bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical History in the Diagnosis of the Cardiac Syncope–The Predictive Scoring System
Authors: MITRO PETER , KIRSCH PETER , VALOČIK GABRIEL , MURíN PAVOL 
Published: July 2011

Background:
Cardiac syncope represents clinical situation with serious prognosis. The aim of the present study was to develop the diagnostic scoring system based on the clinical history allowing to distinguish between cardiac and noncardiac syncope.
Methods:
Clinical history was obtained in the form of the structured questionnaire in 60 patients with cardiac syncope (mean age 70 ± 10 years, 33 men) an in 140 patients with noncardiac syncope (mean age 45 ± 20 years, 44 men). Multivariate regression analysis identified seven variables that were included in the final regression model.
Results:
The age above 55 years, presence of structural heart disease, syncope in supine position, absence of prodromal symptoms, and chest pain before syncope were predictive of cardiac syncope. Predictors of noncardiac syncope were recovery duration of more than 1 minute and syncope occurring immediately after standing up. A diagnostic point score was derived from the regression coefficients. The sum of the points identified patients with cardiac syncope if the diagnostic point score was ≤2. Diagnostic performance of the score was assessed on the validation group of 67 patients with syncope (21 patients with cardiac syncope and 46 patients with noncardiac syncope). Sensitivity was 81%, specificity 84.8%, positive predictive value 70.8%, and negative predictive value 90.7%.
Conclusion:
Predictive model based on parameters form clinical history of the patients may help to distinguish between cardiac and other causes of syncope. (PACE 2011; 34:1480–1485)
Acute Hemodynamic Effects of Right and Left Ventricular Lead Positions during the Implantation of Cardiac Resynchronization Therapy Defibrillators
Authors: STOCKINGER JOCHEM , STAIER KLAUS , SCHIEBELING‐RÖMER JOCHEN , KEYL CORNELIUS 
Published: July 2011

Background: To evaluate the acute hemodynamic effects of different right (RV) and left ventricular (LV) pacing sites in patients undergoing the implantation of a cardiac resynchronization therapy defibrillator (CRT‐D).
Methods: Stroke volume index (SVI), assessed via pulse contour analysis, and dp/dt max, obtained in the abdominal aorta, were analyzed in 21 patients with New York Heart Association class III heart failure and left bundle branch block (mean ejection fraction of 24 ± 6%), scheduled for CRT‐D implantation under general anesthesia. We compared the hemodynamic effects of RV apical (A), RV septal (B), and biventricular pacing using the worst (lowest SVI; C) and best (highest SVI; D) coronary sinus lead positions.
Results: Mean arterial pressure, SVI, and dp/dt max did not differ significantly between RV apical and septal pacing. Dp/dt max and SVI increased significantly during biventricular pacing (dp/dt max: B, 588 ± 160 mmHg/s; C, 651 ± 218 mmHg/s, P = 0.03 vs B; D, 690 ± 220 mmHg/s, P = 0.02 vs C; SVI: B, 33.6 ± 5.5 mL/m2, C, 34.8 ± 6.1 mL/m2, P = 0.08 vs B, D 36.0 ± 6.0 mL/m2, P < 0.001 vs C). The best hemodynamic response was associated with lateral or inferior lead positions in 15 patients. Other LV lead positions were most effective in six patients.
Conclusions: The optimal LV lead position varies significantly among patients and should be individually determined during CRT‐D implantation. The impact of the RV stimulation site in patients with intraventricular conduction delay, undergoing CRT‐D implantation, has to be investigated in further studies. (PACE 2011; 34:1537–1543)
True Bipolar and Integrated Bipolar Sensing and Detection by Implantable Defibrillators
Authors: VERGA TREVOR A. , GILLBERG JEFFREY M. , GREENBERG RICHARD M. , DEGER FLORIN T. 
Published: July 2011

