bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic value of pleural fluid N‐terminal pro‐brain natriuretic peptide levels in patients with cardiovascular diseases
Authors: LIAO Huai , NA Moon Jun , DIKENSOY Oner , LANE Kirk B. , RANDAL Barnette , LIGHT Richard W. 
Published: September 2010

Background and objective:  The diagnosis of the cause of pleural effusions caused by cardiovascular diseases such as congestive heart failure (CHF) and acute pulmonary embolism is sometimes difficult. The purpose of the present study was to evaluate the utility of pleural fluid levels of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) in differentiating pleural effusions due to CHF, pulmonary embolism and post‐coronary artery bypass graft (CABG) surgery.Methods:  The levels of pleural fluid NT‐proBNP were measured by ELISA in a total of 40 patients: 10 with CHF, 10 with pulmonary embolism, 10 post‐CABG and 10 with carcinoma.Results:  The median level of NT‐proBNP in the pleural fluid of patients with CHF was 5390 pg/mL (25th to 75th percentiles, 4566 to 8158 pg/mL), which was significantly higher than that in patients with post‐CABG effusions (424 pg/mL, 352 to 873), with pulmonary embolism (311 pg/mL, 212 to 1159), or with carcinoma (302 pg/mL, 208 to 626) (P < 0.001, CHF group vs all other groups). In receiver‐operating curve analysis, an NT‐proBNP level of ≥2220 pg/mL demonstrated a sensitivity of 100% and a specificity of 96.7% for the identification of CHF.Conclusions:  Measurement of the NT‐proBNP level in pleural fluid is accurate in diagnosing the etiology of the effusion as CHF. Pleural fluid levels above 2220 pg/mL are essentially diagnostic that the pleural effusion is due to CHF.
Air trapping: The major factor limiting diaphragm mobility in chronic obstructive pulmonary disease patients
Authors: DOS SANTOS YAMAGUTI Wellington Pereira , PAULIN Elaine , SHIBAO Simone , CHAMMAS Maria Cristina , SALGE João Marcos , RIBEIRO Marcos , CUKIER Alberto , CARVALHO Celso Ricardo Fernandes 
Published: September 2010

Background and objective: Patients with COPD can have impaired diaphragm mechanics. A new method of assessing the mobility of the diaphragm, using ultrasound, has recently been validated. This study evaluated the relationship between pulmonary function and diaphragm mobility, as well as that between respiratory muscle strength and diaphragm mobility, in COPD patients.Methods: COPD patients with pulmonary hyperinflation (n = 54) and healthy subjects (n = 20) were studied. Patients were tested for pulmonary function, maximal respiratory pressures and diaphragm mobility using ultrasound to measure the craniocaudal displacement of the left branch of the portal vein.Results: COPD patients had less diaphragm mobility than did healthy individuals (36.5 ± 10.9 mm vs 46.3 ± 9.5 mm,P = 0.001). In COPD patients, diaphragm mobility correlated strongly with pulmonary function parameters that quantify air trapping (RV:r = −0.60,P < 0.001; RV/TLC:r = −0.76,P < 0.001), moderately with airway obstruction (FEV1:r = 0.55,P < 0.001; airway resistance:r = −0.32,P = 0.02) and weakly with pulmonary hyperinflation (TLC:r = −0.28,P = 0.04). No relationship was observed between diaphragm mobility and respiratory muscle strength (maximal inspiratory pressure:r = −0.11,P = 0.43; maximal expiratory pressure:r = 0.03,P = 0.80).Conclusion: The results of this study suggest that the reduction in diaphragm mobility in COPD patients is mainly due to air trapping and is not influenced by respiratory muscle strength or pulmonary hyperinflation.
The utility of the chest radiograph in diagnosing exacerbations of pulmonary sarcoidosis
Authors: JUDSON Marc A. , GILBERT Gregory E. , RODGERS J. Keith , GREER Charles F. , SCHABEL Stephen I. 
Published: September 2010

