bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low‐dose haloperidol prevents post‐operative nausea and vomiting after ambulatory laparoscopic surgery
Authors: WANG T. F. , LIU Y. H. , CHU C. C. , SHIEH J. P. , TZENG J. I. , WANG J. J. 
Published: September 2009

Background: We evaluated the prophylactic effect of low‐dose haloperidol (1 mg) on post‐operative nausea and vomiting (PONV) in women undergoing ambulatory laparoscopic surgery. Droperidol (0.625 mg) and saline were controls.Methods: One hundred and fifty women undergoing ambulatory laparoscopic surgery under general anaesthesia were enrolled in this randomized, double‐blind, and placebo‐controlled study. After tracheal intubation, the haloperidol group (n=50) received intravenous haloperidol (1 mg), the droperidol group (n=50) received intravenous droperidol (0.625 mg), and the saline group (n=50) received intravenous saline.Results: Haloperidol‐ and droperidol‐group patients reported a lower incidence of PONV [24% and 23% vs. 49% (saline group); P<0.05] and requested fewer doses of rescue antiemetics [13% and 16% vs. 38% (saline group); P<0.05] during the first four post‐operative hours. During the 24‐h post‐operative period, haloperidol‐ and droperidol‐group patients also reported a lower incidence of PONV [31% and 32% vs. 62% (saline group); P<0.01]. No differences were found between the haloperidol and droperidol groups.Conclusion: Like droperidol (0.625 mg), prophylactic intravenous haloperidol (1 mg) significantly reduced the incidence of PONV in women undergoing ambulatory laparoscopic surgery.
Use of a screening questionnaire for post‐traumatic stress disorder (PTSD) on a sample of UK ICU patients
Authors: TWIGG E. , HUMPHRIS G. , JONES C. , BRAMWELL R. , GRIFFITHS R. D. 
Published: September 2009

Background: Although rates vary across studies, research in recent years shows that prevalence of post‐traumatic stress disorder (PTSD) following intensive care unit (ICU) can be high. Presently no screening tool assessing all three PTSD symptom categories has been validated in ICU patients. The aim of the study was to conduct a preliminary validation of such a measure, the UK‐ Post‐Traumatic Stress Syndrome 14‐Questions Inventory (UK‐PTSS‐14).Methods: A case series cohort study performed at two ICUs in two UK district general hospitals. The UK‐PTSS‐14 was administered at three time‐points (4–14 days, 2 months and 3 months post‐ICU discharge). At time‐point three participants also completed the Post‐traumatic Stress Diagnostic Scale (PDS) and the Impact of Events Scale (IES).Results: Forty‐four patients completed the 3‐month follow up. The UK‐PTSS‐14 was internally reliable at all three time‐points (Cronbach's α=0.89, 0.86 and 0.84, respectively). Test–retest reliability was highest between time‐points two and three (ICC=0.90). Concurrent validity at time‐point three was high against the PDS (r=0.86) and the IES (r=0.71). Predictive validity was highest at time‐point two (r=0.85 with the PDS and r=0.71 with the IES). Receiver operator characteristic curve analysis suggested the highest levels of sensitivity (86%) and specificity (97%) for diagnosis of PTSD were at time‐point two, with an optimum decision threshold of 45 points.Conclusion: This preliminary validation study suggests that the UK‐PTSS‐14 could be reliably used as a screening instrument at 2 months post‐discharge from the ICU to identify those patients in need of referral to specialist psychological services.
Quality of life 2–7 years after major trauma
Authors: ULVIK A. , KVÅLE R. , WENTZEL‐LARSEN T. , FLAATTEN H. 
Published: September 2009

