bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pooled Analysis of Two Randomized, Double‐Blind, Placebo‐Controlled Trials of Milnacipran Monotherapy in the Treatment of Fibromyalgia
Authors: Geisser Michael E. , Palmer Robert H. , Gendreau R. Michael , Wang Yong , Clauw Daniel J. 
Published: July 2010

AbstractMilnacipran has been shown to significantly improve the pain, global well‐being, and physical function of fibromyalgia (FM), and is approved by the U.S. Food and Drug Administration for the management of this disorder. Post hoc analyses of data from two pivotal trials were conducted to further assess the clinical benefits of milnacipran, to determine the impact of baseline pain severity on treatment outcomes, and to confirm the safety and tolerability of this medication in patients with FM. Patients in these trials were randomized to placebo (n = 624), milnacipran 100 mg/day (n = 623), or milnacipran 200 mg/day (n = 837). Two different composite responder analyses were used to evaluate efficacy: a 2‐measure analysis, requiring ≥ 30% improvement from baseline visual analog scale 24‐hour recall pain scores and a Patient Global Impression of Change (PGIC) score of “very much improved” or “much improved”; and a 3‐measure analysis, requiring a ≥ 6‐point improvement from baseline in SF‐36 Physical Component Summary scores in addition to the pain and PGIC criteria. Additionally, a pooled analysis of mean changes from baseline pain scores was conducted in order to evaluate the efficacy of milnacipran over the entire course of treatment. At 3 months, composite responder rates were significantly higher in the milnacipran treatment groups than in the placebo group (2‐ and 3‐measure composite responder analyses: P ≤ 0.001, both doses vs. placebo). These improvements were not dependent on baseline pain severity. Similar composite responder results were observed in patients who continued treatment for up to 6 months. Significant improvements in mean pain scores were seen with both doses of milnacipran vs. placebo as early as 1 week after treatment initiation and were sustained for up to 6 months of milnacipran treatment. The most common adverse events associated with milnacipran were nausea, headache, and constipation.
Comparative Evaluation of Oxygen‐Ozone Therapy and Combined Use of Oxygen‐Ozone Therapy with Percutaneous Intradiscal Radiofrequency Thermocoagulation for the Treatment of Lumbar Disc Herniation
Authors: Gautam Sujeet , Rastogi V. , Jain Ankur , Singh A. P. 
Published: July 2010

AbstractAim:  To compare the efficacy of oxygen‐ozone therapy and the combined use of oxygen‐ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of contained lumbar disc herniation.Methods:  Ninety‐one adult patients with low back pain secondary to contained lumbar disc herniation were randomly assigned into two groups. Ozone group received intradiscal oxygen‐ozone therapy (4 to 7 mL of oxygen ozone mixture); ozone‐PIRFT group received a combination of oxygen‐ozone therapy with PIRFT (radiofrequency lesioning at 80°C for 360 s).Outcome Measures:  Primary outcome measures included a visual analog scale (VAS) for pain and the Oswestry disability index (ODI). Secondary outcome measures included pain relief, reduction of analgesic consumption, and patient's satisfaction. Clinical assessment of these outcome measures was performed at 2 weeks, 1 month, 3 months, 6 months, and 1 year after the procedure.Results:  VAS scores and ODI were significantly decreased by both ozone and ozone‐PIRFT when compared with the baseline values at all points of follow‐up; however, ozone‐PIRFT produced a significant reduction in the VAS scores and ODI when compared to ozone at 2 weeks, 1 month, 3 months, 6 months, and 1 year follow‐up. Ozone‐PIRFT also resulted in a significant change in all secondary measures at all points of follow‐up, as compared with the ozone group.Conclusion:  Ozone‐PIRFT is more efficacious than ozone alone in reducing pain scores, analgesic consumption, improving functional outcome, and satisfaction of patients with contained lumbar disc herniation.
Prediction of Clinical Outcomes in Patients with Unprotected Left Main Trifurcation Lesions Treated by Drug‐Eluting Stents: Importance of 2‐Stent Technique and SYNTAX Score
Authors: CHEN SHAO‐LIANG , YE FEY , ZHANG JUN‐JIE , HU ZUO‐YING , TIAN NAI‐LIANG , ZHANG JUN‐XIA , KWAN TAK W. 
Published: July 2010

