bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary Stents and the Uptake of New Medical Devices in the German System of Inpatient Reimbursement
Authors: HENSCHKE CORNELIA , BAEUMLER MICHAEL , GASKINS MATTHEW , BUSSE REINHARD 
Published: August 2010

Objectives: This study aims to analyze mechanisms for facilitating the uptake of new medical devices in the German system of hospital reimbursement, focusing on the example of coronary stents, including (1) trends in their coding, (2) associated diagnosis‐related group (DRG) payments, (3) their integration in the German DRG (G‐DRG) system, and (4) their diffusion within the inpatient sector.
Methods: Published and gray literature provide the basis for analyzing the system of hospital reimbursement. Data on coronary stents were obtained from various regulatory and government bodies and examined in a longitudinal fashion.
Results: Although German Procedure Classification (Operationen‐ und Prozedurenschlüssel; OPS) codes were created for a range of stent technologies between 2004 and 2009, the regular system of G‐DRG reimbursement does not distinguish between different stents by means of unique DRGs. Instead, supplementary payments or extrabudgetary payments are used to ensure that newer technologies are reimbursed adequately. The limitations of extrabudgetary payments restrict the use of some devices to a small proportion of patients. Data on the diffusion of different stents show that factors other than the reimbursement regime likely also play a role in the frequency with which certain technologies are used. Bare metal stents currently account for most stent implantation procedures in Germany, followed by drug‐eluting stents.
Conclusion: The current system of G‐DRG reimbursement and of extrabudgetary payments ensures that even the most recently developed technologies can be used in the German inpatient sector. Nevertheless, certain technologies may not be reaching the broad patient population. (J Interven Cardiol 2010;23:546–553)
Controversies and future perspectives of antiplatelet therapy in secondary stroke prevention
Authors: Weber Ralph , Diener Hans‐Christoph 
Published: August 2010

Abstract

Introduction
Thrombus formation and differences between ischaemic heart and brain disease
Aspirin resistance
Is there a role of combining aspirin and clopidogrel in secondary stroke prevention?
Drug interaction between clopidogrel and proton pump inhibitors
New antiplatelet agents for secondary stroke prevention

Antiplatelet agents are a cornerstone in the treatment of acute arterial thrombotic events and in the prevention of thrombus formation. However, existing antiplatelet agents (mainly aspirin, the combination of aspirin and dipyridamole and clopidogrel) reduce the risk of vascular events only by about one quarter compared with placebo. As a consequence, more efficacious antiplatelet therapies with a reduced bleeding risk are needed. We give an overview of several new antiplatelet agents that are currently investigated in secondary stroke prevention: adenosine 5′‐diphosphonate receptor antagonists, cilostazol, sarpogrelate, terutroban and SCH 530348. There are unique features in secondary stroke prevention that have to be taken into account: ischaemic stroke is a heterogeneous disease caused by multiple aetiologies and the blood–brain barrier is disturbed after stroke which may result in a higher intracerebral bleeding risk. Several small randomized trials indicated that the combination of aspirin and clopidogrel might be superior to antiplatelet monotherapy in the acute and early post‐ischaemic phase. There is an ongoing debate about antiplatelet resistance. Decreasing response to aspirin is correlated independently with an increased risk of cardiovascular events. However, there is still no evidence from randomized trials linking aspirin resistance and recurrent ischaemic events. Similarly, randomized trials have not demonstrated a clinical significantly decreased antiplatelet effect by the concomitant use of clopidogrel and proton pump inhibitors. Nevertheless, a routine use of this drug combination is not recommended.
Antiplatelet therapy in secondary stroke prevention – state of the art
Authors: Diener Hans‐Christoph , Weimar Christian , Weber Ralph 
Published: August 2010

Abstract

Introduction
Prevention of recurrent stroke using antiplatelets in patients with acute ischaemic stroke
Long‐term secondary stroke prevention in non‐cardioembolic stroke
The role of antiplatelets in cardioembolic stroke prevention
Antiplatelets in patients with symptomatic intracranial stenosis
Antiplatelets in stroke patients with patent foramen ovale
Disclosures