Introduction:
Sensing and detection can be performed in true bipolar or integrated bipolar configuration by implantable defibrillators. New Medtronic generators (Medtronic Inc., Minneapolis, MN, USA) can be configured so that the sensing function of the device can be either true bipolar or integrated bipolar. We compared the sinus rhythm R‐wave amplitude and detection time of induced ventricular fibrillation (VF) at implant (acute phase), and sinus rhythm R‐wave amplitude 3 months or more after the implant (chronic phase) in these two configurations.
Methods:
Twenty‐eight patients were studied in the acute phase, and a subgroup of 15 patients was tested in the chronic phase. The generators were Medtronic model numbers D224VRC, D224TRK, D224DRG, D284VRC, D284TRK, and D284DRG. The leads were Medtronic 6947 or 6935. Sensing was evaluated by recording the electrogram and measuring the R‐wave peak‐to‐peak amplitude in the two configurations. Detection was evaluated by measuring the detection time in the two configurations in two consecutive inductions. The detection time was measured on programmer paper from the marker of the T shock to the marker of VF.
Results:
The acute‐phase values were: R wave in true bipolar configuration 13.9 ± 7.1 mV, R wave in integrated bipolar configuration 13.6 ± 6.9 mV (p = 0.38),VF detection time in true bipolar configuration 3.12 ± 0.39 seconds, and VF detection time in integrated bipolar configuration 3.17 ± 0.39 seconds (p = 0.52).
Conclusions:
Sensing and detection at implant were not significantly different between the true bipolar and the integrated bipolar configurations for the tested leads and generators. (PACE 2011; 34:1561–1568)
Relationship between Ventricular Dyssynchrony and T‐wave Alternans in Patients with Coronary Artery Disease
Authors: YAN GUO‐HUI , WANG MEI , YUE WEN‐SHENG , YIU KAI‐HANG , ZHI GUANG , LAU CHU‐PAK , WL LEE STEPHEN , SIU CHUNG‐WAH , TSE HUNG‐FAT 
Published: July 2011

Introduction: Coronary artery disease (CAD) is associated with increased dispersion of repolarization and sudden cardiac death. We sought to investigate whether ventricular dyssynchrony is associated with proarrhythmic repolarization dispersion as measured by T‐wave alternans (TWA) in patients with CAD.
Methods and Results: We evaluated 154 patients (67 ± 9 years, 123 men) with documented CAD, who underwent exercise treadmill testing and echocardiographic examination. TWA was analyzed continuously during treadmill testing in all standard precordial leads by time‐domain method. Tissue Doppler imaging was performed to measure inter‐ and intraventricular dyssynchrony. Increased TWA ≥ 60μV was observed in 42 (27%) patients. There was higher prevalence of females (31 vs 16%, P = 0.04) and greater body mass index (25.7 ± 2.6 vs 24.6 ± 3.0 kg/m2, P = 0.04) in the TWA ≥ 60μV group of patients than the TWA < 60μV group. The index of interventricular dyssynchrony, Ts‐RL, was significantly increased (75.6 ± 37.8 vs 59.9 ± 35.9 ms, P = 0.03) but not intraventricular dyssynchrony (all P > 0.05) in patients with TWA ≥ 60 μV compared with those with TWA < 60 μV. In addition, a weak but significant positive correlation was observed between TWA and Ts‐RL (r = 0.25, P = 0.003). Multivariate analysis revealed that only Ts‐RL (odds ratio 1.02, 95% confidence interval 1.00–1.03, P = 0.013) was independent predictor for increased TWA.
Conclusions: Our results demonstrated that interventricular dyssynchrony in patients with CAD is associated with increased TWA. This suggests that interventricular dyssynchrony may contribute to proarrhythmic repolarization dispersion. (PACE 2011; 34:1503–1510)
Impact of medico‐legal findings on charge filing in cases of rape in adult women
Authors: HAGEMANN CECILIE T. , STENE LISE E. , MYHRE ARNE K. , ORMSTAD KARI , SCHEI BERIT 
Published: July 2011

AbstractObjective. To assess the impact of the medical documentation and biological trace evidence in rape cases on the legal process. Design. Retrospective descriptive study. Setting and sample. Police‐reported cases of rape of women ≥16 years old in the Norwegian county of Sør‐Trøndelag from January 1997 to June 2003. Methods. Police data were merged with data from the Sexual Assault Center at St Olav's Hospital. Charged and non‐charged cases were compared. Main Outcome Measures. Medico‐legal findings and legal outcome. Results. A total of 185 police‐reported cases were identified. Of the 101 cases examined at Sexual Assault Center, charges were filed in 18 cases. Extragenital injuries were documented in 49 women; five were life threatening. Anogenital injuries were documented in 14 women; eight had multiple anogenital injuries. Documentation of injuries was not associated with charge filing. In only 33% of the cases were swabs collected from women's genitals used as trace evidence by the police. When used, this increased the likelihood for charge filing. A DNA profile matching the suspect was identified in four of the 18 charged cases and in only one among the 54 non‐charged cases. Conclusions. Half of the women had one or more documented injury. Only one‐third of the trace evidence kits collected from the women's anogenital area were analyzed. The analysis of swabs was associated with charge filing, regardless of test results. Increased use of such medical evidence, especially in cases of stranger rape, may ensure women's rights and increase available information to the legal system.
Long‐term follow up of posterior vestibulectomy for treating vulvar vestibulitis
Authors: TOMMOLA PÄIVI , UNKILA‐KALLIO LEILA , PAAVONEN JORMA 
Published: July 2011

