bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upfront computed tomography scanning is more cost‐beneficial than empiric medical therapy in the initial management of chronic rhinosinusitis
Authors: Leung Randy , Kern Robert , Jordan Neil , Almassian Stella , Conley David , Tan Bruce K. , Chandra Rakesh 
Published: July 2011

AbstractBackground:Current treatment algorithms for patients with symptoms of chronic rhinosinusitis (CRS) recommend a trial of empiric medical therapy prior to obtaining a sinus computed tomography (CT) scan, even in cases of negative nasal endoscopy. This empiric approach evolved in an era when same day conventional CT was both impractical and economically irresponsible. The objective of this work was to determine whether upfront CT scanning is more cost‐beneficial than empiric medical therapy for patients presenting with CRS symptoms but negative endoscopic findings.Methods:A Markov economic model was employed. Medication costs, CT costs, treatment response rates, and treatment associated adverse event rates were included as model parameters. Treatment cost values were derived from Medicare.Results:There is a clear cost advantage to the upfront CT algorithm over empiric therapy regardless of the availability of point‐of‐care CT scanning (POC‐CT). This advantage persists during the sensitivity analysis when costs and response rates are fully biased toward empiric therapy. If POC‐CT is available, upfront CT can save $320.50 per patient (range, $138.5–671.5). When POC‐CT CT is unavailable, upfront CT savings persist at $296.60 (range, $106.09–655.40).Conclusion:In patients meeting symptom criteria for CRS but without endoscopic evidence of inflammation, upfront CT scanning is more cost‐beneficial than empiric medical therapy. Adopting upfront CT scanning can save the U.S. healthcare system $1.2 billion dollars per year. Further, POC‐CT can offer same day diagnosis, facilitate prompt treatment, and decrease unnecessary antibiotic prescriptions. © 2011 ARS‐AAOA, LLC.
Thermodynamics of noncovalent interactions in hydrophobically‐substituted water‐soluble polymers from intrinsic viscosity measurements: Application to nucleobase‐substituted pullulans
Authors: Molyneux Philip 
Published: July 2011

AbstractHydrophobically substituted water‐soluble polymers (HSWSP) act as associative thickeners through the reversible crosslinking from noncovalent interactions between the various groups on the polymer chains in aqueous solution. This article shows how the intrinsic viscosity (IV) of nonionic HSWSP can be used to define the thermodynamics of these interactions. Literature data on the IV of pullulans substituted by nucleobase ester groups (thyminylbutyryl and adeninylbutyryl) (Mocanu et al., Can J Chem, 1995, 73, 1933) are used as an exemplar of these procedures. The intramolecular crosslinking in these substituted pullulans is deduced to be “unimolecular” (association constant K1 = 1 M−1), as contrasted with the “bimolecular” behavior expected from the stacking of the free nucleobases; evidently the crosslinking results from hydrophobic interactions between the butyryl linking groups and the main chain. The results are compared with those from other HSWSP, and from cosolute binding systems. The use of the water–octanol partition coefficients of model systems to elucidate hydrophobic interactions in HSWSP, and of denaturant cosolutes (especially urea) to diagnose the presence and strength of these interactions, are also discussed. Emphasis is placed on the need for further such studies to identify the interactions underlying the rheological behavior of the nonionic HSWSP, and of the more common ionic types. © 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2011
The morphology and property of HDPE in the presence of oscillation pressure and poly(ethylene terephthalate)
Authors: Qian Xinyuan , Liu Hong , Liu Fanghui , Gao Xueqin , Zhang Jie 
Published: July 2011

AbstractThe injection‐molded specimens of neat HDPE and the PET/HDPE blends were prepared by conventional injection molding (CIM) and by pressure vibration injection molding (PVIM), respectively. The effect of oscillation pressure and PET phase with different shapes on superstructure and its crystal orientation distribution of injection molded samples were characterized by differential scanning calorimetry (DSC), scanning electron microscopy (SEM), and two‐dimension wide‐angle X‐ray diffraction techniques (2D‐WAXD). Hermans' orientation functions were determined from the wide‐angle X‐ray diffraction patterns. With the PET particles added, the shear viscosity of blend increase and crystallization rate of HDPE phase is enhanced. For the neat HDPE samples, with the promotion from oscillation shear, the orientation parameter experienced a large increase, moreover, the PVIM can induce transverse lamellae (kebabs) twisting in growth direction. Because of the redefined flow field and nucleation effect of PET particles, the crystal orientation of blend is also increased. So the tensile strength of vibration samples enhanced and elongation at break declined. © 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2011
Structural effects of N‐aromatic acyl‐amino acid conjugates on their deconjugation in the cecal contents of rats: implication in design of a colon‐specific prodrug with controlled conversion rate at the target site
Authors: Kong Hyesik , Kim Hyunjeong , Do Heejeong , Lee Yonghyun , Hong Sungchae , Yoon Jeong‐Hyun , Jung Yunjin , Kim Young Mi 
Published: July 2011

