bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Bethesda system for reporting thyroid cytopathology: an institutional experience of the outcome of indeterminate categories
Authors: Önder S. , Firat P. , Ates D. 
Published: September 2013

ObjectiveIn this study, we investigated the efficacy of the Bethesda system (TBS) for reporting thyroid cytopathology in determining the risk of malignancy for indeterminate cases. These cases comprised atypia or follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasia or suspicious for follicular neoplasia (FN/SFN) and suspicious for malignancy (SM) categories. AUS/FLUS cases were further subcategorized according to their patterns, and the malignancy rate for each subcategory was calculated.MethodsA total of 6310 thyroid fine needle aspiration (FNA) cases were analysed and 655 indeterminate cases were enrolled in the study. AUS/FLUS cases were further subcategorized into four patterns as follows: papillary thyroid carcinoma (PTC) pattern, microfollicle pattern, atypical cell pattern and Hürthle cell pattern.ResultsMalignancy rates for AUS/FLUS, FN/SFN and SM were 18.9%, 45.7% and 71%, respectively. Malignancy rates for AUS/FLUS subcategories were as follows: PTC pattern, 28%; microfollicle pattern, 6.9%; atypical cell pattern, 22.2%; and Hürthle cell pattern, 0%.ConclusionThe Bethesda system categorizes thyroid FNAs with increasing risk of malignancy as advocated. However, our findings suggest that the risk of malignancy for AUS/FLUS might be higher than estimated. Particularly, AUS/FLUS cases with focal features suggestive of PTC seem to be associated with a much higher risk of malignancy than other patterns.
Practice considerations for the introduction and use of power mobility for children
Authors: Livingstone Roslyn , Paleg Ginny 
Published: September 2013

AimThe aim of the study was to support clinicians in recommending and justifying power mobility for children of different ages and abilities, and with different needs. The study comprised three distinct parts: a literature review; a Delphi consensus; and clinical practice considerations.MethodA scoping review of eight electronic databases and manual searches carried out in February 2011 identified 15 themes or transferable messages among 27 articles meeting initial inclusion criteria and these formed the basis of a draft paper. Informal consensus at two international conference presentations refined and modified the paper to include 10 messages supported by 24 articles. The literature review was updated in May 2012 and a modified Delphi process sought to formalize the consensus process with an international panel of 16 expert clinicians and researchers using a priori criteria of 80% agreement.ResultsEvidence from studies was classified using the American Academy of Cerebral Palsy and Developmental Medicine guidelines, with evidence from most studies being classified as either level IV or level V, apart from one study each with evidence classified as level II and level III. Expert consensus on the content and wording of nine transferable messages may raise evidence overall to level III.InterpretationThis paper suggests that power mobility may reasonably be considered as an effective and appropriate intervention for children lacking efficient, independent mobility from around 12 months of age including children who may never become competent drivers and children lacking independent mobility only in early childhood.
Impact of hypertension and renin–angiotensin system inhibitors in aortic stenosis
Authors: Capoulade Romain , Clavel Marie‐Annick , Mathieu Patrick , Côté Nancy , Dumesnil Jean G. , Arsenault Marie , Bédard Élisabeth , Pibarot Philippe 
Published: September 2013

