bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated GFR reporting is not sufficient to allow detection of chronic kidney disease in an Italian regional hospital
Authors: Gentile Giorgio , Postorino Maurizio , Mooring Raymond D , De Angelis Luigi , Manfreda Valeria Maria , Ruffini Fabrizio , Pioppo Manuela , Quintaliani Giuseppe 
Published: September 2009

Abstract

Background
Chronic kidney disease (CKD) is an emerging worldwide problem. The lack of attention paid to kidney disease is well known and has been described in previous publications. However, little is known about the magnitude of the problem in highly specialized hospitals where serum creatinine values are used to estimate GFR values.

Methods
We performed a cross-sectional evaluation of hospitalized adult patients who were admitted to the medical or surgical department of Santa Maria della Misericordia Hospital in 2007. Information regarding admissions was derived from a database. Our goal was to assess the prevalence of CKD (defined as an estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2) and detection of CKD using diagnostic codes (Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM]). To reduce the impact of acute renal failure on the study, the last eGFR obtained during hospitalization was the value used for analysis, and intensive care and nephrology unit admissions were excluded. We also excluded patients who had ICD-9-CM codes for renal replacement therapy, acute renal failure, and contrast administration listed as discharge diagnoses.

Results
Of the 18,412 patients included in the study, 4,748 (25.8%) had reduced eGFRs, falling into the category of Kidney Disease Outcomes Quality Initiative (KDOQI) stage 3 (or higher) CKD. However, the diagnosis of CKD was only reported in 19% of these patients (904/4,748). It is therefore evident that there was a "gray area" corresponding to stage 3 CKD (eGFR 30-59 ml/min), in which most CKD diagnoses are missed. The ICD-9 code sensitivity for detecting CKD was significantly higher in patients with diabetes, hypertension, and cardiovascular disease (26.8%, 22.2%, and 23.7%, respectively) than in subjects without diabetes, hypertension, or cardiovascular disease (p < 0.001), but these values are low when the widely described relationship between such comorbidities and CKD is considered.

Conclusion
Although CKD was common in this patient population at a large inpatient regional hospital, the low rates of CKD detection emphasize the primary role nephrologists must play in continued medical education, and the need for ongoing efforts to train physicians (particularly primary care providers) regarding eGFR interpretation and systematic screening for CKD in high-risk patients (i.e., the elderly, diabetics, hypertensives, and patients with CV disease).
The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
Authors: Jokhi Roobin P , Brown Brian H , Anumba Dilly OC 
Published: September 2009

Abstract

Background
Previous work by us and others had suggested that cervical electrical impedance spectroscopy (EIS) may be predictive of the outcome of induced labour. We sought to determine which probe configuration of the EIS device is predictive of the outcome of induced labour and compare this to digital assessment by the Bishop score.

Methods
In a prospective cohort of 205 women admitted for induction of labour, we used four probes of diameter 3, 6, 9 and 12 mm connected to an impedance meter to measure cervical resistivity (CR) in Ohm.meters at 14 electrical frequencies and compared their values to digital assessment of the cervix by the Bishop score for the prediction of the outcome of induced labour. We tested the association of labour characteristics and outcomes with CR and Bishop score by stepwise multilinear regression analyses, and the accuracy of prediction of categorical clinical outcomes by analysis of the area under the curves (AUC) of derived Receiver Operator Characteristic (ROC) curves.

Results
Of the four CR probe dimensions studied, only the 12 mm probe was predictive of any labour indices. In the frequency range 19 - 156 kHz, CR obtained with this probe was higher in women who delivered by caesarean section (CS) than those who delivered vaginally, and in labours lasting > 24 hrs. Cervical resistivity at 78.1 kHz best predicted vaginal delivery [optimal cut-off <2.25 Ohm.meter, AUC 0.66 (95% CI 0.59-0.72), sensitivity 71.0%, specificity 56.5%, LR+ 1.63, LR- 0.51, P < 0.01] and labour duration >24 hrs [optimal cut-off 2.27 Ω.m, AUC 0.65 (95% CI 0.58, 0.72), sensitivity 71%, specificity 59%, LR+ 1.72, LR- 0.50, P < 0.05]. In contrast digital assessment by the Bishop score neither predicted vaginal delivery nor the duration of labour. However, Bishop score predicted time to onset of labour > 12 hours and induction-delivery interval < 24 hrs [optimal cut-off ≤ 4, AUC 0.8 (95% CI 0.75, 0.86), sensitivity 77%, specificity 76%, LR+ 3.3, LR- 0.3, P < 0.05] whilst CR did not.

