bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reuse of ventricular drain sites for cerebrospinal fluid shunting in patients with no prior infection
Authors: Winston Ken R. , Bhardwaj Vinay 
Published: April 2010

Object
The safety of reusing ventricular drain sites for shunting CSF in patients with no history of infection involving either the ventricular drain or the CSF was the focus of this investigation.

Methods
Prospectively accrued clinical data on all patients who, in an 8-year span ending in June 2008, underwent external ventricular drain placement and subsequently required CSF shunts were retrospectively evaluated for evidence of shunt infection and other complications.

Results
The infection rate for 50 consecutive operations in 50 patients who met the inclusion criteria was 2.0%.

Conclusions
Data from this study support the position that the reuse of ventriculostomy tracts when implanting first-time CSF shunts is, with regard to the risk of infection, a safe practice and avoids all risks associated with making a new ventricular entry.
Navigated endoscopic surgery for multiloculated hydrocephalus in children
Authors: Schulz Matthias , Bohner Georg , Knaus Hannah , Haberl Hannes , Thomale Ulrich-Wilhelm 
Published: April 2010

Object
Multiloculated hydrocephalus remains a challenging condition to treat in the pediatric hydrocephalic population. In a retrospective study, the authors reviewed their experience with navigated endoscopy to treat multiloculated hydrocephalus in children.

Methods
Between April 2004 and September 2008, navigated endoscopic procedures were performed in 16 children with multiloculated hydrocephalus (median age 8 months, mean age 16.1 ± 23.3 months). In all patients preoperative MR imaging was used for planning entry sites and trajectories of the endoscopic approach for cyst perforation and catheter positioning. Intraoperatively, a rigid endoscope was tracked by the navigation system. For all children the total number of operative procedures, navigated endoscopic procedures, implanted ventricular catheters, and drained compartments were recorded. In addition, postoperative complications and radiological follow-up data were analyzed.

Results
In 16 children, a total of 91 procedures were performed to treat multiloculated hydrocephalus, including 29 navigated endoscopic surgeries. Finally, 21 navigated procedures involved 1 ventricular catheter and 8 involved 2 catheters for CSF diversion via the shunt. The average number of drained compartments in a shunt was 3.6 ± 1.7 (range 2–9 compartments). In 9 patients (56%) a navigated endoscopic procedure constituted the last procedure within the follow-up period. One additional surgery was necessary in 3 patients (19%) after navigated endoscopy, and in 4 patients (25%) 2 further procedures were necessary after navigated endoscopy. Serial follow-up MR imaging demonstrated evidence of sufficient CSF diversion in all patients.

Conclusions
Navigated endoscopic surgery is a safe and effective treatment option for multiloculated hydrocephalus. The combination of the endoscopic approach and neuronavigation further refines preoperative planning and intraoperative orientation. The aim of treatment is to drain as many compartments as possible and as soon as possible, thereby establishing sufficient CSF drainage with few ventricular catheters in single shunt systems. Close clinical and radiological follow-up is mandatory because multiple revisions are likely.
Clinical impact of integrating positron emission tomography during surgery in 85 children with brain tumors
Authors: Pirotte Benoit J. M. , Lubansu Alphonse , Massager Nicolas , Wikler David , Van Bogaert Patrick , Levivier Marc , Brotchi Jacques , Goldman Serge 
Published: April 2010

Object
In this paper, the authors' goal was to evaluate the impact of PET information on brain tumor surgery in children.

Methods
Between 1995 and 2007, 442 children were referred to the authors' institution for a newly diagnosed brain lesion. Of these, 85 were studied with FDG-PET and/or L-(methyl-11C)-methionine –PET in cases in which MR images were unable to assist in selecting accurate biopsy targets (35 patients) or to delineate tumors for maximal resection (50 patients). In surgical cases, PET and MR images were combined in image fusion planning for stereotactic biopsies or navigation-based resections. The preoperative planning images were compared postoperatively with MR imaging and PET findings and histological data for evaluating the clinical impact on the diagnostic yield and tumor resection.