ABSTRACTN‐aromatic acyl‐amino acid conjugates possess a colon‐targeted property, implying that such conjugates are stable and are not absorbable until reaching the large intestine in which they are microbially converted (hydrolysed) to the parent drugs that are therapeutically active. To investigate the structural effect of N‐aromatic acyl‐amino acid conjugates on the large intestinal deconjugation, the hydrolysis of various N‐aromatic acyl‐amino acid conjugates was examined in the cecal contents. On incubation of conjugates with glycine,d or/andl forms of alanine or phenylalanine in the cecal contents, the conjugates withd amino acids were not hydrolysed. The other conjugates are susceptible to the hydrolysis, the rates of which decreased as the size of the substituent on the 2‐position of the amino acids increased. The conjugates with alkyl analogs (2–4 carbons) of glycine and taurine were resistant to the hydrolysis, while taurine‐ and glycine‐conjugates were hydrolysed effectively. The hydrolysis of N‐aromatic acyl‐glycine conjugates was enhanced by para‐substitution of electron withdrawing groups on the aromatic acyl moiety and vice versa for electron‐donating groups. While a methyl, methoxy or chloro group on the ortho‐position retarded the hydrolysis, a hydroxyl group on the position accelerated it. Our data may provide useful information for the design of a colon‐specific prodrug with controlled conversion rate in the large intestine. Copyright © 2011 John Wiley & Sons, Ltd.
DNA Recognition by Synthetic Constructs
Authors: Pazos Elena , Mosquera Jesús , Vázquez M. Eugenio , Mascareñas José L. 
Published: July 2011

AbstractThe interaction of transcription factors with specific DNA sites is key for the regulation of gene expression. Despite the availability of a large body of structural data on protein–DNA complexes, we are still far from fully understanding the molecular and biophysical bases underlying such interactions. Therefore, the development of non‐natural agents that can reproduce the DNA‐recognition properties of natural transcription factors remains a major and challenging goal in chemical biology. In this review we summarize the basics of double‐stranded DNA recognition by transcription factors, and describe recent developments in the design and preparation of synthetic DNA binders. We mainly focus on synthetic peptides that have been designed by following the DNA interaction of natural proteins, and we discuss how the tools of organic synthesis can be used to make artificial constructs equipped with functionalities that introduce additional properties to the recognition process, such as sensing and controllability.
Resolute italian study in all comers
Authors: Romagnoli Enrico , Godino Cosmo , Ielasi Alfonso , Gasparini Gabriele , Tzifos Vaios , Sciahbasi Alessandro , Lioy Ernesto , Presbitero Patrizia , Colombo Antonio , Sangiorgi Giuseppe 
Published: July 2011

AbstractObjectives: To assess clinical performance of the second‐generation Endeavor Resolute® drug‐eluting stents (DES) in an unrestricted high‐risk cohort of patients. Background: New‐generation DESs aim to further increase its clinical safety and efficacy by means of more biocompatible components limiting inflammatory response, assuring strut coverage and preserving endothelial vascular function. Methods: Between January 2008 and April 2009 820 unselected consecutive high‐risk patients (1,352 lesions) treated with the Endeavor Resolute® stent were enrolled in an independent multicenter registry. Primary end‐points of this registry were immediate procedural outcome, incidence of target lesion failure (TLF, defined as composite of cardiac death, myocardial infarction, and target lesion revascularization) and rate of ARC stent thrombosis at 12‐months follow‐up. Results: High‐risk patient/lesion profile included acute coronary syndrome diagnosis in 57% of patients, diabetes mellitus in 23% and ACC/AHA type B2/C lesion in 74%. Endeavor Resolute® stent was used in an off‐label indication in 52% of cases with stent/patient ratio of 1.93 and average stented segment of 39.8±26.6mm. Immediate procedural success was accomplished in 96.0% of cases and at median 12‐month follow‐up TLF rate was 7.1% with 4.0% of clinically driven repeat revascularizations and 1.1% of definite/probable stent thrombosis incidence. At multivariable analysis, nor off‐label Endeavor Resolute® stent use or multiple stent implantations were associated to an increased risk of adverse events. Conclusions: Extensive use of the new Endeavor Resolute® stent was associated with favorable procedural and 12‐month outcomes despite the treatment of unselected complex clinical and anatomical presentation. Endeavor Resolute® stent showed excellent safety and efficacy profile also in off‐label indications. © 2011 Wiley Periodicals, Inc.
Recanalization of calcified left anterior descending artery chronic total occlusion with rotational atherectomy via bilateral radial approach
Authors: Fang Hsiu‐Yu , Wu Chiung‐Jen 
Published: July 2011

