bluuebunny/crossref_metadata_2025_split huggingface dataset:
Familien mit geistig behinderten Kindern
Authors: Schindelhauer-Deutscher H.J. , Henn W. 
Published: July 2009

Zusammenfassung
Die Geburt eines geistig behinderten Kindes erfordert von den betroffenen Eltern in aller Regel schwierige und belastende kognitive und emotionale Anpassungs- und Bewältigungsleistungen sowie eine Fülle an organisatorischen und zeitlichen Umstrukturierungen innerhalb des Lebensalltags. Dabei sind professionelle Experten wie Ärzte und psychosoziale Fachkräfte wichtige Informationsvermittler, denen jedoch der „Mangel“ des unmittelbaren Betroffenseins durch ein eigenes gleichermaßen behindertes Kind und damit fehlende alltägliche Erfahrungen im Umgang mit einem solchen anhaftet. Diese Lücke zu füllen, ist die wichtigste Aufgabe von Selbsthilfegruppen, deren Bedeutung und Zahl seit Anfang der 1970er Jahre permanent gewachsen ist. Bei der Suche nach geeigneten Selbsthilfeinitiativen leisten Internetdatenbanken wichtige Wegweiserdienste. Am Beispiel einer Studie zum Down-Syndrom werden die Erfahrungen von Eltern eines Kindes mit geistiger Behinderung mit Selbsthilfegruppen dargestellt. Als Fazit werden Möglichkeiten zur besseren Verzahnung von Selbsthilfegruppen und professionellen ärztlichen Angeboten aufgezeigt.
A comparison of continuous subcutaneous paliperidone infusion and repeated subcutaneous injection of risperidone free-base in rats
Authors: Marchese G. , Pittau B. , Casu G. , Peddio G. , Spada G.P. , Pira M. , Deriu A. , Portesani F. , Pisu C. , Lazzari P. , Pani L. 
Published: July 2009

AbstractIt is proposed that to achieve a therapeutic effect in schizophrenia patients, dopamine D2-receptor occupancy by antipsychotics within the striatum must exceed 60−65%. However, at high levels of D2-receptor occupancy, the risk of extrapyramidal symptoms (EPS) is increased. Following oral dosing of antipsychotics, peaks and troughs in plasma drug concentrations may be mirrored by fluctuations in D2-receptor occupancy. Paliperidone, a novel antipsychotic available as extended-release tablets (paliperidone ER), is the major active metabolite of risperidone and exhibits a plasma pharmacokinetic profile with reduced peak−trough fluctuations and consistent D2-receptor occupancy compared with conventional oral antipsychotic formulations. Using formulations that resemble those in clinical practice, this study provides a preclinical evaluation of the pharmacological properties of paliperidone ER and risperidone immediate-release formulation in terms of consistent antipsychotic efficacy over time and extrapyramidal symptom liability. Significant fluctuations in inhibition ofd-amphetamine-induced hyperlocomotion were observed for repeated subcutaneous (SC) risperidone injections, whereas stable inhibitory efficacy was demonstrated during continuous SC paliperidone infusion. Similarly, significant fluctuations in latency on-bar were observed with repeated SC risperidone injections, whereas significantly lower latency on-bar was demonstrated following continuous SC paliperidone infusion. These results in an animal model suggest that although risperidone and paliperidone demonstrate similar pharmacologic effects, continuous administration of paliperidone achieves more stable antipsychotic efficacy with reduced motor impairment, akin to the effects observed with paliperidone ER in clinical studies.
Upper Airway Reconstructive Surgery Long‐Term Quality‐of‐Life Outcomes Compared with CPAP for Adult Obstructive Sleep Apnea
Authors: Robinson Sam , Chia Michael , Carney A. Simon , Chawla Sharad , Harris Penelope , Esterman Adrian Esterman 
Published: July 2009

