bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neck restaging with sentinel node biopsy in T1‐T2N0 oral and oropharyngeal cancer: Why and how?
Authors: Burcia Vincent , Costes Valérie , Faillie Jean Luc , Gardiner Quentin , de Verbizier Delphine , Cartier César , Jouzdani Elham , Crampette Louis , Guerrier Bernard , Garrel Renaud 
Published: March 2010

ObjectiveTo evaluate the lack of accuracy in neck staging with the classical technique (i.e., neck dissection and routine histopathology) with the sentinel node (SN) biopsy in oral and oropharyngeal T1‐T2N0 cancer.Study DesignCross‐sectional study with planned data collection.SettingTertiary center care.Subjects and MethodsIn 50 consecutive patients, the pathological stage of sentinel node (pSN) was established after analyzing SN biopsies (n = 148) using serial sectioning and immunohistochemistry. Systematic selective neck dissection was performed. The pN stage was established with routine histopathologic analysis of both the non‐SN (n = 1075) and the 148 SN biopsies.ResultsThe sensitivity and negative predictive value of pSN staging were 100 percent. Conversely, if one considers pSN staging procedure as the reference test for micro‐ and macro‐metastasis diagnosis, the sensitivity of the classical pN staging procedure was 50 percent (9/1; 95% CI 26.9‐73.1) and its negative predictive value was 78 percent (95% CI 61.9‐88.8). Fifteen patients (30%) were upstaged, including nine cases from pN0 to pSN ≥ 1 and six cases from pN1 to pSN2. Two of the pN0‐pSN1 upstaged patients died with relapsed neck disease.ConclusionThe SN biopsy technique appeared to be the best staging method in cN0 patients and provided evidence that routinely undiagnosed lymph node invasion may have clinical significance.
The Baha system in patients with single‐sided deafness and contralateral hearing loss
Authors: Wazen Jack J. , Van Ess Mark J. , Alameda Jadiel , Ortega Carmello , Modisett Michelle , Pinsky Karen 
Published: March 2010

ObjectiveTo evaluate the effectiveness of the Baha system in cases of single‐sided deafness (SSD) and mild to moderate hearing loss in the better‐hearing ear.Study DesignProspective trial.SettingTertiary otologic referral center.Subjects and MethodsTwenty‐one patients with SSD and mild to moderate hearing loss in the contralateral ear implanted with the Baha system between June 2006 and March 2008 were evaluated following Baha implantation and fitting with the Divino and Intenso processors. Pure‐tone air and bone conduction thresholds, sound‐field testing (aided and unaided in quiet and noise) of consonant nucleus consonant words (Northwestern University Auditory Test No. 6 words), and Hearing in Noise Test sentences were obtained. Patient satisfaction questionnaires were administered pre‐ and post‐intervention for either device.ResultsPatients with SSD and mild to moderate hearing loss in the contralateral ear showed a statistically significant improvement in all measures with the use of the Divino or Intenso processors compared with the unaided situation. Change in hearing, as measured in noise testing word recognition scores, revealed a statistically significant difference between the two aided conditions favoring the Intenso (P < 0.05). The Glasgow Benefit Inventory revealed that 91 percent of the patients reported improvement in their quality of life and would recommend the procedure to others.ConclusionThe Baha system is effective in the rehabilitation of patients with SSD and mild to moderate hearing loss in the only hearing ear. Results of the current study suggest that either the Divino or Intenso processor was successful in reestablishing hearing from the deafened side.
Complications of esophagoscopy in an academic training program
Authors: Tsao Gabriel J. , Damrose Edward J. 
Published: March 2010

ObjectiveTo assess the efficacy and safety of flexible versus rigid esophagoscopy in an academic training setting.Study DesignCase series with chart review.SettingTertiary academic training center.Subjects and MethodsA retrospective medical record review was performed on all adult patients undergoing esophagoscopy from 2002 to 2007.ResultsA total of 546 procedures were performed with flexible (n = 276) or rigid (n = 270) endoscopes. Seven esophageal perforations (2.6%) occurred, all in association with rigid endoscopy and all in patients with a history of head and neck cancer. Esophageal perforation rates were associated with attending level of experience. There were no deaths. No synchronous esophageal cancers were found in any patient undergoing panendoscopy for the evaluation of a head and neck cancer.ConclusionThe 2.6 percent esophageal perforation rate observed in this study is higher than that typically reported for rigid esophagoscopy. When performed as part of routine panendoscopy, no synchronous esophageal tumors were found, questioning the value of esophagoscopy in this setting. All perforations occurred in patients with a history of head and neck cancer and were associated with the level of the surgeon's experience in performing rigid endoscopy.
Palatine tonsil size in obese, overweight, and normal‐weight children with sleep‐disordered breathing
Authors: Wang Jong Hwan , Chung Yoo‐Sam , Cho Young‐Wook , Kim Do‐Youn , Yi Jong Sook , Bae Ji Seon , Shim Myung Joo 
Published: March 2010

