bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous Catheter Replacement for Infectious and Mechanical Complications without Interruption of Peritoneal Dialysis
Authors: Crabtree John H. , Siddiqi Rukhsana A. 
Published: October 2015

Background Conventional management for peritoneal dialysis (PD)-related infectious and mechanical complications that fails treatment includes catheter removal and hemodialysis (HD) via a central venous catheter with the end result that the majority of patients will not return to PD. Simultaneous catheter replacement (SCR) can retain patients on PD by avoiding the scenario of staged removal and reinsertion of catheters. The aim of this study was to evaluate a protocol for SCR without interruption of PD. Methods Clinical outcomes were analyzed for 55 consecutive SCRs performed from 2002 through 2012 and followed through 2013. Results Simultaneous catheter replacements were performed for 28 cases of relapsing peritonitis, 12 cases of tunnel infection, and 15 cases of mechanical catheter complications. All cases for peritonitis and tunnel infection and 80% for mechanical complications continued PD on the day of surgery using a low-volume, intermittent automated PD protocol. Systemic antibiotics were continued for 2 weeks postoperatively (up to 4 weeks for Pseudomonas). Simultaneous catheter replacement was performed as an outpatient procedure in 89.1% of cases. Only 1 of 55 procedures was complicated by peritonitis within 8 weeks. No catheter losses occurred during this postoperative timeframe. Long-term, SCR enabled a median technique survival of 5.1 years. Conclusions In most instances, SCR can be safely performed without interruption of PD for selected cases of peritonitis and tunnel infection and for mechanical catheter complications. The procedure spares the patient from a central venous catheter, a shift to HD, the psychological ordeal of a change in dialysis modality, and a second surgery to insert a new catheter.
Flare Rate in Patients with Rheumatoid Arthritis in Low Disease Activity or Remission When Tapering or Stopping Synthetic or Biologic DMARD: A Systematic Review
Authors: Kuijper T. Martijn , Lamers-Karnebeek Femke B.G. , Jacobs Johannes W.G. , Hazes Johanna M.W. , Luime Jolanda J. 
Published: October 2015

Objective.To evaluate the risk of having a disease flare in patients with rheumatoid arthritis (RA) with low disease activity (LDA) or in remission when deescalating (tapering or stopping) disease-modifying antirheumatic drug (DMARD) therapy.Methods.A search in medical databases including publications from January 1950 to February 2015 was performed. Included were trials and observational studies in adults with RA who were in LDA or remission, evaluating ≥ 20 patients tapering or stopping DMARD. Flare rates had to have been reported. A metaanalysis was performed on studies deescalating tumor necrosis factor (TNF) blockers.Results.Four studies evaluated synthetic DMARD. Flare rates ranged from 8% at 24 weeks to 63% at 4 months after deescalation. Fifteen studies reported on TNF blockers. Estimated flare rates by metaanalysis on studies tapering or stopping TNF blockers were 0.26 (95% CI 0.17–0.39) and 0.49 (95% CI 0.27–0.73) for good-quality and moderate-quality studies, respectively. Flare rates in 3 studies stopping tocilizumab were 41% after 6 months, 55% at 1 year, and 87% at 1 year. Flare rates in 3 studies deescalating abatacept were 34% at 1 year, 41% at 1 year, and 72% at 6 months. Five studies evaluating radiographic progression in patients deescalating treatment all found limited to no progression.Conclusion.Results suggest that more than one-third of patients with RA with LDA or in remission may taper or stop DMARD treatment without experiencing a disease flare within the first year. Dose reduction of TNF blockers results in lower flare rates than stopping and may be noninferior to continuing full dose. Radiological progression after treatment deescalation remains low, but may increase slightly.
Formes assistantes et formes inhérentes. Sur l’union de l’âme et du corps, du Moyen Âge à l’Âge classique
Authors: de Libera Alain 
Published: October 2015

