bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is robotic technology facilitating the minimally invasive approach to partial nephrectomy?
Authors: Dev Harveer S. , Sooriakumaran Prasanna , Stolzenburg Jens‐Uwe , Anderson Christopher J. 
Published: September 2011

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Open partial nephrectomy has been defined as the standard of care for the treatment of small renal masses. Robotic platforms may offer the solution to bridge the gap between open and laparoscopic approaches, providing similar oncological and functional results via a shorter learning curve.This study reviews the current literature, and reports developments in robotic‐assisted partial nephrectomy (RPN). It highlights the important results from various studies which investigate the oncological and functional efficacy of RPN, and establishes its current status as at least equivalent to the laparoscopic approach. Trends are emerging that highlight the advantage of the robotic interface in facilitating this approach, and we postulate that this may become more apparent in future studies.OBJECTIVE
To establish its current status, this study reviews the literature, and reports developments in robotic‐assisted partial nephrectomy (RPN), highlighting results from various studies that investigate the oncological and functional efficacy of RPN. Partial nephrectomy has become the standard therapy for the management of small renal masses. In an effort to overcome the perioperative morbidity associated with an open approach, and the extended warm ischaemia times associated with a laparoscopic approach, robotic platforms have been introduced.
PATIENTS AND METHODS
A search of Medline, EMBASE and Cochrane library databases was completed in July 2010 and used to identify pertinent original articles, editorials, comments and reviews, using the search term ‘partial nephrectomy’. Links to related references were surveyed, and all articles finally included were based on relevance and importance of content, as determined by the authors.
RESULTS
The robotic platform may offer the solution to bridge the gap between open and laparoscopic approaches, achieving warm ischaemia times that consistently average 20 minutes, and providing similar oncological and functional results via a shorter learning curve. It offers cosmesis and convalescence equivalent to that from laparoscopic partial nephrectomy, but with potentially fewer postoperative complications.
CONCLUSION
In terms of oncological and functional outcomes, the early experiences of RPN in selected series of patients appear at least equivalent to open and laparoscopic partial nephrectomy series. Randomized comparisons between the approaches are lacking, as are longer‐term follow‐up data for the robotic technique and formal cost analysis; these will be necessary before RPN can replace open partial nephrectomy as the new standard for the management of small renal masses. Trends continue to emerge that highlight the advantage of using the robotic platform to achieve a minimally invasive approach for partial nephrectomy, and with time and increasing expertise, this may become further apparent.
Contrast‐enhanced ultrasonography with contrast‐tuned imaging technology for the detection of prostate cancer: comparison with conventional ultrasonography
Authors: Xie Shao Wei , Li Hong Li , Du Jing , Xia Jian Guo , Guo Yi Fen , Xin Mei , Li Feng Hua 
Published: September 2011

Study Type – Diagnostic (exploratory cohort)Level of Evidence 2bWhat's known on the subject? and What does the study add?The present study was to perform contrast‐tuned imaging (CnTI) technology to detect prostate cancer and compare the use of CnTI technology for the detection of prostate cancer with conventional ultrasonography. The preliminary data from our study suggested that targeted biopsy of the prostate with CnTI technology could improve the cancer detection and detect higher grade prostate cancers.OBJECTIVES
To perform contrast‐enhanced ultrasonography (CEUS) using contrast‐tuned imaging (CnTI) technology to detect prostate cancer.
To evaluate the detection of prostate cancer with CnTI compared with conventional grey‐scale and power Doppler ultrasonography.
PAIENTS AND METHODS
In all, 150 patients referred for prostate biopsy were evaluated using transrectal grey‐scale, power Doppler and CnTI ultrasonography.
Biopsy was performed at 10 sites in each patient. If an abnormality was found at any of these three ultrasonography examinations, a biopsy specimen was targeted towards from the corresponding site.
The performances of the three ultrasonography techniques for prostate cancer detection were compared.
RESULTS
Prostate cancer was detected at 383 sites from 73 patients. The combination of these three examinations detected more patients with prostate cancer than grey‐scale (P= 0.002), power Doppler (P= 0.001) or baseline imaging (the combination of grey‐scale and power Doppler; P= 0.031) alone.
By biopsy site, CnTI had higher sensitivity and accuracy (73.1% and 83.7%) than grey‐scale (50.9%; P < 0.001 and 78.8%; P < 0.001) or power Doppler (48.3%; P < 0.001 and 77.7%; P < 0.001), while the specificity was similar for grey‐scale (88.4%), power Doppler (87.8%) and CnTI (87.3%; P > 0.05 in each case). CnTI had higher sensitivity (73.1% vs 62.9%; P < 0.001), specificity (87.3% vs 82.1%; P < 0.001) and accuracy (83.7% vs 77.2%; P < 0.001) than baseline imaging.
The mean Gleason score of CnTI‐positive cases was significantly higher than CnTI‐negative cases (7.1 vs 6.3; P= 0.002).
CONCLUSIONS
CEUS using CnTI technology enables a visualization of the microvasculature associated with prostate cancer.
CnTI technology could be used to guide biopsy and improve the detection rate of prostate cancer.
CnTI technology was able to detect higher grade prostate cancers.
Angiotensin II type 1 (AT‐1) receptor inhibition partially prevents the urodynamic and detrusor changes associated with bladder outlet obstruction: a mouse model
Authors: Comiter Craig , Phull Hardeep S. 
Published: September 2011

