bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoglossal Nerve Stimulation and Airway Changes under Fluoroscopy
Authors: Goding George S. , Tesfayesus Wondimeneh , Kezirian Eric J. 
Published: February 2012

ObjectiveTo characterize the changes in the anteroposterior dimensions of both the retropalatal and retrolingual airway spaces of the pharynx and hyoid bone position during hypoglossal nerve stimulation under general anesthesia in subjects with obstructive sleep apnea.Study DesignCross‐sectional.SettingAcademic center.Subjects and MethodsCross‐table fluoroscopic images obtained during hypoglossal nerve stimulation were studied in 26 subjects enrolled in the Apnex Medical Hypoglossal Nerve Stimulation (HGNS) system feasibility trials. Changes in the anteroposterior dimensions (2‐dimensional) of the retropalatal and retrolingual airway spaces and hyoid bone position were recorded. Measurements were estimated in millimeters and standardized to each subject’s C3 vertebral height. Opening of the pharyngeal airspace was examined relative to body mass index.ResultsDuring hypoglossal nerve stimulation, all subjects demonstrated anterior displacement of the tongue base on fluoroscopy. The average retrolingual airway opening was 0.71 ± 0.23 C3 vertebral body heights (9 ± 3 mm). Opening of the retropalatal airway with stimulation occurred in 65% (15/23) of subjects. When present, the average opening was 0.42 ± 0.14 vertebral heights (5 ± 3 mm). Anterior displacement of the hyoid occurred in 92% (23/25) of subjects. Retrolingual airway opening was independent of baseline body mass index.ConclusionUnilateral hypoglossal nerve stimulation results in anterior tongue base displacement and an increase in the anterior‐posterior retrolingual airway dimensions of the pharynx, independent of body mass index. Opening of the retropalatal airway occurred in a majority of subjects and had a trend toward correlation with body mass index.
Esophageal Reflux Disease Proton Pump Inhibitor Therapy Impact on Sleep Disturbance
Authors: Regenbogen Elliot , Helkin Alex , Georgopoulos Rachel , Vasu Tajender , Shroyer A. Laurie W. 
Published: February 2012

ObjectiveTo perform a systematic literature review that evaluates the impact of proton pump inhibitor treatment of gastroesophageal reflux disease on sleep disturbance–related outcomes.Data SourcesPubMed, Web of Science, and Cochrane databases were searched from 1989 (when omeprazole became available) to present; additional references gleaned from citations.Review MethodsThe search strategy identified all randomized placebo‐controlled clinical trials published in English; both proton pump inhibitor use and outcome measures of sleep disturbance were reported for esophageal reflux disease patients. Using a preestablished systematic review protocol and data extraction format, 4 coauthors independently reviewed all articles.ResultsThe original search identified 20 articles; 9 were not directly relevant, and 3 were not placebo controlled. Sample sizes varied from 15 to 642; mean age was 47.4 ± 4.56 years; mean body mass index was 29.4 ± 2.9; the proportion of women varied widely across studies. Esomeprazole was studied most frequently. More than 50% of publications permitted rescue antacids. Two studies reported polysomnography outcomes, without statistically significant improvement. All studies reported non‐polysomnography outcomes; 7 identified statistically significant improvements demonstrating drug treatment superiority over placebo.ConclusionThe existing evidence supports the use of proton pump inhibitors as a treatment for esophageal reflux disease to improve quality‐of‐life sleep disturbance–related outcomes. Given the wide variability in proton pump inhibitor treatments and sleep disturbance–related outcomes reported, however, study‐specific results cannot be directly compared or aggregated. This conclusion appears robust not only for 7 of 8 studies included but also for the 3 highest quality studies.
Does Mannose‐Binding Lectin Have a Role in Adult Turkish Patients with Nasal Polyposis?
Authors: Eren Erdem , Midilli Raşit , Karaca Emin , Onay Hüseyin , Karcı Bülent , Özkınay Cihangir 
Published: February 2012