OBJECTIVETo measure long‐term quality‐of‐life (QOL) improvement following contemporary multilevel upper airway reconstruction surgery, compared with continuous positive airway pressure (CPAP) therapy. Secondary aims were to investigate factors determining clinical effectiveness and QOL impact of reported side effects.DESIGNCohort study.SUBJECTS AND METHODSConsecutive, simultaneously treated adult patients with moderate‐severe obstructive sleep apnea (OSA) having upper airway surgery (N = 77) or CPAP (N = 89) therapy were studied by questionnaire. Glasgow Benefit Inventory (GBI), change in snoring status and Epworth Sleepiness Scale (ESS), subjective CPAP compliance, and side effects in both groups were measured at mean ± SEM 44.12 ± 5.78 months (3.68 ± 0.48 years) after commencement of therapy.RESULTSNo significant difference was seen between surgical outcomes for GBI, snoring, or ESS and CPAP controls. Multivariate analysis showed reduction in Respiratory Disturbance Index (RDI) predicted postoperative snoring and ESS, but not GBI outcomes. Snoring control and GBI were related to CPAP compliance (P < 0.001). CPAP side effects (reported in 26%) significantly reduced the QOL benefit of treatment, independent of compliance. Surgical complications (occurring in 44%) did not affect QOL treatment benefit.CONCLUSIONPatients with poor CPAP compliance and/or significant side effects of CPAP therapy (45% of cases in this series) should be evaluated for contemporary upper airway reconstructive surgery.
Pectoralis Myofascial Flap during Salvage Laryngectomy Prevents Pharyngocutaneous Fistula
Authors: Patel Urjeet A. , Keni Sanjay P. 
Published: July 2009

OBJECTIVETo determine the rate of pharyngocutaneous fistula after salvage laryngectomy and assess if pectoralis myofascial flap reinforcement over primary pharyngeal closure prevents pharyngocutaneous fistula.STUDY DESIGNCase series with chart review.SETTINGTertiary‐care public hospital.SUBJECTS AND METHODSThis study included 43 patients undergoing total laryngectomy between 2003 and 2008. Pectoralis myofascial flap reinforcement of the pharyngeal closure during salvage laryngectomy was performed on patients after June 2006. The main outcome measure was pharyngocutaneous fistula after primary laryngectomy, salvage laryngectomy, and salvage laryngectomy with pectoralis flap reinforcement.RESULTSOf the 43 patients, 26 were treated with primary total laryngectomy while 17 received salvage laryngectomy. Seven of 26 patients (27%) undergoing primary total laryngectomy developed pharyngocutaneous fistula. All patients in this group were closed primarily with no flap reinforcement. For salvage laryngectomy, four of seven patients (57%) with primary pharyngeal closure developed pharyngocutaneous fistula; however, none of 10 patients (0%) undergoing salvage laryngectomy with pectoralis myofascial flap reinforcement developed fistula (P < 0.02; 0%‐23%; 95% CI).CONCLUSIONSWith pectoralis myofascial flap reinforcement, pharyngocutaneous fistula rate after salvage laryngectomy dropped to 0 percent in this study (0%‐23%; 95% CI). This is a simple, reliable technique that prevents postoperative pharyngocutaneous fistula and its associated morbidity after salvage laryngectomy.
Histopathologic Assessment of Fibrosis and nEw Bone Formation in Implanted Human Temporal Bones Using 3D Reconstruction
Authors: Fayad Jose N. , Makarem Andres O. , Linthicum Fred H. 
Published: July 2009

OBJECTIVETo evaluate new bone formation and fibrosis in implanted human temporal bones and relate that to neurosensory elements preservation.STUDY DESIGNHuman temporal bone histopathology study.SETTINGTemporal bone laboratory.SUBJECTS AND METHODSTen human temporal bones from eight patients with multichannel cochlear implants and one single‐electrode implant were examined under light microscopy and reconstructed with AMIRA 4.1 3D reconstruction software. Volumes of new bone formation, fibrosis, and patent area were calculated in each bone.RESULTSThe amount of fibrosis and new bone formation postimplantation varied among bones. There were no statistically significant relationships between age at implantation or duration of implantation and the overall amount of new tissue in the implanted ear. There was a relationship between total amount of new tissue and preservation of neurosensory elements only in segment I of the cochlea (Rho = −0.75, P < 0.013). Most of the new tissue was located in segments I and II, segment III had little to no new tissue formation, and segment IV was clear in all of the subjects.CONCLUSIONNew tissue formation postimplantation was related to preservation of neurosensory elements primarily in segment I of the cochlea. In an era of hearing preservation surgery and hybrid cochlear implants, soft surgical techniques are advocated as a means to decrease surgical trauma.
Anterior Palatoplasty for the Treatment of OSA
Authors: Pang Kenny P. , Tan Raymond , Puraviappan Puravi , Terris David J. 
Published: July 2009