Study Type – Therapy (case control)Level of Evidence 3bWhat's known on the subject? and What does the study add?Angiotensin II is the main effector peptide in the bladder local renin‐angiotensin system. This experiment demonstrates the role of this local renin‐angiotensin system with respect to bladder outlet obstruction.OBJECTIVE
To determine if treatment with an angiotensin II type 1 (AT‐1) receptor antagonist, losartan, can prevent the structural and functional changes that occur in a mouse model of bladder outlet obstruction (BOO).
MATERIALS AND METHODS
Twenty‐four Balb/CAN mice underwent partial urethral obstruction for 6 weeks.
Twelve mice were given oral losartan (10 mg/kg/day), and 12 were not. Six mice served as unobstructed controls, and six unobstructed mice were given oral losartan (10 mg/kg/day) to determine the effect of angiotensin II inhibition on the normal bladder.
Bladder capacity (C), detrusor pressure during voiding (Pdet) and volume at first non‐voiding contraction (NVC1) as a percentage of C were recorded after 6 weeks.
Bladders were stained with haematoxylin and eosin for measurement of detrusor muscular thickness, and graded as 1 = atrophy (<100 µm thick), 2 = normal (100–200 µm thick), 3 = hypertrophy (>200 µm thick) compared with controls.
RESULTS
Compared with controls, BOO mice had greater C (153.5 ± 20.9 vs 57.5 ± 7.4 µl, P < 0.01), higher Pdet (28.8 ± 2.1 vs 12.1 ± 2.1 mm Hg), lower NVC1 (median = 24% vs 54% P= 0.03). BOO mice manifested greater bladder weight (93.2 ± 11.7 mg vs 26.8 ± 2.40 mg, P < 0.01) and greater detrusor muscle thickness (median 3 vs 2, P= 0.02).
Compared with untreated BOO mice, mice treated with losartan had greater mean C (248.8 ± 28.6 vs 153.5 ± 20.9 µL, P= 0.01), no significant change in mean Pdet (24.7 ± 1.6 vs 28.8 ± 2.1 mm Hg, P= 0.2) and a higher mean NVC1 (47% vs 24%, P= 0.02).
Treatment with losartan mediated an insignificant reduction in mean bladder weight (68.1 ± 9.1 mg vs 93.2 ± 11.7 mg, P= 0.10), but a significant reduction in detrusor muscle thickness (median 2 vs 3, P= 0.02). Losartan did not mediate any significant structural or functional changes in the unobstructed mouse bladder.
CONCLUSION
In a mouse model of BOO, treatment with an AT‐1 antagonist partially prevented the urodynamic and structural changes that otherwise occur with BOO.
Ultrasound detection of white matter injury in very preterm neonates: practical implications
Authors: VAN WEZEL‐MEIJLER GERDA , DE BRUÏNE FRANCISCA T , STEGGERDA SYLKE J , VAN DEN BERG‐HUYSMANS ANNETTE , ZEILEMAKER SIJME , LEIJSER LARA M , VAN DER GROND JEROEN 
Published: September 2011