Results
The PET data influenced surgical decisions or procedures in all cases. The use of PET helped to better differentiate indolent from active components in complex lesions (in 12 patients); improved target selection and diagnostic yield of stereotactic biopsies without increasing the sampling; provided additional prognostic information; reduced the amount of tissue needed for biopsy sampling in brainstem lesions (in 20 cases); better delineated lesions that were poorly delineated on MR imaging and that infiltrated functional cortex (in 50 cases); significantly increased the amount of tumor tissue removed in cases in which total resection influenced survival (in 20 cases); guided resection in hypermetabolic areas (in 15 cases); improved early postoperative detection of residual tumor (in 20 cases); avoided unnecessary reoperation (in 5 cases); and supported the decision to undertake early second-look resection (in 8 cases).

Conclusions
The authors found that PET has a significant impact on the surgical decisions and procedures for managing pediatric brain tumors. Further studies may demonstrate whether PET improves outcomes in children.
Stereotactic radiosurgery for deep-seated cavernous malformations: a move toward more active, early intervention
Authors: Nagy Gábor , Razak Adam , Rowe Jeremy G. , Hodgson Timothy J. , Coley Stuart C. , Radatz Matthias W. R. , Patel Umang J. , Kemeny Andras A. 
Published: April 2010

Object
The role of radiosurgery in the treatment of cavernous malformations (CMs) remains controversial. It is frequently recommended only for inoperable lesions that have bled at least twice. Rehemorrhage can carry a substantial risk of morbidity, however. The authors reviewed their practice of treating deep-seated inoperable CMs to assess the complication rate of radiosurgery, the impact that radiosurgery might have on rebleeding, and whether a more active, earlier intervention is justified in managing this condition.

Methods
The authors performed a retrospective analysis of 113 patients with 79 brainstem and 39 thalamic/basal ganglia CMs treated with Gamma Knife surgery. Lesions were stratified into 2 groups: those that might be lower risk with no more than 1 symptomatic bleed before radiosurgical treatment and those deemed high risk with multiple symptomatic hemorrhages before treatment.

Results
Forty-one CMs had multiple symptomatic hemorrhages before radiosurgery with a first-ever bleed rate of 2.9% per lesion per year, a rebleed rate of 30.5% per lesion per year, and a median time of 1.5 years between the first and second bleeds. In this group the rebleed rate decreased to 15% for the first 2 years after radiosurgery and declined further to 2.4% thereafter. Pretreatment multiple bleeds led to persistent deficits in 72% of the patients.
Seventy-seven CMs had no more than 1 symptomatic bleed before radiosurgery, making for a lifetime bleed rate of 2.2% per lesion per year. The short period between the presenting bleed and treatment (median 1 year) makes the natural history in this group uncertain. The rate of hemorrhage in the first 2 years after treatment was 5.1%, and 1.3% thereafter. Pretreatment hemorrhages resulted in permanent deficits in 43% of the patients in this group, a rate significantly lower than in the multiple-bleeds group (p < 0.001).
Posttreatment hemorrhages led to persistent deficits in only 7.3% of the patients. Permanent adverse radiation effects were rare (7.3%) and minor in both groups.

Conclusions
Stereotactic radiosurgery is a safe management strategy for CMs in eloquent sites with the marked advantage of reducing rebleed risks in patients with repeated pretreatment hemorrhages. The benefit in treating CMs with a single bleed is less clear. Note, however, that repeated hemorrhage carries a significant risk of increased morbidity far in excess of any radiosurgery-related morbidity, and the authors assert that this finding justifies the early active management of deep-seated CMs.
Stereotactic radiosurgery for intractable cluster headache: an initial report from the North American Gamma Knife Consortium
Authors: Kano Hideyuki , Kondziolka Douglas , Mathieu David , Stafford Scott L. , Flannery Thomas J. , Niranjan Ajay , Pollock Bruce E. , Kaufmann Anthony M. , Flickinger John C. , Lunsford L. Dade 
Published: April 2010

Object
The aim of this study was to evaluate the outcomes of Gamma Knife surgery (GKS) when used for patients with intractable cluster headache (CH).

Methods
Four participating centers of the North American Gamma Knife Consortium identified 17 patients who underwent GKS for intractable CH between 1996 and 2008. The median patient age was 47 years (range 26–83 years). The median duration of pain before GKS was 10 years (range 1.3–40 years). Seven patients underwent unsuccessful prior surgical procedures, including microvascular decompression (2 patients), microvascular decompression with glycerol rhizotomy (2 patients), deep brain stimulation (1 patient), trigeminal ganglion stimulation (1 patient), and prior GKS (1 patient). Fourteen patients had associated autonomic symptoms. The radiosurgical target was the trigeminal nerve (TN) root and the sphenopalatine ganglion (SPG) in 8 patients, only the TN in 8 patients, and only the SPG in 1 patient. The median maximum TN and SPG dose was 80 Gy.