Background and objective: To quantify the CXR using a profusion of small lung opacities score in patients with pulmonary exacerbation of sarcoidosis. In particular, the study sought to determine whether the CXR changes were a reliable indicator of disease exacerbation.Methods: The study recruited patients with an exacerbation of pulmonary sarcoidosis, who were attending a university medical centre sarcoidosis clinic. Pulmonary exacerbation was defined as worsening pulmonary symptoms, thought to be related to sarcoidosis, that responded to an increase in corticosteroid dose. A subset of patients were identified who met the criteria of spirometric decline of ≥10% in FVC or FEV1from the previous (baseline) visit. Patients required a baseline CXR and spirometry and had CXR and spirometry performed at the initial assessment. Two International Labour Organisation B readers interpreted the CXR in a blinded manner.Results: All study patients (n = 36) were African American; there were 24 patients in the ‘spirometric decline’ subgroup. Agreement between the B readers was moderate (kappa = 0.54,P < 0.01). The mean profusion score increased, or worsened by 1.38 points (SD = 3.60,P = 0.008) for the exacerbation group while the ‘spirometric decline’ group worsened by an average of 1.80 points (SD = 3.81,P = 0.031). There was too much variation for a cut‐off to be identified that would reliably diagnose exacerbations. There was no significant correlation between FVC or FEV1and profusion score.Conclusions: The CXR International Labour Organisation profusion score is not a reliable test to detect pulmonary exacerbations of sarcoidosis. However, a CXR may be useful to exclude other diagnostic possibilities.
Surveillance culture utility and safety using low‐volume blind bronchoalveolar lavage in the diagnosis of ventilator‐associated pneumonia
Authors: BOOTS Robert J. , PHILLIPS Gael E. , GEORGE Narelle , FAOAGALI Joan L. 
Published: September 2010

Background and objectives:  Surveillance cultures may improve the prediction of ventilator‐associated pneumonia (VAP) and empirical antibiotic selection. This study examined the utility and patient safety of blind, non‐protected, low‐volume mini‐bronchial lavage (BM‐BAL) surveillance cultures in predicting VAP.Methodology:  A prospective, cohort study was performed in a large general intensive care unit. BM‐BALs were collected within 12 h of admission then thrice weekly. Each BM‐BAL was screened by Gram staining for intracellular organisms and then quantitatively cultured. VAP was diagnosed using the Clinical Pulmonary Infection Score. The concordance for isolates from the BM‐BAL was assessed against concurrently collected endotracheal aspirates (EA).Results:  Four hundred and twelve patients requiring a minimum of 48 h of mechanical ventilation were enrolled. Fifty patients developed 58 episodes of VAP. Concordant pathogens were found in 85% of BM‐BAL specimens collected 2 days prior to VAP onset. Their antibiograms were stable over the preceding 4 days. The isolation of pathogens with colony counts ≥104 cfu/mL from BM‐BAL performed 2 days prior to the clinical onset of VAP had a sensitivity of 84%, specificity of 50%, positive predictive value of 31% and a negative predictive value of 93% for predicting the development of VAP. BM‐BAL WCC, quantification of bacterial growth and the percentage of intracellular organisms were not helpful in predicting VAP diagnosis.Conclusions:  BM‐BAL surveillance cultures are well tolerated and useful in predicting the pathogens and their antibiograms causing VAP. Diagnostic specimen collection at the time of VAP onset is still required as surveillance cultures may be negative even one day prior to VAP onset.
Respiratory infections unique to Asia
Authors: TSANG Kenneth W. , FILE Jr Thomas M. 
Published: September 2010

