bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catheter Management in Hemodialysis Patients
Authors: Besarab Anatole , Pandey Rahul 
Published: November 2010

Summary
Over 330,000 individuals in the United States depend on hemodialysis (HD), the majority as a result of end-stage renal disease. Sustainable vascular access can be achieved through arteriovenous fistulas, arteriovenous grafts, or tunneled catheters. Tunneled dialysis catheters (TDCs) often remain in use for months or even years, long beyond their initial intended use as a bridging device. Research efforts are focused on identifying strategies to prevent/minimize the risk of the most common catheter-related complications: thrombotic occlusion and infection. Thrombotic occlusion of TDCs prevents adequate dialysis but can be managed successfully through thrombolytic agents to restore/improve blood flow in the majority of patients, allowing immediate HD delivery and prolonging usability of the TDC. Occasionally, catheter exchange with fibrin sheath disruption is needed to preserve the site. Surface-treated catheters could improve the morbidity and mortality associated with HD delivery via an indwelling catheter, but results from studies have been disappointing to date. We review the etiology of catheter-based access failure and the monitoring and interventional steps that should be taken to maintain the patency and safety of catheters for HD. Wherever possible we note the areas in which there is scant data where further randomized clinical trials are needed.
Consensus and Link Structure in Strategic Performance Measurement Systems: A Field Study
Authors: Aranda Carmen , Arellano Javier 
Published: December 2010

ABSTRACT: For a strategy to be effective it must be communicated and widely understood throughout the organization. Our study addresses which of two Strategic Performance Measurement Systems (SPMSs) approaches is more successful at communicating strategy and generating consensus on strategy among managers: (1) the BSC, which makes explicit the links among measures and categories in a hierarchical mode, and (2) an alternative SPMS design, which splits measures into financial and nonfinancial, but lacks this hierarchical structure of links.
We conducted a field experiment in a savings bank and monitored two groups of middle managers working with each of the two SPMS designs. Our results show that (1) middle managers treated with the BSC exhibit a statistically significantly greater effect regarding consensus with respect to top management than those treated with the alternative SPMS, (2) this increased consensus is more pronounced as we move down the list of the BSC perspectives, where the majority of nonfinancial and long term measures are found, and finally (3) some of the managers treated with the nonlinked SPMS experience a loss in consensus.
The implications for the SPMS design process are: (1) the reporting of the performance measures links in a hierarchical mode matters when it comes to designing an effective strategy communication device, and (2) the dispersion in managers’ interpretation of the strategy generated by lacking a linked structure is greater than the tension created by confronting managers’ views with the disclosed link structure.
Item generation and design testing of a questionnaire to assess degenerative joint disease–associated pain in cats
Authors: Zamprogno Helia , Hansen Bernie D. , Bondell Howard D. , Sumrell Andrea Thomson , Simpson Wendy , Robertson Ian D. , Brown James , Pease Anthony P. , Roe Simon C. , Hardie Elizabeth M. , Wheeler Simon J. , Lascelles B. Duncan X. 
Published: December 2010

Abstract
Objective—To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)–associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners.
Animals—100 randomly selected client-owned cats from 6 months to 20 years old.
Procedures—Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs.
Results—22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats.
Conclusions and Clinical Relevance—Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.
Evaluation of an in vitro telomeric repeat amplification protocol assay to detect telomerase activity in canine urine
Authors: McCleary-Wheeler Angela L. , Williams Laurel E. , Hess Paul R. , Suter Steven E. 
Published: December 2010

