bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hoarseness Misattributed to Reflux
Authors: Sulica Lucian 
Published: April 2014

Objective: This study aimed to identify voice disorders commonly misidentified as reflux and sources of such misattribution. Study Design: Retrospective chart review. Methods: Twenty-six patients carrying a diagnosis of reflux alone presenting for second-opinion evaluation were identified from among 381 new patients presenting with a chief complaint of hoarseness over an 8-month period. Patients specifically referred for further workup were excluded. Results: Average duration of reflux treatment was 10.6 ± 9.0 weeks. In no case was reflux alone the cause of hoarseness. Eleven (42%) had phonotraumatic lesions, 9 (34%) had neurologic disorders, 5 (19%) had age-related changes, and 1 (4%) was infectious. Twenty-two (85%) abnormalities were diagnosed by dynamic laryngeal examination with improved optics, including stroboscopy. Only 4 (15%) represented disorders routinely diagnosed with flexible fiberoptic laryngoscopy. Conclusion: Hoarse patients with no apparent cause for dysphonia other than reflux after flexible laryngoscopy, or who fail to improve with appropriate treatment, may benefit from further laryngeal investigation rather than continued empiric treatment or further reflux evaluation.
Reducing the Negative Vocal Effects of Superficial Laryngeal Dehydration With Humidification
Authors: Levendoski Elizabeth Erickson , Sundarrajan Anusha , Sivasankar M. Preeti 
Published: April 2014

Objectives: Environmental humidification is a simple, cost-effective method believed to reduce superficial laryngeal drying. This study sought to validate this belief by investigating whether humidification treatment would reduce the negative effects of superficial laryngeal dehydration on phonation threshold pressure (PTP). Phonation threshold pressure data analysis may be vulnerable to bias because of lack of investigator blinding. Consequently, this study investigated the extent of PTP analysis reliability between unblinded and blinded investigators. Methods: Healthy male and female adults were assigned to a vocal fatigue (n = 20) or control group (n = 20) based on their responses to a questionnaire. PTP was assessed after 2 hours of mouth breathing in low humidity (dehydration challenge), following a 5-minute break in ambient humidity, and after 2 hours of mouth breathing in high humidity (humidification). Results: PTP significantly increased following the laryngeal dehydration challenge. After humidification, PTP returned toward baseline. These effects were observed in both subject groups. PTP measurements were highly correlated between the unblinded and blinded investigator. Conclusions: Humidification may be an effective approach to decrease the detrimental voice effects of superficial laryngeal dehydration. These data lay the foundation for future investigations aimed at preventing and treating the negative voice changes associated with chronic, surface laryngeal drying.
Reduction of Spinal Loads Through Adjustable Interventions at the Origin and Destination of Palletizing Tasks
Authors: Ramsey Todd , Davis Kermit G. , Kotowski Susan E. , Anderson Vern P. , Waters Thomas 
Published: April 2014

Objective: This article evaluates the effectiveness of two interventions: a self-leveling pallet carousel designed to position the loads vertically and horizontally at origin, and an adjustable cart designed to raise loads vertically at destination to reduce spine loads. Background: Low back disorders among workers in manual material handling industries are very prevalent and have been linked to manual palletizing operations. Evidence into the effectiveness of ergonomic interventions is limited, with no research that investigates interventions with adjustable load location. Method: Thirteen males experienced in manual material handling participated in simulated order selecting tasks where spine loads were quantified for each intervention condition: carousel to traditional cart, pallet to traditional cart, pallet to adjustable cart, and carousel to adjustable cart. Results: The results showed that combining both devices results in reduction in spine compression (61%), anterior-posterior shear (72%), and lateral shear (63%) compared to traditional palletizing conditions. Individually, the carousel was responsible for the greatest reductions, but the lowest values were typically achieved by combining the adjustable cart and carousel. Conclusion: The combination of the interventions (self-leveling carousel and adjustable cart) was most effective in reducing the spine loads when compared to the traditional pallet-cart condition. The individual interventions also reduced the loads compared to the traditional condition. Application: With de-palletizing/palletizing tasks being a major source of low back injuries, the combination of self-leveling carousel and adjustable cart has been found to be effective in reducing the peak spine loading as compared to traditional pallet on floor and nonadjustable flat cart conditions.
Adenoid cystic carcinoma of the lacrimal gland metastatic to the kidney: case report and review of the literature
Authors: Bacalja Jasna , Magazin Maja , Ulamec Monika , Rako Duje , Trnski Davor , Krušlin Božo 
Published: April 2014

