bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermal sealing systems with and without tissue divider for total thyroidectomy
Authors: Glover Anthony R. , Gundara Justin S. , Lee James C. , Sywak Mark S. , Delbridge Leigh W. , Sidhu Stan B. 
Published: October 2013

AbstractBackgroundSutureless thyroid surgery utilizing thermal sealing is now well established. However, incremental advances in technology still require formal clinical evaluation in order to ensure that added technology does not compromise safety. In this study, we compared a new thermal sealing device incorporating a tissue divider (LigaSure Small Jaw) with the device we have previously reported for use in total thyroidectomy (LigaSure Precise).MethodsA cohort study was undertaken of 872 total thyroidectomies over a 2‐year period. Patients were selected for each group on the basis of device availability within four institutions and outcomes were obtained from a prospectively maintained database.ResultsSmall Jaw was used in 399 cases and Precise in 473. No significant differences between patient demographics (sex, age), operation indication or pathology were found. Significantly more Small Jaw operations were performed in private versus public hospitals (P < 0.01). Regarding outcomes, there was no significant difference in the incidence of any complication (haematoma, temporary/permanent hypoparathyroidism or temporary/permanent recurrent laryngeal nerve injury). In a subgroup analysis of operations performed in the public hospital system, Small Jaw was found to be significantly faster (mean operative time: 79 versus 103 min) (95% CI 74–84 and 96–110 min) (P < 0.01).ConclusionThe incorporation of a tissue divider into thermal sealing devices is efficacious and safe, with no compromise in clinical outcome, while providing the added benefit of a significant reduction in operative times.
Predictive value of C‐reactive protein with Alvarado score in acute appendicitis
Authors: Thirumallai Siva , Wijesuriya Suraj Ruwan , Mitchell Andrew , Delriviere Luc 
Published: October 2013

AbstractBackgroundThe aim of the study was to evaluate whether C‐reactive protein (CRP) level on admission could aid the diagnostic accuracy of Alvarado score in acute appendicitis.MethodsWe retrospectively evaluated hospital records and database of 234 patients (men 116, women 118, median age 28 years, range 15–87 years) who underwent appendicectomy for acute appendicitis. Patients were categorized into three groups retrospectively based on the Alvarado score. Group I: score 7–10 (n = 155), group II: score 4–6 (n = 71), group III: score less than 3 (n = 10). Negative (NPV) and positive predictive values (PPV) of CRP was calculated.ResultsOverall, 169 of 234 (72.2%) had histopathological confirmation of acute appendicitis. The predicted accuracy of Alvarado score was 84.5% in group I, 50.7% in group II and 25% in group III. The PPV of high CRP and NPV of normal CRP for group I was 88% and 36.4%, in group II, 63% and 72%, in group III, 33% and 86%, respectively.ConclusionThe Alvarado score and CRP taken together improve the predictive value of diagnosing acute appendicitis. Having a normal CRP in the equivocal group of Alvarado 4–6, should be further evaluated by advanced imaging before proceeding to appendicectomy.
Maternal obesity and induction of labor
Authors: O'Dwyer Vicky , O'Kelly Sarah , Monaghan Bernadette , Rowan Ann , Farah Nadine , Turner Michael J. 
Published: October 2013

AbstractObjectiveTo review induction of labor analyzed by body mass index (BMI) category in primigravidas and multigravidas.DesignProspective observational study.PopulationWomen enrolled after sonographic confirmation of singleton pregnancy in the first trimester.SettingLarge university teaching hospital.MethodsMaternal height and weight were measured accurately before BMI calculation. Clinical details were recorded after review of individual obstetric records.Main outcome measuresEmergency cesarean section and obstetric interventions.ResultsOf 2000 women enrolled, 50.4% (n = 1008) were primigravidas and 17.3% (n = 346) were obese. The induction rate was 25.6% and the overall cesarean section rate 22.0%. Primigravidas were more likely to have labor induced than multigravidas (38.1% vs. 23.4%, p < 0.001). Compared with women with a normal BMI, obese primigravidas but not obese multigravidas were more likely to have labor induced. In primigravidas who had labor induced, the cesarean section rate was 20.6% (91/442) compared with 8.3% (17/206) in multigravidas who had labor induced (p < 0.001). In obese primigravidas, induction of labor was also more likely to be associated with other interventions such as epidural analgesia, fetal blood sampling and emergency cesarean section. In contrast, induction of labor in obese multigravidas was not only less common but also not associated with an increase in other interventions compared with multigravidas with a normal BMI.ConclusionsDue to the short‐term and long‐term implications of an unsuccessful induction in an obese primigravida, we recommend that induction of labor should only be undertaken for strict obstetric indications after careful consideration by an experienced clinician.
Recognition of Objects in Simulated Irregular Phosphene Maps for an Epiretinal Prosthesis
Authors: Lu Yanyu , Wang Jing , Wu Hao , Li Liming , Cao Xun , Chai Xinyu 
Published: October 2013

