bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative Management of the Hemodialysis Patient
Authors: Trainor Dominic , Borthwick Emma , Ferguson Andrew 
Published: March 2011

AbstractDialysis‐dependent chronic kidney disease (CKD) is an expanding problem for healthcare systems worldwide. The prevalence of end‐stage renal disease (ESRD) has increased by 20% since 2000 and stands at 1699 per million people in the USA. ESRD is associated with an increased risk of cardiovascular comorbidity, increased severity of cardiovascular disease, and an adjusted all‐cause mortality rate that is 6.4–7.8‐fold higher than the general population. These patients may present electively or emergently for surgery related to, or remote from, the CKD. In any perioperative setting, the patient with hemodialysis‐dependent CKD represents a significant clinical challenge, and successful management of these patients requires effective cooperation and communication between nephrology, anesthesia, and surgical staff. The ESRD patient’s nephrologist will have the best knowledge of their medical history, comorbidities, and future management goals and may have been the clinician who instigated the referral for the surgery, e.g., for parathyroidectomy, vascular access surgery, nephrectomy or renal transplantation. As such, they are in an ideal position to contribute to, or coordinate, early preoperative medical optimization of the patient and also to provide advice during postoperative recovery and rehabilitation. In this article, we provide an overview of some of the key aspects of managing these patients successfully during the perioperative period. We propose the integration of cardiopulmonary exercise testing and cardiovascular optimization into the care of these high‐risk patients and provide an overview of the importance of maintaining microvascular perfusion and the role of viscosity in preserving the capillary perfusion network.
Does Hemodialysis Hurt the Brain?
Authors: Madero Magdalena , Sarnak Mark J. 
Published: March 2011

AbstractDialysis patients have a high prevalence of both structural brain abnormalities and cognitive impairment. The pathogenesis of the structural brain abnormalities and cognitive impairment as well the relationship between the two is however less clear. In this editorial, we question whether the hemodialysis procedure itself may be partly responsible for the structural abnormalities noted on imaging studies as well as for the cognitive impairment. We invoke several mechanisms whereby the procedure itself may “hurt” the brain including rapid changes in blood pressure, microembolization, microbleeds, and cerebral edema. We then summarize research questions whose answers may help move the field forward.
Comorbidities Alone Do Not Explain the Undertreatment of Colorectal Cancer in Older Adults: A French Population‐Based Study
Authors: Quipourt Valérie , Jooste Valérie , Cottet Vanessa , Faivre Jean , Bouvier Anne‐Marie 
Published: March 2011

OBJECTIVES: To investigate the influence of comorbidities on treatment modalities of colorectal cancer according to the age of patients and French recommendations.DESIGN: Population‐based studySETTING: French Digestive Cancer Registry, Burgundy.PARTICIPANTS: Two thousand nine hundred twenty‐one incident colorectal cancers diagnosed between 2004 and 2007.MEASUREMENTS: The independent influence of comorbidities (recorded according to the Charlson index) on treatment was analyzed using multivariate logistic regressions controlling for age, sex, and their interaction.RESULTS: The association between comorbidities and resection for cure was significant only in patients younger than 75 (P interaction=.008). For Stage III colon cancer, 40.4% of the patients aged 75 and older had adjuvant chemotherapy, versus 90.5% of those younger than 75 (P<.001). The association between comorbidities and adjuvant chemotherapy for Stage III colon cancer was significant only in patients younger than 75 (P interaction=.004). Patients aged 75 and older were less likely to receive chemotherapy, even when they had few or no comorbidities. Overall, 29.3% of patients aged 75 and older with advanced colorectal cancer had palliative chemotherapy, versus 77.1% of those younger than 75 (P<.001). Whatever the age, palliative chemotherapy was less frequent for a Charlson comorbidity index of 2 or greater (P interaction=.16). Radiotherapy was administered in 59.0% of patients aged 75 and older with rectal cancer, versus 85.3% of those younger than 75 (P<.001). Whatever the age, patients with a Charlson score of 2 or greater were less likely to receive radiotherapy for rectal cancer than were patients without comorbidities (P interaction=.86).CONCLUSION: Further studies are warranted to identify more precisely the reasons for lower treatment rates for colorectal cancer in the older population.
Rural–Urban Distribution of the U.S. Geriatrics Physician Workforce
Authors: Peterson Lars E. , Bazemore Andrew , Bragg Elizabeth J. , Xierali Imam , Warshaw Gregg A. 
Published: March 2011