ObjectiveTo assess palatine tonsil size relative to degree of obesity in children with sleep‐disordered breathing (SDB).Study DesignCase‐control study.SettingTertiary care rhinology clinic.Subjects and MethodsWe compared the subjective and objective tonsil size, including tonsil height (TH), tonsil width (TW), tonsil thickness (TT), tonsil weight (TWt), and tonsil volume (TV), in 26 obese children and 26 age‐ and gender‐matched control children with SDB, and in 29 overweight children and 29 matched controls with SDB.ResultsDespite similar subjective tonsil size in obese and control children, the objective tonsil size, including TH, TW, TT, and TWt, was larger in obese than in control children, and the mean TV was significantly greater in obese than in control children with SDB (8.53 ± 3.30 mL vs 6.90 ± 2.05 mL; 95% confidence interval [CI] of the difference 0.03‐3.25; P = 0.019). In contrast, mean TV (7.38 ± 3.43 mL vs 7.65 ± 1.97 mL; 95% CI −1.92 to 1.37; P = 0.320) as well as the other parameters of objective palatine tonsil size, including TH, TW, TT, and TWt, did not differ significantly between overweight children and controls.ConclusionObese children with SDB had larger palatine tonsils than did normal‐weight children with SDB. This finding suggests that larger palatine tonsils may have a greater effect on upper airway obstruction in obese than in normal‐weight children with SDB.
Validation of a clinical practice ability instrument for surgical training
Authors: Shin Jennifer J. , Page John H. , Shapiro Jo , Gray Stacey T. , Cunningham Michael J. 
Published: March 2010

ObjectiveTo develop and validate an instrument to measure the progression of clinical practice ability among surgical trainees.Study DesignProspective validation study.SettingThree academic training institutions: Massachusetts Eye and Ear Infirmary, Brigham and Women's Hospital, Harvard School of Public Health.Subjects and MethodsA clinical practice instrument (CPI) was created and prospectively validated in otolaryngology trainees at three institutional sites. The instrument is completed during an oral examination of a trainee who is presented with a patient scenario; the scenario yields one clinical diagnosis, one therapeutic intervention, and one interventional complication. On the basis of the trainee's responses, 21 item scores are calculated focusing on key areas within the diagnostic and management paradigm. Internal consistency, reproducibility, inter‐rater reliability, discriminant and criterion validity, and responsiveness to change over time were evaluated.ResultsThere were 87 administrations of the instrument over a period of 22 months. The subjects (n = 32) spanned the range of training from medical student to clinical fellow. There was strong internal consistency within each domain (Cronbach's alpha 0.85‐0.94, one‐sided 95% confidence interval > 0.81). Inter‐rater reliability was high (kappa 0.66, absolute agreement 72%). Reproducibility of item scores was excellent (intraclass correlation coefficient [ICC] final summary score 0.78, global item score 0.83). Discriminant validity (P < 0.0001), criterion validity (P = 0.03), and responsiveness to change (P = 0.0055) were also established.ConclusionThe CPI serves as a reliable, reproducible, and valid means to measure the progression of clinical practice ability in trainees as they transition from “novice” to “attending equivalent” surgeons.
Long-term pain, neuroinflammation and glial activation
Authors: Hansson Elisabeth 
Published: March 2010