Background:
There were insufficient data on the prognosis of stenting for patients with trifurcated unprotected left main lesions (UPLMS).
Methods:
From the SPEED (stents for percutaneous treatment of coronary artery disease) registry of all percutaneous coronary interventions (PCI) for all types of UPLMS, data of 44 patients with trifurcated UPLMS were selected and analyzed.
Results:
Patients were divided into one‐stent (N = 23) or 2‐stent (N = 21) groups. Clinical follow‐up was available for 100%, and angiographic follow‐up at 8 month was available for 91.3%. There were no differences in myocardial infarction, cardiac death, and stent thrombosis between groups. However, the target lesion revascularization (TLR) and target vessel revascularization (TVR) in the 1‐stent group was lower when compared to the 2‐stent group (13.0% vs. 23.8%, P = 0.004; 13.0% vs. 28.6%, P = 0.003, respectively). Cumulative survival free from major adverse cardiovascular events (MACE) in the 1‐stent group was higher than the 2‐stent group (65.2% vs. 57.1%, P = 0.033). Analysis of the receiver operator curve (ROC) of the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score showed the area under the curve was 0.414 (standard error = 0.089, 95% CI 0.240–0.589, P = 0.348).
Conclusions:
In patients with trifurcated UPLMS, higher TLR/TVR and lower cumulative survival from MACE were seen in the 2‐stent group when compared to the 1‐stent group. The SYNTAX scoring system had no predictive value of outcomes for patients with stenting of trifurcated UPLMS. (J Interven Cardiol 2010;23:352–357)
Distribution and Magnitude of Shear Stress after Coronary Bifurcation Lesions Stenting with the Classical Crush Technique: A New Predictor for In‐Stent Restenosis
Authors: HU ZUO‐YING , CHEN SHAO‐LIANG , ZHANG JUN‐JIE , SHAN SHOU‐JIE , LIU ZHI‐ZHONG , YE FEI , KAN JING , XU HAI‐MEI , NGUYEN KATRINA , KWAN TAK , NGUYEN THACH , HOANG THAI 
Published: July 2010

Background:
Wall shear stress (SS) plays an important role in the initiation and proliferation of coronary atherosclerosis, especially for bifurcations. Stenting in the coronary artery will cause many different changes in velocity, flow, cross‐sectional area, and especially the wall SS. However, it is still unknown how much wall SS distribution varies with stenting in coronary bifurcation.
Objective:
The purpose of this study was to investigate the magnitude and distribution of wall SS after the classical crush stenting for bifurcation lesions.
Methods:
Eleven patients with true coronary bifurcation stenting by the classical crush technique were included. We studied the difference of wall SS between restenosis and nonrestenosis groups in these patients. The differences in SS between preprocedure and postprocedure, as well as between immediately postprocedure and after an 8‐month follow‐up, were also analyzed. Diameter stenosis or minimal lumen diameter were measured by quantitative coronary analysis. The commercial CD STAR‐CCM+ was used to calculate the SS.
Results:
At baseline, the SS in all the segments of all patients was high. The baseline SS of the restenosis group was 50% lower than the nonrestenosis group. Immediately after percutaneous coronary intervention (PCI), the SS in both areas decreased; however, the SS of the nonrestenosis group decreased to its lowest level possible while the SS of the restenosis group decreased moderately. Eight months later, the SS of all the segments of the nonrestenosis group remained persistently low at the same level of right after PCI. In contrary, the SS in the restenosis group returned to near its baseline level.
Conclusion:
From our study, after a 2‐stent crush technique using drug‐eluting stents (DES), the degree of SS reduction appears to predict in‐stent restenosis (ISR). A SS decrease to its lowest level and remaining homogenously low is a prime condition to prevent ISR. A baseline low SS, which decreases minimally after PCI and recovers to around its baseline level, appears to be the setting for restenosis. These conditions can be evaluated as predictors of lesions that may need surveillance angiography and proper IVUS evaluation to prevent future in‐stent restenosis. (J Interven Cardiol 2010;23:330–340)
Contradictory Shear Stress Distribution Prevents Restenosis after Provisional Stenting for Bifurcation Lesions
Authors: ZHANG JUNE‐JIE , CHEN SHAO‐LIANG , HU ZUO‐YING , KAN JING , XU HAI‐MEI , SHAN SHOU‐JIE , LIU ZHI‐ZHONG , YE FEI , KWAN TAK W. , NGUYEN KATRINA , NANJUNDAPPA ARAVINDA , NGUYEN THACH 
Published: July 2010