Abstract:Asia is a highly heterogeneous region with vastly different cultures, social constitutions and populations affected by a wide spectrum of respiratory diseases caused by tropical pathogens. Asian patients with community‐acquired pneumonia differ from their Western counterparts in microbiological aetiology, in particular the prominence of Gram‐negative organisms,Mycobacterium tuberculosis,Burkholderia pseudomalleiandStaphylococcus aureus. In addition, the differences in socioeconomic and health‐care infrastructures limit the usefulness of Western management guidelines for pneumonia in Asia. The importance of emerging infectious diseases such as severe acute respiratory syndrome and avian influenza infection remain as close concerns for practising respirologists in Asia. Specific infections such as melioidosis, dengue haemorrhagic fever, scrub typhus, leptospirosis, salmonellosis, penicilliosis marneffei, malaria, amoebiasis, paragonimiasis, strongyloidiasis, gnathostomiasis, trinchinellosis, schistosomiasis and echinococcosis occur commonly in Asia and manifest with a prominent respiratory component. Pulmonary eosinophilia, endemic in parts of Asia, could occur with a wide range of tropical infections. Tropical eosinophilia is believed to be a hyper‐sensitivity reaction to degenerating microfilariae trapped in the lungs.This article attempts to address the key respiratory issues in these respiratory infections unique to Asia and highlight the important diagnostic and management issues faced by practising respirologists.
Can adiponectin predict abnormal glucose tolerance in Thai women with polycystic ovary syndrome?
Authors: Weerakiet Sawaek , Tingthanatikul Yada , Boonnag Pongamorn , Wansumrith Surapee , Rattanasiri Sasivimol , Leelaphiwat Supatra 
Published: September 2010

AbstractAim:  To evaluate whether adiponectin levels could predict abnormal glucose tolerance (AGT) in Thai women with polycystic ovary syndrome (PCOS).Methods:  A 75‐g oral glucose tolerance test (OGTT) with fasting adiponectin and insulin (FI) blood sampling in 170 women with PCOS were performed consecutively.Results:  The prevalence of AGT was 45.9%. The body mass index (BMI), waist‐to‐hip ratio (WHR), fasting glucose and 2‐h postload glucose were greater in the PCOS women with AGT than those without AGT (P < 0.001). In addition, the PCOS women with AGT had more severe insulin resistance (IR) and lower adiponectin levels than those without AGT. However, the area under the ROC curve of adiponectin and insulin in predicting AGT was smaller than that of homeostatic model of IR (HOMA‐IR) (P < 0.01). The arbitrary cut‐off values at 12 ug/mL of adiponectin, 10 μiu/mL of FI and 2 of HOMA‐IR showed the sensitivity and specificity of 80.8% and 33.7%; 87.2% and 34.8%; and 89.7% and 31.5%, respectively. With these cut‐off points, 46 (27.1%), 42 (24.7%) and 37 (21.8%) women, respectively, could be eliminated from performing OGTT. However, 15 (19.2%), 10 (12.8%) and 8 (10.3%), respectively, missed the diagnosis. In addition, with WHR and acanthosis nigricans adjustment, HOMA‐IR, but not adiponectin, was a significant predictor of AGT.Conclusion:  Our study demonstrated that almost half of the women with PCOS had AGT. Adiponectin levels were significantly lower in the PCOS women with AGT than those without AGT. However, adiponectin was not shown to be as strong a predictive factor and might not be such an excellent screening test as FI and HOMA‐IR.
Giant abdominal tumor of the ovary
Authors: Ueda Sachiyo , Yamada Yoshihiko , Tsuji Yoriko , Kawaguchi Ryuji , Haruta Shoji , Shigetomi Hiroshi , Kanayama Seiji , Yoshida Shozo , Sakata Mariko , Sado Toshiyuki , Kitanaka Koji , Kobayashi Hiroshi 
Published: September 2010