Background: The aim of the present study was to assess potential long‐term reduction in health‐related quality of life (HRQOL) in adult trauma patients 2–7 years after discharge from an intensive care unit (ICU), and to study possible determinants of the HRQOL reduction.Methods: Follow‐up study of a cohort of 341 trauma patients admitted to the ICU of a university hospital during 1998–2003. Of the 228 eligible patients, 210 (92%) completed the study. A telephone interview using the EuroQol 5‐D (EQ‐5D) was conducted. Patients reported their HRQOL both at present and before trauma.Results: Before trauma 88% reported in retrospect no problem in any EQ‐5D dimension, compared with 20% at follow‐up. After trauma (median 4.0 years) 58% suffered pain/discomfort, 44% reported alterations in usual activities, 40% reduced mobility, 35% anxiety/depression, and 15% limited autonomy. A total of 74% experienced reduction in HRQOL. Severe problems were reported by 16%. Women experienced more anxiety/depression than men. Simplified Acute Physiology Score (SAPS) II and Injury Severity Score (ISS) were significantly associated with impaired HRQOL, while age was not. Patients with severe head injury reported better HRQOL than those without severe head injury.Conclusion: More than 2 years post‐injury, 74% reported impaired HRQOL but only 16% had severe problems. The majority still suffered pain/discomfort, indicating that pain management is a key factor in improving long‐term outcome after severe trauma.
Electroencephalogram spindle activity during dexmedetomidine sedation and physiological sleep
Authors: HUUPPONEN E. , MAKSIMOW A. , LAPINLAMPI P. , SÄRKELÄ M. , SAASTAMOINEN A. , SNAPIR A. , SCHEININ H. , SCHEININ M. , MERILÄINEN P. , HIMANEN S‐L. , JÄÄSKELÄINEN S. 
Published: September 2009

Background: Dexmedetomidine, a selective α2‐adrenoceptor agonist, induces a unique, sleep‐like state of sedation. The objective of the present work was to study human electroencephalogram (EEG) sleep spindles during dexmedetomidine sedation and compare them with spindles during normal physiological sleep, to test the hypothesis that dexmedetomidine exerts its effects via normal sleep‐promoting pathways.Methods: EEG was continuously recorded from a bipolar frontopolar–laterofrontal derivation with Entropy Module (GE Healthcare) during light and deep dexmedetomidine sedation (target‐controlled infusions set at 0.5 and 3.2 ng/ml) in 11 healthy subjects, and during physiological sleep in 10 healthy control subjects. Sleep spindles were visually scored and quantitatively analyzed for density, duration, amplitude (band‐pass filtering) and frequency content (matching pursuit approach), and compared between the two groups.Results: In visual analysis, EEG activity during dexmedetomidine sedation was similar to physiological stage 2 (S2) sleep with slight to moderate amount of slow‐wave activity and abundant sleep spindle activity. In quantitative EEG analyses, sleep spindles were similar during dexmedetomidine sedation and normal sleep. No statistically significant differences were found in spindle density, amplitude or frequency content, but the spindles during dexmedetomidine sedation had longer duration (mean 1.11 s, SD 0.14 s) than spindles in normal sleep (mean 0.88 s, SD 0.14 s; P=0.0014).Conclusions: Analysis of sleep spindles shows that dexmedetomidine produces a state closely resembling physiological S2 sleep in humans, which gives further support to earlier experimental evidence for activation of normal non‐rapid eye movement sleep‐promoting pathways by this sedative agent.
Percutaneous CT‐guided fine‐needle aspiration of pulmonary lesions: Results and complications in 409 patients
Authors: Laspas F , Roussakis A , Efthimiadou R , Papaioannou D , Papadopoulos S , Andreou J 
Published: September 2009

SummaryThe purpose of this study was to report our centre’s experience in the results and complications of percutaneous CT‐guided lung biopsy. A retrospective review of 409 patients who underwent percutaneous CT‐guided fine‐needle aspiration of suspicious lung lesions for more than 5 years was carried out. Nodule sizes ranged from 0.6 to 10 cm. The calibre of the needle used was 21–23 G. Specimen adequacy and patient outcome were evaluated. Each case was reviewed for complications. Sufficient diagnostic material was obtained in 369 (90%) of the 409 fine‐needle aspirations. Diagnosis was malignancy in 290 (70%) samples, four (1%) samples were suspicious for malignancy, 65 (16%) samples were negative for malignancy and definite benign findings were identified in 10 (3%) specimens. There were 25 false‐negative cases and one false‐positive case. Sensitivity was 92% and specificity 98%. Pneumothorax was the most common complication and occurred in 17 (4%) patients. Only one of them required thoracic drainage. Blood effusion around the lesion or along the needle track was detected on the post‐biopsy CT in 8 (2%) patients. However, only one of them suffered from a mild haemoptysis. Percutaneous CT‐guided biopsy is an effective and fast procedure for diagnosis of suspected pulmonary malignancy, with a low complication rate.
Construction of modern Australian first trimester ultrasound dating and growth charts
Authors: McLennan AC , Schluter PJ 
Published: September 2009

