bluuebunny/crossref_metadata_2025_split huggingface dataset:
Step‐forward Randomization in Multicenter Emergency Treatment Clinical Trials
Authors: Zhao Wenle , Ciolino Jody , Palesch Yuko 
Published: June 2010

AbstractThe authors present a new centralized randomization method for multicenter emergency treatment clinical trials. With this step‐forward method, treatment randomization for the next subject is performed immediately after the enrollment of the current subject. This design ensures the readiness of the treatment assignment for each subject at the point of study enrollment, and it simultaneously provides effective control on treatment assignments balance and distributions of covariates. The authors also discuss procedures of the step‐forward randomization method along with its implementation for two National Institute of Neurological Disorders and Stroke–funded multicenter acute stroke trials, one double‐blinded and one open‐labeled. Advantages and limitations are presented based on experience gained in these two trials.ACADEMIC EMERGENCY MEDICINE 2010; 17:659–665 © 2010 by the Society for Academic Emergency Medicine
Procainamide and Survival in Ventricular Fibrillation Out‐of‐hospital Cardiac Arrest
Authors: Markel David T. , Gold Laura S. , Allen Judith , Fahrenbruch Carol E. , Rea Thomas D. , Eisenberg Mickey S. , Kudenchuk Peter J. 
Published: June 2010

AbstractObjectives:  Procainamide is an antiarrhythmic drug of unproven efficacy in cardiac arrest. The association between procainamide and survival from out‐of‐hospital cardiac arrest was investigated to better determine the drug’s potential role in resuscitation.Methods:  The authors conducted a 10‐year study of all witnessed, out‐of‐hospital, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) cardiac arrests treated by emergency medical services (EMS) in King County, Washington. Patients were considered eligible for procainamide if they received more than three defibrillation shocks and intravenous (IV) bolus lidocaine. Four logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CI) describing the relationship between procainamide and survival.Results:  Of the 665 eligible patients, 176 received procainamide, and 489 did not. On average, procainamide recipients received more shocks and pharmacologic interventions and had lengthier resuscitations. Adjusted for their clinical and resuscitation characteristics, procainamide recipients had a lower likelihood of survival to hospital discharge (OR = 0.52; 95% CI = 0.36 to 0.75). Further adjustment for receipt of other cardiac medications during resuscitation negated this apparent adverse association (OR = 1.02; 95% CI = 0.66 to 1.57).Conclusions:  In this observational study of out‐of‐hospital VF and pulseless VT arrest, procainamide as second‐line antiarrhythmic treatment was not associated with survival in models attempting to best account for confounding. The results suggest that procainamide, as administered in this investigation, does not have a large impact on outcome, but cannot eliminate the possibility of a smaller, clinically relevant effect on survival.ACADEMIC EMERGENCY MEDICINE 2010; 17:617–623 © 2010 by the Society for Academic Emergency Medicine
Multicenter Study of Preferences for Health Education in the Emergency Department Population
Authors: Kit Delgado M. , Ginde Adit A. , Pallin Daniel J. , Camargo Carlos A. 
Published: June 2010