Aim  Diffuse white matter injury is not well detected by cranial ultrasonography (CUS). The aim of this study was twofold: (1) to assess in very preterm neonates the predictive values of individual CUS abnormalities for white matter injury on MRI and neurological outcome; (2) to develop a strategy optimizing CUS detection of white matter injury.Method  Very preterm neonates (n=67; 44 males, 23 females) underwent serial CUS and single MRI. Predictive values of CUS findings for a white matter classification on MRI, individual MRI findings, and neurological outcome at 2 years corrected age were calculated. The effects of timing and frequency of CUS were evaluated.Results  Periventricular echodensities (PVEs) predicted abnormal white matter on MRI, but absence of PVEs did not predict absence of white matter changes. Peri‐ and intraventricular haemorrhage (P/IVH) was highly predictive of abnormal white matter on MRI. Frequency and timing of CUS did not influence predictive values. P/IVH and abnormal ventricular size/shape were reasonably predictive of unfavourable outcome, whereas absence of CUS abnormalities predicted a favorable outcome.Interpretation  (1) If PVEs are present, there is a significant chance of abnormal white matter on MRI. (2) Increasing frequency of CUS does not increase its diagnostic performance for white matter injury. (3) P/IVH is highly predictive of abnormal white matter on MRI and reasonably predictive of unfavourable outcome. (4) Absence of PVEs and P/IVH on CUS does not guarantee normal white matter, but predicts a favourable outcome.
Neurodevelopmental outcome in preterm infants
Authors: BOS AREND F , ROZE ELISE 
Published: September 2011

Aim  To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon.Method  One hundred and six very preterm children (63 males, 43 females; gestational age 24.0–31.6wk; birthweight 480–2275g) were assessed for cognition and motor outcome at 6 to 12 years. We assessed total, verbal, and performance IQ using the Wechsler Intelligence Scale for Children, and motor outcome using the Movement Assessment Battery for Children (Movement ABC).Results  The IQs and Movement ABC z‐scores were normally distributed, but shifted to the left. Mean total IQ (SD) was 91 (12), performance IQ 89 (13), and verbal IQ 93 (15), being 0.60, 0.73, and 0.47 SD lower than the norm respectively. Movement ABC z‐scores were −1.27 SD lower (SD 1.01). IQ and Movement ABC z‐scores did not correlate with brain lesions or gestational age.Interpretation  The distribution curve for cognition and motor outcome at school age is shifted to the left in preterm children, with an effect size of 0.60 SD for IQ (nine IQ points) and 1.27 SD for motor outcome. These findings are restricted to the current group. Developmental disruptions, affecting cerebral white matter, cortex, cerebellum, and thalamus might be involved, although the exact pathogenetic mechanism is unclear.
Infant Motor Profile and cerebral palsy: promising associations
Authors: HEINEMAN KIRSTEN R , BOS AREND F , HADDERS‐ALGRA MIJNA 
Published: September 2011

Aim  The Infant Motor Profile (IMP) is a novel qualitative assessment of motor behaviour in infancy. The aim of this study was to determine whether IMP scores throughout infancy differ between children with and without cerebral palsy (CP) at 18 months. Furthermore, we evaluated the predictive ability of IMP scores throughout infancy for CP.Method  Fifty‐nine preterm (median gestational age 29.7wk, median birthweight 1285g) and 30 term infants (median gestational age 40.1wk, median birthweight 3588g) were included. IMP assessments were longitudinally performed at (corrected) ages of 4, 6, 10, and 12 months. Neurological outcome was determined at 18 months with the neurological examination according to Hempel. We compared total and domain IMP scores throughout infancy between infants with and without CP.Results  In the term group none of the children was diagnosed with CP at the age of 18 months, in the preterm group eight had CP at 18 months (14%). Three had unilateral spastic CP, and five bilateral spastic CP. Children with CP (n=8) at 18 months had lower IMP scores throughout infancy than children without. These differences were most pronounced for the domains variation and performance. The predictive ability of the total IMP scores throughout infancy for CP was high (area under receiver operating characteristic curve 0.89–0.99) and most pronounced for the variation and performance domains.Interpretation  IMP scores throughout infancy and CP at 18 months are strongly related. In particular, low scores on the variation and performance domains were important indicators for CP. To determine the exact predictive ability of the IMP, further research is needed.
The effects of preterm infant massage on brain electrical activity
Authors: GUZZETTA ANDREA , D’ACUNTO MARIA G , CAROTENUTO MARCO , BERARDI NICOLETTA , BANCALE ADA , BIAGIONI ENRICO , BOLDRINI ANTONIO , GHIRRI PAOLO , MAFFEI LAMBERTO , CIONI GIOVANNI 
Published: September 2011