AbstractVisual prostheses offer a possibility of restoring vision to the blind. It is necessary to determine minimum requirements for daily visual tasks. To investigate the recognition of common objects in daily life based on the simulated irregular phosphene maps, the effect of four parameters (resolution, distortion, dropout percentage, and gray scale) on object recognition was investigated. The results showed that object recognition accuracy significantly increased with an increase of resolution. Distortion and dropout percentage had significant impact on the object recognition; with the increase of distortion level and dropout percentage, the recognition decreased considerably. The accuracy decreased significantly only at gray level 2, whereas the other three gray levels showed no obvious difference. The two image processing methods (merging pixels to lower the resolution and edge extraction before lowering resolution) showed significant difference on the object recognition when there was a high degree of distortion level or dot dropout.
Reproduction of Continuous Flow Left Ventricular Assist Device Experimental Data by Means of a Hybrid Cardiovascular Model With Baroreflex Control
Authors: Fresiello Libera , Zieliński Krzysztof , Jacobs Steven , Di Molfetta Arianna , Pałko Krzysztof Jakub , Bernini Fabio , Martin Michael , Claus Piet , Ferrari Gianfranco , Trivella Maria Giovanna , Górczyńska Krystyna , Darowski Marek , Meyns Bart , Kozarski Maciej 
Published: October 2013

AbstractLong‐term mechanical circulatory assistance opened new problems in ventricular assist device—patient interaction, especially in relation to autonomic controls. Modeling studies, based on adequate models, could be a feasible approach of investigation. The aim of this work is the exploitation of a hybrid (hydronumerical) cardiovascular simulator to reproduce and analyze in vivo experimental data acquired during a continuous flow left ventricular assistance. The hybrid cardiovascular simulator embeds three submodels: a computational cardiovascular submodel, a computational baroreflex submodel, and a hydronumerical interface submodel. The last one comprises two impedance transformers playing the role of physical interfaces able to provide a hydraulic connection with specific cardiovascular sites (in this article, the left atrium and the ascending/descending aorta). The impedance transformers are used to connect a continuous flow pump for partial left ventricular support (Synergy Micropump, CircuLite, Inc., Saddlebrooke, NJ, USA) to the hybrid cardiovascular simulator. Data collected from five animals in physiological, pathological, and assisted conditions were reproduced using the hybrid cardiovascular simulator. All parameters useful to characterize and tune the hybrid cardiovascular simulator to a specific hemodynamic condition were extracted from experimental data. Results show that the simulator is able to reproduce animal‐specific hemodynamic status both in physiological and pathological conditions, to reproduce cardiovascular left ventricular assist device (LVAD) interaction and the progressive unloading of the left ventricle for different pump speeds, and to investigate the effects of the LVAD on baroreflex activity. Results in chronic heart failure conditions show that an increment of LVAD speed from 20 000 to 22 000 rpm provokes a decrement of left ventricular flow of 35% (from 2 to 1.3 L/min). Thanks to its flexibility and modular structure, the simulator is a platform potentially useful to test different assist devices, thus providing clinicians additional information about LVAD therapy strategy.
Short‐Term In Vivo Performance of the Cleveland Clinic PediPump Left Ventricular Assist Device
Authors: Fumoto Hideyuki , Shiose Akira , Flick Christine R. , Noble Lawrence D. , Dudzinski David T. , Casas Fernando , Takaseya Tohru , Arakawa Yoko , Fukamachi Kiyotaka , Smith William A. , Duncan Brian W. 
Published: October 2013