AbstractObjectives:  Emergency departments (EDs) are increasingly proposed as high‐yield venues for providing preventive health education to a population at risk for unhealthy behaviors and unmet primary care needs. This study sought to determine the preferred health education topics and teaching modality among ED patients and visitors.Methods:  For two 24‐hour periods, patients aged 18 years and older presenting to four Boston EDs were consecutively enrolled, and waiting room visitors were surveyed every 3 hours. The survey assessed interest in 28 health conditions and topics, which were further classified into nine composite health education categories. Also assessed was the participants’ preferred teaching modality.Results:  Among 1,321 eligible subjects, 1,010 (76%) completed the survey, of whom 56% were patients and 44% were visitors. Among the health conditions, respondents were most interested in learning about stress and depression (32%). Among the health topics, respondents were most interested in exercise and nutrition (43%). With regard to learning modality, 34% of subjects chose brochures/book, 25% video, 24% speaking with an expert, 14% using a computer, and 3% another mode of learning (e.g., a class). Speaking with an expert was the overall preferred modality for those with less than high school education and Hispanics, as well as those interested in HIV screening, youth violence, and stroke. Video was the preferred modality for those interested in learning more about depression, alcohol, drugs, firearm safety, and smoke detectors.Conclusions:  Emergency department patients and visitors were most interested in health education on stress, depression, exercise, and nutrition, compared to topics more commonly targeted to the ED population such as substance abuse, sexual health (including HIV testing), and injury prevention. Despite many recent innovations in health education, most ED patients and visitors in our study preferred the traditional form of books and brochures. Future ED health education efforts may be optimized by taking into account the learning preferences of the target ED population.ACADEMIC EMERGENCY MEDICINE 2010; 17:652–658 © 2010 by the Society for Academic Emergency Medicine
Evaluating Degradation with Fragment Formation of Prehospital Succinylcholine by Mass Spectrometry
Authors: Merlin Mark A. , Marques‐Baptista Andreia , Yang Hilly , Ohman‐Strickland Pamela , Aquina Christopher , Buckley Brian 
Published: June 2010

AbstractObjectives:  Pharmaceutical manufacturers recommend refrigerating succinylcholine at a temperature range of 2–8°C. With widespread use of prehospital succinylcholine on ambulances without refrigeration, it is important to understand the stability of this drug. Using mass spectrometry, this study investigated the degradation of the succinylcholine compound before and after its exposure to ambulance cabin temperatures, while removing light exposure. A 10% degradation threshold was set as not appropriate for human use, in accordance with U.S. Food and Drug Administration guidelines.Methods:  The study used 17 vials of succinylcholine sealed with duct tape in light‐resistant bags. The bags were placed in climate controlled compartments in two ambulances: one stationed in a garage and the other stationed outdoors. Mass spectrometry analysis was used to examine drug degradation at Time 0, the 14th day of the first month, and monthly from Time 0 to 7 months.Results:  The degradation products of succinyl monocholine (SMC) and choline are already present at Day 0. Ten percent degradation was achieved at approximately 90 days into the experiment. Temperature in the ambulance climate controlled compartment was 70°F, with a range from 56 to 89°F during the 6‐month time period.Conclusions:  Identifiable breakdown fragments of succinylcholine have been identified using mass spectrometry with fresh drug upon receipt from the manufacturer. Ten percent degradation was not observed until approximately 90 days after being placed on ambulances. Temperature variations did not significantly contribute to degradation of succinylcholine, and it is safe for injection until approximately 90 days in similar climates.ACADEMIC EMERGENCY MEDICINE 2010; 17:631–637 © 2010 by the Society for Academic Emergency Medicine
Measuring Nausea in Emergency Department Patients via the Use of Exploratory Factor Analysis
Authors: Cloutier Robert L. , Fuller Bret E. , Hendrickson Robert G. , Jones Nikolas 
Published: June 2010

AbstractObjectives:  The objective was to evaluate the applicability of a previously studied multifactorial nausea scale in the emergency department (ED) setting via exploratory factor analysis (EFA).Methods:  Two studies evaluated the validity and factor structure of 18 nausea descriptors scored on 11‐point Likert scales. Trained research volunteers administered the scale to 83 men and 123 women in the first sample and to 100 men and 230 women in the second sample. All patients were assessed at enrollment and again at 90 minutes to detect changes in symptom severity. An EFA in the first study used a maximum likelihood estimation method with a principal factor analysis. The second study narrowed the descriptors and evaluated the factor structure with a confirmatory factor analysis (CFA).Results:  Two factors were retained in the solution; one contained five items with descriptors of physical symptoms, and a second contained five items with psychological symptoms. CFA determined that the two five‐item scales were stable and reliable measures of patient nausea experience.Conclusions:  The scales measure both physical and psychological symptoms of nausea, indicating that the experience is multidimensional.ACADEMIC EMERGENCY MEDICINE 2010; 17:e33–e39 © 2010 by the Society for Academic Emergency Medicine
Multislice Computed Tomography of the First Rib: A Useful Technique for Bone Age Assessment
Authors: Moskovitch Guillaume , Dedouit Fabrice , Braga José , Rougé Daniel , Rousseau Hervé , Telmon Norbert 
Published: June 2010