Background:
Endothelial shear stress is one of the local hemodynamic factors suspected in the development of coronary atherosclerosis in bifurcation lesions. In patients with provisional stenting, the endothelial shear stress (SS) distribution is unknown.
Objective:
The aim of this study was to investigate the magnitude and distribution of the SS of coronary bifurcation lesions stenting by the provisional approach.
Methods:
Ten consecutive patients were included in this study. Quantitative coronary analysis, flow study, and three‐dimensional computational analysis with the aid of the commercial software CD STAR‐CCM+ were done before and after the provisional stenting procedure and also 8 months later.
Results:
Clinical and angiographic follow‐up were available in all patients. No patient had a side branch (SB) stent. At the 8‐month follow‐up, no major adverse cardiac event (MACE) occurred. There was also no clinical and angiographic restenosis. Before PCI, the distal main vessel (MV)‐lateral, and the SB‐lateral subsegments had relative nonsignificant lower SS value (4.08 ± 2.78 Pa and 4.35 ± 5.04 Pa, respectively) when compared to other segments. After 8‐month follow‐up, sustained decreased SS value was shown in the distal MV‐lateral segment (4.08 ± 2.78–1.68 ± 1.65 Pa), when compared with significantly increased SS value in the SB‐lateral subsegment 4.35 ± 5.04–16.50 ± 40.45 Pa). The explanation is that after stenting in the MV, the flow was redistributed immediately after percutaneous coronary intervention (PCI) and reversed back to its original 8 months later. However, the growth of the fibrous tissue causing in‐stent restenosis (ISR) is prohibited by sirolimus on the stent struts. In contrast, in a branch opened up by plain old balloon angioplasty (POBA), the flow did not change much, the flow could even be worse because it is shifted to the MV after the cross‐sectional area of the MV improved by stenting. However, thanks to POBA, there is increased fibrous tissue formation, enough to increase the SS and prevent further accumulation of cell and cholesterol needed for more restenosis.
Conclusion:
In the provisional approach, low endothelial SS correlated with no restenosis for patients who underwent stenting of the MV, while a contradictory combination of high SS and no restenosis was seen in the SB after only POBA. The mechanism of prevention of restenosis in the SB is by increasing the SS while in the MV, the mechanism of prevention of ISR is secondary to sirolimus on the stents struts. (J Interven Cardiol 2010;23:319–329)
Extension Distance Mismatch—An Unrecognized Factor for Suboptimal Side Branch Ostial Coverage in Bifurcation Lesion Stenting
Authors: VASSILEV DOBRIN , GIL ROBERT , KWAN TAK , NGUYEN THACH , NANJUNDAPPA ARAVINDA , DOGANOV ALEXANDER 
Published: July 2010

Background:
The unsatisfactory side branch (SB) ostial strut coverage remains a problem in coronary bifurcation stenting. Both the surplus and lack of struts at SB ostium may be the causative mechanism. We propose that the inability of available stents to cover the “extension distance” of the bifurcation region is the cause of in‐stent restenosis.
Methods:
The extension distance (ED) is defined as the maximal distance at the carina tip, which must be covered by the stent struts to ensure optimal coverage of the main branch (MB) and SB openings. A mathematical model was created, representing the key factors that govern geometrical reconfigurations after stent implantation in bifurcations. There are two options—with and without bifurcation region deformation. The theoretical assumptions were tested on a bifurcation model (soft polyvinylchloride polymer tubes) permitting free wall deformations and the following parameters: Parent Vessel, MB, SB diameters of 3.5, 3.0, and 2.5 mm, respectively, with an angle of 45° between the MB and SB. After stenting, final KBI with 3.5 mm and 3.0 mm balloons was performed up to 20 atm.
Results:
After the carina displacement, the ED, which has to be covered, is considerably smaller if the suboptimal result (DS >50%) at the SB ostium is acceptable. The maximal EDs from the bench test measurements are: Vision, Abbott Vascular – 5.62 mm ± 0.04; Liberte, Boston Scientific Corp. – 5.2 mm ± 0.03; Chopin2, Balton – 4.58 mm ± 0.05; Volo, Invatec – 4.41 mm ± 0.04; Driver, Medtronics – 4.39 mm ± 0.04; BxSonic, Cordis, J&J – 4.48 mm ± 0.05. The theoretical maximal ED of the model is 6.91 mm—28–62% larger than actually observed with different stents.
Conclusions:
The achievement of perfect ostial coverage of the SB is unsatisfactory with most of the currently available stents, especially when poststenting excessive dilation of the ostium of the SB is performed. (J Interven Cardiol 2010;23:305–318)
Antimicrobial resistance 1979–2009 at Karolinska hospital, Sweden: normalized resistance interpretation during a 30‐year follow‐up on Staphylococcus aureus and Escherichia coli resistance development
Authors: KRONVALL GÖRAN 
Published: July 2010

