bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Impact of Early CT Scans after Lateral Skull‐Base Surgery
Authors: Jiang Zi Yang , Allen Kyle , Kutz J. Walter , Isaacson Brandon 
Published: September 2013

ObjectiveTo determine the frequency and clinical significance of abnormalities on postoperative computerized tomography (CT) scans performed within 24 hours after lateral skull base surgery.Study DesignCase series with chart review.SettingInpatient tertiary care hospital.MethodsAdult patients undergoing lateral skull base surgery were identified using CPT code search from January 2010 to January 2013. Patient demographics, type of skull base lesion, surgical approach, length of operation, time between end of the surgery and CT scan, CT scan findings, and patients’ postsurgical neurologic status were collected.ResultsOne hundred and seventy‐two patients were identified who had a postoperative CT scan after lateral skull base surgery. Diagnoses included schwannoma (95), cerebrospinal fluid fistula (29), middle fossa encephaloceles (9), meningioma (13), superior semicircular canal dehiscence (12), and other disease processes (14). The approaches were middle fossa (64), translabyrinthine (70), suboccipital (17), infratemporal (8), and combined/other (13). Mild pneumocephalus was almost always found, along with mild extra‐axial blood. Twenty‐four patients had significant mass effect found on CT scan, but this was present preoperatively. Three patients had a mild subdural without neurological decline. No patient suffered any clinically significant neurological decline, although 5 patients reported finger numbness that resolved spontaneously and 2 patients had confusion in the immediate postoperative period.ConclusionClinically significant abnormalities on immediate postoperative CT scans were rare, as were cases of neurological decline. Further prospective studies could determine a more cost‐effective algorithm for routine use of postoperative imaging.
Does cannabis smoking predispose to lung bulla formation?
Authors: Fiorelli Alfonso , Accardo Marina , Vicidomini Giovanni , Messina Gaetana , Laperuta Paolo , Santini Mario 
Published: September 2013

Objective The data of a consecutive series of habitual marijuana smokers were retrospectively evaluated and compared with that of non-marijuana smokers to assess differences between the 2 groups. Methods 13 consecutive habitual marijuana smokers were referred for treatment of spontaneous pneumothorax. The demographic, clinical, radiological, and pathological findings of these patients were reviewed and compared with 140 non-marijuana smokers treated for the same pathology at the same time. Results Bullae were seen in 8/13 (62%) and 110/140 (78%) of marijuana smokers and non-marijuana smokers, respectively. However, when patients less than 35-years old were considered, the incidence of bulla was higher in marijuana smokers than non-marijuana smokers (7/10 vs. 3/10, p < 0.05). The pathological findings showed a greater presence of inflammatory cells in specimens from marijuana smokers than those of non-marijuana smokers (8/11 vs. 2/42, respectively, p < 0.05). No significant differences in hospital stay and clinical outcome were registered between the 2 groups. Conclusions Despite the fact that we were unable to demonstrate that marijuana had a causal role in the development of emphysema, our study showed that marijuana smokers had a higher incidence of inflammatory cells in pathological specimens, which may favor lung injury, thus predisposing to bulla formation.
Reduced embolic load during clinical cardiopulmonary bypass using a 20 micron arterial filter
Authors: Jabur GNS , Willcox TW , Zahidani SH , Sidhu K , Mitchell SJ 
Published: September 2013

Objective: To compare the efficiency of 20 and 40 µm arterial line filters during cardiopulmonary bypass for the removal of emboli from the extracorporeal circuit. Methods: Twenty-four adult patients undergoing surgery were perfused using a cardiopulmonary bypass circuit containing either a 20 µm or 40 µm arterial filter (n = 12 in both groups). The Emboli Detection and Classification system was used to count emboli upstream and downstream of the filter throughout cardiopulmonary bypass. The mean proportion of emboli removed by the filter was compared between the groups. Results: The 20 µm filter removed a significantly greater proportion of incoming emboli (0.621) than the 40 µm filter (0.334) (p=0.029). The superiority of the 20 µm filter persisted across all size groups of emboli larger than the pore size of the 40 µm filter. Conclusion: The 20 µm filter removed substantially more emboli than the 40 µm filter during cardiopulmonary bypass in this comparison.
The effect of mud therapy on pain relief in patients with knee osteoarthritis: A meta-analysis of randomized controlled trials
Authors: Liu Hua , Zeng Chao , Gao Shu-guang , Yang Tuo , Luo Wei , Li Yu-sheng , Xiong Yi-lin , Sun Jin-peng , Lei Guang-hua 
Published: September 2013