Abstract: Macroscopic study of the first rib has been described by Kunos et al. as an efficient method of age estimation. We retrospectively reviewed a test sample of 160 first right ribs obtained from multislice computed tomography (MSCT) clinical investigations of living individuals aged 15–30 years old. Based on the descriptions of Kunos et al., we analyzed the morphological appearance of the sternal end of the first rib on two‐ and three‐dimensional MSCT reconstructions and defined changes in appearance in stages (from 2 to 5). We also studied the calcification and ossification of the costal cartilage as an independent feature. By statistical analysis (ANOVA), we determined for each gender the correlation between the estimated stage of the costal face, the appearance of the costal cartilage, and the documented age of the subjects. We demonstrated that MSCT of the first rib appears to be an efficient noninvasive modality for bone age estimation.
Prospective evaluation of angiogenic, hypoxic and EGFR‐related biomarkers in recurrent glioblastoma multiforme treated with cetuximab, bevacizumab and irinotecan
Authors: Hasselbalch Benedikte , Eriksen Jesper Grau , Broholm Helle , Christensen Ib Jarle , Grunnet Kirsten , Horsman Michael R. , Poulsen Hans Skovgaard , Stockhausen Marie‐Thérése , Lassen Ulrik 
Published: June 2010

Hasselbalch B, Eriksen JG, Broholm H, Christensen IJ, Grunnet K, Horsman MR, Poulsen HS, Stockhausen M‐T, Lassen U. Prospective evaluation of angiogenic, hypoxic and EGFR‐related biomarkers in recurrent glioblastoma multiforme treated with cetuximab, bevacizumab and irinotecan. APMIS 2010; 118: 585–94.Several recent studies have demonstrated a beneficial effect of anti‐angiogenic treatment with the vascular endothelial growth factor‐neutralizing antibody bevacizumab in recurrent high‐grade glioma. In the current study, immunohistochemical evaluation of biomarkers involved in angiogenesis, hypoxia and mediators of the epidermal growth factor receptor (EGFR) pathway were investigated. Tumor tissue was obtained from a previous phase II study, treating recurrent primary glioblastoma multiforme (GBM) patients with the EGFR inhibitor cetuximab in combination with bevacizumab and irinotecan. Of the 37 patients with available tumor tissue, 29 were evaluable for response. We concurrently performed immunohistochemical stainings on tumor tissue from 21 GBM patients treated with bevacizumab and irinotecan. We found a tendency of correlation between the hypoxia‐related markers, indicating that they share the same regulatory mechanisms. None of the EGFR‐related biomarkers showed any significant correlations with each other. None of the biomarkers tested alone or in combination could identify a patient population likely to benefit from bevacizumab and irinotecan, with or without the addition of cetuximab. There is still an urgent need for one or more reliable and reproducible biomarkers able to predict the efficacy of anti‐angiogenic therapy.
A clinical comparison of two flap designs for coronal advancement of the gingival margin: semilunar versus coronally advanced flap
Authors: Santana Ronaldo B. , Mattos Carolina M. L. , Dibart Serge 
Published: June 2010