AbstractObjective. To evaluate the safety and the effectiveness of posterior vestibulectomy in the treatment of vulvar vestibulitis syndrome. Design. A retrospective cohort study. Setting. University Hospital, tertiary referral center. Population. Seventy women treated by posterior vestibulectomy for severe vulvar vestibulitis syndrome during 1995–2007 at the Department of Obstetrics and Gynecology, University Hospital, Helsinki. Methods. All operated women were invited to a long‐term follow‐up study. Patient characteristics, baseline visual analog scale (VAS) for dyspareunia and data from the postoperative period were collected. Of the 70 women, 57 attended the follow‐up visit including face‐to‐face interview, gynecological examination with swab‐touch test for vestibular tenderness, current VAS score for dyspareunia and McCoy questionnaire for sexual problems. Main Outcome Measures. Short‐term and long‐term complication rates, dyspareunia by VAS score, vestibular tenderness, sexual problem index and overall patient satisfaction. Results. Ninety‐one per cent were satisfied with the outcome. The VAS for dyspareunia decreased from a median of 9 to 3 (66.7% decrease; p<0.001). Posterior vestibular tenderness was absent in 34 patients (64.2%). Six (8.6%) patients developed postoperative bleeding and 11 (15.7%) mild wound infection. Bartholin's cysts occurred in four (5.7%) patients. Conclusions. Posterior vestibulectomy is effective and safe in the treatment of severe vulvar vestibulitis syndrome and provides long‐term patient satisfaction.
Maternal mortality in Ghana: a hospital‐based review
Authors: LEE QIN YI , ODOI ALEXANDER T. , OPARE‐ADDO HENRY , DASSAH EDWARD T. 
Published: July 2011

AbstractObjective. This study examines the leading causes of maternal mortality in Ghana, classifies the main causes of maternal deaths and suggests how maternal care can be improved. Design. Retrospective review. Setting. Komfo Anokye Teaching Hospital, Ghana. Sample. Three hundred and twenty‐two maternal deaths with 30 269 live births in the period 1 January 2008 to 30 June 2010. Methods. Data on maternal mortality and morbidity were retrieved from the Biostatistics Unit of the hospital. Main Outcome Measures. Maternal mortality ratio (MMR), case fatality rate, leading causes of maternal deaths, duration of admission and staff/patient ratio. Results. The MMR was calculated to be 1 004 per 100 000 live births (95% confidence interval 895.0–1113.2). Of these, 71.1% were direct deaths, 22.4% were indirect deaths and 6.5% were unclassified. Hypertensive states of pregnancy were the leading cause of mortality (26.4%) and, together with hemorrhage, genital tract sepsis and early pregnancy deaths, accounted for 62.2% of all‐cause maternal deaths and 87.3% of direct deaths. Infection and sickle cell disease accounted for 13.7% of all‐cause maternal deaths and 61.1% of indirect deaths. Conclusions. Hypertensive states of pregnancy were the current leading cause of maternal mortality. Adopting a multi‐pronged approach through reducing delays in access to emergency obstetric care, promoting contraceptive use, encouraging early, regular antenatal attendance and shared antenatal care with the medical team is essential to tackle the situation.
Long‐term sequential receptor activator of NF‐κB ligand (RANKL) and osteoprotegrin (OPG) expression in lipopolysaccharide‐induced rat periapical lesions
Authors: Chuang Fu‐Hsiung , Tsai Chi‐Cheng , Chen Jeng‐Huey , Chen Ker‐Kong , Chen Yuk‐Kwan , Lin Ying‐Chu 
Published: July 2011