ObjectiveMannose‐binding lectin is an important component of innate immunity; it initiates the lectin pathway of complement activation critical for innate immunity. Failure of local innate defenses may result in defective responses that lead to the persistent carriage of microorganisms or ongoing inflammation. This study investigated the role of mannose‐binding lectin levels and the frequency of the 6 functional mannose‐binding lectin polymorphisms in Turkish individuals with nasal polyposis.Study DesignA case‐control study.SettingUniversity hospital.Subjects and MethodsFifty‐one patients with nasal polyposis and 53 healthy controls were enrolled. Serum mannose‐binding lectin levels were obtained by enzyme‐linked immunosorbent assay (ELISA) using the mannose‐binding lectin oligomer ELISA kit. Mannose‐binding lectin 2 genotyping was performed by isolating the genomic DNA from leukocytes.ResultsMean mannose‐binding lectin levels were 1693.2 and 1887.8 in the patient and control group, respectively. Although mannose‐binding lectin levels were lower in the patient group, the difference was not statistically significant (P >. 05). No overall association was observed between the mannose‐binding lectin genotype and susceptibility to nasal polyposis (95% confidence interval = 0.716–4.389, odds ratio = 1.773). The mutant allele frequencies of the 3 structural polymorphisms did not differ significantly between the nasal polyposis patients and the controls (P =. 659).ConclusionsMannose‐binding lectins are not involved in the pathogenesis of nasal polyposis in adult Turkish patients, but additional research is needed for further comment.
The Value of Routine pH Monitoring in the Diagnosis and Treatment of Laryngopharyngeal Reflux
Authors: Friedman Michael , Hamilton Craig , Samuelson Christian G. , Kelley Kanwar , Taylor Renwick , Darling Robert , Taylor David , Fisher Michelle , Maley Alexander 
Published: February 2012

ObjectiveTo assess the need for pH testing in diagnosing laryngopharyngeal reflux (LPR).Study DesignCase series with planned data collection.SettingTertiary care center.Subjects and MethodsOn the basis of symptoms and/or abnormal endoscopic findings, more than 500 patients underwent 24‐hour pharyngeal pH testing at a single center (using the Dx‐pH probe) between January 2009 and June 2011. A total of 163 patients not on proton‐pump inhibitors at the time of study and with complete data available for analysis (pH results, body mass index, smoking status, pretest reflux symptom index) were divided into 2 groups by positive (n = 70) and negative (n = 93) Ryan Score. The Reflux Symptom Index (RSI) was compared between groups and assessed overall against Ryan Score parameters at different pH thresholds. The diagnostic utility of an RSI ≥ 13 for prediction of Ryan Score was assessed.ResultsNo significant difference in RSI was seen between Ryan‐positive (17.50 ± 11.47) and Ryan‐negative (14.95 ± 11.43) patients (P =. 161). Overall, RSI correlated poorly with percentage time spent below pH thresholds 6.5, 6.0, 5.5, and 5.0 and upright and supine Ryan parameters at these thresholds (as determined by linear regression analysis). The sensitivity, specificity, positive predictive value, and negative predictive value of RSI ≥ 13 for Ryan positivity were 55.7%, 47.3%, 44.3%, and 58.7%, respectively.ConclusionOur findings show that in our population of otolaryngology patients, the diagnosis of LPR cannot be reliably made on the basis of symptoms alone. Diagnosis, and in particular treatment decisions, should ideally be made on the basis of a combination of symptoms, signs, and confirmatory testing.
Is It Valid to Calculate the 3‐Kilohertz Threshold by Averaging 2 and 4 Kilohertz?
Authors: Gurgel Richard K. , Popelka Gerald R. , Oghalai John S. , Blevins Nikolas H. , Chang Kay W. , Jackler Robert K. 
Published: February 2012

Many guidelines for reporting hearing results use the threshold at 3 kilohertz (kHz), a frequency not measured routinely. This study assessed the validity of estimating the missing 3‐kHz threshold by averaging the measured thresholds at 2 and 4 kHz. The estimated threshold was compared to the measured threshold at 3 kHz individually and when used in the pure‐tone average (PTA) of 0.5, 1, 2, and 3 kHz in audiometric data from 2170 patients. The difference between the estimated and measured thresholds for 3 kHz was within ±5 dB in 72% of audiograms, ±10 dB in 91%, and within ±20 dB in 99% (correlation coefficient r = 0.965). The difference between the PTA threshold using the estimated threshold compared with using the measured threshold at 3 kHz was within ±5 dB in 99% of audiograms (r = 0.997). The estimated threshold accurately approximates the measured threshold at 3 kHz, especially when incorporated into the PTA.
Coping and Quality of Life after Total Laryngectomy
Authors: Eadie Tanya L. , Bowker Brianne C. 
Published: February 2012