Abstract
Objective—To evaluate the usefulness of a PCR-based telomeric repeat amplification protocol (TRAP) assay for detecting telomerase activity in cells from a canine transitional cell carcinoma (TCC) cell line and, ultimately, in the urine of dogs with TCC.
Animals—11 dogs with histologic or cytologic evidence of TCC, 10 dogs with benign lower urinary tract disease, and 9 healthy dogs.
Procedures—Telomerase activity was initially evaluated in cells from canine TCC (K9TCC) and telomerase-negative (WI-38) cell lines. Following assay optimization, telomerase stability was evaluated at various storage durations and temperatures. Urine samples were then obtained prospectively from study dogs.
Results—Telomerase activity was detected in the K9TCC cell line. The TRAP assay detected telomerase activity in as few as 10 K9TCC cells alone and as low as 2% of a total cell population in K9TCC and WI-38 mixing experiments. A loss of telomerase activity was detected with increasing urine storage durations at various temperatures. Telomerase activity was clearly detected in samples collected from 10 of 11 dogs with TCC, 2 of 10 dogs with benign lower urinary tract disease, and none of the 9 healthy dogs.
Conclusions and Clinical Relevance—The TRAP-based assay detected telomerase activity in the canine TCC cell line and revealed that the telomerase ribonucleoprotein complex was inherently unstable at various storage durations and conditions. Telomerase activity was also detectable in urine samples obtained from dogs with TCC, which suggested the TRAP assay may be useful in diagnosing TCC in dogs.
Diurnal hormonal responses in exercise and sports medicine research: range effect adjustments
Authors: Hackney Anthony 
Published: November 2010

Diurnal hormonal responses in exercise and sports medicine research: range effect adjustments
The paper discusses the means in which exercise hormonal data are transformed and expressed as a way to deal with the inherent variability in endocrine measurements. Specifically, the aim of the paper is to present an alterative transformation adjustment method for expressing the exercise responses of hormones, especially those which exhibit a diurnal behaviour in their circulating concentrations. The suggested alterative adjustment method attempts to account for the influence of the "range effect" on diurnal hormonal data and the subsequent effects it may have on statistical, and perhaps physiological, outcomes and data interpretation.
Treatment of Recurrent Sinonasal Polyposis with Steroid-Infused Carboxymethylcellulose Foam
Authors: Pletcher Steven D. , Goldberg Andrew N. 
Published: November 2010

Background Recurrence of sinonasal polyposis after endoscopic sinus surgery can be difficult to manage. Topical steroid sprays and irrigations may not provide adequate treatment and systemic steroid therapy is limited by side effects. This study was designed to evaluate the efficacy of steroid-infused carboxymethylcellulose (CMC) foam as a treatment for recurrence of chronic rhinosinusitis with nasal polyposis after endoscopic sinus surgery. Methods A prospective cohort study was performed enrolling patients with recurrent sinonasal polyposis after endoscopic sinus surgery. All patients had development of symptomatic polyp disease despite aggressive postoperative topical steroid treatment. The study treatment entailed endoscopic placement of 4 mL of CMC foam hydrated with triamcinolone, 40 mg/mL (Kenalog 40; Bristol-Myers Squibb, New York, NY), into the ethmoid cavities bilaterally. Patients were evaluated using videoendoscopy and the Sino-Nasal Outcomes Test 20 (SNOT-20) at three time points: immediately before treatment, 7–14 days after treatment, and 28–35 days after treatment. The videoendoscopies were randomized and scored in a blinded fashion using a modification of the perioperative sinus endoscopy (POSE) scoring system. Results Ten treatments were performed in eight patients; two patients underwent two treatments each. Mean SNOT-20 score improved at both 1 week and 1 month after treatment (2.44 versus 1.65, p < 0.05, and 2.44 versus 1.36, p < 0.01, respectively). Videoendoscopy also revealed improvement when evaluated with the modified POSE score at 1 week (11.8 versus 8.2, p < 0.001), and 1 month (11.8 versus 7.9, p < 0.001). Conclusion Endoscopic placement of steroid-infused CMC foam improves symptoms and endoscopic findings in patients with recurrent sinonasal polyposis after endoscopic sinus surgery.
Endonasal Endoscopic Medial Maxillectomy with Preservation of the Inferior Turbinate
Authors: Weber Rainer K. , Werner Jochen A. , Hildenbrand Tanja 
Published: November 2010