Peut-on prouver que l’âme raisonnable est par elle-même et essentiellement forme du corps ? C’est pour résoudre cette question que des générations de lecteurs d’Averroès recourent à la distinction entre forme inhérente et forme assistante. On examine l’histoire de cette distinction dans l’après-coup du concile de Vienne (1312) et du concile de Latran V (1513), dans sa triple dimension noétique, ontologique et anthropologique. On présente les sources et les divers aspects de la théorie averroïste de la forme assistante, de Siger de Brabant à la scolastique tardive et à la première modernité, selon laquelle l’intellect n’est ni forme inhérente ni moteur séparé , mais forme séparée .
Le Liber particularis de Michel Scot
Authors: Voskoboynikov Oleg 
Published: October 2015

C’est la première édition critique du Liber particularis de Michel Scot, traité cosmologique latin qui constitue la deuxième partie de son Liber introductorius , rédigé entre 1220 et 1235 environ. L’édition est effectuée sur la base du ms. Bodl. Canon. Misc. 555 (collationné avec les mss Vatican, BAV Rossi IX 11 et Milan, Ambrosiana L 92 Sup), afin de restituer une version qui circula, sous une forme relativement stable, en Italie dans la première moitié du xiv	e siècle. Dans l’introduction, on trouvera les données essentielles sur les manuscrits du Liber particularis , sur la place de ce traité dans l’œuvre de Michel Scot et dans le contexte intellectuel de la cour de Frédéric II, ainsi qu’un essai préliminaire visant à l’inscrire dans le développement des savoirs en Occident dans la première moitié du xiii	e siècle.
Central Microscotoma: A Rare Presentation of Epiretinal Membranes
Authors: Dhrami-Gavazi Elona , Sepúlveda Gonzalo , Lee Winston , Freund K. Bailey , Mukkamala Sri Krishna , Odel Jeffrey G. , Chang Stanley 
Published: October 2015

BACKGROUND AND OBJECTIVE:
Patients with a symptomatic epiretinal membrane (ERM) typically complain of metamorphopsia and decreased visual acuity. We describe three patients who presented with the single complaint of a central microscotoma due to ERM, an infrequent initial symptom of this entity.

PATIENTS AND METHODS:
This is a retrospective, interventional, non-comparative case series. Three patients with the chief complaint of a central microscotoma related to ERMs who underwent pars plana vitrectomy by a single surgeon experienced full resolution of the preoperative microscotoma. Best-corrected visual acuity, fundus photography, and optical coherence tomography were obtained at each examination. A comprehensive neuro-ophthalmologic evaluation was performed in all cases, including magnetic resonance imaging of the orbits and brain, automated visual fields, multifocal electroretinography, multifocal visually evoked potentials, and blood tests.

RESULTS:
Three eyes of three patients who presented with the initial sole complaint of a central microscotoma due to ERM are included in this series. A comprehensive neuro-ophthalmologic evaluation ruled out non-retinal etiologies. After months of observation, a pars plana vitrectomy with ERM and internal limiting membrane peeling was performed in all patients. Postoperatively, the patients experienced a complete resolution of their initial, isolated complaint of a central microscotoma.

CONCLUSION:
Central microscotoma, as a rare stand-alone presentation of ERM, is described. This symptom resolved after a successful removal of the ERM. A greater awareness among clinicians that ERMs may present in this manner may help avoid excessive and costly medical evaluations.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:852–858.]
The Result of Transmuscular versus Transosseous Repair of the Posterior Capsule on Early Dislocations in Primary Hip Arthroplasty
Authors: Spaans Elsa A. , Spaans Anne J. , van den Hout Joost A.A.M. , Bolder Stefan B.T. 
Published: October 2015

Purpose Dislocation is a concerning complication of the posterolateral approach for total hip arthroplasty (THA). Use of a larger size femoral head and a correct repair of the posterior structures can reduce the risk on dislocation of the hip prosthesis. In this study we investigated if there was a difference in dislocation rate between transmuscular and transosseous repair of the posterior soft tissues with use of 36 mm heads. Methods A power analysis showed that with a standardised effect size of 0.3 and p-value of 0.05, each group should include at least 174 patients. A total of 465 consecutive primary THAs with a posterolateral approach were performed in patients with primary osteoarthritis by 3 orthopaedic surgeons. There were 246 patients operated using transmuscular repair, the other 219 by using transosseous repair. All patients were given the same prostheses. Results Dislocation rate was 1.7% in all patients with at least 1 year follow-up. No significant difference was found in dislocation between both reconstruction techniques. Clinical outcome scores were comparable between the groups. Conclusions Transosseous and transmuscular repair were equally effective techniques in closing the posterior soft tissues after THA through the posterolateral approach, without difference in dislocation rate or complication rate.
Four-Year Results of Summit Stems for Total Hip Arthroplasty in Japanese Patients
Authors: Tetsunaga Tomonori , Sato Toru , Shiota Naofumi , Tetsunaga Tomoko , Okazaki Yoshiki , Yamada Kazuki 
Published: October 2015