AbstractThe PediPump was implanted in six healthy lambs (mean 25.6 ± 1.4 kg) between the left ventricular apex and the descending aorta to evaluate in vivo performance for up to 30 days. Anticoagulation was achieved by continuous heparin infusion. Three animals were euthanized prematurely, two because of respiratory dysfunction and one because of deteriorating pump performance resulting from thrombus formation inside the pump. Three lambs were electively sacrificed 30 days after implantation; all had stable hemodynamics and minimal hemolysis, as indicated by low plasma free hemoglobin (2.5 ± 3.1 mg/dL). Mean 30‐day pump flow was 1.8 ± 0.1 L/min at a pump speed of 12 200 ± 400 rpm. Neither activated clotting time nor activated partial thromboplastin time followed the changes in heparin dose. At necropsy, depositions were observed at the front (n = 1) and rear rotor axial positioning stops (n = 4); improved polishing techniques on the stationary stop surfaces and the addition of a hard‐carbon, thin‐film coating on the rotating stop of the pumps used for the last two experiments addressed the deposition seen earlier. In conclusion, the PediPump showed excellent hydraulic performance and minimal hemolysis during support for up to 30 days. Depositions observed at the axial positioning stops in earlier experiments were addressed by design and material refinements. We continue to focus on developing effective anticoagulation management in the lamb model as well as on further evaluating and demonstrating pump biocompatibility.
Flow Dynamics of Different Adult ECMO Systems: A Clinical Evaluation
Authors: Lehle Karla , Philipp Alois , Müller Thomas , Schettler Frank , Bein Thomas , Schmid Christof , Lubnow Matthias 
Published: October 2013

AbstractMembrane oxygenator (MO) failure is a known hazard during venovenous extracorporeal membrane oxygenation (v‐v ECMO) therapy. Knowledge about technical and performance details of different ECMO systems (Maquet, Rastatt, Germany; Medos, Stolberg, Germany; Sorin, Modena, Italy) licensed for adults with acute lung failure might improve their handling. This retrospective study comprises 186 adult patients (Regensburg ECMO Registry) treated with v‐v ECMO. Flow dynamic data were used to analyze the performance of different blood pumps, cannula types, and MOs to maintain an adequate blood flow (1–5 L/min). Usage of the Medos ECMO system in critically ill patients required a higher pump speed and generated a higher pressure drop across the MO (dpMO), however, without an increase in free plasma hemoglobin. The dpMO depended on the type of MO and increased with blood flow as expected. Type‐specific normal values are reported. A distinct increase in dpMO above normal values within 1 day required an immediate MO exchange. This was an infrequent technical complication (3%). Finally, pressure‐flow performance of single dual‐lumen cannulas (27 Fr) was comparable with small single‐lumen cannulas (15 Fr), without an increased risk of technical‐induced hemolysis. Despite different performances, all current commercially available adult v‐v ECMO systems produce adequate blood flow without an increased risk in technical‐induced hemolysis. Familiarity with the specific properties of individual systems allows early detection of technical complications. Additionally, the choice of an adequate cannula requires a closer consideration of the individual patient situation.
Glistening in glaucomatous eyes: visual performances and risk factors
Authors: Schweitzer Cedric , Orignac Isabelle , Praud Delphine , Chatoux Olivier , Colin Joseph 
Published: October 2013