Conclusion
Cervical resistivity appears predictive of labour duration and delivery mode following induced labour. However the low predictive values obtained suggest that its current design proffers no immediate clinical utility.
Customized pachymetric guided epithelial debridement for corneal collagen cross linking
Authors: Kymionis George D , Diakonis Vasilios F , Coskunseven Efekan , Jankov Mirco , Yoo Sonia H , Pallikaris Ioannis G 
Published: September 2009

Abstract

Backround
We describe a modified method for deepitheliazation prior to corneal cross linking (CXL). The technique may overcome the current corneal pachymetric limitation parameter (over 400 microns) that is necessary for the safety of the procedure without affecting the overall benefits.

Methods
In a series of two patients, with inferior topographic steepening and regional thinning (less than 400 microns corresponding to the area of corneal steepening), CXL after customized epithelial removal was performed.

Results
There were no intra- or postoperative adverse events seen by the nine month follow up examination. Stabilization of the corneal ectasia was observed up to nine months post-costumized pachymetric-guided epithelial removal.

Conclusion
The technique of customized pachymetric-guided epithelial removal is easy to perform and may overcome the limitations of the preoperative corneal pachymetry expanding the application of the procedure in patients with regional corneal thinning.
Asymptomatic papillary fibroelastoma of the Aortic valve in a young woman - a case report
Authors: Parthenakis Fragiskos , Nyktari Evangelia , Patrianakos Alexandros , Pitsis Antonis , Asimaki Anthoula , Vardas Panos 
Published: September 2009

Abstract
Echocardiography represents an invaluable diagnostic tool for the detection of intracardiac masses while simultaneously provides information about their size, location, mobility and attachment site as well as the presence and extent of any consequent hemodynamic derangement.
A 29-year-old asymptomatic young woman with incidental transthoracic echocardiographic (TTE) discovery of an aortic valve mass is presented. The 2-dimensional TTE showed a mobile, pedunculated mass, attached by a thin stalk to the aortic surface of the right coronary aortic cusp at the junction of its base with the anterior aortic wall. The importance of valve sparing tumour resection even in asymptomatic patients is emphasised.
Modulation of Apolipoprotein D levels in human pregnancy and association with gestational weight gain
Authors: Do Carmo Sonia , Forest Jean-Claude , Giguère Yves , Masse André , Lafond Julie , Rassart Eric 
Published: September 2009

Abstract

Background
Apolipoprotein D (ApoD) is a lipocalin involved in several processes including lipid transport, but its modulation during human pregnancy was never examined.

Methods
We investigated the changes in the levels of ApoD in the plasma of pregnant women at the two first trimesters of gestation and at delivery as well as in the placenta and in venous cord blood. These changes were studied in 151 women classified into 9 groups in relation to their prepregnancy body mass index (BMI) and gestational weight gain (GWG).

Results
Plasma ApoD levels decrease significantly during normal uncomplicated pregnancy. ApoD is further decreased in women with excessive GWG and their newborns. In these women, the ApoD concentration was tightly associated with the lipid parameters. However, the similar ApoD levels in low cholesterol (LC) and high cholesterol (HC) women suggest that the plasma ApoD variation is not cholesterol dependant. A tight regulation of both placental ApoD transcription and protein content is most probably at the basis of the low circulating ApoD concentrations in women with excessive GWG. After delivery, the plasma ApoD concentrations depended on whether the mother was breast-feeding or not, lactation favoring a faster return to baseline values.