Background Endonasal endoscopic medial maxillectomy usually includes removal of the inferior turbinate (IT) even if it is not involved in the disease. A surgical approach is presented in which the IT is temporarily excised and then reinserted, followed by postoperative occlusion of the nose for at least 2 weeks. Methods A retrospective case series of 12 patients with inverted papilloma (IP) of the maxillary sinus (Krouse II–III) and 2 patients with 3 mucoceles of the maxillary sinus after a Caldwell-Luc operation were reviewed. After a follow-up period of 12–80 months (28 months on average) all patients underwent endoscopy, and in four cases, additionally, an MRI was performed. Results There was no recurrence of tumor or mucocele after 12–80 months. The IT and its important function for warming and humidifying the inhaled air could be preserved up to now in all 15 operated sides. The patients did not have any specific pain postoperatively and there was no postoperative bleeding. They all tolerated occlusion for 2–4 weeks. Two patients developed mucoceles due to the formation of scar tissue after endonasal tumor surgery. In three cases of endonasal endoscopic Denker operation patients reported some degree of numbness or irritation of the ipsilateral frontal teeth. Conclusion The IT can be preserved in endonasal endoscopic medial maxillectomy for treatment of IP without a higher incidence of tumor recurrence. Aftercare should specifically focus on preventing the development of mucoceles caused by scarring.
Does Maxillary Arch Remodeling Exist in Nasal Polyposis?
Authors: Gunhan Kivanc , Can Fatma , Uz Uzdan , Serter Selim , Unlu Halis 
Published: November 2010

Background The potential transformation in the maxillary complex morphology is mostly complete during childhood. Recent studies suggest a nasal tissue remodeling both in the overlying mucosa and in the underlying sinus bone in nasal polyposis (NP). Our evaluation of computed tomography (CT) revealed that the maxillary arch is more flat and shallow in patients with chronic rhinosinusitis with NP. The purpose of this study was to determine the possible effects of NP to the maxillary arch morphology in adulthood and to investigate a possible remodeling of the maxillary bone during the course of NP. Methods A prospective study was performed on 25 patients. Grading of the polyps, acoustic rhinometry and rhinomanometry assessments, and CT scans were documented initially, 1 year after diagnosis, and 2 years postoperatively. Twenty-five subjects’ CT scans randomly selected from our CT database formed the comparison group. The plane angle between the maxillary alveolar processes (MAP) and the palatine process of the maxillary bone (MPP), and the depth of the maxillary arch of both groups were compared. Results The results pointed out that the maxillary arch was shallower and the bilateral angles between MAP and MPP were significantly greater than those of the comparison group in all evaluation periods. This difference was less at the end of the postoperative follow-up period. Conclusion Although it is a common belief that maxillofacial formation expires in childhood, this may not be the case under some special conditions such as NP in adulthood. NP might cause maxillary arch remodeling in adults.
Rhinolithiasis: Review of 21 Cases
Authors: Özdemir Süleyman , Akbas Yücel , Görgülü Orhan , Selçuk Tahsin , Sayar Çağdas 
Published: November 2010

Background Rhinolithiasis is masses that result from the deposition of salts around an intranasal foreign body. Rhinoliths are rare and rhinolithiasis is generally reported in the literature in single case studies. This study presents 21 cases of rhinolithiasis with a large series of clinical findings, diagnosis, and treatment. Methods A total of 21 patients diagnosed with rhinolithiasis were identified. Clinical presentations, signs, and symptoms of the patients with radiological findings are presented, and x-ray diffraction analyses of three of the removed rhinoliths were performed to assess their mineralogical composition. Results A total of 21 patients (9 male and 12 female patients; age range, 4–63 years) diagnosed with rhinolithiasis were reviewed in this study. The most common symptoms were noted as purulent rhinorrhea and nasal obstruction. The other symptoms were headache, oral malodor, and recurrent epistaxis. Nasal endoscopic examination was used for diagnosis of all patients. Endoscopic nasal examinations and computerized tomography (CT) findings revealed that rhinolithiasis was accompanied by sinusitis, chronic vestibulitis, allergic rhinitis, septum deviation, and squamous cell carcinoma. Rhinoliths were fully excised by using endoscopic nasal surgery. Mineralogical analyses of the three removed stones revealed dahllite [Ca5(PO4, CO3)3OH]. Conclusion Cases of rhinolithiasis are seen rarely. It should always be considered in patients complaining from long-term unilateral nasal obstruction and unilateral purulent rhinorrhea. The treatment involves the removal of the rhinolith and the use of appropriate antibiotic therapy to control local infection. Rigid nasal endoscopy is the most important method to be used in diagnosis and treatment.
Outcomes of an Early Intervention Program for Children with Disruptive Behaviour
Authors: Hayes Louise , Giallo Rebecca , Richardson Kate 
Published: November 2010

