bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of the competence of the sapheno-femoral junction on the mode of treatment of varicose veins by surgery
Authors: Chastanet S , Pittaluga P 
Published: May 2014

Background It is usually agreed that incompetence of the sapheno-femoral junction (SFJ) is the main indication for stripping or ablation of the great saphenous vein (GSV) in the treatment of varicose veins (VVs). We wanted to test this assumption in our surgical treatment of varicose veins. Methods Study design: retrospective study of the surgical procedures for VVs in our centre between January and October 2012 in patients with reflux in the GSV. The SFJ was considered to be incompetent when both terminal and pre-terminal valves were assessed as incompetent by duplex ultrasound duplex imaging. We compared the preoperative clinical and haemodynamic data according to the surgical procedure performed. Results We reviewed a total of 389 LLs operated on for VVs in which reflux was present in the GSV. The SFJ was incompetent preoperatively in 189 LLs (48.6%). The GSV was treated in 78 cases (20.1%) stripping in 24 cases and radiofrequency ablation (RFA) in 54 cases, while phlebectomy with preservation of the GSV (ASVAL = Ambulatory Selective Varices Ablation under Local Anaesthesia) was done in the 311 remaining cases (79.9%). Incompetence of the SFJ led to stripping or RFA of the GSV in 38.1% of the cases only. Treatment by stripping or RFA was associated with male gender (50% vs 18.9% P < 0.01 χ2), an older age (62.5 vs 53.1 yrs P < 0.01 t-test), a greater body mass index (BMI) (26.1 vs 23.8 P < 0.01 t-test), a higher frequency of CEAP Class C4 to C6 (33.3% vs 4.8% P < 0.01 χ2), a higher frequency of symptoms (94.4% vs 73.6% P < 0.01 χ2) and a greater diameter of the GSV at the thigh (8.1 vs 5.2 mm P < 0.01 t-test). At last the presence of a focal dilatation of the GSV and an extension of the reflux below the lower half of the calf were also more frequent in case of stripping or RFA (respectively 55.6% vs 10.3% and 84.6% vs 18.3% P < 0.01 χ2). Conclusion An incompetent SFJ was not the only clinical feature which determined the choice for preservation or ablation of the GSV in patients with varicose veins. In our experience a greater age, a higher BMI, the presence of trophic skin changes, extension of the reflux below the knee and a more damaged GSV trunk were also taken into account in order to decide whether to ablate or to preserve the GSV.
Compression to prevent the postthrombotic syndrome
Authors: Jeanneret Christina , Aschwanden Markus , Staub Daniel 
Published: May 2014

Summary We give an overview on the current literature concerning compression in the prevention of postthrombotic syndrome, including our own investigations of the hemodynamic changes over time in female and male patients. We also describe the evaluation of a combined reflux-occlusion score to predict occurrence of new pigmentation (C4).
Dutch Venous Ulcer guideline update
Authors: Maessen-Visch M Birgitte , de Roos Kees-Peter 
Published: May 2014

The revised guideline of 2013 is an update of the 2005 guideline “venous leg ulcer”. In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates.
Fainting as an unusual presentation of a large inferior vena cava leiomyosarcoma
Authors: Luca Giuseppe Massimiliano De , Gurrado Angela , Marzullo Andrea , Piccinni Giuseppe , Memeo Riccardo , Vacca Angelo , Testini Mario 
Published: May 2014

Objectives Primary tumors of the inferior vena cava are rare, with leiomyosarcoma representing the vast majority. Method A 60-year-old man was admitted in emergency for fainting and mild anemia. A whole-body computed tomography revealed a retroperitoneal mass of approximately 8 cm in diameter, invading the lumen of the inferior vena cava, extending to the renal vein confluence. An en bloc resection of the solid mass was performed. Macroscopically the tumor did not seem to insist on the resection margin. Results Histopathological examination confirmed the diagnosis of leiomyosarcoma of the inferior vena cava. Postoperative recovery was uneventful and the patient was discharged after eight days, starting adjuvant chemotherapy. During the follow-up, the patient did not show other fainting episode, and at 24 months he is disease free. Conclusions: Unusually, fainting could even be the isolated sign of a large leiomyosarcoma of the inferior vena cava, also when it affects its middle portion.
Natural history of deep vein thrombosis in children
Authors: Spentzouris G , Gasparis A , Scriven RJ , Lee TK , Labropoulos N 
Published: May 2014