Introduction: Adenoid cystic carcinoma (ACC) is a malignant neoplasm that arises within secretory glands. It rarely occurs in the lacrimal gland. Kidney metastases are very rare. Case presentation: We report a case of a 76-year-old female patient treated with right radical nephrectomy because of the tumour mass of the right kidney. Well-circumscribed, firm, grey mass was found on the lower pole of the kidney. Histologically, tumour was considered to be ACC. Retrospective history data showed ACC of the lacrimal gland surgically treated 14 years before with metastasis to the lung operated seven years before. Our diagnosis was metastatic ACC to the kidney. Conclusion: ACC has a remarkable capacity for recurrence. To our knowledge, in the English-speaking area (PubMed), 10 cases of ACC metastatic to the kidney have been described to date, and this is the second reported case of kidney metastasis from primary lacrimal ACC.
Web-based physiotherapy for people moderately affected with Multiple Sclerosis; quantitative and qualitative data from a randomized, controlled pilot study
Authors: Paul Lorna , Coulter Elaine H , Miller Linda , McFadyen Angus , Dorfman Joe , Mattison Paul George G 
Published: April 2014

Objective: To explore the effectiveness and participant experience of web-based physiotherapy for people moderately affected with Multiple Sclerosis (MS) and to provide data to establish the sample size required for a fully powered, definitive randomized controlled study. Design: A randomized controlled pilot study. Setting: Rehabilitation centre and participants’ homes. Subjects: Thirty community dwelling adults moderately affected by MS (Expanded Disability Status Scale 5-6.5). Interventions: Twelve weeks of individualised web-based physiotherapy completed twice per week or usual care (control). Online exercise diaries were monitored; participants were telephoned weekly by the physiotherapist and exercise programmes altered remotely by the physiotherapist as required. Main measures: The following outcomes were completed at baseline and after 12 weeks; 25 Foot Walk, Berg Balance Scale, Timed Up and Go, Multiple Sclerosis Impact Scale, Leeds MS Quality of Life Scale, MS-Related Symptom Checklist and Hospital Anxiety and Depression Scale. The intervention group also completed a website evaluation questionnaire and interviews. Results: Participants reported that website was easy to use, convenient, and motivating and would be happy to use in the future. There was no statistically significant difference in the primary outcome measure, the timed 25ft walk in the intervention group ( P=0.170), or other secondary outcome measures, except the Multiple Sclerosis Impact Scale ( P=0.048). Effect sizes were generally small to moderate. Conclusion: People with MS were very positive about web-based physiotherapy. The results suggested that 80 participants, 40 in each group, would be sufficient for a fully powered, definitive randomized controlled trial.
A study of noninvasive positive-pressure mechanical ventilation in the treatment of acute lung injury with a complex critical care ventilator
Authors: Zhang Jing , Cao Jie , Feng Jing , Wu Qi , Chen Bao-Yuan 
Published: April 2014

Objective * These authors contributed equally to this work. To test the hypothesis that there would be better clinical outcomes following the treatment of patients with acute lung injury (ALI) using noninvasive positive-pressure mechanical ventilation (NIPPV) delivered via a complex critical care ventilator compared with a conventional mini-ventilator. Methods Patients with ALI who required NIPPV were prospectively enrolled and randomly divided between three intervention groups: group A was ventilated using a mini-ventilator; groups B and C were ventilated using a complex critical care ventilator using different settings. Clinical parameters were recorded before and after 8 h of mechanical ventilation. Results A total of 51 patients with ALI were enrolled in the study. Clinical parameters in groups B and C underwent greater improvements than those in group A. Group C demonstrated the lowest treatment failure rate (23.5%). Failure rates were highest in group A (58.8%). Conclusion The findings of this present study suggest that there were more satisfactory clinical outcomes following the treatment of patients with ALI when NIPPV was delivered using a complex critical care ventilator compared with a conventional mini-ventilator.
The analgesic efficacy and safety of nefopam in patient-controlled analgesia after cardiac surgery: A randomized, double-blind, prospective study
Authors: Kim Kyungmi , Kim Wook-Jong , Choi Dae-Kee , Lee Yoon Kyung , Choi In-Cheol , Sim Ji-Yeon 
Published: April 2014

