bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hop Water Extract Inhibits Double-stranded RNA-induced Thymic Stromal Lymphopoietin Release from Human Nasal Epithelial Cells
Authors: Fuchimoto Jun , Kojima Takashi , Kobayashi Naoyuki , Ohkuni Tsuyoshi , Ogasawara Noriko , Masaki Tomoyuki , Obata Kazufumi , Nomura Kazuaki , Kondoh Atsushi , Shigyo Tatsuro , Himi Tetsuo , Sawada Norimasa 
Published: December 2012

Background Thymic stromal lymphopoietin (TSLP) acts as a master switch for allergic inflammation and plays a key role in allergic diseases, including allergic rhinitis. Double-stranded RNA (dsRNA) recognized by Toll-like receptor 3 (TLR3) strongly activates TSLP release from human human nasal epithelial cells (HNECs). Hop (Humulus lupulus L.) extracts have been shown to have potent pharmacologic effects on inflammation. Methods To investigate whether a hop water extract (HWE) prevents TSLP release from HNECs, human telomeras reverse transcriptase (hTERT)-transfected HNECs, used as a model of normal HNECs, were pretreated with HWE before treatment with the TLR3 ligand Polyinosine-polycytidylic acid (poly[I:C]). Results In the hTERT-transfected HNECs, treatment with HWE significantly reduced poly(I:C)-induced production and release of TSLP in a dose-dependent manner, as well as dexamethasone. Treatment with the protein kinase C (PKC) inhibitor GF109203X and NF-κB inhibitor IMD-0354 also reduced poly(I:C)-induced TSLP release from hTERT-transfected HNECs. Treatment with HWE efficiently prevented up-regulation of PKC activity by 12-O-tetradecanoyl phorbol-13-acetate but not NF-κB activity induced by IL-1β in hTERT-transfected HNECs. Conclusion Our results clearly indicated that HWE inhibited dsRNA-induced production and release of TSLP via a PKC signal pathway in HNECs and it may have potent preventive effects against allergic rhinitis.
The Correlation of Microbiology Growth between Subperiosteal Orbital Abscess and Affected Sinuses in Young Children
Authors: Eviatar Ephraim , Lazarovitch Tsilia , Gavriel Haim 
Published: December 2012

Background Subperiosteal orbital abscess (SPOA) typically presents as a collection of pus in the space between the periorbit and the lamina papyracea adjacent to the infected paranasal sinuses. The aim of this study was to investigate the simultaneous microbiological growth from an SPOA and the paranasal sinuses in the same children. Methods A retrospective study was performed on cultures obtained from involved sinuses and surgically drained abscesses in young children with SPOA from January 1992 to March 2009. Results Twenty-two children with a mean age of 5.9 years were included. Results of the microbiological studies were available from the sinuses of 17 children (77.2%) and from the SPOA in 18 children (81.8%). High rates of staphylococci bacteria and Streptococcus viridans were observed compared with lower-than-expected upper respiratory tract infection pathogens. Both groups showed scarce anaerobic and polymicrobial growth. In 13 children (59%), both sinus and abscess culture results were available with correlation found in only 4 (30.7%) of these children. Conclusion In this study we report the results of bacteriological studies of nasal sinuses and SPOAs in young children, with a low rate of correlation between both sites and low rates of anaerobic growth, but high rates of staphylococcal growth in the SPOA cultures. These observations might be related to the trend toward conservative treatment in children.
Rhinoplasty from a Rhinologist's Perspective: Need for Recognition of Associated Sinonasal Conditions
Authors: Picavet Valerie A. , Grietens Jente , Jorissen Mark , Hellings Peter W. 
Published: December 2012