ObjectiveTo investigate how ways of coping and traditional factors (age, sex, time postlaryngectomy, stage of disease, radiation, alaryngeal speech method) predict global quality of life, head and neck cancer–specific quality of life, and voice‐related quality‐of‐life outcomes after total laryngectomy.Study DesignCross‐sectional survey.SettingUniversity‐based laboratory and speech clinic.Subjects and MethodsSixty‐seven individuals who underwent total laryngectomy secondary to cancer were recruited from support groups and professional contacts. Individuals were at minimum 9 months postlaryngectomy. All outcomes were patient reported and included demographic data as well as a number of validated questionnaires: the Ways of Coping–Cancer Version (WOC‐CV) scale, the Voice‐Related Quality of Life (V‐RQOL) scale, and the University of Washington Quality of Life (UW‐QOL) composite and global QOL scores.ResultsFifty‐three individuals identified a stressful aspect of their laryngectomy. As a set, traditional variables (age, time postlaryngectomy, alaryngeal speech method) accounted for only 5% of global QOL scores but between 25% and 30% of the variance of composite UW‐QOL and V‐RQOL scores. Time postlaryngectomy was the strongest traditional predictor. Ways of coping accounted for 23% to 32% of all QOL scores. Avoidant coping strategies (both cognitive and behavioral escape) were among the strongest predictors of poorer QOL. When traditional variables were combined with ways of coping, they together accounted for 26% to 46% of the variance of QOL outcomes.ConclusionCoping is important to consider when evaluating postlaryngectomy outcomes, above and beyond traditionally investigated factors.
Atypical Mycobacterium Detection in Refractory Chronic Rhinosinusitis
Authors: Solyar Alla , Lee Annie S. , Przybyszewski Barbara , Lanza Donald C. 
Published: February 2012

ObjectivesAtypical mycobacterium (AM) involvement in refractory chronic rhinosinusitis (CRS) is sought by some surgeons with customary acid‐fast bacilli cultures (AFBC) in the operating room (OR). We evaluate our experience with AM in CRS by describing (1) associated risk factors, (2) species identified, and (3) frequency of positive cultures in clinic versus OR.Study DesignCase series with chart review.SettingTertiary rhinology practice.Subjects and MethodsAFBC taken between 2005 and 2011 were identified from a microbiology laboratory database. Charts were reviewed for gender, age, medical history, risk factors for AM, pathogen types, and treatments, with statistical comparison using Pearson χ2. The benefit of “targeted AFBC” for cases with high clinical suspicion was compared with “customary AFBC” in the OR.ResultsThirty‐seven patients were identified with AM, of which 10 had one or more risk factors for AM including foreign body (n = 4), non‐HIV immune dysfunction (n = 4), and previous chemoradiation (n = 4). Six different AM species were identified: most frequently Mycobacterium abscessus (57.1%), followed by Mycobacterium avium‐intracellulare complex (14.3%) and Mycobacterium chelonae (14.3%). “Targeted AFBC” from the outpatient setting were positive in 10 of 190 (5.3%) patients, whereas 10 of 373 (2.6%) patients of “customary AFBC” in the OR were positive (P =. 12). Macrolide therapy was employed in 23 of 37 (62%) patients with AM‐associated CRS but was not prescribed in patients with positive “customary AFBC” alone.ConclusionAM‐associated CRS is an uncommon condition that can occur in the absence of foreign body or overtly altered innate/adaptive immunity. Indications and efficacy of macrolide therapy, as well as the potential relationships between existence of AM in tap water, AM biofilms, and frequent use of nasal irrigations warrant further investigation in refractory CRS.
A prospective, multicentre, randomized, double-blind, placebo-controlled trial of onabotulinumtoxinA to treat plantarflexor/invertor overactivity after stroke
Authors: Dunne John Walter , Gracies Jean-Michel , Hayes Michael , Zeman Brian , Singer Barbara Jennifer ,   on behalf of the Multicentre Study Group
Published: February 2012