Objective The efficacy and side-effects of nefopam were prospectively compared with those of fentanyl for patient-controlled analgesia (PCA) following cardiac surgery. Methods Patients scheduled to undergo cardiac surgery were randomly assigned between three PCA groups (nefopam, fentanyl or nefopam + fentanyl). Pain was assessed at rest and during movement at 12, 24, 36, 48 and 72 h after surgery using a visual analogue scale (VAS). Total infused PCA volume, number of rescue drug injections, duration of intubation and length of stay in the intensive care unit were recorded. The incidence of adverse effects was noted at 48 h postoperatively. Results There were no significant between-group differences in VAS score, total PCA infusion volume or number of rescue injections ( n = 92 per group). Nausea was significantly more common in the fentanyl group compared with both other groups. Conclusions PCA with nefopam alone provides suitable postoperative analgesia after cardiac surgery.
The Effect of Mechanical Load on Tendon-to-Bone Healing in a Rat Model
Authors: Hettrich Carolyn M. , Gasinu Selom , Beamer Brandon S. , Stasiak Mark , Fox Alice , Birmingham Patrick , Ying Olivia , Deng Xiang-Hua , Rodeo Scott A. 
Published: April 2014

Background: Joint motion is commonly prescribed after tendon repair surgeries such as rotator cuff repairs; however, the ideal rehabilitation program to optimize tendon-to-bone healing is unknown. Hypotheses: (1) Delayed loading would result in a mechanically stronger and better organized tendon-to-bone interface compared with prolonged immobilization or immediate loading. (2) Low-magnitude load would lead to superior healing compared with high-magnitude load. Study Design: Controlled laboratory study. Methods: A total of 192 rats underwent unilateral patellar tendon detachment and repair followed by placement of a custom external fixator. Rats were assigned to immobilization, immediate postoperative loading, or delayed-onset loading (4- or 10-day delay). Loading was controlled using a specially designed motorized device to apply constant strain until 3 N (low load) or 6 N (high load) of axial tensile force was reached through the healing bone-tendon complex for 50 cycles per day. Rats were sacrificed at 4, 10, 21, or 28 days postoperatively for histomorphometric, immunohistochemical, radiographic, molecular, and biomechanical analyses. Results: The load to failure was significantly higher in the immobilized group compared with the immediate and delayed loading groups ( P < .05). Compared with loaded specimens, the immobilized specimens had significantly less fibrocartilage (at 4, 10, and 28 days), significantly better collagen fiber organization (at 4, 10, and 21 days), decreased expression of matrix metalloproteinase-13 (at 10, 21, and 28 days), and significantly fewer apoptotic cells (at 21 and 28 days). Micro–computed tomographic analyses showed that the 3-N immediate load group had significantly less total volume ( P = .012), bone volume ( P = .012), and bone mineral density ( P = .023) for cortical bone, and the immobilized group had significantly more specimens with new bone formation at the enthesis (100%; P = .001). Conclusion: Immobilization results in a stronger tendon-bone complex, with less scar tissue and a more organized tendon-bone interface compared with all loading regimens in this study. Clinical Relevance: Given the relatively high rate of failure after rotator cuff and other tendon-to-bone repairs, identification of optimal rehabilitation programs postoperatively is an important research goal.
Internal and External Political Dynamics Influencing Lesotho’s Foreign Policy
Authors: Mahlakeng M.K. , Solomon Hussein 
Published: April 2014