OBJECTIVES:To determine the distribution of geriatricians across the rural–urban continuum from 2000 to 2008 and to compare with primary care physicians in 2008.DESIGN:County‐level analysis of physician data from the American Medical Association Physician Masterfile for 2000, 2004, and 2008 merged with U.S. Census data on the number of older (≥65) county residents. Descriptive statistics for each year were stratified according to 2003 Rural Urban Continuum Codes (RUCCs).SETTING:United States.PARTICIPANTS:Physicians in the United States.MEASUREMENTS:Number of physicians per county elderly population.RESULTS:The number of self‐identified geriatricians nationwide increased from 5,157 to 7,412 from 2000 to 2008. The number of geriatricians increased in each RUCC level, with nearly 90% of geriatricians residing in urban areas in all years. In 2008, the number of geriatricians per 10,000 older adults declined as rurality increased (from 1.48 in the most‐urban areas to 0.80 in the most rural). General internal medicine physicians are more plentiful in urban counties and declined as rurality increased (from 27.29 to 3.85 per 10,000 older adults in 2008). In contrast, family physicians were more evenly distributed with the elderly population across the rural–urban continuum (22.02 to 14.27 per 10,000 older adults in 2008).CONCLUSION:Small numbers of geriatricians combined with a growing elderly population poses a challenge and an opportunity. Healthcare systems and policy‐makers will need to modify care models to better use the skill of geriatricians in concert with other providers to provide quality care for older rural and urban Americans.
Continuous Noninvasive Orthostatic Blood Pressure Measurements and Their Relationship with Orthostatic Intolerance, Falls, and Frailty in Older People
Authors: Romero‐Ortuno Roman , Cogan Lisa , Foran Tim , Kenny Rose Anne , Fan Chie Wei 
Published: March 2011

OBJECTIVES: To identify morphological orthostatic blood pressure (BP) phenotypes in older people and assess their correlation with orthostatic intolerance (OI), falls, and frailty and to compare the discriminatory performance of a morphological classification with two established orthostatic hypotension (OH) definitions: consensus (COH) and initial (IOH).DESIGN: Cross‐sectional.SETTING: Geriatric research clinic.PARTICIPANTS: Four hundred forty‐two participants (mean age 72, 72% female) without dementia or risk factors for autonomic neuropathy.MEASUREMENTS: Active lying‐to‐standing test monitored using a continuous noninvasive BP monitor. For the morphological classification, four orthostatic systolic BP variables were extracted (delta (baseline – nadir) and maximum percentage of baseline recovered by 30 seconds and 1 and 2 minutes) using the 5‐second averages method and entered in K‐means cluster analysis (three clusters). Main outcomes were OI, falls (≥1 in past 6 months), and frailty (modified Fried criteria).RESULTS: The morphological clusters were small drop, fast overrecovery (n=112); medium drop, slow recovery (n=238); and large drop, nonrecovery (n=92). Their characterization revealed an increasing OI gradient (17.9%, 27.5%, and 44.6% respectively, P<.001) but no significant gradients in falls or frailty. The COH definition failed to reveal clinical differences between COH+ (n=416) and COH− (n=26) participants. The IOH definition resulted in a clinically meaningful separation between IOH+ (n=85) and IOH− (n=357) subgroups, as assessed according to OI (100% vs 11.5%, P<.001), falls (24.7% vs 10.4%, P<.001), and frailty (14.1% vs 5.4%, P=.005).CONCLUSION: It is recommended that the IOH definition be applied when taking continuous noninvasive orthostatic BP measurements in older people.
Digital Image Capture and Rapid Prototyping of the Maxillofacial Defect
Authors: Sabol Jennifer V. , Grant Gerald T. , Liacouras Peter , Rouse Stephen 
Published: March 2011

AbstractIn order to restore an extraoral maxillofacial defect, a moulage impression is commonly made with traditional impression materials. This technique has some disadvantages, including distortion of the site due to the weight of the impression material, changes in tissue location with modifications of the patient position, and the length of time and discomfort for the patient due to the impression procedure and materials used. The use of the commercially available 3dMDface™ System creates 3D images of soft tissues to form an anatomically accurate 3D surface image. Rapid prototyping converts the virtual designs from the 3dMDface™ System into a physical model by converting the data to a ZPrint (ZPR) CAD format file and a stereolithography (STL) file. The data, in conjunction with a Zprinter® 450 or a Stereolithography Apparatus (SLA), can be used to fabricate a model for prosthesis fabrication, without the disadvantages of the standard moulage technique. This article reviews this technique and how it can be applied to maxillofacial prosthetics.
The Pain Anxiety Symptoms Scale Fails to Discriminate Pain or Anxiety in a Chronic Disabling Occupational Musculoskeletal Disorder Population
Authors: Brede Emily , Mayer Tom G. , Neblett Randy , Williams Mark , Gatchel Robert J. 
Published: March 2011