AbstractBackgroundExperimental studies revealed that renin–angiotensin system (RAS) could play a crucial role in the pathophysiology of aortic stenosis (AS). The objectives of this study were to examine (i) the impact of hypertension on AS progression and clinical events and (ii) the effect of angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin‐receptor blockers (ARBs).Materials and methodsIn this observational study, we retrospectively analysed clinical and Doppler echocardiographic data prospectively collected in 338 patients with AS. Patients were separated into four groups: patients without hypertension and not treated by RAS medication (Ctrl group), patients with hypertension but not treated by RAS medication (HTN group), patients treated with ACEIs, and patients treated with ARBs. AS progression rate was assessed by the annualized increase in peak aortic jet velocity.ResultsCompared with Ctrl group, patients in HTN group had faster stenosis progression (P = 0·01). Patients on ARBs had slower AS progression compared with Ctrl (trend P = 0·10) and HTN (P = 0·002) groups, whereas patients on ACEIs had similar progression rate compared with Ctrl group (P = NS) but lower compared with HTN group (P = 0·02). On multivariable analysis, compared with Ctrl group, HTN group was associated with faster AS progression rate (P = 0·002), whereas ARBs with slower progression (P = 0·0008). During a mean follow‐up of 6·2 ± 2·4 years, HTN (hazard ratio [HR] = 2·45; P = 0·006) and ACEI (HR = 2·30; P = 0·01) groups were associated with a significant increase in all‐cause mortality compared with Ctrl group, whereas ARB group (HR: 0·89; P = 0·80) not. In multivariable analysis, HTN and ACEI groups remained associated with increased mortality.ConclusionsHypertension is associated with significantly faster stenosis progression and higher incidence of clinical events in patients with AS. ARBs but not ACEs were found to abolish the increased risk of mortality associated with hypertension.
Familial mediterranean fever: a fascinating model of inherited autoinflammatory disorder
Authors: Portincasa Piero , Scaccianoce Giuseppe , Palasciano Giuseppe 
Published: September 2013

AbstractBackgroundFamilial Mediterranean fever (FMF) is a rare inherited autosomal recessive autoinflammatory disorder characterized by recurrent and self‐limited episodes of fever and painful serositis, lasting 1–3 days. FMF occurs almost exclusively among ethnic groups of the Mediterranean basin, although cases have also been found in Japan and Korean populations. Diagnosis is based on clinical features, response to colchicine and genetic analysis. Novel drugs are emerging, allowing better management of colchicine‐resistant/colchicine‐intolerant patients. This review aims to attract the attention of the readers on differential diagnosis and management of patients with FMF.MethodsThe current state‐of‐the‐art on FMF is outlined, with respect to epidemiological, genetic, pathophysiological and therapeutic characteristics, based on critical analysis of solid scientific literature.ResultsFMF is more frequent than it was thought before. The phenotypic expression of M694V is more severe than that of V726A. Patients with M694V/M694V homozygosity are exposed to a higher risk of developing renal amyloidosis, arthritis, dermatologic and oral lesions, higher fever and more frequent painful attacks. Life‐long therapy with colchicine (1·0–2·4 mg/day) is effective and safe to prevent recurrent attacks and renal amyloidosis and to reverse proteinuria. In nonresponder patients, alternative novel approaches include interleukin‐1 receptor antagonist anakinra and the interleukin‐1 decoy receptor rilonacept.ConclusionsThe prognosis of FMF is normal if AA amyloidosis is prevented. Colchicine remains the first‐line therapy to treat pain and prevent amyloidosis. A follow‐up should include clinical evaluation, therapeutic adjustments, measurement of serum amyloid A and proteinuria.
A list of highly influential biomedical researchers, 1996–2011
Authors: Boyack Kevin W. , Klavans Richard , Sorensen Aaron A. , Ioannidis John P.A. 
Published: September 2013

AbstractWe have generated a list of highly influential biomedical researchers based on Scopus citation data from the period 1996‐2011. Of the 15,153,100 author identifiers in Scopus, approximately 1% (n=149,655) have an h‐index >=20. Of those, we selected 532 authors who belonged to the 400 with highest total citation count (>=25,142 citations) and/or the 400 with highest h‐index (>=76). Of those, we selected the top‐400 living core biomedical researchers based on a normalized score combining total citations and h‐index. Another 62 authors whose focus is outside biomedicine had a normalized score that was at least as high as the score of the 400th core biomedical researcher. We provide information on the profile of these most influential authors, including the most common Medical Subject Heading terms in their articles that are also specific to their work, most common journals where they publish, number of papers with over 100 citations that they have published as first/single, last, or middle authors, and impact score adjusted for authorship positions, given that crude citation indices and authorship positions are almost totally orthogonal. We also show for each researcher the distribution of their papers across 4 main levels (basic‐to‐applied) of research. We discuss technical issues, limitations and caveats, comparisons against other lists of highly‐cited researchers, and potential uses of this resource.
Comprehensive management of a complex traumatic dental injury
Authors: Cotti Elisabetta , Esposito Stefano , Jacobs Reinhilde , Slagmolen Pieter , Bakland Leif K. 
Published: September 2013