Due to the globalised nature of the world, the political foreign policies of landlocked states (LLS) have been affected, resulting in landlocked countries lagging behind their maritime neighbours in the overall development. Within the notion of landlocked states, it is important to note that there is a difference between states surrounded by the territory of only one other state, which can be defined as ‘enclaves’, and those that have several other states to engage with. The problems of enclaves are more delicate and serious than those of non-enclave LLS. Their mere economic existence, leading to political existence, may depend heavily upon the benevolence of their encircling neighbours. The Kingdom of Lesotho is an enclave landlocked, independent parliamentary constitutional monarchy, entirely surrounded by the Republic of South Africa. The tiny landlocked country, covering 30,355 square kilometres, has been subject to both internal and external political issues. Lesotho has had numerous forms of government, coups and internal political factions, which have hindered political development and stability. Detrimental to its economy, sovereignty and political power was the 1998 South African - Southern African Development Community (SADC) military intervention. The article explores these issues.
COMMUNI-CARE: Assessment tool for reactions and behaviours of patients with dementia in a multisensory stimulation environment
Authors: Lopez José Javier Blanco , Bolívar Juan Carlos Cejudo , Perez Manuel Sánchez 
Published: April 2014

Background The ‘Snoezelen’ is an approach based on stimulation and sensory stimulation proposals, giving priority to the notion of caretaking. The aim of this paper is to present the creation and validation of the COMMUNI-CARE scale. This is a new tool that allows for an evaluation of the psycho-emotional well-being that the patient with dementia shows in a ‘Snoezelen’ multisensory stimulation environment. Methods In total 429 evaluations in 143 multisensory stimulation interventions were made using the COMMUNI-CARE scale, in 16 patients between 53 and 85 years of age, diagnosed with moderate to severe dementia. The goal was to evaluate the psycho-emotional well-being the patients present. Results The tool’s internal consistency showed a Crombach alpha of 0.90. The concurrent validity between the COMMUNI-CARE scale and the Clinical Global Impression (CGI) was of r = −0.961. The Kappa index used to determine the reliability between evaluators was of K = 0.87. Conclusions The COMMUNI-CARE scale fulfills the basic principles of classic psychometrics of construct, and criterion validity and reliability. It does so while showing a clear idea, through its five subscales (anxiety, communication, pleasure, adaptation to the surroundings and affection), of the degree of well-being that the patient with dementia shows during such interventions. This scale embodies, through psychometrics, a very subjective human experience with a tool unavailable to date.
Diagnosis and therapy for prostate tuberculosis
Authors: Kulchavenya Ekaterina , Brizhatyuk Elena , Khomyakov Victor 
Published: April 2014

In its 2012 global report on tuberculosis, the World Health Organization estimated that 3–7% (range 2.1–5.2%) of new cases and 20% (range 13–26%) of previously treated cases had multidrug-resistant tuberculosis (defined as tuberculosis caused by Mycobacterium tuberculosis isolates that are resistant to rifampicin and isoniazid). In many countries in Eastern Europe and central Asia, 9–32% of new patients and more than 50% of previously treated patients have multidrug-resistant tuberculosis. Ninety-three patients with suspected prostate tuberculosis were enrolled in this study and all underwent prostate biopsy. This method allowed confirmation of diagnosis in 32 patients (34.4%): 23 by histology, six by culture and five by polymerase chain reaction (PCR) (among them, two also had positive culture). The efficiency of an optimized scheme for the therapy of prostate tuberculosis (the second part of the study) was estimated in 53 patients. The first group (25 patients) was treated with a standard scheme of chemotherapy; the second group (28 prostate tuberculosis patients) received ofloxacin in addition for 2 months during the intensive phase. The phase continuation in both groups was identical, with rifampicin and isoniazid administered for 6 months. Optimization of the standard therapy by additional administration of ofloxacin improved results of the treatment in 33.8% of patients.
Association of the Single-Limb Hop Test With Isokinetic, Kinematic, and Kinetic Asymmetries in Patients After Anterior Cruciate Ligament Reconstruction
Authors: Xergia Sofia A. , Pappas Evangelos , Georgoulis Anastasios D. 
Published: April 2014