Our objective is to provide the reader with an overview as well as an update on current antiplatelet therapy for secondary stroke prevention. Relevant journals were hand‐searched by the authors to compile a broad but by far not comprehensive summary of innovative and clinically relevant studies. Aspirin, clopidogrel and the combination of dipyridamole plus aspirin are the cornerstone therapy in secondary prevention after non‐cardio‐embolic stroke or transient ischaemic attack. A head‐to‐head comparison showed no difference in the prevention of recurrent stroke between dipyridamole plus aspirin and clopidogrel. More potent antiplatelet drugs or the combination of aspirin and clopidogrel prevent more ischaemic events, but also lead to more bleeding complications. For secondary stroke prevention in patients with atrial fibrillation, oral anticoagulation is more effective than aspirin or the combination of aspirin and clopidogrel.
Clinical characteristics and pathophysiological mechanisms of focal and diffuse traumatic brain injury
Authors: Andriessen Teuntje M. J. C. , Jacobs Bram , Vos Pieter E. 
Published: August 2010

Abstract

Introduction
Classifying TBI
Clinical characteristics
Pathophysiological mechanisms of focal injury
Pathophysiological mechanisms of diffuse injury
Conclusions

Traumatic brain injury (TBI) is a frequent and clinically highly heterogeneous neurological disorder with large socioeconomic consequences. TBI severity classification, based on the hospital admission Glasgow Coma Scale (GCS) score, ranges from mild (GCS 13–15) and moderate (GCS 9–12) to severe (GCS ≤ 8). The GCS reflects the risk of dying from TBI, which is low after mild (∼1%), intermediate after moderate (up to 15%) and high (up to 40%) after severe TBI. Intracranial damage can be focal, such as epidural and subdural haematomas and parenchymal contusions, or diffuse, for example traumatic axonal injury and diffuse cerebral oedema, although this distinction is somewhat arbitrary. Study of the cellular and molecular post‐traumatic processes is essential for the understanding of TBI pathophysiology but even more to find therapeutic targets for the development of neuroprotective drugs to be eventually used in human beings. To date, studies in vitro and in vivo, mainly in animals but also in human beings, are unravelling the pathological TBI mechanisms at high pace. Nevertheless, TBI pathophysiology is all but completely elucidated. Neuroprotective treatment studies in human beings have been disappointing thus far and have not resulted in commonly accepted drugs. This review presents an overview on the clinical aspects and the pathophysiology of focal and diffuse TBI, and it highlights several acknowledged important events that occur on molecular and cellular level after TBI.
Azithromycin as an adjunct to scaling and root planing in the treatment of Porphyromonas gingivalis‐associated periodontitis: a pilot study
Authors: Oteo Alfonso , Herrera David , Figuero Elena , O'Connor Ana , González Itziar , Sanz Mariano 
Published: August 2010

Oteo A, Herrera D, Figuero E, O'Connor A, González I, Sanz M. Azithromycin as an adjunct to scaling and root planing in the treatment of Porphyromonas gingivalis‐associated periodontitis: a pilot study. J Clin Peridontol 2010; 37: 1005–1015. doi: 10.1111/j.1600‐051X.2010.01607.x.AbstractObjective: To evaluate the clinical and microbiological effects of systemic azithromycin as an adjunct to scaling and root planing (SRP) in the treatment of Porphyromonas gingivalis‐associated chronic periodontitis.Methods: Twenty‐nine patients harbouring P. gingivalis were randomized into test and placebo groups. Test patients received SRP plus 500 mg of azithromycin per day (3 days), and control patients received SRP plus placebo. Clinical [plaque and bleeding indexes, probing pocket depth (PPD), clinical attachment level (CAL)] and microbiological data (four‐sites pooled samples, processed by culture) were collected at baseline, and 1, 3 and 6 months, post‐therapy. Clinical variables were compared by anova, and microbiological variables by chi‐square, signed‐rank and Wilcoxon tests.Results: Fifteen test and 11 placebo patients completed the study. Mean PPD decreased 0.34 mm [95% confidence interval (CI) 0.19–0.49] in the placebo and 0.80 mm (CI 0.57–1.04) in the test group after 6 months. For mean CAL gain, the correspondent figures were 0.29 (CI 0.08–0.49) and 0.76 (CI 0.46–1.05), respectively. The frequency of detection of P. gingivalis decreased significantly (p0.01) in the test group after 1, 3 and 6 months.Conclusions: Within the limitations of this study, the adjunctive use of systemic azithromycin in the treatment of P. gingivalis periodontitis demonstrated significant clinical and microbiological benefits when compared with SRP plus placebo.
Osteotome sinus floor elevation technique without grafting: a 5‐year prospective study
Authors: Nedir Rabah , Nurdin Nathalie , Vazquez Lydia , Szmukler‐Moncler Serge , Bischof Mark , Bernard Jean‐Pierre 
Published: August 2010