Abstract
Nociceptive and neuropathic pain signals are known to result from noxious stimuli, which are converted into electrical impulses within tissue nociceptors. There is a complex equilibrium of pain-signalling and pain-relieving pathways connecting PNS and CNS. Drugs against long-term pain are today directed against increased neuronal excitability, mostly with less success.
An injury often starts with acute physiological pain, which becomes inflammatory, nociceptive, or neuropathic, and may be transferred into long-term pain. Recently a low-grade inflammation was identified in the spinal cord and along the pain pathways to thalamus and the parietal cortex. This neuroinflammation is due to activation of glial cells, especially microglia, with production of cytokines and other inflammatory mediators within the CNS. Additionally, substances released to the blood from the injured region influence the blood–brain barrier, and give rise to an increased permeability of the tight junctions of the capillary endothelial cells, leading to passage of blood cells into the CNS. These cells are transformed into reactive microglia. If the inflammation turns into a pathological state the astrocytes will be activated. They are coupled into networks and respond to substances released by the capillary endothelial cells, to cytokines released from microglia, and to neurotransmitters and peptides released from neurons. As the astrocytes occupy a strategic position between the vasculature and synapses, they monitor the neuronal activity and transmitter release. Increased release of glutamate and ATP leads to disturbances in Ca2+ signalling, increased production of cytokines and free radicals, attenuation of the astrocyte glutamate transport capacity, and conformational changes in the astrocytic cytoskeleton, the actin filaments, which can lead to formation and rebuilding of new synapses. New neuronal contacts are established for maintaining and spreading pain sensation with the astrocytic networks as bridges. Thereby the glial cells can maintain the pain sensation even after the original injury has healed, and convert the pain into long-term by altering neuronal excitability. It can even be experienced from other parts of the body. As astrocytes are intimate co-players with neurons in the CNS, more knowledge on astrocyte responses to inflammatory activators may give new insight in our understanding of mechanisms of low-grade inflammation underlying long-term pain states and pain spreading. Novel treatment strategies would be to restore glial cell function and thereby attenuate the neuroinflammation.
Sensory disturbances and neuropathic pain after inguinal hernia surgery
Authors: Magnusson Niklas , Hedberg Mats , Österberg Johanna , Sandblom Gabriel 
Published: March 2010

Abstract

Objectives
The aim of this study was to explore how the handling of nerves affects the risk for developing sensory disturbances (SDs) following groin hernia surgery.

Patients and methods
All patients 18 years or older undergoing surgery for inguinal hernia at Mora Hospital, Sweden, during an eight-month period in 2006, were eligible for inclusion. The surgical procedure was recorded prospectively according to a standardised protocol. One year postoperatively all patients were requested to answer the Inguinal Pain Questionnaire as well as a set of 18 sensory and affective pain descriptors. They were also invited to clinical examination including sensory testing.

Results
Of the 157 hernia repairs in Mora during the period of study, 128 repairs in 116 patients, were registered prospectively according to the study protocol. Laparoscopic total extraperitoneal (TEP) repair was performed in 36 (28%) of the patients. Ninety-two (79%) patients, including five patients operated bilaterally, underwent postoperative examination. SDs were found in 33 (34%) of the groins examined. No descriptor was found that significantly predicted the presence of altered examination findings. No significant association between the intraoperative handling of nerves and SD was seen. In the TEP-group, no SDs were seen. Infiltration of local anaesthetic agents and blockade of the ilioinguinal nerve prior to surgery were found to be significantly associated with SD more than 2 cm away from the scar (both p < 0.05). The presence of SD was not associated with significant pain.

Conclusions
SDs are common after open hernia surgery, but are not associated with persistent postoperative pain.
Hyperesthesia one year after breast augmentation surgery increases the odds for persisting pain at four years A prospective four-year follow-up study
Authors: Kaasa Torill , Romundstad Luis , Roald Helge , Skolleborg Knut , Stubhaug Audun 
Published: March 2010