Background: Asymmetries persist after anterior cruciate ligament reconstruction (ACLR). Physical performance tests such as the single-limb hop test have been used extensively to assess return-to-sport criteria, as they reproduce dynamic athletic maneuvers. Hypothesis: The single-limb hop is associated with muscle strength and kinematic and kinetic asymmetries in ACLR patients 6 to 9 months after surgery. Study Design: Controlled laboratory study. Methods: Twenty-two men with ACLR (mean age, 28.8 ± 11.2 years) at 6 to 9 months (mean, 7.01 ± 0.93 months) after surgery completed isokinetic testing in 3 velocities (120, 180, and 300 deg/s) and a kinetic, kinematic, and functional evaluation of the single-limb hop test. Pearson correlation coefficients were used to assess the relationship between the Limb Symmetry Index (LSI) of the single-limb hop distance and each of the outcome variables. Results: There were significant positive correlations between the LSI of the single-limb hop distance and the LSI of the peak extension torque at 120 deg/s ( P = 0.044, r = 0.37) and the peak extension torque at 180 deg/s ( P = 0.042, r = 0.38) as well as a negative correlation with the peak flexion torque at 180 deg/s ( P = 0.043, r = −0.38). The LSI of the single-limb hop test was not correlated with any kinetic or kinematic variable ( P > 0.05). Conclusion: The findings of the present study demonstrate that distance LSI of the single-limb hop test correlates with isokinetic extension peak torque LSI but not kinetic and kinematic asymmetry. Clinical Relevance: The single-limb hop test can be used as an additional tool for the recognition of muscle strength asymmetries but not for kinetic or kinematic asymmetries 6 to 9 months after ACLR.
JAK2V617F homozygosity drives a phenotypic switch in myeloproliferative neoplasms, but is insufficient to sustain disease
Authors: Li Juan , Kent David G. , Godfrey Anna L. , Manning Harriet , Nangalia Jyoti , Aziz Athar , Chen Edwin , Saeb-Parsy Kourosh , Fink Juergen , Sneade Rachel , Hamilton Tina L. , Pask Dean C. , Silber Yvonne , Zhao Xiaodong , Ghevaert Cedric , Liu Pentao , Green Anthony R. 
Published: April 2014

Key PointsJAK2V617F homozygosity drives a phenotypic switch between myeloproliferative neoplasms. JAK2V617F homozygosity is insufficient to sustain clonal expansion.
Diagnoses, problems and healthcare interventions amongst older people with an unscheduled hospital admission who have concurrent mental health problems: a prevalence study
Authors: Glover Alex , Bradshaw Lucy E , Watson Nicola , Laithwaite Emily , Goldberg Sarah E , Whittamore Kathy H , Harwood Rowan H 
Published: April 2014

AbstractBackgroundFrail older people with mental health problems including delirium, dementia and depression are often admitted to general hospitals. However, hospital admission may cause distress, and can be associated with complications. Some commentators suggest that their healthcare needs could be better met elsewhere.MethodsWe studied consecutive patients aged 70 or older admitted for emergency medical or trauma care to an 1800 bed general hospital which provided sole emergency medical and trauma services for its local population. Patients were screened for mental health problems, and those screening positive were invited to take part. 250 participants were recruited and a sub-sample of 53 patients was assessed by a geriatrician for diagnoses, impairments and disabilities, healthcare interventions and outstanding needs.ResultsMedian age was 86 years, median Mini-Mental State Examination score at admission was 16/30, and 45% had delirium. 19% lived in a care home prior to admission. All the patients were complex. A wide range of main admission diagnoses was recorded, and these were usually complicated by falls, immobility, pain, delirium, dehydration or incontinence. There was a median of six active diagnoses, and eight active problems. One quarter of problems was unexplained. A median of 13 interventions was recorded, and a median of a further four interventions suggested by the geriatrician. Those with more severe cognitive impairment had no less medical need.ConclusionsThis patient group, admitted to hospital in the United Kingdom, had numerous healthcare problems, and by implication, extensive healthcare needs. Patients with simpler conditions were not identified, but may have already been rapidly discharged or redirected to non-hospital services by the time assessments were made. To meet the needs of this group outside the hospital would need considerable investment in medical, nursing, therapy and diagnostic facilities. In the meantime, acute hospitals should adapt to deliver comprehensive geriatric assessment, and provide for their mental health needs.