Objective: To examine the safety and efficacy of onabotulinumtoxinA (Botox) for plantarflexor overactivity following stroke. Design: Double-blind randomized controlled trial, open-label extension phase. Setting: Neurology rehabilitation facilities. Subjects: Eighty-five subjects with lower limb hypertonia received 200 U ( n = 28) or 300 U ( n = 28) of onabotulinumtoxinA or saline ( n = 29) injection. Primary measures: Plantarflexor Ashworth scores at 12 weeks post injection and adverse events. Secondary measures: self-reported spasm frequency and pain, physician rating of hypertonia severity, gait quality and active dorsiflexion. Results: Differences were not seen between onabotulinumtoxinA groups; hence data were pooled. Incidence of adverse events was not different between groups ( P = 0.61). Reduction in hypertonia was not different between groups at 12 weeks ( P = 0.53); however for subjects with Ashworth scores of >3 at baseline, 14/31 in the onabotulinumtoxinA group demonstrated a reduction of >1 grade versus 1/17 receiving placebo injection ( P = 0.01). Overall, onabotulinumtoxinA-injected subjects demonstrated significantly greater improvement in spasm frequency (22/54 versus 4/29, P = 0.01), pain reduction (8/54 versus 1/29, P = 0.02), active dorsiflexion (8/54 versus 1/29 P = 0.03) and gait quality (17/54 versus 6/29, P = 0.02) than controls. In the open-label phase, a second onabotulinumtoxinA injection was associated with greater hypertonia reduction ( P = 0.005) and gait quality ( P = 0.002) compared with single injection. Conclusions: OnabotulinumtoxinA injection for ankle flexor overactivity after stroke was safe and well tolerated but did not alter local spasticity at 12 weeks; it did reduce spasms and improve gait quality. There were no detectable differences between higher and lower doses. A second injection may be associated with greater change.
Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post-hemiplegic shoulder–hand syndrome: a randomized clinical trial
Authors: Hartwig Maik , Gelbrich Götz , Griewing Bernd 
Published: February 2012

Objective: To examine whether the use of a shoulder joint functional orthosis over four weeks can mitigate the development or progression of the shoulder–hand syndrome in patients with shoulder joint subluxation after stroke. Design: Two-armed randomized controlled trial. Setting: Rehabilitation unit of a neurological hospital, single centre. Subjects: Forty-one patients with caudal subluxation of the glenohumeral joint and hemiparesis of the upper extremity after ischaemic brain stroke. Interventions: Support by functional orthosis Neuro-Lux (Sporlastic, Nürtingen, Germany) on top of usual care according to current guidelines (experimental, n = 20) versus usual care alone (control, n = 21). Main measures: Weekly shoulder–hand syndrome scores (severity of clinical symptoms ranging from 0 to 14), discomfort caused by the orthosis, and its usage rate. The primary outcome was the average shoulder–hand syndrome score on days 14, 21 and 28, adjusted for the baseline shoulder–hand syndrome score. Results: The adjusted mean shoulder–hand syndrome score was lower by 3.1 in the intervention compared to the control subjects (95% confidence interval 1.9 to 4.3, P < 0.0001). Marginal or no discomfort from treatment with the orthosis was reported in 15 patients (75%), and only a single patient (5%) felt severe discomfort during the entire treatment. Use of the orthosis during the prescribed time was 89%. Conclusions: The orthosis examined in this trial has been successfully shown to reduce and prevent the development of clinical symptoms of shoulder–hand syndrome. Timing and duration of application of the orthosis as well as its combination with other therapeutic measures should be investigated in future clinical trials.
Differential effects of rhythmic auditory stimulation and neurodevelopmental treatment/Bobath on gait patterns in adults with cerebral palsy: a randomized controlled trial
Authors: Kim Soo Ji , Kwak Eunmi E , Park Eun Sook , Cho Sung-Rae 
Published: February 2012