Abstract
In this long-term follow-up study of 175 women, we investigated the prevalence of and factors associated with persisting pain and sensory changes four years after augmentation mammoplasty. Previously the women had participated in an acute postoperative pain study, and follow-up investigations at 6 weeks and 1 year after surgery. In the present study, the women were mailed questionnaires about pain, sensory changes, and affection of daily life, quality of life and pain catastrophizing 4 years after surgery.
One hundred and sixteen women answered the questionnaire. The fraction of women reporting evoked- and/or spontaneous pain during the last 24 h had declined from 20% at 1 year to 14% at 4 years. Hyperesthesia had declined from 46% at 1 year to 32% at 4 years, while the change in hypoesthesia was small, 47% at 1 year to 51% at 4 years. Methylprednisolone and parecoxib given pre incisionally reduced acute postoperative pain and reduced the prevalence of hyperesthesia after 6 weeks/1 year, but after 4 years we found no significant differences between the test drug groups. Those having concomitant pain and hyperesthesia at 6 weeks and 1 year had high odds for persisting pain at 4 years (OR 7.8, 95% CI 2.1–29.8, P = 0.003; OR 13.2, 95% CI 2.5–71.3, P = 0.003). In patients without pain but with hyperesthesia at 1 year, the hyperesthesia increased the odds for pain at 4 years (OR 2.6 95% CI 1.1–6.1, P = 0.03). Hypoesthesia at 6 weeks or at 1 year did not affect the odds for pain at 4 years. A good general health condition (mental and physical) was associated with reduced odds for pain at 4 years (OR = 0.56, 95% CI 0.35–0.88, P = 0.01). However, using the Short Form health survey, SF-12, the Mental Component Summary Score seemed to affect the odds for chronic pain more than the Physical Component Summary Score.
To conclude, the prevalence of pain and hyperesthesia after breast augmentation declined from 1 to 4 years. Nevertheless, the most striking finding in the current trial was that pain coinciding with hyperesthesia at 6 weeks and 1 year resulted in highly increased odds for persistent postoperative pain. Even hyperesthesia alone, without pain, increased the odds for chronic postsurgical pain. Thus, the present study suggests hyperesthesia as an independent risk factor for chronic postsurgical pain.
Effect of incremental amounts of fish oil in the diet on ruminal lipid metabolism in growing steers
Authors: Shingfield K. J. , Lee M. R. F. , Humphries D. J. , Scollan N. D. , Toivonen V. , Reynolds C. K. , Beever D. E. 
Published: March 2010

Based on the potential benefits to human health, there is interest in developing sustainable nutritional strategies to enhance the concentration of long-chainn-3 fatty acids in ruminant-derived foods. Four Aberdeen Angus steers fitted with rumen and duodenal cannulae were used in a 4 × 4 Latin square experiment with 21 d experimental periods to examine the potential of fish oil (FO) in the diet to enhance the supply of 20 : 5n-3 and 22 : 6n-3 available for absorption in growing cattle. Treatments consisted of total mixed rations based on maize silage fed at a rate of 85 g DM/kg live weight0·75/d containing 0, 8, 16 and 24 g FO/kg diet DM. Supplements of FO reduced linearly (P < 0·01) DM intake and shifted (P < 0·01) rumen fermentation towards propionate at the expense of acetate and butyrate. FO in the diet enhanced linearly (P < 0·05) the flow oftrans-16 : 1,trans-18 : 1,trans-18 : 2, 20 : 5n-3 and 22 : 6n-3, and decreased linearly (P < 0·05) 18 : 0 and 18 : 3n-3 at the duodenum. Increases in the flow oftrans-18 : 1 were isomer dependent and were determined primarily by higher amounts oftrans-11 reaching the duodenum. In conclusion, FO alters ruminal lipid metabolism of growing cattle in a dose-dependent manner consistent with an inhibition of ruminal biohydrogenation, and enhances the amount of long-chainn-3 fatty acids at the duodenum, but the increases are marginal due to extensive biohydrogenation in the rumen.
Markers of cardiovascular risk are not changed by increased whole-grain intake: the WHOLEheart study, a randomised, controlled dietary intervention
Authors: Brownlee Iain A. , Moore Carmel , Chatfield Mark , Richardson David P. , Ashby Peter , Kuznesof Sharron A. , Jebb Susan A. , Seal Chris J. 
Published: March 2010