Background Facial plastic surgeons may primarily focus on esthetic improvement of the nasal shape in patients seeking rhinoplasty (RP). However, medical conditions inside the nasal cavity should not be neglected because they may lead to unresolved sinonasal problems and, hence, dissatisfaction after esthetic RP. This observational study investigated the prevalence of sinonasal symptoms and endonasal pathology in patients requesting esthetic RP. Methods Patients seeking RP (n = 269) were given a questionnaire evaluating nasal obstruction and sinonasal symptoms using visual analog scales and the 22-item Sino-Nasal Outcome Test. In addition, patients underwent nasal endoscopy to evaluate anatomic and/or mucosal disease and skin-prick testing in case of clinical suspicion of allergy. Two control groups consisted of patients with an otological or general ear/nose/throat problem (n = 65) and patients who planned for endoscopic sinus surgery (ESS; n = 90). Results The general appraisal of nasal breathing on a scale from 0–10 in patients seeking RP was as low as 4.3 ± 3.1. Structural pathology was found in 62% of RP patients, with septal deviation being the most frequent problem encountered (54%), followed by internal nasal valve dysfunction (14%). Mucosal disease was present in 28% of RP patients. The mean SNOT-22 score of RP patients (31.8 ± 23.3) was significantly higher than the control group (11.6 ± 7.9; p < 0.001), but lower than the ESS patients (48.5 ± 22.0; p < 0.001). Conclusion The prevalence of endonasal structural or mucosal pathology in patients seeking RP is high and should not be overlooked at the time of planning surgery.
Does Hereditary Hemorrhagic Telangiectasia Affect Olfactory or Gustatory Function?
Authors: Steinbach Silke , Fasunla Ayotunde J. , Schäfers Sophia P. , Lahme Carolin M.E. , Geisthoff Urban W. , Hundt Walter , Wolf Petra , Mandic Robert , Werner Jochen A. , Eivazi Behfar 
Published: December 2012

Background The olfactory and gustatory functions of hereditary hemorrhagic telangiectasia (HHT) patients have not been documented by validated tests. Disorders of the nasal/oral cavity may interfere with the olfactory and gustatory functions. Fifty-four HHT patients were investigated by smell/taste tests. Methods HHT patients provided subjective ratings in areas such as ability to perceive smell/taste. “Sniffin’ Sticks” were used for smell tests, and taste strips were used for taste tests. Results HHT patients rated their subjective olfactory and gustatory function on a visual analog scale from 0 (none) to 100 (high) as 65.3 ± 27.7 and 68.1 ± 25.1, respectively. Comparison of smell test results of HHT patients with normative data of sex- and age-matched controls from Hummel et al. revealed that HHT patients had lower threshold values, whereas there was no difference in identification and discrimination values. HHT patients were hyposmic. In the case of taste qualities, all values (sweet, sour, salty, and bitter) in HHT patients were lower than those in normative data of Mueller et al. However, HHT patients were not hypogeusic. The duration of disease, extranasal manifestation, and treatments did not significantly correlate with smell/taste test values. Conclusion Compared with healthy people, HHT patients exhibit reduced olfactory and gustatory function; however, HHT patients are hyposmic and not hypogeusic. This chemosensory deficit may highlight an early sign of disease and has no correlation with disease severity. HHT patients should be informed about these potential disease manifestations, thus enabling them to improve their quality of life.
Endoscopic Sinus Surgery Might Reduce Exacerbations and Symptoms More than Balloon Sinuplasty
Authors: Koskinen Anni , Penttilä Matti , Myller Jyri , Hammarén-Malmi Sari , Silvola Juha , Haahtela Tari , Hytönen Maija , Toppila-Salmi Sanna 
Published: December 2012

Background Endoscopic sinus surgery (ESS) is considered after medical therapy failure of chronic rhinosinusitis (CRS). The balloon sinuplasty dilates the natural ostium without moving mucosa or bone. It still lacks evidence from randomized controlled trials. The aim of this retrospective controlled study was to compare the symptom outcomes after maxillary sinus surgery with either the ESS or the balloon sinuplasty technique. No previous or additional sinonasal operations were accepted. Methods Two hundred eight patients with CRS without nasal polyps underwent either balloon sinuplasty or ESS. The patients who met with the inclusion criteria (n = 45 in ESS group and n = 40 in balloon group) replied to a questionnaire of history factors, exacerbations, and a visual analog scale (VAS) scoring of the change in symptoms, on average 28 ± 6 (mean ± SD) months postoperatively. Results The groups were identical in the response rate (64%), patient characteristics, and the improvement in all of the asked symptoms. Patients with CRS-related comorbidity and/or present occupational exposure had a statistically significantly better symptom reduction after ESS than after balloon sinusotomy. Moreover, the balloon sinusotomy group reported a statistically significant higher number of maxillary sinus punctures and antibiotic courses during the last 12 months. Conclusion ESS might be superior to balloon sinuplasty, especially in patients with risk factors. There is a need to perform more controlled studies on the treatment choices of CRS.
Revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, adjacent-segment disease, or same-level recurrent stenosis. Part 1. Two-year outcomes and clinical efficacy
Authors: Adogwa Owoicho , Carr Ricardo K. , Kudyba Katherine , Karikari Isaac , Bagley Carlos A. , Gokaslan Ziya L. , Theodore Nicholas , Cheng Joseph S. 
Published: December 2012