Santana RB, Mattos CML, Dibart S. A clinical comparison of two flap designs for coronal advancement of the gingival margin: semilunar versus coronally advanced flap. J Clin Periodontol 2010; 37: 651–658. doi: 10.1111/j.1600‐051X.2010.01582.x.AbstractBackground: The semilunar incision was introduced in oral surgery more than a century ago. The semilunar coronally re‐positioned flap (SLCRF) is one of the variants of this procedure; however, no previous controlled clinical study has evaluated the SLCRF performed as originally described. The objective of the present study was to compare the clinical outcomes of the SLCRF and coronally advanced flap (CAF) procedure in the treatment of maxillary Miller class I recession (GR) defects.Materials and Methods: Twenty‐two patients, with 22 contra‐lateral Miller class I GR defects, were randomly assigned to CAF or SLCRF. Clinical parameters assessed included recession height, width of keratinized tissue, probing depth, vertical clinical attachment level, visual plaque score and bleeding on probing. Clinical recordings were performed at baseline and 6 months later. Inter‐measurements differences were analysed with a χ2 or a paired t‐test, with significance set at α<0.05.Results: Both flap designs were effective in obtaining and maintaining a coronal displacement of the gingival margin. The CAF resulted in clinical improvements significantly better than SLCRF for percentage of root coverage (RC), frequency of complete RC and gain in clinical attachment level. RC obtained in the immediate post‐surgical period of SLCRF‐treated sites was not maintained throughout the subsequent evaluations.Conclusion: RC is significantly better with CAF compared with the original SLCRF technique in the treatment of shallow maxillary Miller class I GR defects.
Assessing the minimally important difference in the Oral Impact on Daily Performances index in patients treated for periodontitis
Authors: Tsakos Georgios , Bernabé Eduardo , D'Aiuto Francesco , Pikhart Hynek , Tonetti Maurizio , Sheiham Aubrey , Donos Nikolaos 
Published: June 2010

Tsakos G, Bernabé E, D'Aiuto F, Pikhart H, Tonetti M, Sheiham A, Donos N. Assessing the minimally important difference in the Oral Impact on Daily Performances index in patients treated for periodontitis. J Clin Periodontol 2010; 37: 903–909. doi: 10.1111/j.1600‐051X.2010.01583.x.AbstractAim: To assess changes over time and determine the minimally important difference (MID) in the Oral Impact on Daily Performances (OIDP) index for patients with severe generalized periodontitis receiving periodontal treatment.Methods: This study was nested in a larger randomized controlled trial and consisted of 45 consecutive subjects of the larger trial (17 receiving intensive and 28 receiving conservative periodontal care). The OIDP index assessed impacts on quality of life (QoL) at baseline and 1 month after treatment. Repeated‐measures anova was used for comparison over time and between treatment groups. To estimate the MID, two subjective global transition scales, related to periodontal and oral health, respectively, were used as anchors, whereas the effect size (ES), standardized response mean and standard error of measurement were also calculated.Results: The mean OIDP score after treatment was significantly lower than at baseline, indicating improvement in QoL, but there were no differences between treatment groups. Based on an agreement between different methods, the MID of the OIDP index was around five scale points and corresponded to a moderate ES.Conclusion: The MID for the OIDP index among patients treated for severe generalized periodontitis provides meaning to change scores and facilitates interpretation of findings.
Is there a relationship between Birthweight and subsequent growth on the development of Dental Caries at 5 years of age? A cohort study
Authors: Kay Elizabeth Jane , Northstone Kate , Ness Andy , Duncan Karen , Crean St John 
Published: June 2010

Kay EJ, Northstone K, Ness A, Duncan K, Crean SJ. Is there a relationship between Birthweight and subsequent growth on the development of Dental Caries at 5 years of age? A cohort study. Community Dent Oral Epidemiol 2010; 38: 408–414. © 2010 John Wiley & Sons A/SAbstract –  Objectives:  To examine the associations between childhood growth and the presence of dental caries at age 5.Methods:  Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) a population‐based, prospective cohort study were used. We enrolled 14 541 pregnancies, and a 10% sample of these were dentally examined and measured at 61 months of age. Birthweight was obtained from medical records, and birth length and birthweight were assessed by trained ALSPAC measurers. A number of social and lifestyle factors were treated as potential confounding factors.Results:  Of 985, children, 242 (24.6%) had caries at 61 months of age. After adjustment, increased weight at birth was associated with a small increased risk of caries at 61 months (OR: 1.08 (95% CI: 1.03, 1.13) per 100 g increase, P = 0.002). A similar association was noted with respect to increased length at birth. Current weight and height did not appear to be associated with caries risk. Children who had caries at 61 months had slower increases in weight and height between birth and 61 months than those without decay at 61 months.Conclusions:  The weak associations we have demonstrated between weight and length at birth and risk of caries at age 61 months cannot be considered causal, however, the relationship between the two variables warrants further investigation.
Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people
Authors: Smidt Dorte , Torpet Lis Andersen , Nauntofte Birgitte , Heegaard Karen Margrethe , Pedersen Anne Marie Lynge 
Published: June 2010

Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AML. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010; 38: 422–435. © 2010 John Wiley & Sons A/SAbstract –  Objective:  To investigate the associations between age, gender, systemic diseases, medications and labial and whole salivary flow rates in older people.Methods:  Unstimulated labial (LS) and unstimulated (UWS) and chewing‐stimulated (SWS) whole salivary flow rates were measured in 389 randomly selected community‐dwelling Danish women and 279 men aged 65–97 years. Systemic diseases, medications (coded according to the Anatomical Therapeutic Chemical (ATC) Classification System), tobacco and alcohol consumption were registered.Results:  The number of diseases and medications was higher and UWS lower in the older age groups. On average, women were slightly older, had more diseases, higher medication intake and lower UWS, SWS and LS than men. High number of diseases and medications was associated with low UWS, SWS and LS. In the healthy (14%) and nonmedicated (19%) participants, flow rates were not associated with age and gender, apart from SWS being lower in nonmedicated women. Low UWS were associated with psychiatric and respiratory disorders, type 2 diabetes and intake of psycholeptics, psychoanaleptics (especially SRRIs), respiratory agents, oral antidiabetics (particularly sulfonylureas), magnesium‐hydroxide, cardiac agents, quinine, thiazides, calcium channel blockers, statins, urinary antispasmodics, glucosamine, NSAIDs, opioids and ophthalmologicals. SWS were lower in participants with ophthalmological disorders using ophthalmologicals (especially antiglaucoma agents and miotics), but also in those taking antidepressants, cardiac agents (mostly digitalis glycosides) and calcium channel blockers. Cardiovascular diseases and intake of anti‐thrombotics (mainly low dose aspirins), calcium channel blockers and oral antidiabetics were associated with low LS.Conclusions:  In older people, low salivary flow rates are associated with specific and high number of diseases and medications, but neither with age and gender per se nor with tobacco and alcohol consumption. Low UWS are associated with more diseases and medications than SWS and LS, which were primarily associated with cardiovascular diseases and medications including preventive agents such as low‐dose aspirins and statins. New insights into medications and their association with salivary gland function were achieved using the ATC classification system.
Factor VIII gene mutations profile in 148 Chinese hemophilia A subjects
Authors: Xue Feng , Zhang Lei , Sui Tao , Ge Jing , Gu Dongsheng , Du Weiting , Zhao Haifeng , Yang Renchi 
Published: June 2010

AbstractBackground:  Hemophilia A (HA) is a common X‐linked recessive bleeding disease caused by mutations in FVIII gene. The identification of mutation in HA subjects can lead to more accurate diagnosis and contribute to the genetic counseling/prenatal diagnosis.Objectives:  Our objective is to identify the FVIII defects in 148 unrelated Chinese HA subjects and to analyze the potential consequence of novel mutations.Methods:  FVIII: C was assayed using one‐stage method, and FVIII inhibitor was tested using Bethesda method. Intron 22 and 1 inversions were identified by PCR technique. Non‐inversion mutations of FVIII gene were identified by direct sequencing. Novel mutations were further analyzed based on a B‐domain deleted FVIII crystallographic structure and bioinformatics tools.Results:  The intron 22 and 1 inversions affected 57 and three severe subjects, respectively. Sixty‐seven different mutations were identified in non‐inversion subjects including 35 novel mutations that were not reported previously. Novel mutations include five nonsense mutations, 15 missense mutations, three insertions, eight small deletions, two splice site mutations and two partial gene deletions. The potential deleterious effects of these novel missense mutations include disruption of the protein core, impairment of inter‐domain interaction and FVIII binding with other proteins.Conclusion:  Similar to other races, intron 22 and one inversions are also recurrent mutation in severe HA subjects monitored in our centre. Sixty‐seven mutations (52% novel reported) among 88 non‐inversion subjects represent the high degree of heterogeneity of FVIII gene mutations causing HA. Characteristic of HA FVIII gene mutations extend our insight into structure–function relationship of the FVIII molecule.