bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Needle Aspiration for Peritonsillar Abscess Still as Good as We Think? A Long-term Follow-up
Authors: Shaul Chanan , Koslowsky Benjamin , Rodriguez Mercedes , Schwarz Yehuda , Muahnna Nidal , Peleg Uri , Sichel Jean-Yves 
Published: November 2014

Objective: The aim was to study the therapeutic management, recurrence, and need for tonsillectomy in patients who underwent needle aspiration for peritonsillar abscess (PTA). Methods: A prospective observational design study was performed. Patients hospitalized in Shaare Zedek Medical Center between the years 2004 and 2007 with a diagnosis of PTA who underwent needle aspiration obtaining pus were included. A minimum 5-year follow-up was required for all patients. Recurrences, complications, the need for a repeated surgical procedure, length of hospital admission, and tonsillectomy were the primary end points. Results: The study included 117 patients. One hundred four patients (88.9%) improved after 1 needle aspiration without any other intervention, whereas 13 patients (11.1%) required an additional procedure. Broad spectrum antibiotics showed a statistical advantage over penicillin only, regarding need for recurrent procedure (14.7% vs 4.7%, P = .02). No short- or long-term complications were documented. Seventeen patients (14.5%) had any recurrence. Primary recurrent tonsillitis, female sex, and younger age were predictive risk factors for recurrent events of PTA (32% vs 10%, P < .01). A total of 18 patients (15.4%) eventually underwent tonsillectomy. Conclusion: Needle aspiration is an effective first line procedure for patients with PTA. Tonsillectomy is not necessary in most cases. In our study, young age, female sex, and recurrent tonsillitis are negative prognostic factors for recurrence. These patients should be managed accordingly. Broad spectrum antibiotics may offer additional advantages when compared to penicillin only.
Endolymphatic Duct Blockage: A Randomized Controlled Trial of a Novel Surgical Technique for Ménière's Disease Treatment
Authors: Saliba Issam , Gabra Nathalie , Alzahrani Musaed , Berbiche Djamal 
Published: November 2014

ObjectivesTo compare the effectiveness of the endolymphatic duct blockage (EDB) and the endolymphatic sac decompression (ESD) to control Ménière's disease symptoms and to evaluate their effect on hearing level.Study DesignProspective nonblinded randomized study.SettingTertiary medical center.Subjects and MethodsFifty‐seven patients affected by a refractory Ménière's disease were included out of which 22 underwent an ESD and 35 underwent an EDB. Five periods of follow‐up were considered: 0 to 1 week, 1 week to 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months. Mean outcome measurements consisted of vertigo control, tinnitus, aural fullness, instability, and hearing level. Hearing level was evaluated using pure‐tone average (PTA) and speech discrimination score (SDS).ResultsThere was no significant difference between the 2 groups in the number of vertigo spells per months preoperatively (P =. 153). Twenty‐four months postoperatively, 96.5% of the EDB group had achieved a complete control of vertigo spells against 37.5% of the ESD group with a statistically significant difference (P =. 002). There was a better control of tinnitus and aural fullness with EDB (P =. 021 and P =. 014, respectively). There was no statistically significant difference in hearing level preoperatively (P =. 976) and 24 months postoperatively (P =. 287) between the 2 groups. Hearing level was preserved in each group with no significant difference between the preoperative and the postoperative levels (P >. 05).ConclusionEDB is more effective than the traditional ESD in controlling the symptoms of Ménière's disease. It is a novel surgical technique with promising results for a complete treatment of Ménière's disease. There are no significant complications or adverse effect.
Detection of skeletal muscle metastasis: torso FDG PET-CT versus contrast-enhanced chest or abdomen CT
Authors: So Young , Yi Jeong Geun , Song Inyoung , Lee Won Woo , Chung Hyun Woo , Park Jeong Hee , Moon Sung Gyu 
Published: November 2014