Aim  Early intervention programmes based on the manipulation of the extra‐uterine environment have been used in preterm infants with the aim of improving development and functional outcome. Infant massage, among them, has proved effective for weight gain and reduced length of stay in the neonatal intensive care unit. We have recently shown that infant massage accelerates brain maturation of low‐risk preterm infants without brain abnormalities as measured by global parameters of electroencephalography (EEG) activity. In the present study we further analyse the same cohort of preterm infants, testing the hypothesis that massage determines changes in EEG spectral activity, a highly sensitive index of brain maturation.Method  Infants were randomly allocated to a massage or comparison group. Intervention consisted of standard care only (comparison group) or standard care plus infant massage (massage group). Massage was started at around 10 days after birth and was provided for 12 days during a 2‐week period. EEG was performed at around 1 and 4 weeks, i.e. before and after intervention. Spectral EEG analysis was performed on 80 seconds of active sleep, applying the fast Fourier transform on the signal obtained from eight monopolar derivations.Results  The modification in global EEG spectral power between the two assessments was significantly different for the two groups, especially for the delta band activity; the spectral power did not change in massaged infants although, not surprisingly, it decreased significantly in the comparison group, as shown by previous studies.Interpretation  We propose that massage intervention affects the maturation of brain electrical activity and favours a process more similar to that observed in utero in term infants.
Diplosegmentation in the pill millipedeGlomeris marginatais the result of dorsal fusion
Authors: Janssen Ralf 
Published: September 2011

SUMMARYAll trunk segments in the pill millipedeGlomeris marginata(Myriapoda:Diplopoda) are initially patterned genetically, (as visualized by the embryonic expression pattern of theeven‐skippedgene) and formed morphologically, (as visualized by 4‐6‐diamidin‐2‐phenylindol stained embryos) in a single segmental period. In addition, formation of every nascent trunk segment concerns ventral as well as dorsal segmental units. Only after the formation of the nascent posterior trunk segments, the dorsal segmental units of two adjacent segments fuse to form a single dorsal segmental unit that subsequently covers two ventral leg‐bearing segmental units. The formation of a diplosegmental unit, or in short a diplosegment, is thus the result of dorsal fusion of embryonic tissue and not the result of any splitting‐process or fusion of dorsal tergites. The new data also argue against heterochrony as a primary causative factor for the formation of the diplosegments during the formation of dorsal versus ventral segmental units. Furthermore, no evidence was found supporting the hypothesis that anterior trunk segments in diplopods represent degenerate diplosegments. Two possible scenarios arise from the ontogenetic data presented here, whether this represents an ancestral feature of the diplopods, or alternatively if they represent an isolated case only found inGlomeris(and close relatives). If the former is the case, my work may provide an impressive example ofHaeckel's recapitulation theory.
Association Between Serum Cholesterol and Noncardiovascular Mortality in Older Age
Authors: Newson Rachel S. , Felix Janine F. , Heeringa Jan , Hofman Albert , Witteman Jacqueline C. M. , Tiemeier Henning 
Published: September 2011

ObjectivesTo clarify the association between cholesterol and noncardiovascular mortality and to evaluate how this association varies across age groups.DesignProspective population‐based cohort study.SettingRotterdam, the Netherlands.ParticipantsAdults aged 55 to 99 (N = 5,750).MeasurementsParticipants were evaluated for total cholesterol and subfractions and followed for mortality for a median of 13.9 years. Total cholesterol and its subfractions were evaluated in relation to noncardiovascular mortality. Cox regression analyses were conducted in the total sample and within age‐groups (55–64, 65–74, 75–84, ≥85).ResultsAge‐ and sex‐adjusted analyses showed that each 1‐mmol/L increase in total cholesterol was associated with an approximately 12% lower risk of noncardiovascular mortality (hazard ratio (HR) = 0.88, 95% confidence interval (CI) = 0.84–0.92, P < .001). Age group–specific analyses demonstrated that this association reached significance after the age of 65 and increased in magnitude across each subsequent decade. This was driven largely by non‐high‐density lipoprotein cholesterol (non‐HDL‐C) (HR = 0.89, 95% CI 0.85–0.93, P < .001) and was partly attributable to cancer mortality. Conversely, HDL‐C was not significantly associated with noncardiovascular mortality (HR = 0.92, 95% CI 0.79–1.07, P = .26).ConclusionHigher total cholesterol was associated with a lower risk of noncardiovascular mortality in older adults. This association varied across the late‐life span and was stronger in older age groups. Further research is required to examine the mechanisms underlying this association.
Sugar consumption and preference among Mexican, Chinese, and Nigerian immigrants to Texas
Authors: Alonge Olusegun K. , Narendran Sena , Hobdell Martin H. , Bahl Saroj 
Published: September 2011