Results
Favorable pain relief (Barrow Neurological Institute Grades I–IIIb) was achieved and maintained in 10 (59%) of 17 patients at a median follow-up of 34 months. Three patients required additional procedures (repeat GKS in 2 patients, hypothalamic deep brain stimulation in 1 patient). Eight (50%) of 16 patients who had their TN irradiated developed facial sensory dysfunction after GKS.

Conclusions
Gamma Knife surgery for intractable, medically refractory CH provided lasting pain reduction in approximately 60% of patients, but was associated with a significantly greater chance of facial sensory disturbances than GKS used for trigeminal neuralgia.
A prospective, multicenter, randomized trial of the Onyx liquid embolic system and N-butyl cyanoacrylate embolization of cerebral arteriovenous malformations
Authors: Loh Yince , Duckwiler Gary R. 
Published: April 2010

Object
The Onyx liquid embolic system (Onyx) was approved in the European Union in 1999 for embolization of lesions in the intracranial and peripheral vasculature, including brain arteriovenous malformations (AVMs) and hypervascular tumors. In 2001 a prospective, equivalence, multicenter, randomized controlled trial was initiated to support a submission for FDA approval. The objective of this study was to verify the safety and efficacy of Onyx compared with N-butyl cyanoacrylate (NBCA) for the presurgical treatment of brain AVMs.

Methods
One hundred seventeen patients with brain AVMs were treated with either Onyx (54 patients) or NBCA (63 patients) for presurgical endovascular embolization between May 2001 and April 2003. The primary end point was technical success in achieving ≥ 50% reduction in AVM volume. Secondary end points were operative blood loss and resection time. All adverse events (AEs) were reported and assigned a relationship to the Onyx or NBCA system, treatment, disease, surgery, or other/unknown. The Data Safety Monitoring Board adjudicated AEs, and a blinded, independent core lab assessed volume measurements. Patients were monitored through discharge after the final surgery or through a 3- and/or 12-month follow-up if resection had not been performed or was incomplete.

Results
The use of Onyx led to ≥ 50% AVM volume reduction in 96% of cases versus 85% for NBCA (p = not significant). The secondary end points of resection time and blood loss were similar. Serious AEs were also similar between the 2 treatment groups.

Conclusions
Onyx is equivalent to NBCA in safety and efficacy as a preoperative embolic agent in reducing brain AVM volume by at least 50%.
Radiographic severity of Rheumatoid Arthritis in African Americans: Results from a multicenter observational study
Authors: Bridges S. Louis , Causey Zenoria L. , Burgos Paula I. , Huynh B. Quynh N. , Hughes Laura B. , Danila Maria I. , van Everdingen Amalia , Ledbetter Stephanie , Conn Doyt L. , Tamhane Ashutosh , Westfall Andrew O. , Jonas Beth L. , Callahan Leigh F. , Smith Edwin A. , Brasington Richard , Moreland Larry W. , Alarcón Graciela S. , van der Heijde Désirée M. 
Published: April 2010