AbstractA 24‐year‐old female patient presented with complaint of palatal swelling and a sinus tract facial to tooth #22. She reported an injury to the tooth 15 years earlier and no recollection of treatment, although there was evidence of an endodontic access into the crown. Radiographically the root appeared to have stopped developing, and it was associated with a large periapical lesion. After 3 unsuccessful attempts at apexification using calcium hydroxide (CH), further examination including use of cone‐beam computed tomography (CBCT) was carried out. The latter allowed for better evaluating the situation and for better planning a more comprehensive treatment plan to include surgical removal of the apical lesion. The large radiolucent area extended from tooth #21 to #23. Using a dedicated software tool developed to be used in conjunction with CBCT, volumetric assessment of the lesion was carried out for healing follow up. The root end was filled from the apical direction with newly developed accelerated silicate cement 4–5 mm into the apical part of the canal. Subsequently, the rest of the canal was filled with the same type of cement. At the 1‐year postsurgical follow up, the tooth remained asymptomatic, and using the CBCT volumetric program, bony healing could be demonstrated.
Association between adolescents' self‐perceived oral health and self‐reported experiences of abuse
Authors: Kvist Therese , Annerbäck Eva‐Maria , Sahlqvist Lotta , Flodmark Olof , Dahllöf Göran 
Published: September 2013

This study investigated the association between self‐perceived oral health and self‐reported exposure to different types of child abuse. It was hypothesized that self‐perceived oral health is compromised in exposed adolescents. All Grade‐9 compulsory school and second‐year high‐school pupils in Södermanland County, Sweden (n = 7,262) were invited to take part in a population‐based survey; 5,940 adolescents responded. Survey items on health and social wellbeing included self‐perceived oral health and exposure to abuse. The results showed that poor self‐perceived oral health was associated with self‐reported experience of physical abuse, intimate partner violence, forced sex, and bullying (adjusted OR = 2.3–14.7). The likelihood of reporting poor oral health increased from an adjusted OR of 2.1 for a single incident of abuse to an adjusted OR of 23.3 for multiple abuses. In conclusion, poor self‐perceived oral health and previous exposure to child physical abuse, intimate partner violence, bullying, and forced sex is associated. It is important that dental professionals recognize adolescents with poor subjective oral health and take into consideration child abuse as a possible cause in order to prevent these adolescents from further victimization. These results further strengthen that dental professionals are an important resource in child protection.
Historical vignette: Medical treatment of status epilepticus
Authors: Janz Dieter 
Published: September 2013

SummaryThe treatment of status epilepticus has changed over the past five decades since the first colloquium on status epilepticus, held in Marseille in 1962. New intravenous drugs, such as valproate, levetiracetam, lacosomide or ketamine and new routes of administration, such as intranasal or bucal, as well as high‐class randomized clinical trials in the prehospital setting and early stages of status have changed the field. However it is remarkable, how the basic principles and difficulties of treatment of status epilepticus have remained the same. This article is as a translation of a narrative review authored by Dieter Janz at the Marseille Colloquium 1962, published in 1967. The medical practice and all available treatment at that time have been reviewed critically in the article. The translation of the original French article has been kept as close as possible to the original, to give a detailed account on the treatment of status at that time.
The London‐Innsbruck Status Epilepticus Colloquia 2007–2011, and the main advances in the topic of status epilepticus over this period
Authors: Shorvon Simon , Trinka Eugen 
Published: September 2013