Objective To determine the natural history of deep vein thrombosis in children presented with a first episode in the lower extremity veins. Methods Children with objective diagnosis of acute deep vein thrombosis were followed up with ultrasound and clinical examination. Risk factors and clinical presentation were prospectively collected. The prevalence of recurrent deep vein thrombosis and the development of signs and symptoms of chronic venous disease were recorded. Results There were 27 children, 15 males and 12 females, with acute deep vein thrombosis, with a mean age of 4 years, range 0.1–16 years. The median follow-up was 23 months, range 8–62 months. The location of thrombosis involved the iliac and common femoral vein in 18 patients and the femoral and popliteal veins in 9. Only one vein was affected in 7 children, two veins in 14 and more than two veins in 6. Recurrent deep vein thrombosis occurred in two patients, while no patient had a clinically significant pulmonary embolism. Signs and symptoms of chronic venous disease were present at last follow-up in 11 patients. There were nine patients with vein collaterals, but no patient developed varicose veins. Reflux was found in 18 veins of 11 patients. Failure of recanalization was seen in 7 patients and partial recanalization in 11. Iliofemoral thrombosis ( p = 0.012) and failure to recanalize ( p = 0.036) increased significantly the risk for developing signs and symptoms. Conclusions Children with acute proximal deep vein thrombosis develop mild chronic venous disease signs and symptoms at mid-term follow-up and are closely related with iliofemoral thrombosis and failure to recanalization.
Antibody against chromatin assembly factor-1 is a novel autoantibody specifically recognized in systemic lupus erythematosus
Authors: Doe K , Nozawa K , Hiruma K , Yamada Y , Matsuki Y , Nakano S , Ogasawara M , Nakano H , Ikeda T , Ikegami T , Fujishiro M , Kawasaki M , Ikeda K , Amano H , Morimoto S , Ogawa H , Takamori K , Sekigawa I , Takasaki Y 
Published: May 2014

Autoantibodies to proliferating cell nuclear antigen (PCNA) are specifically, if rarely, present in systemic lupus erythematosus (SLE) patient sera. Even SLE patients lacking PCNA reactivity often show reaction to PCNA-binding protein. Here, immunoreactivity to chromatin assembly factor-1 (CAF-1), an essential molecule for DNA replication and a PCNA-binding protein, was compared for the sera of SLE patients, normal healthy controls (NHCs) and other disease controls, and in autoimmune sera reactive to standard autoantigens, by enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence, and immunoblotting. CAF1 and IRF1 expression in SLE and NHC peripheral mononuclear cells were compared by quantitative real-time polymerase chain reaction. Serum interferon-γ-inducing protein-10 and anti-double-stranded (ds)DNA antibody levels were measured by ELISA. Increased CAF-1 autoimmune reactivity was recognized in SLE or serum anti-dsDNA antibody-positive patients. Significantly greater central nervous system (CNS) involvement (aseptic meningitis) and serum anti-dsDNA antibody titers were present more often in anti-CAF-1 antibody-positive than antibody-negative SLE patients. IFN-γ positively regulated CAF-1 expression in vitro and was associated with anti-CAF-1 antibody production in SLE. Thus, a novel anti-CAF-1 autoantibody is frequently found in patients with SLE and is a useful biomarker for diagnosis, especially in cases with CNS involvement. Aberrant IFN-γ regulation appears to play an important role in anti-CAF-1 antibody production in SLE.
Prediction of springback in anisotropic sheet metals: The effect of orientation and friction
Authors: Nguyen VT , Thomson PF , Chen Z 
Published: May 2014

In this paper, springback of anisotropic sheet based on the modified form of the asymmetric non-quadratic yield function (YLD96) for plane stress conditions due to Barlat et al. (Yield function development for aluminium alloy sheets. J Mech Phys Solids 1997; 45: 1727–1763), suitable for describing mixed (isotropic and kinematic) hardening in aluminium alloy sheets under the Bauschinger Effect was compared with the results of tests. Simulation of uniaxial tensile and cyclic tests including both nonlinear isotropic and nonlinear kinematic hardening showed the necessity of including the Bauschinger effect in the constitutive equations at both small and large strains. Following the application to prediction of springback in draw bending of these alloys oriented in the rolling direction, draw-bending tests on AA2024-O and AA7075-O alloy sheets are described. The springback parameters of specimens with axes oriented at 45° and 90° to the rolling direction were measured and compared with prediction based on the modified form of the YLD96, which captured the hardening response at small and large strains when combined with the mixed hardening model, predicting springback in very good agreement with experimental results. The number of components of back stress used in this model depends on the nature of the nonlinear behaviour of the material. For alloys AA2024-O and AA7075-O, excellent agreement with experiments required the use of up to three nonlinear components of back stress. Prediction suggested values of friction consistent with published values and showed that friction inversely affected the radius of sidewall curl, but was not sensitive to lower and upper opening angle. This was consistent with the findings of Carden et al. (Measurement of springback. Int J Mech Sci 2002; 44: 79–101), although those authors also reported that very low friction may increase springback in their proposed draw-bending test. The results confirmed the efficacy of the yield surface model based on YLD96, modified to include nonlinear isotropic and nonlinear kinematic hardening, for predicting deformation subject to the Bauschinger effect.
Late spontaneous recanalization of symptomatic atheromatous internal carotid artery occlusion
Authors: Delgado Montserrat G , Vega Pedro P , Lahoz Carlos H , Calleja Sergio 
Published: May 2014