AbstractA giant abdominal tumor can exert a mass effect on surrounding structures. We report here a 34‐year‐old single female who presented with an increased abdominal girth and was subsequently found to have a giant abdominal mass. Large volume aspiration (85 L) at a slow rate (1 L/min) was initially performed before surgical resection to prevent the development of severe clinical hypotension after large volume aspiration. The patient underwent left salpingo‐oophorectomy. Histology revealed a serous cystadenoma of the ovary. Systemic hemodynamics were sequentially measured during the perioperative period. The patient is now well.
Intractable recurrent cervical cancer with pelvic bone involvement successfully treated with external hemipelvectomy
Authors: Hamanishi Junzo , Higuchi Toshihiro , Mandai Masaki , Fukuhara Ken , An Masae , Nakayama Tomitaka , Takakura Kenji , Fujii Shingo 
Published: September 2010

AbstractThe indication of external hemipelvectomy for lateral recurrent cervical cancer involving the pelvic bone is controversial. We report the second longest surviving patient of recurrent cervical cancer successfully treated by external hemipelvectomy. A 38‐year‐old woman who had undergone conization for stage Ia1 cervical cancer six years earlier had severe right inguinal pain. A large multicystic recurrent tumor was identified in the right obturator region. After chemotherapy and chemoradiation, the tumor regressed, but soon relapsed. The patient's symptoms flared and the tumor was enlarged involving the right iliac bone. We performed right external hemipelvectomy with amputation of the right lower extremity, right iliac wing and ischiopubic bone. There was no major complication after the operation and the patient was discharged on postoperative day 48. After 27 months of follow‐up, she has no complaints and is without evidence of recurrence. In selected cases of intractable lateral recurrent cervical cancer with pelvic bone involvement, relief from tumor‐related pain and a possibility of prolonged survival can be expected by external hemipelvectomy.
Magnetic resonance imaging and hysteroscopy to diagnose colo‐uterine fistula: A rare complication of diverticulitis
Authors: Kassab Ahmed , El‐Bialy Gehan , Hashesh Hany , Callen Peter 
Published: September 2010

AbstractColo‐uterine fistula of diverticular origin is an extremely rare disease due to the resistance of uterine tissue. Methods for diagnosis remain to be established. Non‐invasive imaging like magnetic resonance imaging (MRI) may help to establish a proper diagnosis, but confirmation may be reached by diagnostic hysteroscopy or even surgical exploration. We report a 78‐year‐old female who presented with continuous dull aching pain associated with increasing constipation. MRI suspected a fistula between the posterior aspect of the uterine body and the sigmoid colon which contained extensive diverticulosis. Hysteroscopy confirmed the fistulous opening, but colonoscopy confirmed diverticular disease with no evidence of malignancy. The patient had en block surgical treatment of the uterus and the adjacent colon, followed by an uneventful recovery. The sensitivity and specificity of non‐invasive imaging procedures to diagnose such cases remain to be established. As imaging procedures cannot rule out neoplasia, endoscopic procedures need to be added.
Hysterectomy for hematometra in a 15‐year‐old mentally handicapped girl with congenital cervicovaginal agenesis and concomitant ovarian adenoma
Authors: Rana Ashma , Gurung Geeta , Begum Syeda H. , Adhikari Shilu , Neupane Bhanu B. 
Published: September 2010

AbstractWe report a case of hematometra and bilateral hematosalphinx in a 15‐year‐old mentally handicapped adolescent girl, complicated by vaginal agenesis over cervical atresia in the presence of an ovarian adenoma. The case was managed by abdominal hysterectomy and bilateral salphingectomy of the hematosalphinx, which had formed a tubo‐ovarian mass. One ovary was preserved. This case also considers the management of the mentally handicapped patient unable to comprehend pain arising from cryptomenorrhea.
Anatomical and functional results after stapled transanal rectal resection (STARR) for obstructed defaecation syndrome
Authors: Meurette G. , Wong M. , Frampas E. , Regenet N. , Lehur P. A. 
Published: September 2010