ABSTRACTThis pilot study investigated the relationship between sugar consumption/ preference and the length of residence in the U.S. among certain immigrant groups.The study sample consisted of 213 volunteers from community organizations and church groups, of Nigerian (45%), Mexican (31%), and Chinese (24%) descent. Data were collected on demographics, sugar consumption/preference (24‐hour dietary recall), and oral health status. The age of respondents varied from 18 to 93 years with a mean age of 37.0 ± 11.7 years. The mean length of residence was 9.2 ± 7.2 years, and the mean sugar consumption was 122.4 ± 114.6 g/day. Immigrants from Mexico and Nigeria reported consuming more servings of sweets per day than the Chinese (p= .006); Mexican immigrants had the highest level of sugar preference (p= .001). No significant differences were observed between the length of residence and either sugar consumption or sugar preference. Greater availability of sugar and sweet snacks does not always result in increased sugar consumption or sugar preference.
Parents’ perspectives on a dental home for children with special health care needs
Authors: Kagihara Lynette E. , Huebner Colleen E. , Mouradian Wendy E. , Milgrom Peter , Anderson Betsy A. 
Published: September 2011

ABSTRACTThe authors surveyed parent‐leaders about aspects of a dental home for children with special health care needs (CSHCN). State leaders in two advocacy groups completed the survey; the response rate was 70.6% of all states. Two of the most highly rated aspects of a dental home, endorsed as “essential” by 89% of respondents, pertained to dentist–parent interactions: the dentist listens carefully to the family, and the dentist helps the family feel like a partner in treatment decisions. Likewise, 89% said it was essential that insurance coverage allows the child to see needed providers. Dentists’ lack of knowledge or willingness to treat CSHCN and refusal of Medicaid insurance coverage were identified as major barriers to care. More than 84% of respondents reported that parents were unaware of the recommendation to establish dental care by 1 year of age. Establishing policy and educational strategies should help parents meet this dental health goal.
Efficacy and safety of recombinant tissue plasminogen activator and gas versus bevacizumab and gas for subretinal haemorrhage
Authors: Mayer Wolfgang J. , Hakim Imad , Haritoglou Christos , Gandorfer Arnd , Ulbig Michael , Kampik Anselm , Wolf Armin 
Published: September 2011

Abstract.Purpose:  To report the 12 months efficacy of initial intravitreal bevacizumab or intravitreal recombinant tissue plasminogen activator (rtPA) combined with expansile gas in patients with subretinal haemorrhage caused by neovascular age‐related macular degeneration (AMD).Methods:  Forty‐five eyes of 45 patients with subretinal haemorrhage (1–5 disc diameters) involving the fovea secondary to neovascular AMD were evaluated retrospectively consecutively. Thirty‐two eyes underwent treatment with rtPA (50 μg/0.05 ml) combined with intravitreal sulphur hexafluoride (SF6). The other 13 eyes were treated with bevacizumab (1.25 mg/0.05 ml) and SF6. Thereafter, all patients received Vascular Endothelial Growth Factor (anti‐VEGF) treatment according to modified PrONTO criteria. Main outcome was change of best‐corrected visual acuity (VA) at 12 months as determined by Early Treatment Diabetic Retinopathy (ETDRS).Results:  There was more improvement in patients initially treated with rtPA and gas (14 letters; bevacizumab and gas eight letters) and not suffering from adverse events. The incidence of vitreous haemorrhages was significantly higher in the rtPA group (nine of 32 versus one of 13, p < 0.01). In both groups, an average of 3.5 anti‐VEGF injections were performed per patient during 12 months (no difference between both groups).Conclusion:  Both initial treatment regimen lead to improved functional results after 1 year. However, patients, not suffering from adverse events, who underwent initial treatment with rtPA and gas showed better results. To maintain VA, controlling neovascular AMD by anti‐VEGF treatment regime after initial treatment with rtPA+gas is important for all cases.