Recommendations for whole-grain (WG) intake are based on observational studies showing that higher WG consumption is associated with reduced CVD risk. No large-scale, randomised, controlled dietary intervention studies have investigated the effects on CVD risk markers of substituting WG in place of refined grains in the diets of non-WG consumers. A total of 316 participants (aged 18–65 years; BMI>25 kg/m2) consuming < 30 g WG/d were randomly assigned to three groups: control (no dietary change), intervention 1 (60 g WG/d for 16 weeks) and intervention 2 (60 g WG/d for 8 weeks followed by 120 g WG/d for 8 weeks). Markers of CVD risk, measured at 0 (baseline), 8 and 16 weeks, were: BMI, percentage body fat, waist circumference; fasting plasma lipid profile, glucose and insulin; and indicators of inflammatory, coagulation, and endothelial function. Differences between study groups were compared using a random intercepts model with time and WG intake as factors. Although reported WG intake was significantly increased among intervention groups, and demonstrated good participant compliance, there were no significant differences in any markers of CVD risk between groups. A period of 4 months may be insufficient to change the lifelong disease trajectory associated with CVD. The lack of impact of increasing WG consumption on CVD risk markers implies that public health messages may need to be clarified to consider the source of WG and/or other diet and lifestyle factors linked to the benefits of whole-grain consumption seen in observational studies.
Linseed oil in the maternal diet increases long chain-PUFA status of the foetus and the newborn during the suckling period in pigs
Authors: de Quelen Francine , Boudry Gaëlle , Mourot Jacques 
Published: March 2010

Linseed oil, being rich in 18 : 3n-3, represents an alternative source ofn-3 PUFA in the maternal diet. However, little is known about the effect of this oil on the long chainn-3 PUFA composition of offspring, which are required for normal growth and maturation of numerous organs. The main objective of the experiment was therefore to investigate fatty acid composition of tissues from sows at the end of gestation and from piglets during the first week of postnatal life in response to maternal dietary linseed oil intake. Sows received either a lard (LAR)-based diet or a linseed oil (LSO)-based diet during gestation and lactation. Fatty acid composition was evaluated in sow plasma, placenta and milk, and in different tissues of piglets on days 0, 3, 7, 21 and 32. The LSO diet increased the proportions ofn-3PUFA and especially 22 : 6n-3 in the placenta. The carcass of LSO piglets at birth contained greater proportions of 20 : 5n-3, 22 : 5n-3 and 22 : 6n-3. The LSO sow milk exhibited greater proportions of 18 : 3n-3compared with the LAR sow milk. The piglets suckling LSO sows had greater proportions of 18 : 3n-3, 20 : 5n-3 and 22 : 5n-3 in plasma and carcass. The proportions of 22 : 5n-3 and 22 : 6n-3 were greater in the brain of LSO piglets than in that of LAR piglets during the suckling period. In conclusion, LSO in the maternal diet during gestation and lactation increases 22 : 6n-3 concentrations in the placenta and in the foetus carcass, and it maintains 22 : 6n-3 concentrations in the brain during the first week of postnatal life.
Effects of an acute α-lactalbumin manipulation on mood and food hedonics in high- and low-trait anxiety individuals
Authors: Verschoor Ellen , Finlayson Graham , Blundell John , Markus C. Rob , King Neil A. 
Published: March 2010

Serotonergic hypofunction is associated with a depressive mood state, an increased drive to eat and preference for sweet (SW) foods. High-trait anxiety individuals are characterised by a functional shortage of serotonin during stress, which in turn increases their susceptibility to experience a negative mood and an increased drive for SW foods. The present study examined whether an acute dietary manipulation, intended to increase circulating serotonin levels, alleviated the detrimental effects of a stress-inducing task on subjective appetite and mood sensations, and preference for SW foods in high-trait anxiety individuals. Thirteen high- (eleven females and two males; anxiety scores 45·5 (sd5·9); BMI 22·9 (sd3·0)kg/m2) and twelve low- (ten females and two males; anxiety scores 30·4 (sd4·8); BMI 23·4 (sd2·5) kg/m2) trait anxiety individuals participated in a placebo-controlled, two-way crossover design. Participants were provided with 40 g α-lactalbumin (LAC;l-tryptophan (Trp):large neutral amino acids (LNAA) ratio of 7·6) and 40 g casein (placebo) (Trp:LNAA ratio of 4·0) in the form of a snack and lunch on two test days. On both the test days, participants completed a stress-inducing task 2 h after the lunch. Mood and appetite were assessed using visual analogue scales. Changes in food hedonics for different taste and nutrient combinations were assessed using a computer task. The results demonstrated that the LAC manipulation did not exert any immediate effects on mood or appetite. However, LAC did have an effect on food hedonics in individuals with high-trait anxiety after acute stress. These individuals expressed a lower liking (P = 0·012) and SW food preference (P = 0·014) after the stressful task when supplemented with LAC.