Introduction Definitive treatment of symptomatic atheromatous internal carotid artery occlusion remains controversial, as far as in rare cases, late spontaneous recanalization has been seen. Methods We consecutively studied 182 patients (January 2003 to August 2012) with an ischemic stroke in the internal carotid artery territory and diagnosis of atheromatous internal carotid artery occlusion during hospitalization. Findings Seven patients presented a late spontaneous recanalization (>3 months) of the internal carotid artery. We described therapeutic attitude according to usual care in these patients. Conclusions The authors attempt to highlight the unusual condition of recanalization after a symptomatic atheromatous chronic internal carotid artery occlusion. If these patients can be treated similar to patients with asymptomatic carotid pathology, then this needs to be clarified. However, due to the risk of ipsi- and contralateral ischemic strokes, revascularization techniques should be considered in certain cases. More studies are needed to establish the most appropriate therapeutical approach in order to avoid arbitrary treatment of these patients.
The legibility of prescription medication labelling in Canada
Authors: Leat Susan J. , Ahrens Kristina , Krishnamoorthy Abinaya , Gold Deborah , Rojas-Fernandez Carlos H. 
Published: May 2014

Introduction: The legibility of medication labelling is a concern for all Canadians, because poor or illegible labelling may lead to miscommunication of medication information and poor patient outcomes. There are currently few guidelines and no regulations regarding print standards on medication labels. This study analyzed sample prescription labels from Ontario, Canada, and compared them with print legibility guidelines (both generic and specific to medication labels). Methods: Cluster sampling was used to randomly select a total of 45 pharmacies in the tri-cities of Kitchener, Waterloo and Cambridge. Pharmacies were asked to supply a regular label with a hypothetical prescription. The print characteristics of patient-critical information were compared against the recommendations for prescription labels by pharmaceutical and health organizations and for print accessibility by nongovernmental organizations. Results: More than 90% of labels followed the guidelines for font style, contrast, print colour and nonglossy paper. However, only 44% of the medication instructions met the minimum guideline of 12-point print size, and none of the drug or patient names met this standard. Only 5% of the labels were judged to make the best use of space, and 51% used left alignment. None of the instructions were in sentence case, as is recommended. Discussion: We found discrepancies between guidelines and current labels in print size, justification, spacing and methods of emphasis. Conclusion: Improvements in pharmacy labelling are possible without moving to new technologies or changing the size of labels and would be expected to enhance patient outcomes.
Sample size requirements to detect a two- or three-way interaction in longitudinal cluster randomized clinical trials with second-level randomization
Authors: Heo Moonseong , Xue Xiaonan , Kim Mimi Y 
Published: May 2014

Background When randomizations are assigned at the cluster level for longitudinal cluster randomized trials (longitudinal-CRTs) with a continuous outcome, formulae for determining the required sample size to detect a two-way interaction effect between time and intervention are available. Purpose To show that (1) those same formulae can also be applied to longitudinal trials when randomizations are assigned at the subject level within clusters and (2) this property can be extended to 2-by-2 factorial longitudinal-CRTs with two treatments and different levels of randomization for which testing a three-way interaction between time and the two interventions is of primary interest. Methods We show that slope estimates from different treatment arms are uncorrelated, regardless of whether randomization occurs at the third or second level and also regardless of whether slopes are considered fixed or random in the mixed-effects model for testing two-way or three-way interactions. Sample size formulae are extended to unbalanced designs. Simulation studies were applied to verify the findings. Results Sample size formulae for testing two-way and three-way interactions in longitudinal-CRTs with second-level randomization are identical to those for trials with third-level randomization. In addition, the total number of observations required for testing a three-way interaction is demonstrated to be four times as large as that required for testing a two-way interaction, regardless of the level of randomization for both fixed- and random-slope models. Limitations The findings may be only applicable to longitudinal-CRTs with normally distributed continuous outcome. Conclusion All of the findings are validated by simulation studies and enable the design of longitudinal clinical trials to be more flexible in regard to the level of randomization and allocation of clusters and subjects.
Continuous Glucose Monitoring and Trend Accuracy
Authors: Signal Matthew , Gottlieb Rebecca , Le Compte Aaron , Chase J. Geoffrey 
Published: May 2014