SummaryAccurate pregnancy dating is vital to obstetric management. However, first trimester fetal charts commonly used in Australia rely on data reported more than three decades ago. This study reports first trimester dating and growth charts for crown‐rump length between 5 and 14 weeks of gestation and biparietal diameter between 9 and 14 weeks of gestation on an Australia population using modern real‐time ultrasound equipment. All consenting eligible women attending a large Sydney clinic for first trimester ultrasound between March 2005 and December 2006 were recruited. Measurements were carried out to Australasian Society for Ultrasound in Medicine standard protocols. Statistical analyses were undertaken using polynomial regression models and thorough diagnostic checks made. Overall 396 eligible women consented to the study, with 268 between 9 and 14 weeks of gestation. The average participant age was 34 years (range 22–45 years), 371 and all yielded valid biometry measurements. Equations, means and 90% reference intervals for crown‐rump length measurements and biparietal diameter measurements were derived using polynomial regression models. Thorough residual and diagnostic checks were made. Once validated by others, we believe they will warrant consideration for use by Australasian Society for Ultrasound in Medicine.
Predicting regional control based on pretreatment nodal size in squamous cell carcinoma of the head and neck treated with chemoradiotherapy: A clinican’s guide
Authors: Porceddu SV , Sidhom M , Foote M , Burmeister E , Stoneley A , El Hawwari B , Milross C , Kenny L , Poulsen M , Coman WB 
Published: September 2009

SummaryThe aim of this study was to determine the regional control rate with concurrent chemoradiotherapy (CRT) based on pretreatment nodal size in mucosal head and neck squamous cell carcinoma (HNSCC) in patients who achieved a complete response (CR) at the primary site by 12 weeks post‐treatment. Between December 1997 and November 2003, 117 patients with node‐positive HNSCC were treated with concurrent CRT, with 108 (92%) achieving a CR at the primary site by 12 weeks. There were 93 males (86%), median age 55 (37–79) years and the most common primary site was the oropharynx (65%). Patients were divided into three subgroups: ≤3.0 cm 70 (65%), 3.1–6.0 cm 30 (28%) and ≥6.1 cm 8 (7%). All patients received concurrent platinum‐based chemotherapy and the median radiation dose was 70 Gy (60–72 Gy). The 3‐year regional control rate based on pretreatment nodal size was ≤3.0 cm 88% (95% confidence interval (CI) 78–94%), 3.1–6.0 cm 72% (95%CI 49–86%) and ≥6.1 cm 50% (95%CI 15–77%) (P = 0.001). The 3‐year regional control rate based on pre‐treatment nodal size was ≤3.0cm 88% (95%CI 78–94%), 3.1–6.0 cm 72% (95%CI 49–86%) and ≥6.1 cm 50% (95%CI 15–77%) (P = 0.001). These results provide a quantitative guide for the clinician as to the likelihood of regional control based on pretreatment nodal size following CRT in patients who achieve a CR at the primary site by 12 weeks post‐treatment.
Patients’ preference for radiotherapy fractionation schedule in the palliation of symptomatic unresectable lung cancer†
Authors: Tang JI , Shakespeare TP , Lu JJ , Chan YH , Lee KM , Wong LC , Mukherjee RK , Back MF 
Published: September 2009

SummaryThe palliative radiotherapeutic management of unresectable non‐small‐cell lung cancer is controversial, with various fractionation (Fx) schedules available. We aimed to determine patient’s choice of Fx schedule after involvement in a decision‐making process using a decision board. A decision board outlining the various advantages and disadvantages apparent in the Medical Research Council study of Fx schedules (17 Gy in two fractions vs 39 Gy in 13 fractions) was discussed with patients who met Medical Research Council eligibility criteria. Patients were then asked to indicate their preferred Fx schedules, reasons and their level of satisfaction with being involved in the decision‐making process. Radiation oncologists (RO) could prescribe radiotherapy schedules irrespective of patients’ preferences. Of 92 patients enrolled, 55% chose the longer schedule. English‐speaking patients were significantly more likely to choose the longer schedule (P = 0.02, 95% confidence interval: 1.2–7.6). Longer Fx was chosen because of longer survival (90%) and better local control (12%). Shorter Fx was chosen for shorter overall treatment duration (80%), cost (61%) and better symptom control (20%). In all, 56% of patients choosing the shorter schedule had their treatment altered by the treating RO, whereas only 4% of patients choosing longer Fx had their treatment altered (P < 0.001). Despite this, all (100%) patients were satisfied with being involved in the decision‐making process. The decision board was useful in aiding decision‐making, with both Fx schedules being acceptable to patients. Interestingly, despite the longer average survival associated with longer Fx, nearly half of the patients believed that this was not as important as a shorter duration of treatment and lower cost. Despite patients’ preferences, there were significant alterations of preferred schedules because of RO’s own biases.
Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation
Authors: Corry J , Poon W , McPhee N , Milner AD , Cruickshank D , Porceddu SV , Rischin D , Peters LJ 
Published: September 2009

SummaryPercutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGT) for nutritional support of patients with head and neck cancer undergoing curative (chemo)radiotherapy without any good scientific basis. A randomized trial was conducted to compare PEG tubes and NGT in terms of nutritional outcomes, complications, patient satisfaction and cost. The study was closed early because of poor accrual, predominantly due to patients’ reluctance to be randomized. There were 33 patients eligible for analysis. Nutritional support with both tubes was good. There were no significant differences in overall complication rates, chest infection rates or in patients’ assessment of their overall quality of life. The cost of a PEG tube was 10 times that of an NGT. The duration of use of PEG tubes was significantly longer, a median 139 days compared with a median 66 days for NGT. We found no evidence to support the routine use of PEG tubes over NGT in this patient group.
Comparison of prostate set‐up accuracy and margins with off‐line bony anatomy corrections and online implanted fiducial‐based corrections
Authors: Greer PB , Dahl K , Ebert MA , Wratten C , White M , Denham JW 
Published: September 2009

SummaryThe aim of the study was to determine prostate set‐up accuracy and set‐up margins with off‐line bony anatomy‐based imaging protocols, compared with online implanted fiducial marker‐based imaging with daily corrections. Eleven patients were treated with implanted prostate fiducial markers and online set‐up corrections. Pretreatment orthogonal electronic portal images were acquired to determine couch shifts and verification images were acquired during treatment to measure residual set‐up error. The prostate set‐up errors that would result from skin marker set‐up, off‐line bony anatomy‐based protocols and online fiducial marker‐based corrections were determined. Set‐up margins were calculated for each set‐up technique using the percentage of encompassed isocentres and a margin recipe. The prostate systematic set‐up errors in the medial–lateral, superior–inferior and anterior–posterior directions for skin marker set‐up were 2.2, 3.6 and 4.5 mm (1 standard deviation). For our bony anatomy‐based off‐line protocol the prostate systematic set‐up errors were 1.6, 2.5 and 4.4 mm. For the online fiducial based set‐up the results were 0.5, 1.4 and 1.4 mm. A prostate systematic error of 10.2 mm was uncorrected by the off‐line bone protocol in one patient. Set‐up margins calculated to encompass 98% of prostate set‐up shifts were 11–14 mm with bone off‐line set‐up and 4–7 mm with online fiducial markers. Margins from the van Herk margin recipe were generally 1–2 mm smaller. Bony anatomy‐based set‐up protocols improve the group prostate set‐up error compared with skin marks; however, large prostate systematic errors can remain undetected or systematic errors increased for individual patients. The margin required for set‐up errors was found to be 10–15 mm unless implanted fiducial markers are available for treatment guidance.
Measurement‐specific bioavailable testosterone using concanavalin A precipitation: Comparison of calculated and assayed bioavailable testosterone
Authors: Yamamoto Kenrou , Koh Eitetsu , Matsui Futoshi , Sugimoto Kazuhiro , Sin Ho‐Su , Maeda Yuji , Namiki Mikio 
Published: September 2009

Objective:  To assess the value of calculated bioavailable testosterone (cBT) and assayed BT (aBT) for the diagnosis of late‐onset hypogonadism (LOH) in middle‐aged and elderly subjects.Methods:  In order to assay serum BT, sex hormone‐binding globulin was precipitated with concanavalin‐A and then testosterone was measured using liquid chromatography‐tandem mass spectrometry. To validate the non‐sex‐hormone‐binding‐globulin‐bound testosterone, gel filtration chromatography and concanavalin‐A sepharose were used. Following this validation, the usefulness between aBT and cBT was evaluated in clinical samples.Results:  Eighty‐eight healthy male volunteers (mean age 65.6 years, range: 50–86) were recruited for this study. A significant correlation was found between cBT and aBT (R2 = 0.53, P < 0.01). Mean value ratio (cBT/aBT) was 2.48. Both cBT (R2 = 0.122) and aBT (R2 = 0.251) decreased with age. Variations in aBT were less marked than those for cBT, suggesting that aBT can be used to determine age‐related reduced testosterone levels.Conclusion:  aBT levels are more reliable than cBT levels for the diagnosis of LOH in middle‐aged and elderly subjects.
Predicting creep crack initiation in austenitic and ferritic steels using the creep toughness parameter and time‐dependent failure assessment diagram
Authors: DAVIES C. M. 
Published: September 2009