AbstractBackground:  The Pain Anxiety Symptoms Scale (PASS) was developed to measure fear and anxiety responses to pain. Many studies have found associations between PASS scores and self‐report measures of pain, anxiety, and disability as well as among inhibited movement patterns and activity avoidance behaviors (eg, kinesophobia). This study aimed to identify clinically meaningful cut‐off points to identify high or low levels of pain anxiety and to determine if the PASS provides additional useful information in a functional restoration (FR) treatment program for chronic disabling occupational musculoskeletal disorder (CDOMD) patients.Methods:  A consecutive cohort of 551 patients with CDOMD, who entered and completed a FR program, was administered a battery of psychosocial assessments, including the PASS, at admission and discharge. Socioeconomic outcomes were collected 1 year after discharge. After identifying clinical ranges for mild, moderate, and severe pain anxiety, the three groups were compared on self‐report measures of psychosocial distress, clinical diagnoses of psychosocial disorders, and 1‐year socioeconomic outcomes.Results:  Correlations between the PASS and all measures of pain, anxiety, and disability were statistically significant. However, only the Pain Disability Questionnaire showed a large correlation coefficient (r > 0.5). Patients with the highest PASS scores were more likely to be diagnosed with a number of Axis I (depression, opioid dependence) or Axis II (Borderline Personality) psychiatric disorders. They were more likely to display treatment‐seeking behavior at 1 year after discharge. However, the PASS failed to differentiate between any other 1‐year outcomes.Conclusions:  The PASS is elevated when other measures of psychosocial distress are also elevated. However, the PASS fails to discriminate between different indices of depression and anxiety and it is not highly related to 1‐year outcomes in a CDOMD cohort. If time and resources are limited, a different measure of psychosocial distress that does relate to socioeconomic outcomes might be a better option in a CDOMD evaluation process.
20. Meralgia Paresthetica
Authors: Patijn Jacob , Mekhail Nagy , Hayek Salim , Lataster Arno , van Kleef Maarten , Van Zundert Jan 
Published: March 2011

AbstractMeralgia paresthetica (MP) is a neurological disorder of the nervus cutaneous femoris lateralis (lateral femoral cutaneous nerve) (LFCN) characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. Medical history and neurological examination are essential in making the diagnosis. However, red flags such as tumor and lumbar disc herniations must be ruled out. While the diagnosis of MP is essentially a clinical diagnosis, sensory nerve conduction velocity studies are a useful additional diagnostic tool.The first choice in management of MP is, besides treating the underlying cause, always a conservative approach. Simple measures such as losing weight and not wearing tight belts and/or trousers can be advised. Pharmacological therapy consists mainly of antineuropathic medication.Anatomical variants of the LFCN occur in a quarter of patients and may be the reason for negative response to diagnostic blocks. For interventional treatment of MP, such as local injection with anesthetics and corticosteroids or pulsed radiofrequency treatment of the LFCN, the evidence is limited. In particular, pulsed radiofrequency treatment of the LFCN should only take place in a study context.
25. Ischemic Pain in the Extremities and Raynaud’s Phenomenon
Authors: Devulder Jacques , van Suijlekom Hans , van Dongen Robert , Diwan Sudhir , Mekhail Nagy , van Kleef Maarten , Huygen Frank 
Published: March 2011

AbstractTwo important groups of disorders result from an insufficient blood supply to the extremities: critical vascular disease and the Raynaud’s phenomenon. The latter can be subdivided into a primary and a secondary type. Critical ischemic disease is often caused by arteriosclerosis due to hypertension or diabetes. Primary Raynaud’s is idiopathic and will be diagnosed as such if underlying systemic pathology has been excluded. Secondary Raynaud’s is often a manifestation of a systemic disease. It is essential to try to establish a diagnosis as soon as possible in order to influence the evolution of the disease.A sympathetic nerve block can be considered in patients with critical ischemic vascular disease after extensive conservative treatment, preferably in the context of a study (2B±). If this has insufficient effect, spinal cord stimulation can be considered in a selected patient group (2B±). In view of the degree of invasiveness and the costs involved, this treatment should preferably be applied in the context of a study and with the use of transcutaneous pO2 measurements.In case of primary Raynaud’s, life style changes are the first step. Sympathectomy can be considered as a treatment of Raynaud’s phenomenon (2C+), but only after multidisciplinary evaluation of the patient and in close consultation with the patient’s rheumatologist, vascular surgeon or internist.
Multicenter Experience with Implantable Defibrillators Subject to Recall
Authors: PERROTTA LAURA , PIERAGNOLI PAOLO , RICCIARDI GIUSEPPE , SACCHI STEFANIA , MASCIA GIUSEPPE , PADELETTI MARGHERITA , BONGIORNI MARIA GRAZIA , CURNIS ANTONIO , BELLOCCI FULVIO , MICHELUCCI ANTONIO , PORCIANI MARIA CRISTINA , PADELETTI LUIGI 
Published: March 2011