Nedir R, Nurdin N, Vazquez L, Szmukler‐Moncler S, Bischof M, Bernard J‐P. Osteotome sinus floor elevation technique without grafting: a 5‐year prospective study. J Clin Peridontol 2010; 37: 1023–1028. doi: 10.1111/j.1600‐051X.2010.01610.x.AbstractAim: To evaluate the long‐term stability of peri‐implant bone formation following implant placement without grafting into resorbed posterior maxillae.Materials and Methods: Twenty‐five implants of 10 mm were placed in 17 patients to rehabilitate atrophic maxillae by means of an osteotome sinus floor elevation (OSFE) procedure without grafting. Mean residual bone height was 5.4±2.3 mm. Bone levels were evaluated at 1, 3 and 5 years using periapical radiographs.Results: All implants fulfilled survival criteria and gained peri‐implant bone (mean increase 3.2±1.3 mm). Implant protrusion into the sinus decreased from 4.9±1.9 mm after surgery to 1.5±0.9 mm after 5 years. Mean crestal bone loss amounting to 0.8±0.8 mm stabilized over the 5‐year observation interval. Twenty implants showed additional peri‐implant bone gain following the 1‐year control.Conclusions: Implant rehabilitation of atrophic maxillae may be greatly simplified using implants 10 mm and the OSFE technique without grafting. Grafting material is not needed to gain at least 3 mm of bone in the atrophic maxilla. The procedure appears predictable with favourable long‐term results.
Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24‐month randomized clinical trial
Authors: Casarin Renato Corrêa Viana , Del Peloso Ribeiro Érica , Nociti Francisco Humberto , Sallum Antônio Wilson , Ambrosano Gláucia Maria Bovi , Sallum Enilson Antônio , Casati Márcio Zaffalon 
Published: August 2010

Casarin RCV, Ribeiro ÉDP, Nociti Jr FH, Sallum AW, Ambrosano GMB, Sallum EA, Casati MZ: Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24‐month randomized clinical trial. J Clin Periodontol 2010; doi: 10.1111/j.1600‐051X.2010.01614.x.AbstractObjective: This study aimed to evaluate the response of proximal furcations treated with enamel matrix derivative proteins (EMD) in a 24‐month follow‐up.Materials and Methods: Twelve patients presenting bilateral class II proximal furcation with vertical probing depth (PD)5 mm and bleeding on probing were selected. The furcations were assigned to: a control group (n=12), open flap debridement (OFD)+EDTA and a test group (n=12) – OFD+EDTA+EMD. The gingival margin position, PD, relative vertical and horizontal clinical attachment level (RVCAL and RHCAL), vertical and horizontal bone level (VBL and HBL) and furcation closure were evaluated before treatment and after 6, 12 and 24 months.Results: After follow‐up, no statistical difference could be seen between groups. At 24 months, the test group showed 1.9 ± 1.6 mm PD reduction whereas the control group showed 1.0 ± 1.3 mm PD reduction. RHCAL gains of the control and the test group were 0.7 ± 1.3 and 1.4 ± 0.9 mm, respectively. However, at 24 months, the test group only presented five remaining class II furcations versus 10 furcations in the control group (p<0.05).Conclusion: It could be concluded that EMD therapy promoted a reduction in the number of proximal furcations presenting a diagnosis of class II after 24 months of treatment compared with OFD therapy.
Public awareness of oral cancer, of oral potentially malignant disorders and of their risk factors in some rural populations in Sri Lanka
Authors: Amarasinghe Hemantha K. , Usgodaarachchi Udaya S. , Johnson Newell W. , Lalloo Ratilal , Warnakulasuriya Saman 
Published: August 2010