Background Skeletal muscle metastasis (SMM) in cancer patients has not been sufficiently evaluated regarding prevalence and proper method of detection. Purpose To determine the prevalence of SMM and compare the diagnostic competencies for SMM of torso F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) and contrast-enhanced chest or abdomen CT. Material and Methods We investigated 18,225 PET-CT studies of 6359 cancer patients performed from 2005 to 2012. The PET-CT studies describing potential SMM were retrieved and the corresponding medical records were reviewed. The gold standard for SMM was histopathologically-proven SMM or imaging study-based disease progression. The detectability of SMM was compared between PET-CT and contrast-enhanced CT. Results Twenty-six patients had 84 SMM lesions, representing a SMM prevalence of 0.41%. Lung cancer was the most common SMM-associated malignancy (54%) and the gluteal/pelvic girdle muscle was the most frequently involved SMM site (37%). All 84 SMM lesions were visualized on PET-CT (100%). Of these PET-CT positive 84 SMM lesions, 51 lesions were in the CT field of view (FOV) (61%), whereas 33 lesions were out of the CT FOV (39%). Among these 51 lesions, 17 lesions showed rim-enhancing nodules/masses (33%), eight lesions showed homogeneously enhancing nodules (16%), three lesions showed heterogeneously enhancing nodules (6%), and 23 SMM lesions (45%) were non-diagnostic by CT. All 51 SMM lesions within CT FOV were detected on PET-CT (100%), whereas only 28 were visualized on CT (54.9%), resulting in a significant difference ( P < 0.005). On average, 2.6 more organs with concomitant metastases were found when SMM was revealed by PET-CT. Conclusion The prevalence of SMM was as low as 0.41% in the current large cohort of cancer patients. Torso PET-CT was a more competent modality than contrast-enhanced CT in the detection of SMM.
Gd-EOB enhanced MRI T1-weighted 3D-GRE with and without elevated flip angle modulation for threshold-based liver volume segmentation
Authors: Grieser Christian , Denecke Timm , Rothe Jan-Holger , Geisel Dominik , Stelter Lars , Cannon Walter Thula , Seehofer Daniel , Steffen Ingo G 
Published: November 2014

Background Despite novel software solutions, liver volume segmentation is still a time-consuming procedure and often requires further manual optimization. With the high signal intensity of the liver parenchyma in Gd-EOB enhanced magnetic resonance imaging (MRI), liver volume segmentation may be improved. Purpose To evaluate the practicability of threshold-based segmentation of the liver volume using Gd-EOB-enhanced MRI including a customized three-dimensional (3D) sequence. Material and Methods A total of 20 patients examined with Gd-EOB MRI (hepatobiliary phase T1-weighted (T1W) 3D sequence [VIBE]; flip angle [FA], 10° and 30°) were enrolled in this retrospective study. The datasets were independently processed by two blinded observers (O1 and O2) in two ways: manual (man) and threshold-based (thresh; study method) segmentation of the liver each followed by an optimization step (man+opt and thresh+opt; man+opt [FA10°] served as reference method). Resulting liver volumes and segmentation times were compared. A liver conversion factor was calculated in percent, describing the non-hepatocellular fraction of the total liver volume, i.e. bile ducts and vessels. Results Thresh+opt (FA10°) was significantly faster compared to the reference method leading to a median volume overestimation of 4%/8% ( P < 0.001). Using thresh+opt (FA30°), segmentation was even faster ( P < 0.001) and even reduced median volume deviation of 0%/2% (O1/O2; both P > 0.2). The liver conversion factor was found to be 10%. Conclusion Threshold-based liver segmentation employing Gd-EOB-enhanced hepatobiliary phase standard T1W 3D sequence is accurate and time-saving. The performance of this approach can be further improved by increasing the FA.
Timing of Surgery for Complete Proximal Hamstring Avulsion Injuries
Authors: Subbu Raj , Benjamin-Laing Harry , Haddad Fares 
Published: November 2014

Background: Avulsion of the proximal hamstring origin is well documented, and surgical treatment is advocated for complete avulsions. Purpose: To compare the return to preinjury level of sport and the complexity of surgery in athletes undergoing surgical intervention for complete proximal hamstring avulsions within 6 weeks, 6 months, and after 6 months of injury. Study Design: Case series; Level of evidence, 4. Methods: This was the largest case series from a tertiary referral center reported in the literature. A total of 112 athletes were included, with complete proximal avulsion injuries confirmed on MRI scans; 63 patients (56.3%) were high-level athletes. Patients were divided into subgroups depending on the timing of surgical intervention: “early” was defined within 6 weeks, “delayed” within 6 weeks to 6 months, and “late” after 6 months. All patients were surgically explored and repaired with the aim of comparing the timing between each group and the return to preinjury sport. All patients underwent an individualized rehabilitation protocol. There was no loss to follow-up. The primary outcome measure was the return to preinjury level sports activity. Results: A total of 108 patients (96.4%) returned to sport. In the early intervention group, the average time of return to play was 16 weeks, 9 weeks faster than the delayed group and 13 weeks faster than the late group. There were 2 partial reruptures in those with delayed intervention—both athletes retired from competitive sport but were recreationally active. Two other athletes recovered well but retired from playing at all levels. Twelve athletes (2 in the early intervention group, 5 in the delayed, 5 in the late) were delayed by local nerve symptoms. Only 2 cases required further exploration. Conclusion: Early surgical intervention was associated with good clinical outcomes and a quicker return to sport; however, delaying the diagnosis can lead to prolonged morbidity and an increased likelihood of complications.
Do Patients Return to Sports and Work After Total Shoulder Replacement Surgery?
Authors: Bülhoff Matthias , Sattler Peter , Bruckner Thomas , Loew Markus , Zeifang Felix , Raiss Patric 
Published: November 2014