ABSTRACTMethods for evaluating the creep toughness parameter, Kmatc, are reviewed and Kmatc data are determined for a ferritic P22 steel from creep crack growth tests on compact tension, C(T), specimens of homogenous parent material (PM) and heterogeneous specimen weldments at 565 °C and compared to similar tests on austenitic type 316H stainless steel at 550 °C. Appropriate relations describing the time dependency of Kmatc are determined accounting for data scatter. Considerable differences are observed in the form of the Kmatc data and the time‐dependent failure assessment diagrams (TDFADs) for both the 316H and P22 steel. The TDFAD for P22 shows a strong time dependency, but is insensitive to time for 316H. Creep crack initiation (CCI) time predictions are obtained using the TDFAD approach and compared to experimental results from C(T) specimens and feature components. The TDFAD based on parent material properties can be used to obtain conservative predictions of CCI on weldments. Conservative predictions are almost always obtained when lower bound Kmatc values are employed. Long‐term test are generally more relevant to industrial component lifetimes. The different trends between long‐ and short‐term CCI time and growth data indicate that additional long‐term test are required to further validate the procedure to predict the lifetimes of high temperature components.
Critical crack size that causes retardation of short fatigue crack by single overload
Authors: KONDO Y. , SUDO T. , KUBOTA M. 
Published: September 2009

ABSTRACTThe effect of crack length on the retardation of fatigue crack propagation caused by single overload was investigated using carbon steels S25C and S45C. The retardation and crack arrest occurred even in short cracks ranging from 50 to several hundred microns. In case retardation occurs, it is caused by the increase of crack closure stress as in a long crack. The occurrence of retardation, however, showed a complex dependency on crack length, yield strength of material and the value of baseline stress ratio R. At stress ratio R =−1, retardation did not occur for very short crack as short as 50 μm in the case of low yield strength material. This was because the increase of crack closure stress was prevented by the compressive stress component of baseline load. The plastically deformed layer near the crack tip was collapsed by the compressive stress of baseline load, which prevented the development of crack closure. In the case of high yield strength material, however, retardation occurred even in 50 μm crack. On the contrary at R = 0, retardation in the low yield strength material occurred even in 50 μm crack. The prevention of increase of crack closure did not occur in the case of R = 0. As a consequence, retardation basically occurs even in short crack as short as 50 μm unless the development of crack closure is impeded.
Six‐month outcomes on A1C and cardiovascular risk factors in patients with type 2 diabetes treated with exenatide in an ambulatory care setting
Authors: Brixner D. I. , McAdam‐Marx C. , Ye X. , Boye K. S. , Nielsen L. L. , Wintle M. , Misurski D. , Fabunmi R. 
Published: September 2009

Aim: This study evaluated changes in clinical effectiveness measures of patients with type 2 diabetes initiating exenatide therapy in a real‐world setting. Methods: Eligible patients identified in the General Electric (GE) electronic medical record (EMR) research database from 1 January 2000 through 31 December 2007 were ≥18 years old with type 2 diabetes. Patients had prescription orders in the previous 395 days for metformin, a sulfonylurea, or a thiazolidinedione as monotherapy or in combination, and had at least 6 months of follow‐up activity. Baseline clinical measures were documented from 45 days prior up to 15 days after exenatide initiation and follow‐up measures documented at 6 months ± 45 days. Results: A total of 1709 patients were identified for study inclusion. The overall mean A1C reduction (s.e.m.) at 6 months was −0.8% (0.05) (p<0.001), weight loss was −3.2 kg (0.14) (p<0.001), blood pressure (BP) lowering was −1.9 mmHg (0.46) systolic blood pressure (SBP) (p<0.001) and −0.5 mmHg (0.27) diastolic blood pressure (DBP) (p = 0.078). Changes in low‐density lipoprotein (LDL), triglycerides and HDL were −7.4 mg/dl (1.7) (p<0.001), −23.2 mg/dl (6.7) (p = 0.001) and −0.8 mg/dl (0.33) (p = 0.012) respectively. In a quartile analysis by weight loss, mean A1C reduction ranged from −1.1 to −0.65% in the highest to lowest weight loss quartiles respectively. Conclusions: In a real‐world setting, exenatide initiation is associated with significant improvements in the measures of clinical effectiveness for type 2 diabetes. These reductions were comparable to those reported in randomized, controlled registration trials after 6 months of therapy.