Amarasinghe HK, Usgodaarachchi US, Johnson NW, Lalloo R, Warnakulasuriya S. Public awareness of oral cancer, of oral potentially malignant disorders and of their risk factors in some rural populations in Sri Lanka. Community Dent Oral Epidemiol 2010; 38: 540–548. © 2010 John Wiley & Sons A/SAbstract – Objective:  The aim of this study was to investigate the level of public awareness of oral cancer, of oral potentially malignant disorders (OPMD) and of risk factors for developing these diseases in a province of Sri Lanka, a country with one of the highest incidences of these diseases in the world.Methods:  A cross‐sectional community‐based survey was carried out in Sabaragamuwa province by interviewing 1029 subjects above 30 years of age, over a 1‐year period from November 2006.Results:  The level of public awareness of oral cancer was 84%, but only 23% for OPMD. Awareness was especially poor in low socioeconomic groups. The majority of subjects were not aware of the symptoms of oral cancer and of OPMD. Thirty‐two percent were unaware that chewing betel quid was a risk factor for these diseases, as were 65% for tobacco smoking and 81% for heavy consumption of alcohol. Overall, 76% were not aware of any of the dangers inherent in the frequent use of areca nut. The majority of smokers, betel quid chewers and alcohol consumers were not aware that their lifestyles were placing their long‐term health at serious risk.Conclusions:  Knowledge of oral cancer, OPMD and their associated risk factors was poor among this population, indicating an urgent need to implement public health education and promotion strategies.
Parameters associated with active caries lesions assessed by two different visual scoring systems on occlusal surfaces of primary molars – a multilevel approach
Authors: Braga Mariana M. , Martignon Stefania , Ekstrand Kim R. , Ricketts David N.J. , Imparato José Carlos P. , Mendes Fausto M. 
Published: August 2010

Braga MM, Martignon S, Ekstrand KR, Ricketts DNJ, Imparato JCP, Mendes FM. Parameters associated with active caries lesions assessed by two different visual scoring systems on occlusal surfaces of primary molars – a multilevel approach. Community Dent Oral Epidemiol 2010; 38: 549–558. © 2010 John Wiley & Sons A/SAbstract – Objective:  The aim of this in vivo study was to evaluate the association between several parameters related to children and to their teeth, and the presence of active carious lesions assessed by two different visual indices on occlusal surfaces of primary molars.Methods:  Occlusal surfaces of 757 primary molars in 139 children (3–12 years old) were classified as sound, or having inactive or active carious lesions using the Nyvad criteria (NY) and the International Caries Detection and Assessment System (ICDAS‐II) and a supplemental lesion activity assessment system (ICDAS‐LAA). Several parameters related to the tooth and to the child were recorded. Associations between these parameters and the presence of active carious lesions on occlusal surfaces were evaluated using logistic multilevel analysis.Results:  Second primary molar teeth and children with high caries experience were more frequently with active occlusal carious lesions compared to sound and inactive occlusal carious lesions classified by both visual scoring systems. Teeth with a mature dental plaque on the occlusal surface and younger children had more active caries than inactive occlusal carious lesions (excluding sound teeth in the analysis). A previous visit to a dentist was related to a lower frequency of active occlusal carious lesions classified by NY only, and upper primary molars presented with higher numbers of active occlusal carious lesions classified by ICDAS‐LAA.Conclusions:  Presence of mature dental plaque and tooth type are tooth‐related variables associated with active carious lesions on occlusal surfaces of primary teeth, as well as anterior caries experience and age are variables related to the child.
The histopathological spectrum of acute generalized exanthematous pustulosis (AGEP) and its differentiation from generalized pustular psoriasis
Authors: Kardaun Sylvia H. , Kuiper Hilde , Fidler Vaclav , Jonkman Marcel F. 
Published: August 2010

Background: Acute generalized exanthematous pustulosis (AGEP) represents a severe, acute, pustular skin reaction that is most often induced by drugs. AGEP can be difficult to differentiate from generalized pustular psoriasis (GPP) both clinically and histopathologically. We present a systematic description of the histopathological spectrum of AGEP and GPP with a focus on discriminating features. Materials and methods: A retrospective, descriptive, comparative histopathological study was completed utilizing step sections of 43 biopsies of 29 cases with a validated diagnosis of probable or definite AGEP and 24 biopsies of 19 cases with an established diagnosis of GPP. Results: In AGEP, biopsies from erythema and pustules showed minor differences, whereas histopathology of the acute stage of GPP showed major differences compared to the chronic stage. Comparing AGEP and GPP, the presence of eosinophils, necrotic keratinocytes, a mixed interstitial and mid‐dermal perivascular infiltrate and absence of tortuous or dilated blood vessels were in favor of AGEP. Moreover, chronic GPP was characterized by prominent epidermal psoriatic changes. The frequency of a psoriatic background of AGEP patients in our study was higher than that of psoriasis in the general population. However, histopathology of a subgroup of AGEP patients with a personal history of psoriasis revealed no significant differences from the other AGEP patients. Conclusions: The spectrum of histopathological features of both AGEP and GPP is presented. Despite considerable overlap, subtle consistent histopathological differences and the grade of severity of specific features can help in differentiation. We could neither substantiate earlier reports that follicular pustules exclude AGEP nor did we see vasculitis as a specific feature in AGEP. Our study also supports the concept that AGEP is a separate entity that is distinct from GPP.Kardaun SH, Kuiper H, Fidler V, Jonkman MF. The histopathological spectrum of acute generalized exanthematous pustulosis (AGEP) and its differentiation from generalized pustular psoriasis.
Cocaine‐related retiform purpura: evidence to incriminate the adulterant, levamisole
Authors: Walsh Noreen M. G. , Green Peter J. , Burlingame Rufus W. , Pasternak Sylvia , Hanly John G. 
Published: August 2010