AbstractAim  The STARR procedure is a surgical option for the treatment of rectocoele associated with obstructed defaecation syndrome (ODS). The aim of the study was to assess the efficacy of this technique in restoring anatomy and the long‐term sustainability of symptom control and quality of life.Methods  Of 48 patients operated on from 2003 to 2007, 30 were enrolled for this prospective assessment of anatomical correction and functional improvement of ODS. Results from a standardized questionnaire concerning functional results (ODS score), faecal incontinence (Cleveland Clinic score) and Patient Assessment of Constipation Quality of Life (PAC‐QoL) were prospectively collected. Systematic dynamic defaecography, together with anorectal physiology testing, were performed before surgery and 6 months after. Twenty‐five patients were available for long‐term assessment of functional outcome (more than 4 years).Results  The mean age of the population was 57 ± 7 years. STARR produced significant improvements in the PAC QoL (P < 0.05) and ODS score (P < 0.0001), but not in the incontinence score. At defaecography, correction was significant with respect to the depth (P = 0.007), perimeter (P < 0.0001) and neck (P = 0.001) of rectocoele. Anorectal physiology revealed a lower maximal tolerated rectal volume (P < 0.0001). After 58 months, the 25 patients showed sustained functional results and QoL. Four patients (16%) underwent further surgical procedure for pelvic floor disorders and eight patients (32%) still required laxatives.Conclusion  Our study confirms the efficacy of the STARR procedure, with sustained improvement in function and QoL. However, a substantial number of patients remain symptomatic.
Analysis of the outcome of intracytoplasmic sperm injection using fresh or frozen sperm
Authors: Kalsi Jas , Thum M. Yau , Muneer Asif , Pryor John , Abdullah Hossam , Minhas Suks 
Published: September 2010

Study Type – Diagnostic (retrospective cohort)  Level of Evidence 2b What’s known on the subject? and What does the study add? The results of ICSI using fresh or frozen sperm on the site of sperm retrieval remains controversial with respect to outcome.The results of this study showed no difference in outcome using ICSI either with respect to the site of retrieval or whether the sperm used was fresh or frozen. It also showed that the outcome of ICSI is not related to the underlying cause of the azoospermia.OBJECTIVES• To compare the outcome of first‐attempt intracytoplasmic sperm injection (ICSI) ICSI–embryo transfer (ET) cycles using frozen‐thawed testicular sperm (FTTS), fresh testicular sperm (FTS), frozen‐thawed epididymal sperm (FTES) and fresh epididymal sperm (FES) so as to determine which of these has the most successful ICSI outcome with respect to fertilization rate (FR), pregnancy rate (PR) and birth rate.• To assess the outcomes according to the underlying aetiology of azoospermia.PATIENTS AND METHODS• The records of 493 patients undergoing first‐attempt ICSI between 1993 and 2008 were reviewed retrospectively. FTS was used in 112 cycles, FTTS in 43 cycles, FES in 279 cycles, and FTES in 59 cycles.• Within each group, the aetiology of the azoospermia was recorded according to history, clinical examination and histological analysis (n= 316).• The FR, clinical PR and delivery rate were calculated for each group with respect to the type of sperm retrieval used.RESULTS• Analysis of the data showed no significant differences between any of the four groups in the FR, PR or delivery rate (P > 0.05).• There were no significant differences seen between fresh sperm (FTS and FES) and frozen sperm (FTTS and FTES) or between epididymal sperm (FES and FTES) and testicular sperm (FTS and FTTS) in any of the outcomes measured (P > 0.05). However, sub‐set analysis showed a statistically higher FR and PR for FTTS over fresh sperm.• When comparing aetiologies, there was no significant difference in the FR, clinical PR and delivery rate between obstructive azoospermia (OA) and non‐obstructive azoospermia (NOA) groups. However, sub‐set analysis showed a higher PR and birth rate for FTTS over fresh sperm in both OA and NOA groups.CONCLUSIONS• The results of the present study suggest that using frozen sperm in ICSI cycles is a reliable and favourable method with the same outcome as fresh sperm.• Testicular and epididymal sperm have similar ICSI outcomes for both fresh and frozen samples. However, results suggest a tendency for higher PRs and birth rates for frozen than for fresh testicular sperm in both OA and NOA aetiologies.• The aetiology of azoospermia does not significantly affect the outcome of first‐attempt ICSI. The higher rates in the frozen groups suggest that these patients have had better quality semen when they were initially harvested and frozen.
A novel cost‐effective approach to post‐vasectomy semen analysis
Authors: Senanayake Eshan , Pacey Allan A. , Maddireddy Vinod , Shariff Umar , Hastie Ken , Rosario Derek J. 
Published: September 2010