AbstractObjectiveTo describe radiographic changes in African Americans with rheumatoid arthritis (RA) from the Consortium for the Longitudinal Evaluations of African Americans with Early Rheumatoid Arthritis (CLEAR) Registry, a multicenter observational study.MethodsSelf‐declared African American patients were enrolled in CLEAR I, a longitudinal cohort of early RA (disease duration of <2 years) from 2000 to 2005, or in CLEAR II, a cross‐sectional cohort (any disease duration) from 2006 to the present. Demographic and clinical data were obtained, and sets of hand/wrist and foot radiographs were scored using the modified Sharp/van der Heijde scoring system.ResultsA total of 357 and 418 patients were enrolled in CLEAR I and CLEAR II, respectively. We report here an interim analysis of radiographic severity in these patients. For the CLEAR I cohort, 294 patients had a mean radiographic score of 2.89 at the baseline visit; 32.0% showed either erosions (25.9%) or joint space narrowing (JSN; 19.4%). At the 36‐month visit, the mean score was 5.65; 44.2% had erosions, 41.5% had JSN, and 54.4% had either. Among those patients without radiographic damage at baseline, 18.9% had progressed at the 36‐month visit, compared with 57.1% of those with baseline damage (P < 0.0001). For the CLEAR II cohort, of 167 patients with RA of any duration, 65.3% exhibited joint erosions, 65.3% exhibited JSN, and 74.8% exhibited either. The mean radiographic score was 33.42.ConclusionTo our knowledge, this is the largest radiographic study of African American RA patients. Damage occurs early in the disease and is associated with radiographic progression at 3 years of disease duration. The CLEAR Registry will provide a valuable resource for future analyses of genetic, clinical, and environmental factors associated with radiographic severity of RA in African Americans.
Rheumatologists' awareness of and screening practices for Hepatitis B virus infection prior to initiating immunomodulatory therapy
Authors: Stine Jonathan G. , Khokhar Omar S. , Charalambopoulos John , Shanmugam Victoria K. , Lewis James H. 
Published: April 2010

AbstractObjectiveTo assess the degree of awareness of the American College of Rheumatology (ACR) guidelines and package insert information on the screening for and management of hepatitis B virus (HBV) infection by rheumatologists in patients receiving immunomodulation drug therapies.MethodA questionnaire survey was administered to a nationwide sample of 1,000 members of the ACR. Each participating physician answered questions regarding their awareness of the risk of HBV reactivation, familiarity with published guidelines regarding HBV reactivation, their decision process in screening patients for HBV, knowledge of antiviral treatments for HBV, personal experience with HBV reactivation, and preferred approach to prophylaxis and subsequent monitoring of those patients.ResultsResponses were highly variable with regard to awareness, screening, and treatment options. The overall response rate was 15.3%. Of those surveyed, 7.4% had seen HBV reactivation. Depending on the agent, 19–53% were aware of manufacturers' warnings for HBV reactivation within drug package inserts. Nearly three‐quarters (72%) would screen for HBV reactivation regardless of the presence/absence of manufacturers' warnings. Only 69% reported performing universal screening prior to initiating therapy with biologic disease‐modifying antirheumatic drugs. The majority (81%) would defer to a gastroenterologist/hepatologist to determine prophylactic therapy for HBV. Only 22% had managed patients who were given prophylaxis against HBV reactivation while receiving immunosuppressants.ConclusionBased on this survey, improving education among rheumatologists regarding the risks of HBV reactivation and its prevention for patients receiving immunosuppressants seems warranted. More specific consensus guidelines are recommended to achieve universal screening as the standard of care in these patients, especially with the increasing prevalence of HBV infection estimated in the US.
Improving the quality of industry and occupation data at a central cancer registry
Authors: Armenti Karla R. , Celaya Maria O. , Cherala Sai , Riddle Bruce , Schumacher Pamela K. , Rees Judy R. 
Published: April 2010

AbstractBackgroundCentral cancer registries are required to collect industry and occupation (I/O) information when available, but the data reported are often incomplete.MethodsWe audited the completeness of I/O data in the New Hampshire State Cancer Registry (NHSCR) database for diagnosis year 2005, and reviewed medical records for a convenience sample of 474 of these cases. We compared I/O data quality before and after a statewide registrar training session on occupationally related cancers.ResultsThe original 2005 data contained both I/O data in 11.5% of cases, and lacked any I/O data in 74.5%. Corresponding figures for cases selected for audit were 15.2% and 77.2%, which improved to 54.2% and 11.8% after medical record review. After registrar training, 47% of reports contained both I/O data, and only 14.4% of cases lacked any I/O data.ConclusionsStatewide training to highlight the importance of I/O data is an effective method to improve I/O data quality. Am. J. Ind. Med. 53:995–1001, 2010. © 2010 Wiley‐Liss, Inc.
The effectiveness of intergroup contact at work: Mediators and moderators of hospital workers' prejudice towards immigrants
Authors: Pagotto Lisa , Voci Alberto , Maculan Valentina 
Published: April 2010