AbstractA 79‐year‐old female was admitted to the hospital complaining of frequent chest pain. She was diagnosed with a non‐ST segment elevation myocardial infarction. A thallium scan, echocardiogram, and angiography showed a left anterior descending artery chronic total occlusion. Externalization of retrograde wire was performed and replaced with a rota‐floppy wire. Rotational atherectomy using a bilateral radial artery approach recanalized the lesion. The patient was discharged uneventfully 7 days post‐PCI and remained asymptomatic at follow up 8 months postprocedure. © 2011 Wiley Periodicals, Inc.
A comparative analysis of major clinical outcomes using drug‐eluting stents versus bare metal stents in diabetic versus nondiabetic patients
Authors: Minha Sa'ar , Bental Tamir , Assali Abid , Vaknin‐Assa Hana , Lev Eli I. , Rechavia Eldad , Battler Alexander , Kornowski Ran 
Published: July 2011

AbstractObjectives: We aim to explore the clinical outcome of drug‐eluting stents (DES) versus bare‐metal stents (BMS) implantation in diabetics versus nondiabetic patients. Background: Diabetic patients sustain worse long‐term clinical outcomes after percutaneous coronary interventions (PCI) when compared with nondiabetics. The use of DES decreases the rate of repeat revascularization in this population but data concerning long‐term clinical benefits, such as myocardial infarction (MI) or mortality is scant. Methods: We analyzed data from a comprehensive registry of 6,583 consecutive patients undergoing PCI at our center. A propensity score was used for analysis of outcomes and for matching (DES vs. BMS). Outcome parameters were total mortality, MI, repeat target vessel revascularization (TVR) rates, and risk‐adjusted event‐free survival. Within this cohort, we identified 2,571 nondiabetic patients and these were compared with 1,826 diabetic coronary patients. Results: Mean and median follow up time was 3 and 3.25 years, respectively. Overall, diabetics had higher rates of major‐adverse cardiovascular events (MACE) at 4 years compared with nondiabetics (23.03 vs. 31.96 P > 0.001). DES use was associated with lower rates of TVR in both groups [diabetics hazard ratio (HR) = 0.56, 95% confidence interval (CI): 0.42–0.76, P < 0.001, nondiabetics HR = 0.73, 95% CI: 0.55–0.97, P = 0.03] while sustained decreased rates of both mortality and MI were evident solely among diabetics (HR = 0.71, 95% CI: 0.56–0.89, P = 0.004 in diabetic vs. HR = 0.88, 95% CI: 0.69–1.13, P = 0.3). Conclusions: In a “real‐world,” unselected population and extended clinical use, DES in diabetics was associated with sustained decreased rates of MI, death, TVR, and MACE while this benefit was attenuated in the nondiabetic population. © 2011 Wiley‐Liss, Inc.
Timing of the restenosis following nitinol stenting in the superficial femoral artery and the factors associated with early and late restenoses
Authors: Iida Osamu , Uematsu Masaaki , Soga Yoshimitsu , Hirano Keisuke , Suzuki Kenji , Yokoi Hiroyoshi , Muramatsu Toshiya , Inoue Naoto , Nanto Shinsuke , Nagata Seiki 
Published: July 2011