Background: Studies evaluating the return to sports and work after shoulder arthroplasty are rare, and there are no studies evaluating return to work after total shoulder arthroplasty (TSA). Hypothesis: Patients undergoing TSA will be able to return to their preoperative sports levels and occupations. Study Design: Case series; Level of evidence, 4. Methods: A total of 154 patients with 170 TSAs for primary glenohumeral arthritis were included. Two subgroups were formed: patients who had participated in sports during the 5 years before surgery (group 1; n = 105 [68%]) and patients who had never participated in sports (group 2; n = 49 [32%]). The return-to-work rate in patients who had not retired after surgery were also analyzed, as were responses to a survey. Results: The mean age at the time of surgery was 71 years (range, 33-88 years) in group 1 and 76 years (range, 54-88 years) in group 2. Mean follow-up time was 6.2 years (range, 2.5-12.6 years). Fifty-seven patients (54%) in group 1 participated in sports right up to the time of surgery. All 57 (100%) returned to sports after surgery. A further 3 patients (3%) from group 1 resumed sporting activity after surgery; swimming was the most popular sport. No patient in group 2 started sports activity after shoulder replacement surgery. Many of the patients, 14% of the entire group, had retired by final follow-up because of TSA. Fourteen percent of patients in group 1 and group 2 were pursuing their work at the time of most recent follow-up. Thirty patients of the entire cohort (19.5%) had to change their occupations because of surgery. Conclusion: Patients who participated in sports before TSA were successfully able to return to sports activities after surgery. Patients who did not participate in sports just before surgery were unlikely to start sports after surgery. Fourteen percent of the entire cohort was able to return to work after surgery.
Hybrid reconstruction of the upper limb in a patient with chronic limb ischemia
Authors: Argyriou Christos , Georgiadis George S , Mantatzis Michael , Schoretsanitis Nikolaos G , Antoniou George A , Papadopoulou Maria Z , Vogiatzaki Theodosia , Lazarides Miltos K 
Published: November 2014

Aim Hybrid vascular interventions performed in patients with chronic limb ischemia are considered minimally invasive techniques for treating complex multilevel arterial occlusive disease. Methods We report the case of a 42-year-old woman with a critical upper limb ischemia, who underwent angioplasty and secondary stenting of the distal-third of the axillary artery followed by a brachial–brachial bypass using an autologous graft. Results The patient had an uneventful recovery. To our knowledge, this is the first case reported in the literature of hybrid vascular reconstruction in the upper limb due to atherosclerosis. Conclusion Hybrid revascularization procedure in the upper limb is technically feasible, safe for the patient, and should become a part of the armamentarium of the modern vascular surgeon.
Plasma exchange to remove HIT antibodies: dissociation between enzyme-immunoassay and platelet activation test reactivities
Authors: Warkentin Theodore E. , Sheppard Jo-Ann I. , Chu F. Victor , Kapoor Anil , Crowther Mark A. , Gangji Azim 
Published: November 2014

Key Points
Repeated plasma exchange removes sufficient HIT-IgG to achieve negative SRA despite ongoing strong-positive EIA. Serially-diluted HIT sera tested in both SRA and EIA show that SRA negativity can be achieved with minimal decrease in EIA reactivity.
Synthesis of flake-like graphene from nickel-coated polyacrylonitrile polymer
Authors: Kwon Ho-je , Ha Jun Mok , Yoo Sung Ho , Ali Ghafar , Cho Sung Oh 
Published: November 2014