OBJECTIVEReview long‐term results of the modified cautery‐assisted palatoplasty (mod CAPSO)/anterior palatoplasty for the treatment of mild‐moderate obstructive sleep apnea (OSA).STUDY DESIGNProspective series of 77 patients. All patients were >18 years old, type I Fujita, body mass index (BMI) < 33, Friedman clinical stage II, with apnea‐hypopnea index (AHI) from 1.0 to 30.0. The mean follow‐up time was 33.5 months. The procedure involved an anterior soft palatal advancement technique with or without removal of the tonsils. The procedure was done under general or local anesthesia.RESULTSThere were 69 men and eight women; the mean age was 39.3 years old; and mean BMI was 24.9 (range 20.7–26.8). There were 38 snorers and 39 OSA patients. The AHI improved in patients with OSA, 25.3 ± 12.6 to 11.0 ± 9.9 (P < 0.05). The overall success rate for this OSA group was 71.8 percent (at mean 33.5 months). The mean snore scores (visual analog score) improved from 8.4 to 2.5 (for all 77 patients). Lowest oxygen saturation also improved in all OSA patients. Subjectively, all patients felt less tired.CONCLUSIONThis technique has been shown to be effective in the management of patients with snoring and mild‐moderate OSA.
Differential Expression of SKI Oncogene Protein in Hemangiomas
Authors: Teresa M. O , Tan Melin , Tarango Mark , Fink Lou , Mihm Martin , Ma Yupo , Waner Milton 
Published: July 2009

OBJECTIVEThe pathogenesis for benign tumorigenesis in hemangiomas is unknown. Oncogene proteins may be influential in this process. SKI proteins have been previously described in various malignancies. We investigated the differential expression of the SKI (sarcoma viral oncogene) protein in hemangiomas.STUDY DESIGNProspective basic science study.SUBJECTS AND METHODSParaffin‐embedded hemangioma tissues were obtained from the senior author from 2005 to 2006. We created the first vascular tissue array composed of 12 hemangioma specimens at various stages of growth and anatomic location. Two cores were taken from each sample. Controls were also included. Immunohistochemical studies were performed using SKI, CD31, and Ki67.RESULTSAll 12 hemangioma tissues overexpressed the SKI protein. The staining pattern was perinuclear within the endothelial cells. The intensity of staining was inversely proportional to the growth stage. The endothelial cells that were SKI‐positive were involved in active cell division.CONCLUSIONSKI oncogene protein is differentially and specifically expressed in hemangioma tissues. SKI acts as a transcriptional co‐repressor and inhibits the TGF‐β pathway, thus leading to uncontrolled cellular proliferation and transformation. All vascular controls were negative for SKI staining.CLINICAL SIGNIFICANCE OF STUDYThe SKI oncogene protein is upregulated by hemangiomas and may play a role in hemangioma tumorigenesis.
Functional Outcomes after Transoral Robotic Surgery for Head and Neck Cancer
Authors: Iseli Tim A. , Kulbersh Brian D. , Iseli Claire E. , Carroll William R. , Rosenthal Eben L. , Magnuson J. Scott 
Published: July 2009

OBJECTIVETo evaluate functional outcomes following transoral robotic surgery for head and neck cancer.STUDY DESIGNCase series with planned data collection.SETTINGAcademic hospital.SUBJECTS AND METHODSBetween March 2007 and December 2008, 54 of 62 candidate patients underwent transoral robotic tumor resection. Outcomes include airway management, swallowing (MD Anderson Dysphagia Inventory), and enterogastric feeding.RESULTSTumors were most commonly oropharynx (61%) or larynx (22%) and T1 (35%) or T2 (44%). Many received radiotherapy (22% preoperatively, 41% postoperatively) and chemotherapy (31%). Endotracheal intubation was retained (22%) for up to 48 hours, tracheostomy less frequently (9%), and all were decannulated by 14 days. Most commenced oral intake prior to discharge (69%) or within two weeks (83%). A worse postoperative Dysphagia Inventory score was associated with retained feeding tube (P = 0.020), age >60 (P = 0.017), higher T stage (P = 0.009), laryngeal site (P = 0.017), and complications (P = 0.035). At a mean 12 months' follow‐up, 17 percent retained a feeding tube (9.5% among primary cases). Retained feeding tube was associated with preoperative tube requirement (P = 0.017), higher T stage (P = 0.043), oropharyngeal/laryngeal site (P = 0.034), and recurrent/second primary tumor (P = 0.008). Complications including airway edema (9%), aspiration (6%), bleeding (6%), and salivary fistula (2%) were managed without major sequelae.CONCLUSIONTransoral robotic surgery provides an emerging alternative for selected primary and salvage head and neck tumors with low morbidity and acceptable functional outcomes. Patients with advanced T stage, laryngeal or oropharyngeal site, and preoperative enterogastric feeding may be at increased risk of enterogastric feeding and poor swallowing outcomes.
Association of Heartburn and Laryngopharyngeal Symptoms with Endoscopic Reflux Esophagitis, Smoking, and Drinking
Authors: Lin Chang‐Chun , Wang Ya‐Yu , Wang Kai‐Li , Lien Han‐Chung , Liang Ming‐Tai , Yen Ting‐Ting , Wang Jing‐Ping , Liu Shi‐An , Wang Chen‐Chi 
Published: July 2009