Objective: Outcomes are presented from a public mental health early intervention program for children aged 5–9 years with disruptive behaviours. Method: This was a school-based intervention initiative, delivered within a psychiatric child and adolescent mental health service and includes child, parent and teacher components. Participants were 235 children selected via school-based population assessments. Results: A baseline period was used as a form of control that would demonstrate the stability of problem behaviours. Results showed that during a 26-week baseline period, teachers reported increasing levels of problem behaviour, and that the behaviour was creating increased difficulty in the classroom. The shorter 7-week baseline also showed the difficult behaviours were ongoing. Following the intervention, significant improvements in children's behaviour were seen on the Strengths and Difficulties Questionnaire reported by parents (η2 = 0.30) and teachers (η2 = 0.23), and on the parent Eyberg Child Behaviour Inventory (η2 = 0.35), and teacher Sutter-Eyberg Student Behaviour Inventory (η2 = 0.22). Conclusion: The outcomes show promising results from an early intervention program delivered in schools by a public mental health service and are discussed within the context of dissemination of evidence-based programs though mental health services.
Missed Diagnosis of Autism in an Australian Indigenous Psychiatric Population
Authors: Roy Meera , Balaratnasingam Sivasankaran 
Published: November 2010

Objective: The aim of this paper is to review the diagnosis among adult Indigenous patients from the Kimberley region of Western Australia who had an existing diagnosis of schizophrenia. A visit from a psychiatrist specializing in intellectual disability provided the opportunity for conducting psychiatric assessments from a developmental perspective. Method: Selected patients with schizophrenia were assessed from an intellectual disability perspective from an active case load of 215 patients. Result: Thirteen out of 14 selected patients were considered to have a diagnosis of autism when a developmental history was undertaken. Case studies are presented to illustrate the overlap in symptoms and potential for the diagnosis of autism to be missed. Conclusions: Autism spectrum disorders may be missed in Indigenous population groups. This has implications for treatment and service provision. Clinicians need to be mindful of the diagnostic possibility that an autism spectrum disorder might be masquerading as schizophrenia in the context of intellectual disability and atypical presentation.
A Partnership Evaluation: Public Mental Health and Dental Services
Authors: Wieland Beth , Lau Geoffrey , Seifert Dianne , Siskind Dan 
Published: November 2010

Objective: This study evaluates the partnership between a mental health service and a public dental hospital in providing timely and efficient access to dentistry to patients with a mental illness. In addition, the factors that contributed to the sustainability of the partnership were examined. Method: The partnership was appraised using a survey-based evaluation with 20 patients, 43 community mental health staff and 14 dental staff, and focus groups with mental health and dental staff. Results: The partnership between the services is the key element to the success of improving access to dental services for patients. Overall feedback received from mental health staff highlighted the importance of the partnership and its role in meeting the oral health needs of patients. Generally, patients were satisfied with the treatment they received and valued the dental service. Results highlighted an ongoing problem of poor dietary and lifestyle choices. Dental staff felt that mental health patients were less likely to take care of their teeth and were more likely to cancel appointments. Dental staff also acknowledged frustration with patients with a mental illness not attending appointments or following through with a recommended course of treatment. Conclusions: The partnership with the local dental hospital has created a sustainable way to ensure improved dental health outcomes for patients of mental health services. This partnership has led to increased access to dental services and improved follow-up.
How to Tackle a Giant: Creating a Genuine Evaluation of the Better Access Program
Authors: Rosenberg Sebastian , Hickie Ian 
Published: November 2010

