-only group. The aim of this study was to compare the prevalence of postoperative complications of patients with cancer at the gastroesophageal junction treated with either neoadjuvant chemotherapy or surgery alone in patients from “The Danish Clinical Registry of Carcinomas of the Esophagus, the Gastro-Esophageal Junction and the Stomach.” Materials and methods: A historical follow-up study, comparing postoperative complications between two cohorts before and after implementation of chemotherapy was completed. Results: In all, 180 consecutive patients treated with perioperative chemotherapy and a comparative surgery-only group of patients were identified from The Danish Clinical Registry of Carcinomas of the Esophagus, the Gastro-Esophageal Junction and the Stomach. No difference was found in demographics between the two groups, except for alcohol consumption and a lower T and N stage in the surgery-only group, and no difference in complication rates was found. Furthermore, no variable in the multivariate analysis was significantly associated with anastomotic leakage which was considered the most severe complication. Conclusion: Since perioperative chemotherapy does not appear to increase surgical complications, the future challenges include defining the optimal combination of chemo- and/or radiotherapy, but more importantly also to select the patients who will benefit the most from the different neoadjuvant strategies.
Losartan treating podocyte injury induced by Ang II via downregulation of TRPC6 in podocytes
Authors: Chi-Xianggeng  , Hu-Bo  , Yu SY , Yin-Lianghong  , Meng-Yu  , Wang-Boxun  , Yang-Jinsheng  , Lin-Jiahui  , Huang-Dexu  , Chen-lanlan  
Published: March 2015

Objective: In this study, we investigated the molecule mechanisms of podocyte injury and proteinuria and the protective effects of losartan. Methods: This study set up three groups: a control group; an Ang II group (Ang II 10–6 mol/l, Sigma); and a losartan group (losartan 10–6 mol/l, Sigma). We used RT-PCR assay to detect TRPC6 mRNA expression, and Western blot to detect TRPC6 protein expression. Results: TRPC6 overexpression was the basic change of podocyte injury and proteinuria occurrence. Losartan can treat podocyte injury and proteinuria induced by Ang II via downregulation of TRPC6 in podocytes. Conclusion: These findings maybe provide an ideal drug target for the diagnosis and treatment of acquired glomerular diseases.
Transient Contrast Encephalopathy after Carotid Artery Stenting
Authors: Dangas George , Monsein Lee H. , Laureno Robert , Peterson Michael A. , Laird John R. , Satler Lowell F. , Mehran Roxana , Leon Martin B. 
Published: March 2015

Purpose: To report an unusual case of transient contrast encephalopathy arising after carotid artery stenting. Case Report: An 82-year-old right-handed man with a recent history of transient ischemic events was admitted to the hospital for evaluation of carotid artery disease. During cerebral angiography, which identified a 90% right internal carotid artery stenosis, the patient received 25 mL of an ionic, low-osmolar contrast agent (ioxaglate) in each carotid artery. The following day he underwent successful carotid stenting, during which 180 mL of ioxaglate were used. He developed rapidly worsening confusion and left hemiparesis on the table. Noncontrast computed tomography showed marked cortical enhancement and edema of the right cerebral hemisphere in the distribution of the right anterior and middle cerebral arteries. The patient improved rapidly and by day 2 was completely recovered; magnetic resonance imaging documented no cortical edema and normal sulci. One month after the procedure, he was well, with patent carotid arteries. Conclusions: Transient neurotoxicity after carotid interventions must be differentiated from massive cerebral infarction and hyperperfusion syndrome, but the prognosis is excellent. However, subsequent contrast studies in a patient with this complication should be undertaken with extreme caution.
Neutrophil Respiratory Burst Activity and Pro- and Anti-inflammatory Cytokines in AAA Surgery: Conventional versus Endoluminal Treatment
Authors: Parodi Juan C. , Ferreira L. Mariano , Fornari M. Cecilia , Berardi Vanina E. , Diez Roberto A. 
Published: March 2015

Purpose: To examine the inflammatory impact of endovascular and conventional surgery of abdominal aortic aneurysm (AAA) as assessed by the activation of neutrophils and serum levels of pro- and anti-inflammatory cytokines. Methods: Twenty-four patients undergoing AAA exclusion were treated with either endovascular (n = 14) or conventional (n=10) techniques. Clinical and hematological data, respiratory burst of neutrophils, and the expression of adhesion and activation molecules (CD18, CD11b, CD69, and HLA-DR) were analyzed by flow cytometry. The enzyme-linked immunosorbent assay technique was used to measure proinflammatory cytokine interleukin (IL)–8 and anti-inflammatory cytokines IL-1 receptor antagonist (IL-1RA) and transforming growth factor β1 (TGF-β1). Results: All patients, most of whom had normal cytokine values before surgery, were successfully treated. No significant changes were found in surface antigens. Basal respiratory burst was quite heterogeneous; in all cases respiratory burst activity decreased after surgery and remained low throughout the observation period. Despite marked interpatient differences, IL-1RA and IL-8 increased after surgery, whereas TGF-β1 decreased, although the variation achieved statistical significance only in the conventional group. Elevated IL-1RA returned to normal within 48 hours in the endoluminal group, whereas the level remained high in the conventional group in the last sample. Conclusions: Despite heterogeneity before surgery, the respiratory burst decreased for most of the patients regardless of the approach, and both techniques increased IL-1RA. Although both procedures seemed to decrease TGF-β1, the difference was significant only with the conventional approach. IL-1RA levels fell toward basal values quicker in the endograft patients, suggesting that the endoluminal approach was less aggressive.
Endovascular Repair of AAA Rupture 20 Months after Endoluminal Stent-Grafting
Authors: Ramaiah Venkatesh G. , Thompson Charles S. , Rodriguez-Lopez Julio A. , DiMugno Leanne , Olsen Dawn , Diethrich Edward B. 
Published: March 2015

Purpose: To demonstrate the feasibility of endovascular repair of a ruptured abdominal aortic aneurysm (AAA) previously treated with an endoluminal stent-graft. Case Report: An 84-year-old man with a 9.5-cm AAA underwent endoluminal repair with an Endologix stent-graft, but a type I endoleak was detected postprocedurally. The patient was discharged and lost to follow-up. Twenty months later, he suffered an aneurysm rupture, which was repaired using endovascular techniques. Although he had a postoperative course complicated by aspiration pneumonia and renal failure, he recovered fully and was discharged from the hospital with no evidence of endoleak on the postprocedural imaging studies. Conclusions: Late ruptures after endoluminal AAA stent-grafting can be successfully treated with endovascular techniques.
Abdominal Pain and Hemoperitoneum: Sole Presenting Symptoms for “Leaking AAA” after Endovascular Repair
Authors: White Rodney A. , Donayre Carlos E. , Walot Irwin , Kopchok George , Woody Jonathan 
Published: March 2015

Purpose: To describe an unusual presentation of impending aortic endograft rupture and successful endovascular rescue. Case Report: A 77-year-old man with an enlarging aortic aneurysm was treated with a Talent bifurcated endoprosthesis; a moderate endoleak that appeared to be related to either proximal or distal fixation sites was noted in the body of the aneurysm. The patient was observed for 1 month, and repeat imaging demonstrated persistent endoleak without major increase in the aneurysm diameter. Another examination was scheduled for 3 months hence, but, 2 months later, the patient presented with abdominal pain and a hemoperitoneum. A proximal extension cuff resolved the leak and led to resolution of the hemoperitoneum. Conclusions: A leaking aneurysm can be repaired using endovascular techniques in patients with an existing endograft. The need for frequent imaging surveillance of patients with endoleak is underscored.