Background: The management of implantable cardioverter defibrillators (ICDs) affected by advisories, which often include generator replacement, is complex and the risk of device failure needs to be carefully assessed for each patient.
Methods: We analyzed the response to the advisory communication in the Italian centers involved in the recall for the Prizm 1861 and Renewal (Boston Scientific–formerly Guidant—St. Paul, MN, USA) communication.
Results: One hundred and thirty‐nine of 843 Prizm (16.5%) and 458 of 2,342 Renewal devices (19.6%) were explanted. The total incidence over a 4‐year time frame of the failure event was equal to zero of 710 (0%) for Prizm ICDs and eight of 2,342 (0.34%) for Renewal ICDs. A limited percentage of devices affected by recall were definitely explanted following the indications stated by the advisory. The failure rates that resulted from analysis of our data (0% for Prizm and 0.34% for Renewal) were inferior to those already found or projected along the device lifetime globally, as reported in the most recent Company Product Performance Report (0.72% for Prizm and 1.83% for Renewal).
Conclusions: In absence of underestimation of the events, a lower incidence than expected could resize the dimension of the problem, justifying the concept of a more frequent follow‐up of patient with respect to the choice of an immediate device explant. (PACE 2011; 34:998–1002)
Osseointegration of commercial microstructured titanium implants incorporating magnesium: a histomorphometric study in rabbit cancellous bone
Authors: Park Jin‐Woo , An Chang‐Hyeon , Jeong Seong‐Hwa , Suh Jo‐Young 
Published: March 2011

Abstract
Objective: Recent studies have suggested that magnesium (Mg) ions exert a beneficial effect on implant osseointegration. This study assessed the osseointegration of nanoporous titanium (Ti) surface incorporating the Mg produced by hydrothermal treatment in rabbit cancellous bone to determine whether this surface would further enhance bone healing of moderately rough‐surfaced implants in cancellous bone, and compared the result with commercially available micro‐arc oxidized Mg‐incorporated implants.
Material and methods: The Mg‐incorporated Ti surfaces (RBM/Mg) were obtained by hydrothermal treatment using an alkaline Mg‐containing solution on grit‐blasted moderately rough (RBM) implants. Untreated RBM and recently introduced Mg‐incorporated microporous Ti implants produced by micro‐arc oxidation (M) were used controls in this study. The surface characteristics were evaluated by scanning electron microscopy, X‐ray photoelectron spectroscopy and optical profilometry. Twenty‐four threaded implants with a length of 10 mm (eight RBM implants, eight RBM/Mg implants and eight M implants) were placed in the femoral condyles of 12 New Zealand White rabbits. Histomorphometric analysis was performed 4 weeks after implantation.
Results: Hydrothermally treated and untreated grit‐blasted implants displayed almost identical surface morphologies and Ra values at the micron‐scale. The RBM/Mg implants exhibited morphological differences compared with the RBM implants at the nano‐scale, which displayed nanoporous surface structures. The Mg‐incorporated implants (RBM/Mg and M) exhibited more continuous bone apposition and a higher degree of bone‐to‐implant contact (BIC) than the untreated RBM implants in rabbit cancellous bone. The RBM/Mg implants displayed significantly greater BIC% than untreated RBM implants, both in terms of the all threads region and the total lateral length of implants (P<0.05), but no statistical differences were found between the RBM/Mg and M implants except BIC% values in total lateral length.
Conclusion: These results indicate that a nanoporous Mg‐incorporated surface may be effective in enhancing the osseointegration of moderately rough grit‐blasted implants by increasing the degree of bone−implant contact in areas of cancellous bone.
To cite this article: Park J‐W, An C‐H, Jeong S‐H, Suh J‐Y. Osseointegration of commercial microstructured titanium implants incorporating magnesium: a histomorphometric study in rabbit cancellous bone. Clin. Oral Impl. Res. 23, 2012; 294–300. doi: 10.1111/j.1600‐0501.2010.02144.x
Early implant healing: promotion of platelet activation and cytokine release by topographical, chemical and biomimetical titanium surface modifications in vitro
Authors: Kämmerer P. W. , Gabriel M. , Al‐Nawas B. , Scholz T. , Kirchmaier C. M. , Klein M. O. 
Published: March 2011