Objective: This paper proposes a framework for a systematic evaluation of the Better Access Program, the largest single component of mental health reform announced under the Council of Australian Governments National Action Plan on Mental Health 2006–11. Method: The article explores the genesis of the Program and considers extant data sets and information available with which to establish the impact of the Program on consumers and service providers. Results: There are useful data available in Australia from which to derive pre- and post-implementation analysis about the impact of the Better Access Program. There is doubt as to whether these data form part of the Federal Government's current approach to evaluation of the Program. Conclusions: Anything less than a genuine and comprehensive evaluation will leave Australia unable to assess the real impact of the Better Access Program. The merit of further expenditure in the vital area of primary mental health care will be in doubt as a consequence.
Cervicothoracic junction kyphosis: surgical reconstruction with pedicle subtraction osteotomy and Smith-Petersen osteotomy
Authors: Samudrala Srinath , Vaynman Shoshanna , Thiayananthan Ty , Ghostine Samer , Bergey Darren L. , Anand Neel , Pashman Robert S. , Johnson J. Patrick 
Published: December 2010

ObjectSagittal plane deformities can be subdivided into kyphotic and lordotic forms and further characterized according to their global or regional (focal) presentation. Regional deformities of a significant magnitude constitute a gibbous deformity. Pedicle subtraction osteotomy (PSO) and interlaminar Smith-Petersen osteotomies have been used to correct sagittal plane deformities in the cervical, thoracic, and lumbar spine. By resecting a portion of the vertebral body and closing in the gap of this vertebra, the spine is placed in local lordosis and kyphosis is corrected. These osteotomies have generally been carried out in the lumbar or less frequently in the thoracic area. While PSO has been performed in the mid and lower thoracic spine, there have been no case series of patients undergoing PSO at the CTJ. Specifically, a PSO approach that addresses the challenges of the CTJ is needed. Here, the authors review their case series of PSOs performed in the CTJ. Their goal in the treatment of these patients was to correct the regional CTJ kyphosis, restore forward gaze, and reduce the pain associated with the deformity.MethodsEight patients (5 males and 3 females, mean age 63 years) underwent PSO for the correction of CTJ kyphosis. Pedicle subtraction osteotomy was performed at C-7 or the upper thoracic vertebrae and was facilitated by a computer-guided intraoperative monitoring system. Surgical indications included postlaminectomy kyphosis, spinal cord tumor resection, posttraumatic kyphosis, and degenerative cervical spondylosis.ResultsThe mean follow-up was 15.3 months (range 12–20 months), and the mean preoperative CTJ kyphosis was 38.67° (range 25°–60°). Clinically satisfactory correction of the regional deformity was accomplished in all patients, achieving a mean correction of 35.63° (range 15°–66°) at the CTJ, with restoration of forward gaze and significant reduction in pain.ConclusionsA CTJ deformity is a distinctive form of kyphosis that presents as a variable local deformity and requires complex spinal reconstructive techniques to restore sagittal balance and forward gaze. Pedicle subtraction osteotomy allows for significant correction through one spinal segment, and it can be used safely to correct the regional sagittal alignment of the cervical spine and head in relation to the pelvis. Pedicle subtraction osteotomy can be used alone or in combination with other techniques as some patients may require multistage procedures with anterior and posterior spinal reconstruction to obtain stable sagittal correction. All deformities in these patients were kyphotic in nature with only mild elements of scoliosis or coronal plane deformity. This is unlike lumbar and thoracic curves where the kyphosis is frequently associated with scoliosis.