The term ‘cocaine‐induced pseudovasculitis' was coined to encompass a constellation of clinical and laboratory findings which mimics a systemic vasculitis but lacks confirmatory evidence of vasculitis on biopsy. Antineutrophil cytoplasmic antibodies reacting with human neutrophil elastase (HNE) have been reported to distinguish the cocaine‐related syndrome from a true autoimmune vasculitis. Published cases of retiform purpura related to cocaine use are rare and an etiologic role for levamisole, a common adulterant of cocaine, has been postulated. We describe two female patients aged 39 and 49 years with cocaine‐related retiform purpura, mainly affecting the legs. The initial clinical and serological profile in case 1 led to a suspicion of anti‐phospholipid syndrome and in case 2 to Wegener's granulomatosis with an unexplained associated neutropenia. Skin biopsies revealed a mixed pattern of leukocytoclastic vasculitis and microvascular thrombosis in case 1 and pure microvascular thrombosis in case 2. Identification of anti‐HNE antibodies in both patients linked their disease to cocaine. The mixed vasculopathic pattern in case 1 and the associated neutropenia in case 2, both known adverse effects of levamisole, point to this as the true etiologic agent. Urine toxicology shortly after a binge of cocaine use in each case was positive for levamisole.Walsh NMG, Green PJ, Burlingame RW, Pasternak S, Hanly JG. Cocaine‐related retiform purpura: evidence to incriminate the adulterant, levamisole.
Mobilization strategies in hard‐to‐mobilize patients with lymphoid malignancies
Authors: Jantunen Esa , Kvalheim Gunnar 
Published: August 2010

AbstractDepending on definitions and patient characteristics, 5–40% of patients with lymphoid malignancies are hard‐to‐mobilize. Several premobilization factors such as previous chemotherapy (CT), disease, marrow infiltration and platelet count at the time of mobilization influence the efficacy of CD34+ cell mobilization. In general, however, prediction of hard‐to‐mobilize patient is difficult. Postmobilization factors especially low blood CD34+ counts are important in clinical practice as we have now ways to enhance mobilization at this point. Plerixafor combined with granulocyte‐colony stimulating factor (G‐CSF) has significantly increased efficacy of remobilization in patients who have failed a previous mobilization attempt with a success rate of about 70%. Addition of plerixafor to G‐CSF or more recently to a mobilization regimen consisting of CT + G‐CSF is promising as blood CD34+ counts can be increased  three to fivefold to facilitate effective collection with less aphaeresis sessions. As plerixafor is expensive, development of practical algorithms for its use is important to make blood stem cell mobilization and collection more efficient in a cost‐effective way. This review attempts to summarize current treatment strategies in hard‐to‐mobilize patients with lymphoid malignancies.
An update on minor salivary gland secretions
Authors: Eliasson Lars , Carlén Anette 
Published: August 2010

Eliasson L, Carlén A. An update on minor salivary gland secretions. Eur J Oral Sci 2010; 118: 435–442. © 2010 Eur J Oral Sci In this article, the literature on minor salivary gland secretion rates, composition, and function is reviewed. Measurements of the minor salivary gland secretion rates and composition are complicated, and the secretions display large biological variability. Despite this, some characteristics of these secretions have been found repeatedly in independent investigations. Minor gland saliva varies between different oral sites. Buccal saliva flow is higher than labial saliva flow, which in turn is usually higher than the palatal gland secretion rate. It is generally agreed that minor gland saliva is important for the whole saliva composition, and especially for the secretory immunoglobulin A and mucins. The secretion from these glands seems also important for subjective feelings of dry mouth and general wellbeing. Further research is essential for understanding the role of these secretions for oral, as well as for general, health.