Kronvall G. Antimicrobial resistance 1979–2009 at Karolinska hospital, Sweden: normalized resistance interpretation during a 30‐year follow‐up on Staphylococcus aureus and Escherichia coli resistance development. APMIS 2010; 118: 621–39.To utilize a material of inhibition zone diameter measurements from disc diffusion susceptibility tests between 1979 and 2009, an objective setting of epidemiological breakpoints was necessary because of methodological changes. Normalized resistance interpretation (NRI) met this need and was applied to zone diameter histograms for Staphylococcus aureus and Escherichia coli isolates. The results confirmed a slow resistance development as seen in Northern countries. The S. aureus resistance levels for erythromycin, clindamycin and fusidic acid in 2009 were 3.2%, 1.8% and 1.4% with denominator correction. A rise in resistance to four antimicrobials in 1983 was probably because of a spread of resistant Methicillin Susceptible Staphylococcus Aureus (MSSA). For E. coli, the denominator‐corrected resistance levels in 2009 were 27% for ampicillin, around 3% for third‐generation cephalosporins, 0.1% for imipenem, 2.5% for gentamicin, 19% for trimethoprim, 4.5% for co‐trimoxazole, 1.2% for nitrofurantoin and 9% for ciprofloxacin. The temporal trends showed a rise in fluoroquinolone resistance from 1993, a parallel increase in gentamicin resistance, a substantial increase in trimethoprim and sulphonamide resistance in spite of decreased consumption, and a steady rise in ampicillin resistance from a constant level before 1989. A short review of global resistance surveillance studies is included.
Early healing after elevation of the maxillary sinus floor applying a lateral access: a histological study in monkeys
Authors: Scala Alessandro , Botticelli Daniele , Rangel Idelmo Garcia , De Oliveira José Américo , Okamoto Roberta , Lang Niklaus Peter 
Published: July 2010

AbstractAim: To describe the early healing within the void obtained after the elevation of the sinus mucosa and simultaneous implant installation without the use of any grafting material in monkeys.Material and methods: Implants were installed simultaneously with the elevation of the maxillary sinus using the lateral approach in eight monkeys without the use of grafting material. The healing after 4, 10, 20 and 30 days was evaluated in the area distal to the implants. Paraffin sections were prepared and analyzed using qualitative histological methods.Results: The healing process was initiated by the formation of a coagulum and followed by a provisional matrix and woven bone. Subsequently, a parallel‐fiber bone replaced woven bone. The dimension of the elevated area shrank during the healing process. Sprouts of woven bone, present to a moderate extent after 4 days, were more numerous after 10 and 20 days. Newly formed bone originated from the sinus walls and septa, while there was no evidence of participation of the Schneiderian membrane in this process. After 30 days, the window access appeared to be closed by a layer of newly formed trabecular bone.Conclusions: The coagulum that filled the void distal to the implant after simultaneous elevation of the sinus floor gave rise to newly formed bone. However, the void occupied by the coagulum shrank substantially. The Schneiderian membrane did not provide a basis for new bone formation in the early phase of healing. To cite this article:
Scala A, Botticelli D, Rangel IG Jr, de Oliveira JA, Okamoto R, Lang NP. Early healing after elevation of the maxillary sinus floor applying a lateral access: a histological study in monkeys. Clin. Oral Impl. Res. 21, 2010; 1320–1326. doi: 10.1111/j.1600‐0501.2009.01964.x
Emotional intelligence of dental students and patient satisfaction
Authors: Azimi S. , AsgharNejad Farid A. A. , Kharazi Fard M. J. , Khoei N. 
Published: July 2010