Objectives A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). Methods A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. Results A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] −0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD −0.30), with differences in favour of mud therapy. Conclusions Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion.
Tracheal intubation in intellectually disabled patients: Clinical usefulness of remifentanil and sevoflurane without a muscle relaxant
Authors: Cagiran Esra , Eyigor Can , Balcioglu Taner , Uyar Meltem 
Published: September 2013

Objective To compare two remifentanil doses (1 µg/kg and 2 µg/kg) in order to determine the preferred dose in intellectually disabled patients undergoing day care dental surgery under sevoflurane-induced general anaesthesia. Methods Patients were randomly assigned to receive either 1 µg/kg (group 1) or 2 µg/kg (group 2) remifentanil; both groups received 8% sevoflurane anaesthesia induction. All other conditions were identical in both groups. Heart rate (HR), mean arterial pressure (MAP) and intubation conditions were assessed. Results A total of 27/30 (90.0%) patients in group 1 and 29/30 patients (96.7%) in group 2 had acceptable intubation conditions. Remifentanil administration resulted in significant reductions in HR compared with baseline levels, in both groups. There were no significant between-group differences in HR at any timepoint. MAP decreased significantly compared with baseline in group 2 only. Conclusion Successful tracheal intubation in intellectually disabled patients can be accomplished with a combination of 1 µg/kg or 2 µg/kg remifentanil and 8% sevoflurane anaesthesia induction, without the requirement for neuromuscular blocking drugs.
Three single nucleotide polymorphisms of the vascular endothelial growth factor (VEGF) gene and glioma risk in a Chinese population
Authors: Jiang Haitao , Lian Minxue , Xie Jiangtao , Li Jinzheng , Wang Maode 
Published: September 2013

Objective To investigate the association between three single nucleotide polymorphisms (SNPs) of the vascular endothelial growth factor ( VEGF) gene and the risk of glioma in a Han Chinese population. Methods This hospital-based case–control study used polymerase chain reaction–restriction fragment length polymorphism analysis to detect three SNPs (−634 G/C, +936 C/T and +1612 G/A) of the VEGF gene in patients with glioma compared with healthy control subjects. Results The study investigated 880 patients with gliomas and 880 age- and sex-matched healthy control subjects. Patients with gliomas had a significantly higher frequency of the −634 CC genotype (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.05, 1.75) and the +936 TT (OR 1.73, 95% CI 1.20, 2.48) genotype compared with the control subjects. Patients with glioblastomas had a significantly higher frequency of the −634 CC and +936 TT genotypes. Patients with grade IV gliomas had a significantly higher frequency of the −634 CC and +936 TT genotypes. The +1612 G/A polymorphisms were not associated with glioma risk. Conclusion The VEGF − 634 CC and +936 TT genotypes were associated with a higher risk of glioma in a Han Chinese population.
Suture Anchor Fixation of Bony Bankart Fractures
Authors: Giles Joshua W. , Puskas Gabor J. , Welsh Mark F. , Johnson James A. , Athwal George S. 
Published: September 2013

Background: As an alternative to the standard single-point suture-anchor technique, a suture-bridge technique has been described for the treatment of bony Bankart fractures. There is, however, little evidence supporting one technique over the other. Purpose/Hypothesis: To compare the failure strength, fixation stability, and loading mechanics of the 2 techniques for the fixation of bony Bankart fractures. We hypothesized that use of the double-point suture-bridge technique would result in superior strength and fixation stability because of the increased compression and contact area between the bony fragment and glenoid fracture site. Study Design: Controlled laboratory study. Methods: A total of 16 shoulders (8 pairs) were tested with an intact glenoid, after creation of a 15% bony Bankart fracture, and after fragment fixation using a single-point or suture-bridge technique. Paired specimens were randomly assigned to each technique. Cyclic progressive loading was applied via a materials testing machine to the glenoid concentrically and eccentrically according to a staircase protocol. Failure strength, fragment displacement, glenoid strain load transfer, and contact area were quantified. Results: No significant differences in failure strength were found between the single-point and suture-bridge techniques (mean strength, 74 ± 28 N vs 77 ± 56 N, respectively; P = .91). Additionally, no significant differences were found for glenoid load transfer ( P ≥ .318) and glenohumeral joint contact ( P = .357) between the 2 techniques. Centralized loading, however, produced significant differences in fragment displacement at 5, 150, and 200 N ( P ≤ .045), with the single-point technique permitting greater fragment displacement in all cases (0.06-0.28 mm). Similarly, eccentric loading caused significantly greater fragment displacement with the single-point technique at ≥25 N compared with the suture-bridge technique (mean range, 0.38-0.63 mm vs 0.14-0.19 mm, respectively; .009 ≤ P ≤ .048). Conclusion: Single-point and suture-bridge techniques for the fixation of bony Bankart fragments have equivalent failure strengths and load transfers. The suture-bridge technique does provide statistically greater initial fracture fragment stability; however, the clinical implications of this are presently unknown. Clinical Relevance: This study will aid in the selection of the optimal repair technique for bony Bankart fractures by providing important insights into the quality of initial fixation and ultimate strength.
Clinical Outcomes After Chronic Distal Biceps Reconstruction With Allografts
Authors: Snir Nimrod , Hamula Mathew , Wolfson Theodore , Meislin Robert , Strauss Eric J. , Jazrawi Laith M. 
Published: September 2013