Abstract
Graphene can be synthesized from polyacrylonitrile (PAN) polymer through pyrolysis. A metal catalyst such as nickel (Ni) is required for the conversion of the polymer to graphene. The metal catalysts can be placed either atop or underneath the polymer precursor. We observed that spatially non-uniform and disconnected graphene was fabricated when PAN film coated with a Ni layer was pyrolyzed, resulting in flake-like graphene. Formation of the flake-like graphene is attributed to the dewetting of the Ni layer coated on the PAN film. Dewetting phenomenon can be reduced by decreasing the pyrolysis temperature, and hence, more uniform graphene could be prepared. The effects of Ni coating thickness and the pyrolysis temperature on the fabricated graphene have been experimentally analyzed.
A frame-based domain-specific language for rapid prototyping of FPGA-based software-defined radios
Authors: Ouedraogo Ganda Stephane , Gautier Matthieu , Sentieys Olivier 
Published: November 2014

Abstract
The field-programmable gate array (FPGA) technology is expected to play a key role in the development of software-defined radio (SDR) platforms. As this technology evolves, low-level designing methods for prototyping FPGA-based applications did not change throughout the decades. In the outstanding context of SDR, it is important to rapidly implement new waveforms to fulfill such a stringent flexibility paradigm. At the current time, different proposals have defined, through software-based approaches, some efficient methods to prototype SDR waveforms in a processor-based running environment. This paper describes a novel design flow for FPGA-based SDR applications. This flow relies upon high-level synthesis (HLS) principles and leverages the nascent HLS tools. Its entry point is a domain-specific language (DSL) which handles the complexity of programming an FPGA and integrates some SDR features so as to enable automatic waveform control generation from a data frame model. Two waveforms (IEEE 802.15.4 and IEEE 802.11a) have been designed and explored via this new methodology, and the results are highlighted in this paper.
Chloride-liberal fluids are associated with acute kidney injury after liver transplantation
Authors: Nadeem Ashraf , Salahuddin Nawal , El Hazmi Alyaa , Joseph Mini , Bohlega Balsam , Sallam Hend , Sheikh Yasser , Broering Dieter 
Published: November 2014

Abstract
Introduction
Acute kidney injury (AKI) occurs frequently after liver transplantation and is associated with significant morbidity and mortality. Recent evidence has linked the predominant usage of `chloride-liberal’ intravenous fluids, such as 0.9% saline to the development of renal dysfunction in general critically ill patients. We compared the effects of perioperative fluid types on AKI in liver transplant recipients.

Methods
An observational analysis of liver transplant recipients over a 33-month period, between January 2010 and September 2013, was performed. Intensive care unit database and patient records were analyzed for determinants of early postoperative AKI. Univariate and multivariate regression analysis was carried out using a two-tailed P value less than 0.05 to establish significance. The institutional Research Ethics Committee approved the study methodology (RAC no. 2131 073).

Results
One hundred and fifty-eight liver transplants were performed, AKI developed in 57 (36.1%) patients: 39 (68.4%) fully recovered, 13 (22.8%) developed chronic renal failure and 10 (17.5%) required long-term hemodialysis. On univariate regression analysis, AKI was significantly associated with greater than 3,200 ml of chloride-liberal fluids infused within the first postoperative day (HR 5.9, 95% CI 2.64, 13.2, P <0.001), greater than 1,500 ml colloids received in the operating room (hazard ratio (HR) 1.97, 95% CI 1.01, 3.8, P = 0.046), vasopressor requirement for 48 hours posttransplant (HR 3.34, 95% CI 1.55, 7.21, P = 0.002), hyperchloremia at day 2 (HR 1.09, 95% CI 1.01, 1.18, P = 0.015) and preoperative model for end-stage liver disease (MELD) score (HR 1.08, 95% CI 1.03, 1.13, P <0.001).
After stepwise multivariate regression, infusion of greater than 3,200 ml of chloride-liberal fluids (HR 6.25, 95% CI 2.69, 14.5, P <0.000) and preoperative MELD score (HR 1.08, 95% CI 1.02, 1.15, P = 0.004) remained significant predictors for AKI.