AbstractObjectives: We sought to investigate the timing of restenosis and the restenosis factors following nitinol stenting in the superficial femoral artery (SFA). Background: Restenosis following nitinol stenting in the SFA remains unsolved. Methods: We analyzed 742 limbs in consecutive 585 patients who underwent successful endovascular therapy for de novo SFA lesions. Patency was assessed by duplex ultrasonography. Primary patency was defined as treated vessels without restenosis and secondary patency was defined as target vessels reopened by repeat revascularization. Receiver‐operating characteristic (ROC) analysis was performed to delineate the timing of restenosis. Patients were subsequently classified into three groups: no restenosis, early restenosis, and late restenosis. Cox proportional hazard regression analyses were performed to explore the determinants of restenosis in each restenosis group. Results: Primary and secondary patency was 67 and 86% at 6 years, respectively. ROC curves indicated the 369th day was the best cutoff point distinguishing the early (144 limbs) and the late (42 limbs) restenoses. Sustained patency was observed in 556 limbs. After multivariate analysis, cilostazol (P = 0.0007) was negatively associated; female gender (P = 0.0071), diabetes mellitus (P = 0.0428), critical limb ischemia (P = 0.0435), and stent fracture (P = 0.0004) were positively associated with the early restenosis. Trans Atlantic Inter‐Society Consensus II C/D was positively associated with both the early (P = 0.0017) and the late (P = 0.0359) restenoses. Conclusions: Restenosis predominantly occurred within a year following nitinol stenting in the SFA, and the factors associated with the early restenosis were different from those with the late restenosis. © 2011 Wiley‐Liss, Inc.
Preprocedural hemoglobin predicts mortality following peripheral vascular interventions
Authors: Jaffery Zehra , Shamai Lior , White Christopher J. 
Published: July 2011

AbstractBackground: Serum hemoglobin (H) level is a well‐known predictor of all‐cause mortality in patients undergoing percutaneous coronary interventions but has not been studied in patients undergoing peripheral vascular interventions (PVI). We sought to determine the prognostic significance of serum H in patients undergoing PVI. Methods: We identified 346 consecutive patients undergoing PVI who had a documented a baseline and a postprocedural serum H level over a 33‐month period. A multivariate analysis of predictors of 9‐month mortality was performed. Results: Of 346 patients identified, there were 28 deaths (8.1%) over a 9‐month follow‐up period. Periprocedural H change was not associated with death [OR: 1.12 (95% CI: 0.71–1.79), P = NS]. In a multivariate model independent predictors of all‐cause mortality were clinical bleeding [OR: 10.7 (95% CI: 0.012–0.769), P = 0.026], emergency intervention [OR: 4.5 (95% CI: 0.07–0.71), P = 0.011], ejection fraction [OR: 1.02 (95% CI: 1.01–1.05), P = 0.020], and preprocedural H [OR: 1.56 (95% CI: 1.19–2.04) P = 0.001]. Conclusion: In patients undergoing PVI, preprocedural H was a significant predictor of 9‐month all‐cause mortality. The highest mortality rate was seen in patients with a preprocedural H level ≤ 10 g/dl. Preprocedural H level can be used in clinical practice to risk stratify patients being considered for PVI. Further investigation is needed to assess if optimization of H level preprocedure improves midterm mortality. © 2011 Wiley‐Liss, Inc.
Successful treatment for refractory coronary thrombus with scoring balloon angioplasty
Authors: Hosokawa Yusuke , Tanaka Keiji , Mizuno Kyoichi 
Published: July 2011

AbstractA female with chronic atrial fibrillation presented with an acute myocardial infarction. The angiogram revealed total occlusion of the right coronary artery. A combined strategy using intracoronary thrombolysis, aspiration catheter, plain old balloon angioplasty, and “Fogarty‐like” procedure was performed. However, we failed to achieve good coronary flow because the thrombus was large and hard with a calcified surface revealed by intravascular ultrasound examination. Ultimately, compression of the thrombus with the AngioSculpt™ scoring balloon catheter (AngioScore, Fremont, CA) led to resolution of normal coronary flow without the need for implantation of a coronary stent. Calcified thrombus is rarely observed in a coronary artery embolism, especially one formed in the left atrial appendage. In this case, the AngioSculpt scoring balloon catheter shows efficacy in treating this calcified thrombus. © 2011 Wiley Periodicals, Inc.
Protein‐losing enteropathy resolved by percutaneous intervention
Authors: Butera Gianfranco , Marini Davide , MacDonald Simon T. 
Published: July 2011

AbstractThe extracardiac total cavopulmonary connection is the final stage of palliation of hearts with single‐ventricle physiology. Protein‐losing enteropathy (PLE) and plastic bronchitis are catastrophic sequale that may occur in patients with the total cavopulmonary connection and may complicate the early and long‐term follow‐up. Here we report on the successful treatment of a 16‐year boy affected by PLE by percutaneous closure of a persistent anterograde pulmonary blood flow by using an 8‐mm Amplatzer VSD Occluder. © 2011 Wiley‐Liss, Inc.
Qualitative comparison of coronary angiograms between 4 french catheters with an Advanced Cardiovascular Injection System and 6 french catheters with manual injection
Authors: Gonzalez Manuel A. , Ben‐Dor Itsik , Gaglia Michael A. , Torguson Rebecca , Shimellis Hirity , Bui Anh , Suddath William O. , Pichard Augusto D. , Satler Lowell F. , Waksman Ron 
Published: July 2011