Study Type – Diagnostic (cost minimisation analysis)  Level of Evidence 3bOBJECTIVETo examine compliance, clearance rates and cost‐effectiveness of a novel approach to managing men following vasectomy based on the testing of sperm viability.PATIENTS AND METHODSBetween January 2003 and March 2005, 832 men undergoing vasectomy were followed prospectively for a minimum of 12 months.Post‐vasectomy semen analysis (PVSA) was carried out at 16 weeks with repeat at 20 weeks only if sperm were detected on initial PVSA i.e. a single clear PVSA on simple microscopy was deemed sufficient for declaring vasectomy successful.In men with persistent non‐motile sperm (PNMS) in the second specimen, comprehensive analysis of number and viability of sperm using a fluorescent probe was carried out on a fresh semen specimen taken in accordance with British Andrology Society (BAS) guidelines.RESULTSOverall compliance with the PVSA protocol was 81.3% (95% CI 78.5 to 83.8). No sperm were seen in 540 (78.8%) and 70 (10.3%) at the initial and 2ndPVSA respectively.Persistent spermatozoa at 20 weeks were present in 66 (9.8%, 7.8 to 12.2) cases with 58 (8.6%, 6.7 to 11.0) having PNMS and 8 (1.2%, 0.6 to 2.3) having motile sperm.Fluorescent viability testing in 53 of the 58 with PNMS showed viable sperm in 2 (3.8%, 1.0 to 12.8). The failure rate of vasectomy defined by PVSA (8 with motile sperm on 2ndPVSA and 2 with viable non‐motile sperm on fluorescent testing) was 1.2% (0.7 to 2.2).Average cost per vasectomy of PVSA using this protocol was £10.77 (US$ 16.67) compared with a minimum likely average cost using BAS guidelines of £18.10 (US$ 28).CONCLUSIONDemonstrating absence of sperm on simple light microscopy in a single specimen of semen at 16 or 20 weeks post‐vasectomy and reserving comprehensive testing of sperm viability for only the higher risk group with PNMS improves compliance and represents a cost‐effective strategy for declaring surgical success. This reduces the costs of PVSA by least 40% compared with adherence with BAS guidelines without compromising success in determining outcome after vasectomy.
Barycentric Coordinates on Surfaces
Authors: Rustamov Raif M. 
Published: September 2010

AbstractThis paper introduces a method for defining and efficiently computing barycentric coordinates with respect to polygons on general surfaces. Our construction is geared towards injective polygons (polygons that can be enclosed in a metric ball of an appropriate size) and is based on replacing the linear precision property of planar coordinates by a requirement in terms of center of mass, and generalizing this requirement to the surface setting. We show that the resulting surface barycentric coordinates can be computed using planar barycentric coordinates with respect to a polygon in the tangent plane. We prove theoretically that the surface coordinates properly generalize the planar coordinates and carry some of their useful properties such as unique reconstruction of a point given its coordinates, uniqueness for triangles, edge linearity, similarity invariance, and smoothness; in addition, these coordinates are insensitive to isometric deformations and can be used to reconstruct isometries. We show empirically that surface coordinates are shape‐aware with consistent gross behavior across different surfaces, are well‐behaved for different polygon types/locations on variety of surface forms, and that they are fast to compute. Finally, we demonstrate effectiveness of surface coordinates for interpolation, decal mapping, and correspondence refinement.