Purpose A retrospective study to evaluate the clinical and radiographic outcome of the Summit primary total hip arthroplasty (THA) at a minimum follow-up of 4 years. Methods 87 hips in 84 Japanese patients underwent THA using Summit stems. 3 patients were lost to follow-up, and 4 patients were excluded because a Summit stem was judged to be inappropriate for their narrow femoral canals. The remaining 80 hips in 77 patients were evaluated. Mean age was 66 years (range, 33-86 y). Mean postoperative follow-up period was 52 months (range, 48-66 m). Results There was no early stem subsidence after surgery. Of the 80 hips, 60 (75%) showed radiographic signs of stem osseointegration including zones 3 and 5 at final follow-up. Stress shielding occurred in 50 hips (62.5%), and third-degree stress shielding was observed in 12 hips (15%). 3 patients experienced postoperative thigh pain due to distal fixation. Conclusions These short-term results indicate that the Summit stem achieved good initial fixation, although there were some cases of distal fixation. Careful long-term follow-up and observation will be necessary for hips in which stress shielding occurs.
Determination of the Mechanical Properties of Lumbar Porcine Vertebrae with 2D Digital Image Correlation
Authors: Campos-López Juan Pablo , Fuerte-Hernández Ariel , Hernández-Gómez Luis Héctor , Martínez-García Amalia , Beltrán-Fernández Juan Alfonso , Urriolagoitia-Calderón Guillermo 
Published: October 2015

Purpose To evaluate the strain fields and to calculate the modulus of elasticity and Poisson's ratio of trabecular bone of the 6 lumbar vertebrae of the porcine spine by a 2-dimensional digital image correlation (2D DIC). Methods This study was performed through a 2D DIC technique and the specimens were tested under compression. The resulting images were analyzed numerically by 2D DIC. Then, representative regions of interest were examined. The strain fields were determined and stress-strain curves were obtained. Results The full field measurement of the strain in the lumbar bone spine was evaluated and with this data, the Young's modulus and Poisson's ratio were determined. Conclusions This research highlights the potential applications of noninvasive acquisition techniques in biomechanical analysis. This is useful in the mechanical characterization of bony structures and in the design of prostheses.
First Impressions about Adherus, a New Dural Sealant
Authors: Zoia Cesare , Bongetta Daniele , Lombardi Francesco , Custodi Viola Marta , Pugliese Raffaelino , Gaetani Paolo 
Published: October 2015

Purpose The aim of the study is to report our first impressions about Adherus, a novel dural sealant, used in neurosurgical endoscopic transnasal procedures. Methods We retrospectively reviewed the clinical and surgical records of the first 11 patients with intraoperative high-flow cerebrospinal fluid leak treated with the aid of Adherus at our center between February and October 2014. The healing at the level of the dural plasty was monitored and evaluated radiologically and with regular endoscopic inspections. Results With a median follow-up of 210 days, no postoperative CSF leak or surgical site infections were found in any of the cases. Conclusions Based on our preliminary experience, this new dural sealant seems to provide an effective aid in dural plasty during endoscopic transphenoidal procedures.
High level of Serum AFP is an Independent Negative Prognostic Factor in Gastric Cancer
Authors: Chen Yueguang , Qu Hui , Jian Mi , Sun Guorui , He Qingsi 
Published: October 2015