AbstractPurposeTo analyse risk factors and visual performances of glaucomatous eyes with glistening in the intra‐ocular lens (IOL).MethodsProspective study performed between November 2010 and April 2011 and involving 67 consecutive glaucomatous eyes (47 patients), who previously had a phacoemulsification with a hydrophobic acrylic IOL implanted in the capsular bag. Glistening was classified in three groups of severity grade: G0 (<50 microvacuoles per mm2), G1 (50–150 microvacuoles per mm2), and G2 (>150 microvacuoles per mm2). All eyes underwent a best‐corrected visual acuity evaluation (BCVA, LogMAR scale), a complete clinical examination, a visual field test, a contrast sensitivity evaluation and a wavefront analysis of high‐order aberrations (HOAs) using a Shack–Hartmann aberrometer. Eyes with a posterior capsular opacification and a BCVA>0.30 LogMAR were excluded.ResultsTwenty six eyes (38.8%) had a grade 0, 12 eyes (17.9%) a grade 1 and 29 eyes (43.3%) a grade 2 of glistening severity grade. The mean follow‐up after cataract surgery was 35.2 ± 24.2 months and was significantly higher for G1 and G2 groups (p < 0.001). A higher number of topical glaucoma medication were associated with a higher glistening severity grade (p < 0.05). G1 and G2 groups had significantly lower mean contrast sensitivity values at high spatial frequencies and significantly higher loss variance (LV) values of the visual field test (p < 0.05). There was no significant difference in mean BCVA between groups (p = 0.455).ConclusionsIn glaucomatous eyes, glistening increased with time was associated with the number of topical glaucoma medications daily instilled and altered visual performances. It should be a consideration for glaucoma patients who are more likely to develop glistening within the IOL optic.
A 10‐year experience of outcome in chemotherapy‐treated hereditary retinoblastoma
Authors: Bartuma Katarina , Pal Niklas , Kosek Sonja , Holm Stefan , All‐Ericsson Charlotta 
Published: October 2013

AbstractPurposeThe aim is to report the 10‐year retrospective experience of systemic chemotherapy for a population‐based group of patients with hereditary retinoblastoma at a national referral centre. The outcomes include control rates, treatment side‐effects, adjuvant therapy, failure rate, survival, secondary cancers and visual acuity.MethodsAll patients (n = 24, 46 eyes) diagnosed with retinoblastoma and treated with systemic chemotherapy at a national referral centre during 2001–2011 were included. Data were extracted from medical records.ResultsThe patients were followed for a mean of 60 months (range 13–144). Four—six cycles of VEC was administered to all newly diagnosed group B/C/D/E eyes with bilateral disease and 83% (38 of 46) responded to the treatment. None of the patients discontinued chemotherapy because of adverse reactions. Altogether 26% (12 of 46) of the eyes received second‐line therapy (other than thermotherapy, cryotherapy and chemotherapy). The failure rate was 35% (16 of 46) and mortality rate 0%. None of the patients developed CNS manifestations (metastases or trilateral retinoblastoma). One of the patients developed a second primary tumour (osteosarcoma) 4 years following retinoblastoma diagnosis. Altogether 17% (4 of 24) patients received radiation therapy, 28% (13 of 46) of the eyes had to be enucleated, and one patient underwent bilateral enucleation. The age‐correlated visual acuity was mean of 73% of expected visual acuity.ConclusionGroup A/B retinoblastomas have a distinct chemotherapy response, while group C/D/E tumours do not respond as well. The success rate was 65%; while patients have a good prognosis for life, approximately one‐third of all hereditary cases received radiation therapy or underwent enucleation.
Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam
Authors: Kruse Alexandra Y , Phuong Cam N , Ho Binh TT , Stensballe Lone G , Pedersen Freddy K , Greisen Gorm 
Published: October 2013

AbstractAimNeonatal deaths (≤28 days) account for more than half of child mortality in Vietnam. Presumably most die in hospital, but data are scarce. This study aimed to identify risk factors of death among hospitalised neonates.MethodsWe prospectively studied all neonatal deaths and expected deaths (discharged alive after withdrawal of life‐sustaining treatment) in a Vietnamese tertiary paediatric hospital during a 12‐month period in 2009–2010. The medical files were audited classifying admission prognosis, discharge outcome, cause of death/expected death according to two classifications, and important and potentially avoidable risk factors during the hospital stay.ResultsAmong 5763 neonates admitted, 235 deaths and 67 expected deaths were included. According to both classifications, major causes were congenital malformations, prematurity and severe infections. Six risk factors were identified in 85% (60/71) of the neonates with a relatively good prognosis: recognition or response to danger signs, internal transfers, nosocomial infections, sepsis management, access to usual equipment/staff, and family perception.ConclusionAmong 302 neonatal deaths/expected deaths, the major causes were congenital malformations, prematurity and severe infections. Six important and potentially avoidable risk factors could be addressed in the subgroup with relatively good admission prognosis, without implementing new technology or major organisational changes.
Seventeen‐year study shows rise in parapneumonic effusion and empyema with higher treatment failure after chest tube drainage
Authors: Yu Danny , Buchvald Frederik , Brandt Bodil , Nielsen Kim G 
Published: October 2013