Abstract
Objectives: Platelet releasate has been shown to promote osteogenetic cell proliferation and differentiation. Topography and chemistry of biomaterials have high impact on platelet activation. More specifically, the bioactive cell adhesive peptide sequence Arg–Gly–Asp (RGD) triggers platelet activation mediated by the αIIbβ3 integrin receptor. Accordingly, topographical, chemical and biomimetical (immobilized RGD peptide) modifications of titanium (Ti) surfaces may enhance early platelet activation and bony healing of implants. Therefore, the aim of the study was to evaluate platelet activation with subsequent platelet‐derived cytokine release by accordingly modified Ti surfaces.
Materials and methods: Pre‐treated (PT; mean roughness [Ra]=0.04 μm, contact angle [CA]=91°), acid‐etched (A, Ra=0.83 μm, CA=106°), large grit‐sandblasted, acid‐etched (SLA, Ra=3.2 μm, CA=109°) as well as hydrophilically modified acid‐etched (modA, Ra=0.83 μm, CA=0) and modified large grit‐sandblasted, acid‐etched (modSLA, Ra=3.2 μm; CA=0°) titanium surfaces were investigated. Additionally, RGD peptides were chemically immobilized on PT, A and SLA surfaces (PT‐RGD [CA=18°], A‐RGD [CA=0°], SLA‐RGD [CA=0°]). The different Ti surfaces were incubated with platelet concentrate of three healthy volunteers at room temperature for 15 min and for 30 min. High thrombogenous collagen served as the control group. Out of the supernatant, platelet consumption was assessed via platelet count (PC). Cytokine release was quantified via the level of platelet‐derived growth factor (PDGF) and vascular endothelial growth factor (VEGF).Results:After 15 min, especially the rough SLA surface showed a strong decrease in PC and a strong increase in VEGF and PDGF levels. After 30 min, high platelet consumption as well as high levels of VEGF and PDGF were measured for unspecifically modified (modA) and especially for biomimetic, specifically modified (PT‐RGD, A‐RGD) surfaces, indicating a delayed effect of the surface modifications on platelet activation.
Discussion: Modifications of surface roughness modifications appear to influence early platelet activation and cytokine release after 15 min whereas surface chemistry modifications with increased hydrophilic properties and surface modifications via RGD peptide on plainer surfaces lead to a further, more specific promotion of platelet activation and degranulation after 30 min. The observed effect could be valuable for critical clinical situations like compromised bone sites.
To cite this article: Kämmerer PW, Gabriel M, Al‐Nawas B, Scholz T, Kirchmaier CM, Klein MO. Early implant healing: promotion of platelet activation and cytokine release by topographical, chemical and biomimetical titanium surface modifications in vitro. Clin. Oral Impl. Res. 23, 2012 504–510. doi: 10.1111/j.1600‐0501.2011.02153.x
Paediatric drug use with focus on off‐label prescriptions in Swedish outpatient care – a nationwide study
Authors: Olsson J , Kimland E , Pettersson S , Odlind V 
Published: March 2011

AbstractAim:  To determine drug prescription and proportion of off‐label dispensing in the Swedish paediatric outpatient population.Methods:  All dispensed outpatient prescriptions to children aged 0 < 18 years as well as the proportion of off‐label drug use during 2007 were analysed using data from the Swedish Prescribed Drug Register.Results:  In total, 2.19 million drug prescriptions of 898 different drug substances were dispensed to paediatric patients, and of those substances, 64% had been dispensed off‐label at least once. The overall off‐label rate of all prescriptions was 13.5%, among which topical drugs as well as sex hormones were the most commonly prescribed off‐label drugs. More than half of all children in Sweden had received at least one prescribed drug in 2007.Conclusions:  There is a high prescribing of medicines to children in outpatient care in Sweden with a considerable amount of off‐label prescriptions. Topically administered drugs, sex hormones, antidepressants, hypnotics, cardiovascular drugs and nonsteroidal anti‐inflammatory drugs were commonly prescribed off‐label.