Conclusion
It is speculated that the decrease in plasma ApoD concentration during pregnancy is an adaptive response aimed at maintaining fetal lipid homeostasis. The exact mechanism of this adaptation is not known.
Mary Elizabeth Hickox Mandels, 90, bioenergy leader
Authors: Allen Fred , Andreotti Raymond , Eveleigh Douglas E , Nystrom John 
Published: September 2009

AbstractMary E H Mandels, who spearheaded the US Army's national bioconversion studies for four decades and was an early proponent of conversion of waste biomass to readily bioconvertible sugars for the production of chemicals and transportation fuels such as ethanol, died 17 February 2008 at Natick, MA, USA. She was 90.
Immanentism, Double Abjection, and the Politics of Psyche in (Post)Colonial Taiwan
Authors: Liu Joyce C. H. 
Published: September 2009

This essay discusses what I define as the psyche politics employed in the discourse of identity and of subjectivity in Taiwan during the Japanese colonial period (1895-1945), and how the use of such politics of psyche recurred in postcolonial Taiwan, especially in the discourse of the nativized Taiwanese subject of the recent decades under the Democratic Progressive Party (DPP) government (1990s to 2008). I use psyche politics to refer to the discursive operations of molding, shaping, fashioning, policing, and governing of the interior essence of life.
Through analyzing the discursive event triggered by Yoshinori Kobayashi's graphic history On Taiwan, (Shin G manism Sengen Supesharu—Taiwan Ron) which appeared in 2001, and the discourse of self-effacement and self-abjection present in many literary texts, cultural policies, and public opinions during the Japanese colonial period, I point out that the discursive self-abjection, or the will to cleanse the uncleanliness of one's heart, maneuvered and coerced through cultural regime, is indispensable for the formation of a non-I subject. More significantly, the discourse of the gong, the reverse side of the self-abjection, sets the frame of the spiritual totality to be shared by the individuals as parts of the whole. The two symbiotic states, self-abjection and the participation within the gong, constructed a particular mode of discourse of the psyche in East Asia during the Pacific War and paved the way for the frame of consciousness of the modern nation-state as well as the ground for subjectivation. Through such a discursive mode of psyche politics, a certain sense of community is engineered. We observe that the function of abjection operates in double directions: the internal effacement and the external exclusion. The locus of the gong, defined variously according to different contexts, which is often erected in the name of love in order to uphold the sense of community, paradoxically also serves the cause for cruelty and abjection against difference, both outside and inside the community.
Retrospective case review of time taken for 130 professional musicians to fully return to playing their instruments following hand surgery
Authors: Butler Katherine , Winspur Ian 
Published: September 2009

Background. Surgery on musicians must be entered into cautiously and should be the only treatment option indicated after trialling all other appropriate ones. There are four main principles that must be carefully considered when operating on musicians: the exact location of incisions, anatomic repair and reconstruction, adjustment of any anticipated anatomic compromise to the musician's specific musical needs and the need for an early return to limited playing. The purpose of this case review was to identify which instrument and what medical condition require the most time for the musician to fully return to playing. This in turn can assist in realistic goal setting with individual patients according to these two categories. Methods. A retrospective review of a single surgeon's case series of 130 professional musicians was undertaken. Data regarding their medical condition, instrument played, length of time off the instrument following surgery and the time taken to return to full normal professional playing were recorded and analysed. Results. A total of 97.7 percent of the patients returned to full time playing and there was a 2.3% ‘failure’ rate. The results indicate that piano players appear to initially take the most time to return to their instrument and string players take the most time to fully rehabilitate. Trauma appears to be the most difficult condition from which to initially recover however, nerve decompressions (with the exception of carpal tunnel releases) take the most time to fully rehabilitate. The most common medical condition requiring surgical intervention was nerve compressions and the piano was the most common instrument played in the series. Conclusions. This case series highlights the importance of early return to playing and utilizing the musical instrument as a therapeutic tool in the rehabilitation programme of musicians.
The Role of Voriconazole in the Treatment of Central Nervous System Blastomycosis
Authors: Ta Mai , Flowers Stephanie A , Rogers P David 
Published: September 2009