SummaryIn this article, the three previous London‐Innsbruck Colloquia on Status Epilepticus are reviewed. The background to the colloquia and the range of topics covered in each colloquium are outlined. The areas in which advances in the study of status epilepticus, and also areas in which advances have been disappointing are highlighted.
A role for inflammation in status epilepticus is revealed by a review of current therapeutic approaches
Authors: Janigro Damir , Iffland II Philip H. , Marchi Nicola , Granata Tiziana 
Published: September 2013

SummaryA significant number of patients with epilepsy fail to respond to currently available antiepileptic drugs. This suggests a need for alternative approaches to reduce the occurrence of seizures in these patients. Recent data have shown that in addition to well‐known neuronal mechanism, seizures may be a consequence of misguided inflammatory response and blood–brain barrier disruption. Both peripheral and brain proinflammatory events have been demonstrated to govern the onset of status epilepticus. Evidence deriving from the experimental and clinical realms supports the notion that a role for proinflammatory and cerebrovascular events in seizure disorders is broader than previously suspected. As a result, methods to pharmacologically reduce blood–brain barrier permeability and reduce inflammation have emerged as means to reduce seizure burden. For instance, corticosteroids have been shown to be beneficial and the same agents may be able to further reduce seizure burden in conjunction with currently prescribed antiepileptic drugs.
Intrinsic epileptogenicity of dysplastic cortex: Converging data from experimental models and human patients
Authors: Battaglia Giorgio , Colciaghi Francesca , Finardi Adele , Nobili Paola 
Published: September 2013

SummaryFocal cortical dysplasia (FCD) is a brain malformation associated with particularly severe drug‐resistant epilepsy that often requires surgery for seizure control. The molecular basis for such enhanced propensity to seizure generation in FCD is not as yet elucidated. To investigate cellular and molecular bases of epileptogenic mechanisms and possible effect of severe epilepsy on the malformed cortex we have here performed a parallel analysis of a rat model of acquired cortical dysplasia previously established in our laboratory, i.e., the methylazoxymethanol/pilocarpine (MAM‐PILO) rats, and surgical samples from patients with type IIB FCD.Data from the MAM‐PILO rat model and human FCD samples reveal in both conditions: (1) that status epilepticus (SE) and/or seizures can further modify the cellular and molecular settings of the malformed cortex; (2) excitation/inhibition imbalance, and dysregulation of the N‐methyl‐d‐aspartate/ membrane‐associated guanylate kinase (NMDA/MAGUK) expression; (3) activation of cell death in neurons and glia. The data therefore highlight the mechanistic relevance of glutamate/NMDA hyperactivation in FCD epileptogenesis and suggest that epilepsy is a pathologic process capable of affecting structure and function of both neurons and glia.
Neurogenesis and neuronal regeneration in status epilepticus
Authors: Rotheneichner Peter , Marschallinger Julia , Couillard‐Despres Sebastien , Aigner Ludwig 
Published: September 2013

SummaryNeurogenesis in the adult central nervous system has been well documented in several mammals including humans. By now, a plethora of data has been generated with the aim of understanding the molecular and cellular events governing neurogenesis. This growing comprehension will provide the basis for modulation of neurogenesis for therapeutic purposes, in particular in neurodegenerative diseases. Herein, we review the current knowledge on neurogenesis, in particular in the frame of epilepsy, since seizures have massive effects on neurogenesis. Conversely, some studies have suggested that aberrant neurogenesis might contribute to the development or manifestation of epilepsy and, moreover, chronic inhibition of neurogenesis in epilepsy might contribute to comorbidities of epilepsy such as cognitive deficits. Therefore, a better understanding of neurogenesis in the context of epilepsy is still required for future therapeutic purposes.
Autoimmunity, seizures, and status epilepticus
Authors: Davis Rebecca , Dalmau Josep 
Published: September 2013