Background Gastric cancer with a high level of serum alpha fetoprotein (AFP) is uncommon and has unique clinicopathological features and a poorer prognosis. The aim of this research was to elucidate the clinicopathological and prognostic features of gastric cancer with a high level of AFP. Methods The sera from 1,286 patients with gastric cancer treated at Qilu Hospital of Shandong University from January 2004 to December 2008 were analyzed preoperatively for AFP, CEA and CA19-9 levels after excluding active or chronic hepatitis, liver cirrhosis and hepatocellular carcinoma as well as preoperative distant metastasis. Patients were divided into 2 groups: 86 serum AFP-positive patients and 1,200 serum AFP-negative patients according to a cutoff of 20 ng/mL. The clinicopathological features and prognostic factors were compared between the groups. Results A higher incidence of serosal invasion, lymph node metastasis and liver metastasis and poorer prognosis was observed in the AFP-positive group compared with the AFP-negative group (all p<0.05). Serum AFP showed the highest specificity (93.66%) and diagnostic accuracy (92.38%) for predicting liver metastasis among the 3 tumor markers examined. Multivariate survival analysis revealed that AFP positivity was an independent prognostic factor in all 1,286 gastric cancer patients. The prognosis of AFP-positive gastric cancer was poorer than that of AFP-negative gastric cancer (p<0.05). Conclusions A high level of serum AFP is an independent prognostic factor in gastric cancer and can be used for evaluating the prognosis of gastric cancers whether in the presence or absence of liver metastasis.
Mammographic findings after reshaping with autoprosthesis in women undergoing contralateral breast reconstruction and mastectomy
Authors: Scaperrotta Gianfranco , Capalbo Emanuela , Ferranti Claudio , Falco Giuseppe , Nava Maurizio B. , Di Leo Gianni , Marchesini Monica , Suman Laura , Panizza Pietro 
Published: October 2015

Aims and background Breast reduction and mastopexy combined with inferior dermo-lipo-glandular flap (autoprosthesis) gives good breast shape, long-term projection, and upper pole fullness. We assess the impact on breast oncologic surveillance compared to other techniques. Methods A total of 105 patients who underwent mastectomy and reconstruction were divided into 3 groups of 35 patients each: groups 1 and 2 include patients with contralateral breast symmetrization performed with and without autoprosthesis technique, respectively. Group 3 is a control group without contralateral breast reshaping. On mammography, edema, skin thickening, architectural distortion, and calcifications were recorded, as well as further diagnostic examinations, biopsies, and surgical treatments required. Results Statistically significant differences (p<0.001) in the first follow-up mammography between groups 1 and 2 were stromal edema (6% vs 51%) and architectural distortion (74% vs 63%). The latest findings meant architectural distortion also have significant difference (p<0.001) in the last mammography (79% vs 66%). Microcalcification has statistically significant difference (p<0.001) in the latest postsurgical mammography, increased in group 1. Skin thickening had a similar course in either group. Mammography follow-up was not impaired in most cases notwithstanding the parenchyma distortion as compared with mammography after breast-conserving surgery. Four core biopsies were performed in both groups: 3 new breast cancers and 1 benign epithelial hyperplasia were found. Conclusions No difficulties were found impairing mammographic evaluation in patients treated with autoprosthesis as compared to other techniques.
Hypofractionated Whole-Breast Radiotherapy and Concomitant Boost after Breast Conservation in Elderly Patients
Authors: Cante Domenico , Franco Pierfrancesco , Sciacero Piera , Girelli Giuseppe , Pasquino Massimo , Borca Valeria Casanova , Tofani Santi , La Porta Maria Rosa , Ricardi Umberto 
Published: October 2015

Aims To report the 5- and 10-year results of accelerated hypofractionated whole-breast radiotherapy (WBRT) with concomitant boost to the tumor bed in 83 consecutive patients with early breast cancer aged >70 years. Methods All patients were treated with breast conservation and hypofractionated WBRT. The prescription dose to the whole breast was 45 Gy (2.25 Gy/20 fractions) with an additional daily concomitant boost of 0.25 Gy to the surgical cavity (2.5 Gy/20 fractions up to 50 Gy). The maximum detected toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. We considered as skin toxicity: erythema, edema, desquamation, ulceration, hemorrhage, necrosis, telangiectasia, fibrosis-induration, hyperpigmentation, retraction and atrophy. Cosmetic results were assessed as set by the Harvard criteria. Results With a median follow-up of 60 months (range 36-88), no local recurrence was observed. The maximum detected acute skin toxicity was G0 in 57% of patients, G1 in 40% and G2 in 3%. Late skin and subcutaneous toxicity was generally mild with no ≥G3 events. The cosmetic results were excellent in 69% of patients, good in 22%, fair in 5%, and poor in 4%. Conclusions The present results support the use of hypofractionation employing a concomitant boost to the lumpectomy cavity in women aged >70 years. This is a convenient treatment option for both this type of population and health-care providers.
A Targeted Approach to Genetic Counseling in Breast Cancer Patients: The Experience of an Italian Local Project
Authors: La Verde Nicla , Corsi Fabio , Moretti Anna , Peissel Bernard , Dalu Davide , Girelli Serena , Fasola Cinzia , Gambaro Anna , Roversi Gaia , Azzollini Jacopo , Radice Paolo , Pensotti Valeria , Farina Gabriella , Manoukian Siranoush 
Published: October 2015