J Oral Pathol Med (2012) 41: 186–193Background:  Long‐term sequential expression of receptor activator of NF‐κB ligand (RANKL) and osteoprotegrin (OPG) in lipopolysaccharide (LPS)‐induced rat periapical lesions has not been studied.Materials:  Seventy‐two 4‐week‐old Wistar rats were divided into eight experimental groups and one control group (eight animals in each).Methods:  Lipopolysaccharide‐induced periapical lesions were produced in rats by occlusal exposure of the pulp of their lower first molars in all experimental groups but not the control group. The extent of periapical destruction was measured by radiographic imaging. RANKL and OPG mRNA were measured in all tissue sections containing the periapical lesions as well as the control group every week from week 1 to week 8 by real‐time quantitative reverse transcription polymerase chain reaction. RANKL and OPG protein were determined by immunohistochemistry. Osteoclasts were identified by enzyme histochemistry.Results:  The sequential changes in the mRNA and protein expression of RANKL and OPG were largely compatible with the occurrence of osteoclasts histologically and enzymes histochemically, as well as the mean areas of the periapical lesions radiographically during long‐term observation of the LPS‐induced rat periapical lesions.Conclusion:  This study may be the first to demonstrate the long‐term RANKL and OPG expression every week from week 1 to week 8 using LPS to produce periapical infection in a Wistar rat model. The long‐term findings of high expressions of RANKL and OPG further extend the potential application of the Wistar rat model for future experimental trials using RANKL inhibitor to evaluate the treatment outcome for LPS‐induced rat periapical lesions.
The expression and significance of MRP1, LRP, TOPOIIβ, and BCL2 in tongue squamous cell carcinoma
Authors: Zhang Bin , Liu Mo , Tang Hai‐kuo , Ma Hui‐bin , Wang Cheng , Chen Xiaohua , Huang Hong‐zhang 
Published: July 2011

J Oral Pathol Med (2012) 41: 141–148Background:  Multiple drug resistance protein 1 (MRP1), lung resistance protein (LRP), topoisomerase IIβ (TOPOIIβ) and B‐cell lymphoma 2 (BCL2) are well known in the development of drug resistance in cancer cells. The aim of this study was to evaluate the relationship between them and the clinicopathological features, their expression differences between tumor tissue and experimental drug‐resistant model in tongue carcinoma.Materials and methods:  Multiple drug resistance protein 1, LRP, TOPOIIβ, and BCL2 expression was examined by immunohistochemistry in specimens from radical surgeries of 65 patients with tongue carcinoma. A cisplatin‐resistance cell line, SCC‐15/cisplatin, was established from a cisplatin‐sensitive cell line, SCC‐15. A MTT‐based method was used to analyze drug potencies. Immunofluorescence was used to detect protein expression in both cell lines. Western blot was used to compare the protein expressions in specimens and SCC‐15/cisplatin cells.Results:  We found higher expression of MRP1, LRP, and BCL2 and lower expression of TOPOIIβ in tongue carcinoma compared with adjacent non‐neoplastic tongue tissues (P < 0.05). In addition, MRP1 and TopoIIβ expression were significantly associated with clinical stage, lymph node metastasis and histologic grade, and LRP was significantly associated with histologic grade in the samples (P < 0.05). Finally, Western blot showed that higher expressions of MRP1, LRP, and BCL2 and lower expression of TopoIIβ were observed in SCC‐15/cisplatin cells than in clinical samples.Conclusion:  Our results suggest that the high expressions of MRP1, LRP, and BCL2 and low expression of TOPOIIβ in patients with tongue carcinoma indicates that intrinsic drug resistance may exist in tongue carcinoma, and is associated with tumor differentiation and cisplatin resistance in tongue carcinoma.
Prevotella nigrescens and Porphyromonas gingivalis are associated with signs of carotid atherosclerosis in subjects with and without periodontitis
Authors: Yakob M. , Söder B. , Meurman J. H. , Jogestrand T. , Nowak J. , Söder P.‐Ö. 
Published: July 2011