OBJECTIVESThis study was conducted to investigate the association of laryngopharyngeal symptoms and heartburn with endoscopic esophagitis, smoking, and drinking. The clinical importance of the Reflux Symptom Index (RSI) in predicting endoscopic esophagitis was also evaluated.STUDY DESIGNCase series with planned data collection.SUBJECTS AND METHODSFrom November 2006 to February 2007, 156 adults received a whole‐body physical check‐up. They filled out the RSI questionnaire and were dichotomized into either a “no problem group” or a “possible patients group” according to their scores on the RSI. All subjects received an esophagoscopy. The relationship between RSI score and endoscopic esophagitis, smoking, and drinking was analyzed.RESULTSVoice change, but not heartburn, was significantly associated with endoscopic reflux esophagitis. Based on the RSI scores, some items in addition to voice change were significantly associated with smoking or drinking but not with endoscopic esophagitis.CONCLUSIONSWhile screening patients for reflux esophagitis by using the RSI questionnaire, there is little value in using heartburn to predict endoscopic esophagitis in Taiwanese people. On the other hand, a husky voice might be a good clinical indicator of patients at risk of having reflux esophagitis.
A late iron age neck-ring from Pentire, Newquay, Cornwall, with a note on the find from Boverton, vale of Glamorgan
Authors: Nowakowski Jacqueline , Gwilt Adam , Megaw Vincent , La Niece Susan 
Published: July 2009

AbstractThe chance discovery in 2007 at Pentire, on the outskirts of Newquay, Cornwall, of a leaded bronze neck-ring offers an opportunity to update our knowledge of other neck-rings of the ‘Wraxall’ class, predominantly from south-western Britain. The shared metallurgy and stylistic similarities of the neck-rings confirm previous opinion that the ‘Wraxall’ class belongs to a period when indigenous communities were being influenced by provincial Roman technology, while maintaining elements of indigenous art forms.
Interferon-gamma in suppurative otitis media: significance of otorrhoea type and disease outcome
Authors: Lasisi A O , Olayemi O , Arinola O G , Omilabu S A 
Published: July 2009

AbstractBackground:Interferon-γ has been reported to have an immunoregulatory role in otitis media with effusion. However, such a role remains to be determined in acute suppurative otitis media.Aim:To determine the levels of interferon-γ in middle-ear secretion in children with acute suppurative otitis media, and to determine the significance of interferon-γ to the nature of otorrhoea and the outcome of otitis media.Settings and design:Prospective, longitudinal follow up of patients selected from community and tertiary health centres.Methods:We selected children with acute suppurative otitis media, diagnosed as otorrhoea of less than three months' duration. Middle-ear secretions were collected by pipetting and stored at −80°C. Interferon-γ was assayed using enzyme-linked immunosorbent assay. The patients were treated and followed up for nine to 12 months, to separate those with resolved acute suppurative otitis media from those with chronic suppurative otitis media.Result:The study initially included 358 cases of acute suppurative otitis media. Nine-month follow up was achieved in 304 patients (85 per cent). Of these patients, acute suppurative otitis media resolved in 187 (61 per cent), while chronic suppurative otitis media was evident in 117 (39 per cent). The children with completed follow up comprised 173 boys and 131 girls, aged between four months and nine years (mean age 6.6 years; standard deviation 1.32). These children had purulent otorrhoea in 171 cases (56 per cent) and mucoid otorrhoea in 133 cases (44 per cent). The children's middle-ear secretion interferon-γ concentrations ranged from 12 to 126 pg/ml. The mean middle-ear secretion interferon-γ concentration was 27.2 pg/ml (standard deviation 8.8) in patients whose acute suppurative otitis media resolved, and 73.1 pg/ml (standard deviation 9.5) in those progressing to chronic suppurative otitis media. In children with purulent otitis media, the mean middle-ear secretion interferon-γ concentration was 43.5 pg/ml (standard deviation 15.6); in those with mucoid otitis media, it was 74.3 pg/ml (standard deviation 19.1). Univariate analysis revealed significant differences in middle-ear secretion interferon-γ concentration, comparing resolved acute suppurative otitis media and chronic suppurative otitis media cases (p = 0.00), and comparing purulent and mucoid otitis media cases (p = 0.00). Pearson correlation testing revealed significant inverse correlation between interferon-γ concentration and middle-ear secretion immunoglobulin G concentration (p = 0.01), immunoglobulin E concentration (p = 0.03) and immunoglobulin A concentration (p = 0.00).Conclusion:A high concentration of interferon-γ in middle-ear secretions promotes chronicity of suppurative otitis media. Further research in this area may lead to the development of agents which assist the control of suppurative otitis media chronicity.
Extra-pulmonary small cell carcinoma of the neopharynx: case report and review of neopharyngeal tumours after total laryngectomy
Authors: George A , Uppal H , Phelan C , Hughes R 
Published: July 2009