AbstractThe objective of this study was to determine the degree of correlation between emotional intelligence of dental students, patient satisfaction and related factors. A total of 123 senior students and their patients participated in the study. Students completed the 133 item Bar‐On Standardised Emotional Quotient Inventory (EQI) and patients completed a seven item satisfaction questionnaire. The mean score for EI of female students was 442 and 462 for male students, for an overall average score of 452 for all dental students. Male students significantly scored higher in stress control (P = 0.0), general mood (P = 0.011) and intrapersonal scales (P = 0.024). There was a statistically significant relationship between student gender and average EI score (P = 0.007). Married students scored higher in adaptability (P = 0.019) and general mood scales (P = 0.039). Significant relationships existed between students’ gender (P = 0.009), level of patient education (P = 0.0) and patient satisfaction levels. Not recording a significant relationship for the interpersonal scale (r = 0.134), there was a significant relationship amongst intrapersonal, stress control, adaptability, and general mood dimensions of the students and patient satisfaction reports. There was a statistically significant relationship between general emotional intelligence score of the students and patient satisfaction. Patients of the students with high general emotional intelligence scores were significantly more satisfied with treatment than patients of students with low EI.
Teaching and assessment of Professional attitudes in UK dental schools – Commentary
Authors: Field J. , Ellis J. , Abbas C. , Germain P. 
Published: July 2010

AbstractThe General Dental Council expects professionalism to be embedded and assessed through‐out the undergraduate dental programme. Curricula need therefore to accommodate these recommendations. A stroll poll of UK dental schools provided a basis for understanding the current methods of teaching and assessing professionalism. All respondent schools recognised the importance of professionalism and reported that this was taught and assessed within their curriculum. For most the methods involved were largely traditional, relying on lectures and seminars taught throughout the course. The most common form of assessment was by grading and providing formative feedback after a clinical encounter. Whilst clinical skills and knowledge can perhaps be readily taught and assessed using traditional methods, those involved in education are challenged to identify and implement effective methods of not only teaching, but also assessing professionalism. A variety of standalone methods need to be developed that assess professionalism and this will, in turn, allow the effectiveness of teaching methods to be assessed.
The structure of observed learning outcome (SOLO) taxonomy: a model to promote dental students’ learning
Authors: Lucander H. , Bondemark L. , Brown G. , Knutsson K. 
Published: July 2010

AbstractSelective memorising of isolated facts or reproducing what is thought to be required – the surface approach to learning – is not the desired outcome for a dental student or a dentist in practice. The preferred outcome is a deep approach as defined by an intention to seek understanding, develop expertise and relate information and knowledge into a coherent whole. The aim of this study was to investigate whether the structure of observed learning outcome (SOLO) taxonomy could be used as a model to assist and promote the dental students to develop a deep approach to learning assessed as learning outcomes in a summative assessment. Thirty‐two students, participating in course eight in 2007 at the Faculty of Odontology at Malmö University, were introduced to the SOLO taxonomy and constituted the test group. The control group consisted of 35 students participating in course eight in 2006. The effect of the introduction was measured by evaluating responses to a question in the summative assessment by using the SOLO taxonomy. The evaluators consisted of two teachers who performed the assessment of learning outcomes independently and separately on the coded material. The SOLO taxonomy as a model for learning was found to improve the quality of learning. Compared to the control group significantly more strings and structured relations between these strings were present in the test group after the SOLO taxonomy had been introduced (P < 0.01, one tailed test for both results). The SOLO taxonomy is recommended as a model for promoting and developing a deeper approach to learning in dentistry.
Vincristine, an efficacious alternative for diffuse neonatal haemangiomatosis
Authors: Pérez‐Valle S , Peinador M , Herraiz P , Saénz P , Montoliu G , Vento M 
Published: July 2010

AbstractDiffuse neonatal haemangiomatosis (DNH) is an uncommon condition characterized by multiple cutaneous and visceral haemangiomas frequently causing severe complications. Corticosteroids constitute the first therapeutic line; however, when they fail, other alternatives are available, provided possible side effects are closely monitored during and after treatment. We present a case of life‐threatening DNH, non‐responsive to corticosteroids, successfully treated with Vincristine with minor side effects. We conclude that Vincristine is a valid alternative in corticosteroid‐resistant DNH.