Yakob M, Söder B, Meurman JH, Jogestrand T, Nowak J, Söder P.‐Ö. Prevotella nigrescens and Porphyromonas gingivalis are associated with signs of carotid atherosclerosis in subjects with and without periodontitis. J Periodont Res 2011; 46: 749–755. ©2011 John Wiley & Sons A/SBackground and Objective:  Oral microorganisms may be involved in the development of cardiovascular diseases, and Porphyromonas gingivalis is one of the periodontal microorganisms that has been found in carotid atheroma. The aim of this work was to study subgingival microorganisms and early carotid lesions in subjects with and without periodontitis.Material and Methods:  Eighty‐eight subjects with periodontitis and 40 subjects without periodontitis underwent dental examinations in 2003. The presence of the periodontal microorganisms Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens and Tannerella forsythia was analyzed from subgingival plaque using PCR amplification. The common carotid artery was scanned using ultrasound and the calculated intima‐media area (cIMA) was measured. The association between periodontitis, the cIMA value and the presence of periodontal microorganisms, together with several confounders, was studied in a multiple logistic regression model.Results:  Smoking [odds ratio (OR) = 5.64; p = 0.001), level of education (OR = 5.02; p < 0.05) and the presence of P. gingivalis (OR = 6.50; p < 0.05) were associated with periodontitis. Explanatory factors for the increased cIMA were periodontitis (OR = 4.22; p < 0.05), hypertension (OR = 4.81; p < 0.05), high body mass index (OR = 5.78; p < 0.01), male gender (OR = 3.30; p < 0.05) and poor socioeconomic status (OR = 4.34; p < 0.05). P. nigrescens (OR 4.08; p < 0.05) and P. gingivalis (OR 7.63; p < 0.01) also appeared as explanatory variables associated with increased cIMA values.Conclusion:  This cross‐sectional study showed that P. nigrescens and P. gingivalis were significantly associated with increased cIMA values.
Traumatic dental injuries and their association with malocclusion in the primary dentition of Irish children
Authors: Norton Eimear , O’Connell Anne C. 
Published: July 2011

Abstract –  Aims:  This study sought to establish the prevalence of traumatic dental injuries in the primary dentition of Irish children and to investigate the relationship between dental trauma and non‐nutritive sucking habits.Materials and methods:  Following ethical approval, a variety of schools and crèches in an urban setting were identified and parents of over 1000 children were contacted. Consent was obtained, and parental questionnaires were completed prior to a clinical examination of the children by one operator in a non‐dental setting. Signs of previous dental trauma were noted, and overbite and overjet were measured.Results:  Eight hundred and thirty‐nine children were examined. The prevalence of dental trauma was 25.6%, with boys more frequently affected. The most commonly observed dental injury was fracture of enamel (39.4%), followed by crown discolouration (20.2%). Only 38.8% of the children with a reported history of trauma sought dental care. Non‐nutritive sucking habits were reported in 63.5% of the sample, and these habits, if prolonged, were significantly associated with anterior open bites and increased overjet (P < 0.001). Using regression analysis, it was established that the risk of dental injury is 2.99 times greater if the child has an overjet >6 mm and 2.02 times greater if the child has an anterior open bite.Conclusions:  Non‐nutritive sucking habits are associated with the establishment of anterior open bite and increased overjet in the primary dentition. These malocclusions are, in turn, significantly associated with an increased prevalence of dental trauma in the primary dentition.
Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth
Authors: Garcia‐Godoy Franklin , Murray Peter E. 
Published: July 2011

Abstract – The regeneration of immature permanent teeth following trauma could be beneficial to reduce the risk of fracture and loss of millions of teeth each year. Regenerative endodontic procedures include revascularization, partial pulpotomy, and apexogenesis. Several case reports give these procedures a good prognosis as an alternative to apexification. Care is needed to deliver regenerative endodontic procedures that maintain or restore the vitality of teeth, but which also disinfect and remove necrotic tissues. Regeneration can be accomplished through the activity of the cells from the pulp, periodontium, vascular, and immune system. Most therapies use the host’s own pulp or vascular cells for regeneration, but other types of dental stem cell therapies are under development. There are no standardized treatment protocols for endodontic regeneration. The purpose of this article is to review the recent literature and suggest guidelines for using regenerative endodontic procedures for the treatment of permanent immature traumatized teeth. Recommendations for the selection of regenerative and conventional procedures based on the type of tooth injury, fracture type, presence of necrosis or infection, periodontal status, presence of periapical lesions, stage of tooth development, vitality status, patient age, and patient health status will be reviewed. Because of the lack of long‐term evidence to support the use of regenerative endodontic procedures in traumatized teeth with open apices, revascularization regeneration procedures should only be attempted if the tooth is not suitable for root canal obturation, and after apexogenesis, apexification, or partial pulpotomy treatments have already been attempted and have a poor prognosis.