Background: Continuous glucose monitoring (CGM) devices are being increasingly used to monitor glycemia in people with diabetes. One advantage with CGM is the ability to monitor the trend of sensor glucose (SG) over time. However, there are few metrics available for assessing the trend accuracy of CGM devices. Aim: The aim of this study was to develop an easy to interpret tool for assessing trend accuracy of CGM data. Methods: SG data from CGM were compared to hourly blood glucose (BG) measurements and trend accuracy was quantified using the dot product. Trend accuracy results are displayed on the Trend Compass, which depicts trend accuracy as a function of BG. A trend performance table and Trend Index (TI) metric are also proposed. The Trend Compass was tested using simulated CGM data with varying levels of error and variability, as well as real clinical CGM data. Results: The results show that the Trend Compass is an effective tool for differentiating good trend accuracy from poor trend accuracy, independent of glycemic variability. Furthermore, the real clinical data show that the Trend Compass assesses trend accuracy independent of point bias error. Finally, the importance of assessing trend accuracy as a function of BG level is highlighted in a case example of low and falling BG data, with corresponding rising SG data. Conclusions: This study developed a simple to use tool for quantifying trend accuracy. The resulting trend accuracy is easily interpreted on the Trend Compass plot, and if required, performance table and TI metric.
Diagenetic alterations in a silt- and clay-rich mudstone succession: an example from the Upper Cretaceous Mancos Shale of Utah, USA
Authors: Taylor K. G. , Macquaker J . H. S. 
Published: May 2014

An understanding of the nature and scales of diagenetic variability within organic-rich mudstones is critical to the accurate assessment of shale-gas reservoir properties, as well as for elucidating chemical evolution pathways within mudstones. Here we integrate field observations with thin section descriptions (optical and electron optical techniques) and mineralogical data for the Blackhawk Member time-equivalent Mancos Shale in Book Cliffs, Utah, to determine the impacts of early and burial diagenesis on this mudstone succession.The detrital assemblage in the Mancos Shale comprises quartz-silt, feldspar, clay minerals, dolomite and organic matter (TOC of 1 to 2.5%). Biogenic silica is negligible. Field mapping reveals laterally continuous (km scale), ferroan dolomite cemented units up to 0.3 m thick, are present. These cemented units cap both coarsening-upward units (1 to 3 m thick), and stacked successions of coarsening-upward units (5 to 15 m thick). These upward-coarsening sediment packages, capped by dolomite cemented strata, correlate to bedsets and parasequences in updip settings. Pervasive cementation in these dolomite-cemented units is likely to have occurred prior to compaction as a result of bacterially mediated respiratory processes. Cementation at these levels is particularly evident because cement precipitation occurred during breaks in sediment accumulation below marine flooding surfaces. The abundance of dolomite cements highlights the importance of macroscopic-scale diagenetic carbonate mobility in these mudstones.In addition to carbonate-cements, diagenetic alteration and precipitation of quartz and alumina-silicate minerals are also important in these mudstones. Kaolinite is present both in uncompacted test of organisms and as vein fills in septarian concretions. Kaolinite precipitation is interpreted to have occurred prior to significant compaction and indicates that both silicon and aluminium were mobile during early diagenesis. We interpret the abundance of early diagenetic kaolinite cement to be the result of Al-mobilization by organic acids generated during organic matter oxidation reactions, with the Al sourced from poorly crystalline detrital aluminium oxides and clay minerals. There is also indirect evidence for burial diagenetic kaolinitization of feldspar grains. Quartz cement takes the form of quartz overgrowths and microcrystalline quartz crystals. Textures and CL spectra for the quartz microcrystalline cement suggests that recrystallization of biogenic silica (opal-A) was likely to have been an important source for quartz cements, although smectite-to-illite transformation may have contributed some. These mineral phases highlight that microscopic-scale diagenetic mobility of silica is important, even within mudstones lacking obvious sources of biogenic silica and is likely to be an important processes in a wide range of mudstones.
Authigenic illite within northern and central North Sea oilfield sandstones: evidence for post-growth alteration
Authors: Wilkinson M. , Haszeldine R. S. , Fallick A. E. 
Published: May 2014

AbstractIt has been previously reported that late diagenetic fibrous illite, separated out from oilfield sandstones for dating by the K-Ar method, has systematically shown an increasing K-content with burial depth in the UK northern and central North Sea. This is surprising as fibrous illite is believed to form rapidly, in response to a geological event such as oil charging, and to retain its composition during subsequent burial. If the composition of the illite is related to present-day conditions, rather than the conditions of initial formation, then argon loss may have occurred, making K-Ar ages of questionable validity. Variations in crystal chemistry of the illite and their fundamental particle size and shape (length/width) distribution suggest alteration of the illite from the time of formation. The extent to which K-Ar ages of illite might need to be re-interpreted as a result of this post-formation alteration is not quantifiable at present; however there is evidence to suggest that the ages may be interpreted in terms of burial models involving both crystal nucleation and growth, and that a high proportion of Ar within the crystals may be retained during post-growth recrystallization.