AbstractObjective:We report the first documented case in the world literature of primary extra-pulmonary small cell carcinoma occurring in the neopharynx following laryngectomy.Method:We present a case report and a review of the world literature regarding the management of tumours of the neopharynx and extra-pulmonary small cell carcinoma.Results:The paucity of cases of extra-pulmonary small cell carcinoma has resulted in many departments managing this neoplasm similarly to pulmonary small cell cancer. However, the site of the primary can have an impact on disease survival and treatment options.Conclusion:Neopharyngeal small cell carcinoma has not previously been reported. It should be managed in the same way as other extra-pulmonary small cell carcinomas occurring within the pharynx or larynx, with combined multi-drug chemotherapy and radiotherapy. Surgery has a limited role due to the aggressiveness of the disease and the high risk of local and distant spread at presentation.
Turbulent spectra in the solar wind plasma
Authors: SHAIKH DASTGEER , ZANK G. P. 
Published: July 2009

AbstractObservations of interstellar scintillations at radio wavelengths reveal a Kolmogorov-like scaling of the electron density spectrum with a spectral slope of −5/3 over six decades in wavenumber space. A similar turbulent density spectrum in the solar wind plasma has been reported. The energy transfer process in the magnetized solar wind plasma over such extended length scales remains an unresolved paradox of modern turbulence theories, raising the especially intriguing question of how a compressible magnetized solar wind exhibits a turbulent spectrum that is a characteristic of an incompressible hydrodynamic fluid. To address these questions, we have undertaken three-dimensional time-dependent numerical simulations of a compressible magnetohydrodynamic fluid describing super-Alfvénic, supersonic and strongly magnetized plasma. It is shown that the observed Kolmogorov-like (−5/3) spectrum can develop in the solar wind plasma by supersonic plasma motions that dissipate into highly subsonic motion that passively convect density fluctuations.
Transjudicial Dialogue and the Rwandan Genocide: Aspects of Antagonism and Complementarity
Authors: SADAT LEILA 
Published: July 2009

AbstractThe Rwandan genocide remains one of the most horrific atrocities of the twentieth century, resulting in the death of an estimated 500–800,000 human beings, massacred over a 100-day period. In the fourteen years since the genocide, attempts at justice and reconciliation in Rwanda have involved a delicate interplay between national legal systems and the international legal order. This article examines three fora in which Rwandans have been tried for involvement in the genocide: the International Criminal Tribunal for Rwanda, Rwandan courts including Gacaca tribunals, and French attempts to exercise universal jurisdiction. Using Rwanda as a case study, the article illustrates the issues, concerns, and difficulties that arise when multiple jurisdictions assert a right to exercise criminal jurisdiction over the perpetrators of serious atrocity crimes. Beginning with a discussion of the political context, this article considers what the competing narratives and litigation in various fora have meant for the project of international and transnational criminal justice. Cases involving the commission of atrocities pose unique challenges for the international legal order. As the normative structure of international criminal law has arguably been strengthened, political constraints increasingly come to the fore. As illustrated by Rwanda, universal jurisdiction or other bases of jurisdiction may remain necessary vehicles for justice and reconciliation, or, at the very least, they may serve as a catalyst for change in Rwanda itself.
Pipes, Colanders, and Leaky Buckets: Reflections on the Futility Debate
Authors: Paris John J. 
Published: July 2009

The issue of physician refusal of requested treatment has fueled a two-pronged debate in our society-one on the meaning of futility and the other on the limits of patient autonomy. The latter is a genuinely philosophic dispute; the former, it seems, is a modern relapse into nominalism.It is not the meaning of a word, but the moral basis for the actions of the par-ticipants that should be the focus of our attention, Yet the medical literature distracts us with articles titled “Medical Futility: Its Meaning and Ethical Implica-tions” “The Problem with Futility” “Who Defines Futility?,” “The Illusion of Futility,” and even “Beyond Futility.”The history of the futility debate, which was launched by a 1983 study of Bedell and Delbanco that demonstrated the ineffectiveness of CPR for certain catego-ries of patients, has been documented elsewhere. Here we will inquire if the term, and its rapid intrusion into the medical lexicon, serves a useful purpose or if, as Truog suggested, we would all be better off if this new buzzword were jettisoned.