Object
Same-level recurrent lumbar stenosis, pseudarthrosis, and adjacent-segment disease (ASD) are potential complications that can occur after index lumbar spine surgery, leading to significant discomfort and radicular pain. While numerous studies have demonstrated excellent results following index lumbar spine surgery in elderly patients (age > 65 years), the effectiveness of revision lumbar surgery in this cohort remains unclear. The aim of this study was to assess the long-term effectiveness of revision lumbar decompression and fusion in the treatment of symptomatic pseudarthrosis, ASD, and same-level recurrent stenosis, using validated patient-reported outcomes.

Methods
After a review of the institutional database, 69 patients who had undergone revision neural decompression and instrumented fusion for ASD (28 patients), pseudarthrosis (17 patients), or same-level recurrent stenosis (24 patients) were included in this study. Baseline and 2-year scores on the visual analog scale for leg pain (VAS-LP), VAS for back pain (VAS-BP), Oswestry Disability Index (ODI), and Zung Self-Rating Depression Scale (SDS) as well as the time to narcotic independence, time to return to baseline activity level, health state utility (EQ-5D, the EuroQol-5D health survey), and physical and mental component summary scores of the 12-Item Short-Form Health Survey (SF-12 PCS and MCS) were assessed.

Results
Compared with the preoperative status, VAS-BP was significantly improved 2 years after surgery for ASD (mean ± standard deviation 9 ± 2 vs 4.01 ± 2.56, p = 0.001), pseudarthrosis (7.41 ± 1 vs 5.52 ± 3.08, p = 0.02), and same-level recurrent stenosis (7 ± 2.00 vs 5.00 ± 2.34, p = 0.003). The 2-year ODI was also significantly improved after surgery for ASD (29 ± 9 vs 23.10 ± 10.18, p = 0.001), pseudarthrosis (28.47 ± 5.85 vs 24.41 ± 7.75, p = 0.001), and same-level recurrent stenosis (30.83 ± 5.28 vs 26.29 ± 4.10, p = 0.003). The Zung SDS score and SF-12 MCS did not change appreciably after surgery in any of the cohorts, with an overall mean 2-year change of 1.01 ± 5.32 (p = 0.46) and 2.02 ± 9.25 (p = 0.22), respectively.

Conclusions
Data in this study suggest that revision lumbar decompression and extension of fusion for symptomatic pseudarthrosis, ASD, and same-level recurrent stenosis provides improvement in low-back pain, disability, and quality of life and should be considered a viable treatment option for elderly patients with persistent or recurrent back and radicular pain. Mental health symptoms may be more refractory to revision surgery.
Revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, adjacent-segment disease, or same-level recurrent stenosis. Part 2. A cost-effectiveness analysis
Authors: Adogwa Owoicho , Owens Ryan , Karikari Isaac , Agarwal Vijay , Gottfried Oren N. , Bagley Carlos A. , Isaacs Robert E. , Cheng Joseph S. 
Published: December 2012

Object
Despite advances in technology and understanding in spinal physiology, reoperation for symptomatic adjacent-segment disease (ASD), same-level recurrent stenosis, and pseudarthrosis in elderly patients continues to occur. While revision lumbar surgery is effective, attention has turned to questions on the utility and value of the revision decompression and fusion procedure. To date, an analysis of the cost and health state gain associated with revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, ASD, or same-level recurrent lumbar stenosis has yet to be performed. The aim of this study was to assess the long-term outcomes and cost-effectiveness of revision surgery in elderly patients with recurrent or persistent back and leg pain.

Methods
After reviewing their institutional database, the authors found 69 patients 65 years of age and older who had undergone revision decompression and instrumented fusion for back and leg pain associated with pseudarthrosis (17 patients), same-level recurrent stenosis (24 patients), or ASD (28 patients) and included them in this study. Total 2-year back-related medical resource utilization and health state values (quality-adjusted life years [QALYs], calculated from the EQ-5D, the EuroQol-5D health survey, with US valuation) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts. The mean total 2-year cost per QALY gained after revision surgery was assessed.

Results
The mean (± standard deviation) time between the index surgery and revision surgery was 3.51 ± 3.63 years. A mean cumulative 2-year gain of 0.35 QALY was observed after revision surgery. The mean total 2-year cost of revision surgery was $28,256 ± $3000 (ASD: $28,829 ± $3812, pseudarthrosis: $28,069 ± $2508, same-level recurrent stenosis: $27,871 ± $2375). Revision decompression and extension of fusion was associated with a mean 2-year cost of $80,594 per QALY gained.