AbstractThe present research examines the effectiveness of intergroup contact between 167 Italian hospital workers and foreign patients in reducing prejudice towards immigrants in general. The outcomes of contact at work were analysed controlling for the influence of contact outside the workplace and through mass media, and taking into account the role of empathy, anxiety and group membership salience. Results indicate that the beneficial effects of contact at work were partially mediated by increased empathy and reduced anxiety, experienced both in the work environment and towards immigrants in general. Finally, high levels of group membership salience facilitated the influence of contact on intergroup emotions. These findings show that contact at work can be a powerful means to reduce prejudice, thanks to its capacity to evoke changes in affective responses. Copyright © 2010 John Wiley & Sons, Ltd.
Political accountability, public constitution of recent past and the collective memory of socio‐political events: A discursive analysis
Authors: Tileagă Cristian 
Published: April 2010

AbstractThis paper presents a discursive analysis of a political news interview as a site for the interactional organization of the public constitution of recent past. In a context of commemoration and finding out the truth about the past, the focus is on how the collective memory of socio‐political events and political accountability is managed and what discursive practices representatives of nation‐states draw upon to understand and construct ideological representations of socio‐political events, namely the Romanian ‘revolution’ of 1989. The analysis shows how the possibilityversusthe actuality of knowing the truth about the events, (political) accountability and stake for actions are discussed, framed and given significance by constituting the ‘events’ of 1989as‘revolution’. The analysis further reveals how this ascribed categorial meaning is used by the interviewee as background for delegitimizing critical voices and sidestepping responsibility for past actions and knowing the truth. Social and community psychologists can learn more about how individuals and communities construct ideological versions of socio‐political events by considering the interplay between questions of political accountability and arguments over the meaning of political categories, and engaging with the accounting practices in which themeaningof socio‐political events is being negotiated by members of society Copyright © 2010 John Wiley & Sons, Ltd.
Modulating the Substrate Specificity of LTA4H Aminopeptidase by Using Chemical Compounds and Small‐Molecule‐Guided Mutagenesis
Authors: Jiang Xiaolu , Zhou Lu , Wu Yiran , Wei Dengguo , Sun Chunyi , Jia Jia , Liu Ying , Lai Luhua 
Published: April 2010

AbstractLeukotriene A4 hydrolase (LTA4H) is a bifunctional zinc‐containing enzyme with an epoxide hydrolase activity and an aminopeptidase activity of unclear function. The two activities occupy different, but overlapping sites. In this study we have focused on the non‐overlapping regions of these sites and have found that a series of previously reported compounds—diphenyl ether, 4‐phenoxyphenol, and their derivatives—can change the substrate specificity of LTA4H aminopeptidase, from arginyl peptide to alanyl peptide. The possible substrate specificity alteration mechanism was studied with the aid of molecular modeling and site‐directed mutagenesis. Furthermore, several mutants that show different substrate specificity, such as F314E and V367W, were successfully designed by using the proposed small‐molecule binding site as a model. F314E behaves as a highly selective aminopeptidase towards arginyl peptides with a selectivity increase of 850‐fold, whereas V367W prefers alanyl peptides over arginyl peptides, just as the organic modulators do.
Coronary guidewire circumcision during use of a gopher support catheter: Potential adverse interaction with polymer‐jacketed wire design
Authors: Armstrong Ehrin J. , Shunk Kendrick A. 
Published: April 2010

AbstractSupport catheters with a threaded, distal tip may be useful for crossing recalcitrant coronary lesions. The interaction between the Gopher support catheter and polymer‐coated coronary guidewires may, however, result in circumferential stripping of polymer from the guidewire, with resulting wire damage or fracture. We report two cases of polymer‐coated guidewire damage with use of a Gopher support catheter, suggesting that these two devices should not be used together. © 2010 Wiley‐Liss, Inc.
Practical tips and tricks for the measurement of fractional flow reserve
Authors: Sharif Faisal , Trana Catalina , Muller Olivier , De Bruyne Bernard 
Published: April 2010

AbstractCoronary pressure measurement has emerged as one of the most promising tool to assist interventional cardiologist to make accurate clinical decisions. Fractional flow reserve (FFR) is a simple way of reliably assessing the functional consequences of coronary atherosclerosis. The training in FFR is easy, and coronary pressure measurements can be obtained swiftly in the catheterization laboratory. This review outlines the practical set up of FFR in the catheterization laboratory and also discusses the potential pitfalls in the measurement of FFR. © 2010 Wiley‐Liss, Inc.