Background: Blastomycosis is an endemic mycosis caused by the dimorphic fungus Blastomyces dermatitidis. Although this disease primarily involves the lungs, the clinical spectrum of blastomycosis can range from subclinical infection to extrapulmonary dissemination. The central nervous system (CNS) form of blastomycosis is primarily treated with an amphotericin B formulation, but associated toxicities of this agent preclude its use in some patients. Voriconazole is a broad-spectrum triazole antifungal that has emerged as a potential treatment option for CNS blastomycosis because of its excellent penetration into the cerebrospinal fluid and brain tissue. Objective: To evaluate evidence for the use of voriconazole in the treatment of CNS blastomycosis. Data Sources: A literature search was performed using MEDLINE, EMBASE, Cochrane Database, and PubMed (all up to April 2009). Search terms included voriconazole, blastomyces, blastomycosis, CNS, cerebral, and central nervous system. Study Selection and Data Extraction: English-language clinical trials, case reports, treatment guidelines, and background material were searched for voriconazole safety and efficacy data. References of reviewed articles were examined and used to identify additional sources. Data Synthesis: A search of the literature yielded 2 published case reports and 2 case series documenting a total of 7 cases of CNS blastomycosis. In all cases, CNS blastomycosis was successfully treated sequentially with amphotericin B followed by voriconazole. To date, no clinical trials have evaluated the use of voriconazole in treating CNS blastomycosis. Ages of the patients with documented cases of CNS blastomycosis ranged from 14 months to 63 years. In at least 5 cases, CNS blastomycosis presented as lesions in the brain detected by magnetic resonance imaging. One case presented as focal splenic lesions. The remaining 2 were diagnosed based on neuroimaging studies or positive spinal fluid serology. Prior to receiving voriconazole, patients were treated with an amphotericin B formulation combined in some situations with either fluconazole or itraconazole. Subjects underwent treatment with voriconazole for an average of 11 months, with disease remission or stabilization detected in all cases. Conclusions: Further studies are needed to fully elucidate the role of voriconazole in the treatment of CNS blastomycosis. It nonetheless may be considered as an azole option for either follow-up therapy after liposomal amphotericin B therapy or as salvage therapy in patients intolerant of amphotericin B or other azoles.
Rohmer's Salon
Authors: Bersani Leo , Dutoit Ulysse 
Published: September 2009

Abstract
Eric Rohmer's films are repeatedly concerned with love affairs and matchmaking schemes, and they feature social occasions during which much of the talk concerns intimacy and romance. However, according to Leo Bersani and Ulysse Dutoit, they also explore alternatives to such eroticism and such conversation—especially strange and nonsexual connections between characters and their environment.
Pseudo-Quintilian's Major Declamations: Beyond School and Literature
Authors: Breij Bé 
Published: September 2009

Résumé
Outre exercice rhétorique et genre littéraire en soi, la déclamation a une troisième fonction, que l'on pourrait intituler “situational ethics”: le déclamateur doit se mettre dans la peau d'un caractère et répondre aux problèmes éthiques qui se posent pour ce caractère. Dans cette contribution il est montré, au moyen de la notion pietas, comment ces trois fonctions se présentent ensemble dans les Declamationes maiores.
Ellipsoid Analysis of Calvarial Shape
Authors: Jacobsen Petra A. , Becker Devra , Govier Daniel P. , Krantz Steven G. , Kane Alex 
Published: September 2009