Background: Chronic ruptures of the distal biceps are often complicated by tendon retraction and fibrosis, precluding primary repair. Reconstruction with allograft augmentation has been proposed as an alternative for cases not amenable to primary repair. Purpose: To investigate the clinical outcomes of late distal biceps reconstruction using allograft tissue. Study Design: Case series; Level of evidence, 4. Methods: A total of 20 patients who underwent distal biceps reconstruction with allograft tissue between May 2007 and May 2012 were identified. Charts were retrospectively reviewed for postoperative complications, gross flexion and supination strength, and range of motion. Subjective functional outcomes were assessed prospectively with the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results: Eighteen patients with adequate follow-up were included in the study. All had undergone late distal biceps reconstruction with allografts (Achilles [n = 15], semitendinosus [n = 1], gracilis [n = 1], or anterior tibialis [n = 1]) for symptomatic chronic ruptures of the distal biceps. At a mean office follow-up of 9.3 months (range, 4-14 months), all patients had full range of motion and mean gross strength of 4.7 of 5 (range, 4-5) in flexion and supination. After a mean out-of-office follow-up at 21 months (range, 7-68.8 months), the mean DASH score was 7.5 ± 17.9, and the mean MEPS increased from 43.1 preoperatively to 94.2 postoperatively ( P < .001). The only complication observed was transient posterior interosseous nerve palsy in 2 patients. Additionally, all but 1 patient reported a cosmetic deformity. However, all patients found it acceptable. Conclusion: Late reconstruction for chronic ruptures of the distal biceps using allograft tissue is a safe and effective solution for symptomatic patients with functional demands in forearm supination and elbow flexion. While there are several graft options, the literature supports good results with Achilles tendon allografts. Further studies are needed to evaluate the clinical outcomes of other allograft options.
Binary lipids-based nanostructured lipid carriers for improved oral bioavailability of silymarin
Authors: Shangguan Mingzhu , Lu Yi , Qi Jianping , Han Jin , Tian Zhiqiang , Xie Yunchang , Hu Fuqiang , Yuan Hailong , Wu Wei 
Published: September 2013

The main purpose of this study was to prepare binary lipids-based nanostructured lipid carriers to improve the oral bioavailability of silymarin, a poorly water-soluble liver protectant. Silymarin-loaded nanostructured lipid carriers were prepared by the method of high-pressure homogenization with glycerol distearates (Precirol ATO-5) and oleic acid as the solid and liquid lipids, respectively, and lecithin (Lipoid E 100) and Tween-80 as the emulsifiers. The silymarin-nanostructured lipid carrier prepared under optimum conditions was spherical in shape with mean particle size of ∼78.87 nm, entrapment efficiency of 87.55%, loading capacity of 8.32%, and zeta potential of −65.3 mV, respectively. In vitro release of silymarin-nanostructured lipid carriers was very limited even after 12 h, while in vitro lipolysis showed fast digestion of nanostructured lipid carriers within 1 h. Relative oral bioavailability of silymarin-nanostructured lipid carriers in Beagle dogs was 2.54- and 3.10-fold that of marketed Legalon® and silymarin solid dispersion pellets, respectively. It was concluded that nanostructured lipid carriers were potential drug delivery systems to improve the bioavailability of silymarin. Other than improved dissolution, alternative mechanisms such as facilitated absorption as well as lymphatic transport may contribute to bioavailability enhancement.
The Value of Laboratory Tests in Diagnosing Secondary Osteoporosis at a Fracture and Osteoporosis Outpatient Clinic
Authors: Klerk Gijs de , Hegeman J. Han , van der Velde Detlef , van der Palen Job , van Bergeijk Leo , Duis Henk J. ten 
Published: September 2013