SummaryThe recent discovery of a category of autoimmune encephalitis associated with antibodies against neuronal cell‐surface and synaptic proteins has renewed interest for autoimmune causes of epilepsy. The identification of autoimmune encephalitis has changed paradigms in the diagnosis and management of several novel and treatable syndromes that occur with seizures and status epilepticus previously attributed to viral or idiopathic etiologies. This review focuses on the novel group of autoimmune encephalitis and also discusses some classical paraneoplastic syndromes that constitute another group of autoimmune disorders that may result in seizures.
The multifaceted care of status epilepticus
Authors: Wijdicks Eelco F. M. 
Published: September 2013

SummaryAfter seizures have been controlled, long‐term care of status epilepticus may be needed and collectively involves every major organ. First, as a result of rapid escalation of antiepileptic drugs, there are initial concerns with hypotension, acid‐base abnormalities, and cardiac arrhythmias. Second, refractory status epilepticus and the continuous need for intravenous administration of anesthetic drugs will lead to a multitude of systemic complications that require long‐term complex care. Most anticipated problems are infectious complications with a high risk of pneumonia and sepsis, but thromboembolism due to immobilization and catheter placement are also common. If a good outcome is possible or anticipated in a patient with refractory status epilepticus, physicians should plan for a surveillance and treatment protocol to adequately support these patients.
What can we learn from status epilepticus registries?
Authors: Ferlisi Monica , Hocker Sara 
Published: September 2013

SummaryThere is a remarkable dearth of information about the various therapies used, often widely so, to control refractory or super‐refractory status epilepticus despite its high mortality and morbidity. As pointed out by recent literature reviews, there are no controlled studies, and information is based almost entirely on open, often small and retrospective, case series or case reports. Randomized or controlled studies that are sufficiently powered are not feasible in relation to the many therapies and treatment approaches available. For this reason, we proposed an international case registry of therapies used in refractory and super‐refractory cases and their outcome. Clinicians from different countries will be asked to complete an online questionnaire when they treat a patient with refractory or super‐refractory status epilepticus. Information gathered from this database will summarize the spectrum of etiologies, treatments, and outcomes of this challenging condition and may even form the bases for treatment guidelines or future targeted treatment trials.
Treatment of Recurrent Electrographic Nonconvulsive Seizures (TRENdS) Study
Authors: Husain Aatif M. 
Published: September 2013

SummaryNonconvulsive seizures (NCS) and nonconvulsive status epilepticus (NCSE) are electrographic seizures (ESz) that are not associated with overt clinical seizure activity. NCS are distinct ESz, whereas NCSE has ongoing, continuous electrographic seizure activity. Both are common in critically ill patients admitted to hospital intensive care units (ICUs), and studies have shown that about 20% of ICU patients undergoing continuous electroencephalography (cEEG) monitoring will have NCS/NCSE. Although the treatment for convulsive SE is well established, there is no clear consensus for the treatment of NCS/NCSE. Antiepileptic drugs (AEDs), such as phenytoin (PHT) and fosphenytoin (fPHT), used in convulsive SE are also used to treat NCS/NCSE despite lack of data for their appropriateness for these conditions. Recent studies have shown that very aggressive treatment of NCSss/NCSE can lead to worse outcomes because the AEDs used can have significant adverse effects. Recently, several intravenous (IV) AEDs have become available for substitution therapy when their oral use is not possible. There are retrospective case reports and case series that suggest that these AEDs may be beneficial for treatment of NCS/NCSE. The Treatment of Recurrent Electrographic Nonconvulsive Seizures (TRENdS) Study will compare the efficacy and tolerability of fPHT and lacosamide in patients having NCS as noted by cEEG monitoring. The study is currently open to recruitment and has 13 sites in the United States. A total of 200 subjects will be randomized, 100 to each treatment arm.