Aims and background Patients with hereditary breast cancer (BC) may benefit from genetic counseling and testing for detection of causative mutations, definition of therapeutic and preventive strategies, and identification of at-risk relatives. Italy has few oncogenetic centers and genetic evaluation of all patients with BC is not feasible. Moreover, lack of uniformity in the selection of patients generates inappropriate referral to the geneticist. We designed a model that may represent a reproducible way to select patients at risk for hereditary BC, with the aims of rationalizing access to genetic centers and improving clinical management and surveillance. Methods The genetic unit of a Cancer Center and the Departments of Oncology from 2 public Hospitals in Milan were involved in the project. After training sessions at the genetic unit, operators from the 2 hospitals evaluated all patients with BC attending a first oncologic visit, through a specific interview. Patients considered at risk of hereditary BC attended counseling at the genetic unit. Results Of 419 patients, 61 (14.5%) were eligible for genetic counseling after the interview. Of these, 46 (10.9%) strictly met testing criteria. Overall, 52 (12.4%) patients underwent genetic counseling and 47 were tested for BRCA1/ BRCA2 mutation. After genetic test results, the available options for treatment/surveillance were discussed by a multidisciplinary team, according to the level of genetic risk. Conclusions It is possible to improve the process of referring patients with suspected hereditary BC for genetic risk assessment. The application of clinical screening reduced the genetics unit's workload and enabled optimization of time and resources.
Diffusion-Weighted Magnetic Resonance Imaging in Patients with Prostate Cancer Treated with Radiotherapy
Authors: Iannelli Giancarlo , Caivano Rocchina , Rago Luciana , Simeon Vittorio , Lotumolo Antonella , Rabasco Paola , Villonio Antonio , Gioioso Matilde , Mastrangelo Pietro , Barchetti Flavio , Panebianco Valeria , Macarini Luca , Guglielmi Giuseppe , Cammarota Aldo 
Published: October 2015

Aims To evaluate the utility of a multiparametric 3T magnetic resonance imaging (MRI) study using diffusion-weighted images (DWI) for the assessment of prostate cancer before and after radiotherapy (RT). Methods A total of 34 patients, who received a histologic diagnosis of prostate adenocarcinoma, underwent MRI examination before and after local RT for the assessment of response to treatment. Apparent diffusion coefficient (ADC) values were calculated and compared. Results Before RT, DWI shows pathologic restriction of signal, while after RT pathologic restriction of signal was reduced or disappeared. The ADC values were significantly increased after therapy (p<0.05). Conclusions The use of DWI with ADC measurements may be an imaging biomarker in the assessment of prostate cancer.
Benign Nodule Shrinkage: A Diagnosis not to be Missed
Authors: Lacout Alexis , Chevenet Carole , Marcy Pierre-Yves 
Published: October 2015

Background Thyroid nodules presenting ultrasonographic (US) findings suspicious for malignancy should undergo fine-needle aspiration and further cytologic analysis according to the Bethesda 2010 classification. Benign necrotic thyroid nodules may also harbor suspicious US features as follows: ill-defined margins, taller than wide aspect, strong hypoechogenicity, high stiffness index on elastography examination, and reported worrisome cytologic or histologic alterations. Methods and results We report the case of a benign thyroid nodule showing shrinkage over time and harboring malignant US features. Fine-needle aspiration cytology examination showed necrosis and no malignant cells. Conclusions Precise Doppler US analysis of the nodule and its evolution over time may limit the risk of false-positive diagnosis of thyroid malignancy.