Background: As more and more patients meeting the criteria for osteoporosis are referred to a fracture and osteoporosis outpatient clinic (FO clinic), the laboratory costs to screen for secondary osteoporosis also increases. This study was conducted to determine the value of screening on underlying diseases at an FO clinic by obtaining a standard set of laboratory tests. Methods: We included all 541 patients ≥50 years with a fracture referred to our FO clinic, during the period January 2005 to January 2007. The bone mineral density (BMD) was measured by dual energy x-ray absorptiometry and expressed as a T score. A standard set of laboratory tests was obtained to screen on underlying diseases. Results: Laboratory results were as often abnormal in patients with a normal BMD compared to patients with a low BMD. Underlying diseases were infrequently diagnosed. However, the prevalence of secondary osteoporosis in men was quite high, up to 18.2%. The costs to diagnose 1 patient with an underlying disease did vary between €92 and €972 depending on the group of patients described. Conclusion: Screening all patients, referred to an FO clinic, for underlying diseases by obtaining a standard set of laboratory tests is probably not useful since laboratory tests are as often abnormal in patients with a normal BMD compared to patients with a low BMD. Moreover, the prevalence of secondary osteoporosis is low, while laboratory costs are substantial.
A Magnetic Resonance Imaging Study of the Significance of the Distal Femoral Physis During Medial Patellofemoral Ligament Reconstruction
Authors: Greenrod William , Cox James , Astori Ivan , Baulch Justin , Williams John 
Published: September 2013

Background: Medial patellofemoral ligament (MPFL) reconstruction in adults often utilizes screw fixation in the distal femur. The aim was to define the safety of similar fixation in young patients, with respect to their open physis. Purpose: To define the age-related relationship between the femoral insertion of the MPFL and the medial aspect of the distal femoral physis on magnetic resonance imaging (MRI) scans. The study investigates whether screw fixation at this point is safe with respect to patient age and screw inclination. Study Design: Cross-sectional study. Methods: Retrospective review of the MRI scans of 159 skeletally immature patients. The femoral insertion of the MPFL was defined with respect to the distal femoral physis. The predicted paths of 2-cm screw fixation were simulated both parallel to the joint line and 45° distally oblique; physeal and joint penetration were noted when present. Results are plotted against age and compared as quartile ranges. Results: The femoral insertion of the MPFL was found to be distal to the distal femoral physis in all patients by an average of 10 mm (range, 2-16 mm). The mean distance increases slightly with age in a nonlinear relationship ( r = 0.51, P < .001) from 9 mm at age 10 years to 12 mm by age 16 years. For the classic, parallel screw, the risk of physeal breach is high for all age groups (mean, 64%). For the novel, oblique screw, joint penetration and physeal breach were less prevalent (mean, 13%), and importantly, the vast majority of these breaches were in younger children (age <9 years 9 months). With oblique screws, older children were at significantly lower risk than younger children (<3% vs 48%; P < .001). Conclusion: This study accurately defines the relationship between the femoral insertion of the MPFL and the distal femoral physis in children and adolescents. A high risk of potentially poor outcomes was found during anatomic reconstruction of the MPFL in children utilizing classic (parallel) screw fixation, irrespective of age. However, in children older than 10 years, a 20-mm screw, from the anatomic MPFL insertion and directed 45° distally oblique, should be safe in 98% of patients.
NETosis: how vital is it?
Authors: Yipp Bryan G. , Kubes Paul 
Published: September 2013

AbstractIn this review, we examine the evidence that neutrophil extracellular traps (NETs) play a critical role in innate immunity. We summarize how NETs are formed in response to various stimuli and provide evidence that NETosis is not universally a cell death pathway. Here we describe at least 2 different mechanisms by which NETs are formed, including a suicide lytic NETosis and a live cell or vital NETosis. We also evaluate the evidence for NETs in catching and killing pathogens. Finally, we examine how infections are related to the development of autoimmune and vasculitic diseases through unintended but detrimental bystander damage resulting from NET release.
Sexual activity increases resistance against Pseudomonas entomophila in male Drosophila melanogaster
Authors: Gupta Vanika , Ali Zeeshan S , Prasad Nagaraj G 
Published: September 2013

Abstract

Background
Maintenance and deployment cost of immunity is high, therefore, it is expected to trade-off with other high cost traits like sexual activity. Previous studies with Drosophila melanogaster show that male’s ability to clear bacteria decreases with increase in sexual activity. We subjected this idea to test using two pathogens (Pseudomonas entomophila and Staphylococcus succinus) and three different populations of Drosophila melanogaster.

Results
We found that sexual activity enhanced male survivorship in a pathogen specific manner. Sexually active males show higher resistance than virgins upon infection with Pseudomonas entomophila. Interestingly, the beneficial effects of sexual activity increased with time of co-habitation with females and declined when access to females was restricted. We observed no change in male survivorship upon experimentally varying the number of sexual interactions.

Conclusion
Our results show that the sexual activity-immunity trade-off in males cannot be generalised. The trade-off is potentially mediated through complex interactions between the host, pathogen and the environment experienced by the host.