Purpose: The purpose of this research was to develop a novel quantitative method of describing calvarial shape by using ellipsoid geometry. The pilot application of Ellipsoid Analysis was to compare calvarial form among individuals with untreated unilateral coronal synostosis, metopic synostosis, and sagittal synostosis and normal subjects. Methods: The frontal, parietal, and occipital bones of 10 preoperative patients for each of the four study groups were bilaterally segmented into six regions using three-dimensional skull reconstructions generated by ANALYZE™ imaging software from high-resolution computed tomography scans. Points along each segment were extracted and manipulated using a MATLAB®-based program. The points were fit to the least-squares nearest ellipsoid. Relationships between the six resultant right and left frontal, parietal, and occipital ellipsoidal centroids (FR, FL, PR, PL, OR, and OL, respectively) were tested for association with a synostotic group. Results: Results from the pilot study showed meaningful differences between length ratio, angular, and centroid distance relationships among synostotic groups. The most substantial difference was exhibited in the centroid distance PL-PR between patients with sagittal synostosis and metopic synostosis. The measures most commonly significant were centroid distances FL-PR and FL-PL and the angle OR-FR-PR. Derived centroid relationships were reproducible. Conclusion: Ellipsoid Analysis may offer a more refined approach to quantitative analysis of cranial shape. Symmetric and asymmetric forms can be compared directly. Relevant shape information between traditional landmarks is characterized. These techniques may have wider applicability in quantifying craniofacial morphology with increase in both specificity and general applicability over current methods.
Comparison of Dental Caries Prevalence in Patients with Cleft Lip and/or Palate and Their Sibling Controls
Authors: Al-Dajani Mahmoud 
Published: September 2009

Objective: To evaluate the prevalence of dental caries in patients with cleft lip and/or palate and their cleft-free sibling controls. Methods: The two subject groups (patient and control) comprised 106 participants. The former group consisted of 53 patients with cleft lip and/or palate, aged 12 to 29 years, who visited the Oral and Maxillofacial Surgery Hospital at Damascus University of Syria. The control group consisted of the patients’ siblings who had no clefts, and they were sex matched to the patient group. Dental caries were examined clinically and were reported using the decayed, missing, and filled permanent teeth (DMFT) index. The DMFT scores were compared between the two groups. Results: The author found an overall association of dental caries with the presence of cleft lip and/or palate (odds ratio  =  2.52; 95% confidence interval  =  1.389–4.574; p < .05). The DMFT index scores were proportionally higher in patients with cleft lip and/or palate compared with the control group (p < .001). Conclusion: Subjects with cleft lip and palate are susceptible to dental caries independently of socioeconomic status.
Vertical and Sagittal Growth in Patients with Unilateral and Bilateral Cleft Lip and Palate—A Retrospective Cephalometric Evaluation
Authors: Holst Alexandra I. , Holst Stefan , Nkenke Emeka , Fenner Matthias , Hirschfelder Ursula 
Published: September 2009

Objective: To investigate whether the craniofacial vertical and sagittal jaw relationship in patients with cleft lip and palate (CLP) differed from that of age-matched noncleft controls, before and after the pubertal growth spurt. Design: Retrospective observational study. Patients: The study group comprised 126 patients with CLP, subdivided according to gender and cleft type, and the control group comprised 53 age-matched skeletal class I patients. Methods: Angular and linear measurements were taken from prepubertal and postpubertal lateral cephalograms of all patients. Results: In patients with cleft lip and palate, the maxillary retrognathism became more remarkable with increasing age; whereas, the retrognathic position of the mandible became less pronounced as compared with controls. Reduced posterior midfacial height, a common prepubertal finding in patients with cleft lip and palate, was significant in postpubertal girls and young women with unilateral cleft lip and palate (p  =  .002). The total anterior facial height in male patients with bilateral cleft lip and palate was larger than in control patients (p  =  .002) after the pubertal growth spurt due to an increased anterior midfacial height. In male patients with unilateral cleft lip and palate, this finding was due to an increased anterior lower facial height (p < .001). Conclusions: Patients with cleft lip and palate treated according to a standardized treatment concept had adequate craniofacial jaw relationships after puberty. Despite a measured skeletal class I in both male and female patients with cleft lip and palate regardless of cleft type, there was a slight tendency toward a skeletal class III. Findings were similar for all groups of cleft lip and palate patients irrespective of the type of orthodontic treatment performed.