Conclusions
Revision decompression and fusion provided a significant gain in health state utility for elderly patients with symptomatic pseudarthrosis, same-level recurrent stenosis, or ASD, with a mean 2-year cost of $80,594 per QALY gained. When indicated, revision surgery for symptomatic ASD, same-level recurrent stenosis, and pseudarthrosis is a valuable treatment option for elderly patients experiencing persistent back and leg pain. Findings in this study provided a value measure of surgery that can be compared with future cost-per-QALY-gained studies of medical management or alternative surgical approaches.
Formulation and characterization of gastroretentive drug delivery system of losartan potassium
Authors: Jaimini Manish , Tanwar Yuveraj Singh , Srivastava Birendra 
Published: December 2012

Floating matrix tablets of losartan potassium were developed with an aim to prolong its gastric residence time and increase the bioavailability of drug. Rapid gastrointestinal transit could result in incomplete drug release from the drug delivery system above the absorption zone leading to diminished efficacy of the administered dose. The tablets were prepared by wet granulation technique, using polymers Methocel K15 and Methocel K100 in combination with other standard excipients. Sodium bicarbonate was incorporated as gas generating agent. The effects of sodium bicarbonate and polymers on drug release profile and floating properties were investigated. It was found that viscosity of Methocel K15 and Methocel K100 along with sodium bicarbonate had significant impact on the release and floating properties of the delivery system. The decrease in the release rate was observed with an increase in the viscosity of the polymeric system. Polymer with high viscosity Methocel K100 was shown to be beneficial than low viscosity polymer Methocel K15 in improving the floating properties of gastric floating drug delivery system (GFDDS). The observed difference in the drug release and floating properties of GFDDS could be attributed to the difference in the basic properties of two polymers, Methocel K15 and Methocel K100 due to their water uptake potential and functional group substitution. The release mechanism were explored and described with zero-order, first-order and Korsmeyer-Peppas equations. The drug release profiles and buoyancy of the floating tablets were stable when stored at 40°C/75% RH for 6 months.DOI: http://dx.doi.org/10.3329/icpj.v2i1.12872 International Current Pharmaceutical Journal 2012, 2(1): 11-17
An 83-Year-Old Man with Worsening Cognitive Decline
Authors: Fischer Rachel , Konstantinidis Ioannis , Linares Francisco , McGonigle Daniel , Simon Asher B. 
Published: December 2012

CME Educational Objectives

1.
Identify classic presentation of vascular dementia.

2.
Know the most effective treatments for vascular dementia and when they are indicated.

3.
Understand the impact of medical comorbidities on vascular dementia.

The patient is an 83-year-old white man who is widowed and a former professor with a PhD in education, now retired and living in assisted senior housing due to impairments resulting from Alzheimer’s dementia. His medical history is significant for hypertension, type 2 diabetes mellitus, coronary artery disease, and colon cancer in remission.
An 84-Year-Old Man with Agitation
Authors: Baldes David , Nelson Katharine J. 
Published: December 2012

CME Educational Objectives

1.
Recognize the impact of behavioral and psychological symptoms of dementia, including agitation.

2.
Identify nonpharmacological interventions for agitation in patients with dementia.

3.
Describe the risks and benefits associated with treatment with atypical antipsychotic medications for management of agitation in patients with dementia.

An 84-year-old, married, white man with a history of idiopathic Parkinson’s disease with dementia, hypertension, hyperlipidemia, and coronary artery disease was brought by ambulance to the emergency department for agitation and confusion. His wife had summoned emergency services after he struck her in the face. She reported that the patient had worsening nighttime agitation over the previous 7 to 10 days. She also noted he had worsening shortness of breath on exertion and cough over this period of time.
A 75-Year-Old Man with Provoked Confabulation
Authors: Egol Claudine , Rapp Erica , Simon Asher B. 
Published: December 2012

CME Educational Objectives

1.
Recognize the presenting symptoms of Alzheimer’s dementia.

2.
Know the differences between Korsakoff syndrome and Alzheimer’s dementia.

3.
Know the relationship between alcohol consumption and Alzheimer’s dementia.

The patient is a 75-year-old man who presented to the outpatient psychiatric clinic for evaluation and treatment of worsening memory and difficulty managing household tasks. According to the patient’s wife, though his memory decline started 3 years ago, she has most recently noticed his significant word finding difficulties and frequent “story-telling,” prompting her to seek further evaluation.
A 43-Year-Old Man with Memory and Behavior Disturbance
Authors: Dickmann Patricia J. , Nelson Katharine J. 
Published: December 2012