AbstractAimTo evaluate epidemiology, pre‐admission characteristics and management of paediatric parapneumonic effusions (PPEs) and empyema in a tertiary paediatric pulmonary centre between 1993 and 2010.MethodsRetrospective chart review study using paediatric and thoracic database searches, with particular emphasis on pre‐admission characteristics, disease stage (simple or complex effusion or empyema), general management and surgical procedures.ResultsOne hundred children were eligible, exhibiting a significant increase in incidence from 0.5 to 2.6 per 100 000 across the study period. Baseline characteristics were similar across disease stages. Streptococcus pneumoniae was the most common pathogen. Surgical intervention beyond chest tube drainage (CTD) was required in 50%; this rate showed a particular increase in children aged 0–5 years (OR, 3.1), but was otherwise not influenced by baseline characteristics, disease stage or use of intrapleural fibrinolytics. Length of hospitalisation did not differ across disease stages or primary interventional procedures.ConclusionThis study confirmed an increasing incidence of PPEs and empyema in a Scandinavian tertiary paediatric pulmonary centre. Young children exhibited higher treatment failure after CTD. Length of hospitalisation was similar across disease stages and was comparable to previous reports according to primary interventional procedure.
Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation
Authors: Borckink Ilse , Essouri Sandrine , Laurent Marie , Albers Marcel JIJ , Burgerhof Johannes GM , Tissières Pierre , Kneyber Martin CJ 
Published: October 2013

AbstractAimNasal continuous positive airway pressure (NCPAP) has been proposed as an early first‐line support for infants with severe respiratory syncytial virus (RSV) infection. We hypothesised that infants <6 months with severe RSV would require shorter ventilator support on NCPAP than invasive mechanical ventilation (IMV).MethodsRetrospective cohort analysis of infants admitted to two paediatric intensive care units, one primarily using NCPAP and one exclusively using IMV, between January 2008 and February 2010.ResultsWe studied 133 (NCPAP n = 89, IMV n = 46) consecutively admitted infants. On admission, disease severity [i.e. Paediatric RISk of Mortality (PRISM) II score (NCPAP 5.1 ± 2.8 vs. IMV 12.2 ± 6.0, p < 0.001) and SpO2/FiO2 ratio (NCPAP 309 ± 81 vs. IMV 135 ± 98, p < 0.001)] was higher in the IMV group. NCPAP remained independently associated with shorter ventilatory support (hazard ratio 2.3, 95% CI 1.1–4.7, p = 0.022) after adjusting for PRISM II score, PCO2, SpO2/FiO2 ratio, bronchopulmonary dysplasia and occurrence of clinically suspected secondary bacterial pneumonia.ConclusionNasal continuous positive airway pressure was independently associated with a shorter duration of ventilatory support. Differences in baseline disease severity mandate a randomised trial before the routine use of NCPAP can be recommended.
Adolescents and young adults with physical illness: a comparative study of psychological distress
Authors: Ferro Mark A 
Published: October 2013

AbstractAimThere is limited research investigating the relationship between physical illness and psychological distress among adolescents during the transition to young adulthood. This study examined risk for clinically relevant psychological distress over a 10‐year period comparing adolescents and young adults with asthma or epilepsy with healthy controls.MethodsThis research used data from the British Household Panel Survey (1991–2009) to compare healthy 16 to 25‐year‐olds (n = 7342) with individuals with asthma (n = 1798) and epilepsy (n = 117). Psychological distress was measured using the 12‐item General Health Questionnaire. Controlling for sociodemographic characteristics, generalised linear modelling was used to examine risk of psychological distress over time.ResultsUsing healthy individuals as the reference category, prevalence ratios for psychological distress among individuals with asthma and epilepsy ranged from 1.1 to 2.7 and 2.3 to 7.0, respectively. Controlling for potential confounding factors (sex, marital status, employment status, income), risk for psychological distress was increased among individuals with asthma (OR = 1.94, p < 0.0001) or epilepsy (OR = 3.45, p = 0.0002) compared with healthy controls during the follow‐up.ConclusionRecognizing the increased risk among individuals with physical illness, paediatric and adult health professionals are well positioned to facilitate successful transition to adult health services and prevent or reduce psychological distress in this vulnerable population.