Conclusions
In a sample of liver transplant recipients, infusion of higher volumes of chloride-liberal fluids and preoperative status was associated with an increased risk for postoperative AKI.
Dynamic arterial elastance as a predictor of arterial pressure response to fluid administration: a validation study
Authors: García Manuel Ignacio Monge , Romero Manuel Gracia , Cano Anselmo Gil , Aya Hollmann D , Rhodes Andrew , Grounds Robert Michael , Cecconi Maurizio 
Published: November 2014

Abstract
Introduction
Functional assessment of arterial load by dynamic arterial elastance (Eadyn), defined as the ratio between pulse pressure variation (PPV) and stroke volume variation (SVV), has recently been shown to predict the arterial pressure response to volume expansion (VE) in hypotensive, preload-dependent patients. However, because both SVV and PPV were obtained from pulse pressure analysis, a mathematical coupling factor could not be excluded. We therefore designed this study to confirm whether Eadyn, obtained from two independent signals, allows the prediction of arterial pressure response to VE in fluid-responsive patients.

Methods
We analyzed the response of arterial pressure to an intravenous infusion of 500 ml of normal saline in 53 mechanically ventilated patients with acute circulatory failure and preserved preload dependence. Eadyn was calculated as the simultaneous ratio between PPV (obtained from an arterial line) and SVV (obtained by esophageal Doppler imaging). A total of 80 fluid challenges were performed (median, 1.5 per patient; interquartile range, 1 to 2). Patients were classified according to the increase in mean arterial pressure (MAP) after fluid administration in pressure responders (≥10%) and non-responders.

Results
Thirty-three fluid challenges (41.2%) significantly increased MAP. At baseline, Eadyn was higher in pressure responders (1.04 ± 0.28 versus 0.60 ± 0.14; P <0.0001). Preinfusion Eadyn was related to changes in MAP after fluid administration (R2 = 0.60; P <0.0001). At baseline, Eadyn predicted the arterial pressure increase to volume expansion (area under the receiver operating characteristic curve, 0.94; 95% confidence interval (CI): 0.86 to 0.98; P <0.0001). A preinfusion Eadyn value ≥0.73 (gray zone: 0.72 to 0.88) discriminated pressure responder patients with a sensitivity of 90.9% (95% CI: 75.6 to 98.1%) and a specificity of 91.5% (95% CI: 79.6 to 97.6%).

Conclusions
Functional assessment of arterial load by Eadyn, obtained from two independent signals, enabled the prediction of arterial pressure response to fluid administration in mechanically ventilated, preload-dependent patients with acute circulatory failure.
Predicting cardiovascular intensive care unit readmission after cardiac surgery: derivation and validation of the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) cardiovascular intensive care unit clinical prediction model from a registry cohort of 10,799 surgical cases
Authors: van Diepen Sean , Graham Michelle M , Nagendran Jayan , Norris Colleen M 
Published: November 2014

Abstract
Introduction
In medical and surgical intensive care units, clinical risk prediction models for readmission have been developed; however, studies reporting the risks for cardiovascular intensive care unit (CVICU) readmission have been methodologically limited by small numbers of outcomes, unreported measures of calibration or discrimination, or a lack of information spanning the entire perioperative period. The purpose of this study was to derive and validate a clinical prediction model for CVICU readmission in cardiac surgical patients.

Methods
A total of 10,799 patients more than or equal to 18 years in the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry who underwent cardiac surgery (coronary artery bypass or valvular surgery) between 2004 and 2012 and were discharged alive from the first CVICU admission were included. The full cohort was used to derive the clinical prediction model and the model was internally validated with bootstrapping. Discrimination and calibration were assessed using the AUC c index and the Hosmer-Lemeshow tests, respectively.

Results
A total of 479 (4.4%) patients required CVICU readmission. The mean CVICU length of stay (19.9 versus 3.3 days, P <0.001) and in-hospital mortality (14.4% versus 2.2%, P <0.001) were higher among patients readmitted to the CVICU. In the derivation cohort, a total of three preoperative (age ≥70, ejection fraction, chronic lung disease), two intraoperative (single valve repair or replacement plus non-CABG surgery, multivalve repair or replacement), and seven postoperative variables (cardiac arrest, pneumonia, pleural effusion, deep sternal wound infection, leg graft harvest site infection, gastrointestinal bleed, neurologic complications) were independently associated with CVICU readmission. The clinical prediction model had robust discrimination and calibration in the derivation cohort (AUC c index = 0.799; Hosmer-Lemeshow P = 0.192). The validation point estimates and confidence intervals were similar to derivation model.

Conclusions
In a large population-based dataset incorporating a comprehensive set of perioperative variables, we have derived a clinical prediction model with excellent discrimination and calibration. This model identifies opportunities for targeted therapeutic interventions aimed at reducing CVICU readmissions in high-risk patients.