Objectives: To investigate the effects of rhythmic auditory stimulation (RAS) on gait patterns in comparison with changes after neurodevelopmental treatment (NDT/Bobath) in adults with cerebral palsy. Design: A repeated-measures analysis between the pretreatment and posttreatment tests and a comparison study between groups. Setting: Human gait analysis laboratory. Subjects: Twenty-eight cerebral palsy patients with bilateral spasticity participated in this study. The subjects were randomly allocated to either neurodevelopmental treatment ( n = 13) or rhythmic auditory stimulation ( n = 15). Interventions: Gait training with rhythmic auditory stimulation or neurodevelopmental treatment was performed three sessions per week for three weeks. Temporal and kinematic data were analysed before and after the intervention. Rhythmic auditory stimulation was provided using a combination of a metronome beat set to the individual’s cadence and rhythmic cueing from a live keyboard, while neurodevelopmental treatment was implemented following the traditional method. Main measures: Temporal data, kinematic parameters and gait deviation index as a measure of overall gait pathology were assessed. Results: Temporal gait measures revealed that rhythmic auditory stimulation significantly increased cadence, walking velocity, stride length, and step length ( P < 0.05). Kinematic data demonstrated that anterior tilt of the pelvis and hip flexion during a gait cycle was significantly ameliorated after rhythmic auditory stimulation ( P < 0.05). Gait deviation index also showed modest improvement in cerebral palsy patients treated with rhythmic auditory stimulation ( P < 0.05). However, neurodevelopmental treatment showed that internal and external rotations of hip joints were significantly improved, whereas rhythmic auditory stimulation showed aggravated maximal internal rotation in the transverse plane ( P < 0.05). Conclusions: Gait training with rhythmic auditory stimulation or neurodevelopmental treatment elicited differential effects on gait patterns in adults with cerebral palsy.
Cutaneous Lymphomas in European Pet Rabbits (Oryctolagus cuniculus)
Authors: Ritter J. M. , Bomhard W. von , Wise A. G. , Maes R. K. , Kiupel M. 
Published: February 2012

Cutaneous lymphoma is a common skin neoplasm of pet rabbits in Europe but is rarely reported in pet rabbits in North America. These neoplasms have not been previously characterized, nor has the cause for the apparent predilection for cutaneous lymphoma in European pet rabbits compared with North American pet rabbits been investigated. In this retrospective study, the authors morphologically and immunohistochemically characterized 25 cutaneous lymphomas in European pet rabbits according to the World Health Organization classification. Tumors were classified as diffuse large B cell lymphomas, with 14 lymphomas exhibiting a centroblastic/centrocytic subtype and 11 tumors exhibiting a T cell–rich B cell subtype. To investigate a potential viral etiology of these lymphomas, 3 diffuse large B cell and 3 T cell–rich B cell lymphomas were evaluated by polymerase chain reaction for retroviral and herpesviral genes. Neither virus was detected. In contrast to other domestic animals, cutaneous lymphomas in European pet rabbits were highly pleomorphic and frequently contained multinucleated giant cells. Unexpectedly, the second most common subtype was T cell–rich B cell lymphoma, a subtype that is rare in species other than horses. Based on a limited number of samples, there was no support for a viral etiology that would explain the higher incidence of lymphoma in European pet rabbits compared with American pet rabbits. Further investigation into genetic and extrinsic factors associated with the development of these tumors is warranted.
Financialization and Global Imbalances
Authors: Lucarelli Dr Bill 
Published: February 2012

The concept of “financialization” has informed recent analyses of the contemporary dynamics of monopoly capitalism. In the wake of the global financial crisis in 2007-08, the strategic role of finance and its capacity to destabilize the real economy and push it to the brink of economic depression has rekindled debates over the historical causes and institutional forms which have characterized this phase of capitalist evolution. In other words, to what extent have the neoliberal policies pursued by most OECD countries over the past 30 years contributed to the emergence of this finance-led regime of accumulation? More specifically, what are the implications of the extraordinary build-up of private debt, which has financed private consumption and fuelled successive asset price and stock market euphoric bubbles over this period? At the same time, the problem of growing global imbalances between the surplus countries/regions and the deficit countries/regions has emerged as a major source of financial instability. It will be proposed that the breakdown of the mechanisms, which have supported the dynamics of financialization, have set the stage for the current global capitalist crisis. JEL codes: B5, B14, B16, B23
Soft Budget Constraints and Predatory States
Authors: Vahabi Mehrdad 
Published: February 2012

The concept of the soft budget constraint (SBC) was initially formulated by economist Janos Kornai in the context of socialist economies. I argue that the SBC can be regarded as the political economy of a predatory state in both the so-called socialist and capitalist economies. The hard budget constraint (HBC) is not related to an ideal competitive market economy but to a household level budget constraint, particularly by salaried members of the population in both types of economies. JEL codes: D20, E20, P2, P5