CME Educational Objectives

1.
Recognize the diverse symptoms and signs of tertiary syphilis.

2.
Identify appropriate laboratory screening and confirmatory tests for syphilis.

3.
Have awareness of the rising rates of syphilis in the United States.

A 43-year-old single man, working for several years as a flight attendant, was evaluated in the emergency department for unusual behaviors. He denied significant psychiatric history or medical problems.
Outcomes of Femtosecond Laser Cataract Surgery With a Diffractive Multifocal Intraocular Lens
Authors: Lawless Michael , Bali Shveta Jindal , Hodge Chris , Roberts Timothy V. , Chan Colin , Sutton Gerard 
Published: December 2012

PURPOSE:
To report the visual and refractive outcomes in an initial series of eyes undergoing femtosecond laser cataract surgery with implantation of a diffractive multi-focal intraocular lens (IOL).

METHODS:
The first 61 consecutive eyes undergoing femtosecond laser cataract surgery and ReSTOR (Alcon Laboratories Inc) +3.00-diopter (D) add IOL implantation between May and July 2011 were enrolled in the study (LCS group). The control group consisted of a retrospective consecutive cohort of 29 eyes that underwent manual phacoemulsification cataract surgery and ReSTOR +3.00-D add IOL implantation (MCS group) between December 2010 and April 2011. Visual and refractive parameters were collected pre- and postoperatively at 1 and 3 months.

RESULTS:

Mean postoperative spherical equivalent refraction was −0.01±0.35 D and −0.06±0.30 D in the LCS and MCS groups, respectively (
P
=.492). Mean absolute refractive prediction error (PE) was 0.26±0.25 D for the LCS group and 0.23±0.16 D for the MCS group (
P
=.489). Mean arithmetic refractive PE was 0.06±0.44 D and −0.02±0.30 D for the LCS and MCS groups, respectively (
P
=.388). No significant difference was noted in mean postoperative uncorrected distance visual acuity or uncorrected near visual acuity between groups. No eyes in either group had surgical complications or loss of corrected distance visual acuity in the follow-up period.

CONCLUSIONS:
Mean spherical equivalent refraction and visual acuity of our initial group of patients undergoing laser cataract surgery are comparable to the manual phacoemulsification cohort for the AcrySof ReSTOR +3.00-D add IOL.
Pentacam HR Criteria for Curvature Change in Keratoconus and Postoperative LASIK Ectasia
Authors: Epstein Robert L. , Chiu Yi-Lin , Epstein Greg L. 
Published: December 2012

PURPOSE:
To determine criteria for keratoconus or postoperative LASIK ectasia progression or improvement based on Pentacam HR (Oculus Optikgeräte GmbH) measured steepest corneal curvature.

METHODS:
Sixty-one eyes from 41 patients with keratoconus or postoperative LASIK ectasia were evaluated. Each eye was measured 5 times with the Pentacam HR during the same clinic visit and the random measurement variations of Rmin(back) and maximal keratometry (Kmax; mathematically linked to Rmin[front]) were statistically analyzed. Confidence levels for diagnosing true curvature change were determined for 3 typical clinical situations differing by the number of available Pentacam measurements.

RESULTS:
With a single past and single present Pentacam HR measurement available (situation 1+1), the 95% confidence levels of true change for ΔKmax, ΔRmin(front), and ΔRmin(back) were 1.51 diopters (D), 0.162 mm, and 0.290 mm, respectively. With one prior and the average of five present Pentacam measurements (situation 5+1), the 95% confidence levels of true change for ΔKmax, ΔRmin(front), and ΔRmin(back) were 1.17 D, 0.126 mm, and 0.225 mm, respectively. With the average of five past and five present measurements (situation 5+5), the 95% confidence levels of true change for ΔKmax, ΔRmin(front), and ΔRmin(back) were 0.68 D, 0.072 mm, and 0.130 mm, respectively.

CONCLUSIONS:
Steepest corneal curvature changed with 95% confidence if the difference between single past and present Kmax exceeded 1.51 D. With the advantage of five past and five present measurements, 95% confidence of real Kmax change occurs at a 0.68-D difference.