AbstractObjectives: This study aimed to test whether advanced cardiovascular injection (ACI) via 4 French (Fr) catheters is more advantageous than manual injection with 6 Fr catheters. Background: For coronary angiography, proponents of contrast media ACI believe it utilizes smaller‐diameter catheters when compared with manual injection, without compromising the quality of the angiogram, and has the potential to reduce the amount of contrast used and lessen the use of closure devices. Methods: In a prospective study, 200 consecutive patients referred for elective coronary angiography were randomized to standard 6 Fr catheters with manual injection versus 4 Fr catheters with ACI. The study's primary endpoint is the quality of the coronary angiogram. Secondary endpoints include groin complications, utilization of closure devices, and volume of contrast media. Thirty‐six patients who underwent ad hoc percutaneous coronary intervention were excluded from the analysis. Results: The final analysis included 80 patients treated with 4 Fr catheters with ACI and 84 patients treated with 6 Fr catheters with manual injection. The groups had similar demographic and clinical characteristics. The quality of the angiogram was similar between groups with the exception of more left coronary sinus flush with 4 Fr catheters (3.57 ± 1.1 vs. 2.98 ± 0.9, P < 0.001) and less closure device use with 4 Fr (25 vs. 71.4%, P < 0.01) compared to 6 Fr catheters. The procedure duration, volume of contrast used, vascular complications, and time to ambulation were similar between groups (all P > 0.05). Conclusions: 4 Fr diagnostic catheters with ACI offer similar quality coronary angiograms, similar rates of vascular complications, procedure duration, contrast used, and time to ambulation, but have a significantly lesser need for closure devices compared to the 6 Fr system with manual injection. © 2011 Wiley‐Liss, Inc.
Assessment of macro‐ and microcirculation in contemporary critical limb ischemia
Authors: Kawarada Osami , Yokoi Yoshiaki , Higashimori Akihiro , Waratani Naoto , Fujihara Masahiko , Kume Teruyoshi , Sakata Kenji , Honda Yasuhiro , Fitzgerald Peter J. 
Published: July 2011

AbstractObjectives: A paucity of data exists regarding manifestations of macro‐ and microcirculation in contemporary critical limb ischemia (CLI). The aim of this study was (1) to evaluate the differences in foot circulation based on angiographic findings, (2) to clarify the relationship between macro‐ and microcirculation, and (3) to investigate the effects of postural changes on micro as well as macrocirculation between the supine position to the dependent position. Methods: A total of 40 critically ischemic limbs in 29 patients were included in this study. Noninvasive evaluation of macrocirculation, based on the ankle brachial index (ABI) and ankle pressure, and microcirculation, using skin perfusion pressure (SPP), was performed in both the supine and dependent positions. Results: There was no significant difference in macro‐ and microcirculations between any angiographical involvements. In the supine position, dorsal SPP correlated significantly with ABI (P = 0.021, r = 0.363) and ankle‐pressure (P = 0.001, r = 0.495), whereas plantar SPP failed to correlate with ABI (P = 0.198, r = 0.208) or ankle‐pressure (P = 0.185, r = 0.214). In the dependent position, however, SPP showed no significant correlation with ABI and ankle pressure. Postural change from the supine to dependent position yielded a significant increase in SPP (dorsal: 37.2 ± 16.2 to 77.9 ± 17.7 mm Hg, P < 0.001; plantar: 33.6 ± 17.3 to 75.7 ± 18.3 mm Hg, P < 0.001) as well as ABI and ankle‐pressure (ABI: 0.70 ± 0.35 to 0.78 ± 0.42, P = 0.003; ankle‐pressure; 108 ± 61 to 111 ± 60 mm Hg, P = 0.038). The effect of postural change on SPP showed no difference between patients with and without any clinical and angiographical complications. Conclusions: Of microcirculation assessed, only dorsal SPP correlated significantly with macrocirculation in the supine position. Furthermore, postural change from the supine to dependent position produced a dramatic improvement in microcirculation due to the effects of gravity. © 2011 Wiley Periodicals, Inc.