bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maxillary Sinus Augmentation by the Crestal Core Elevation Technique
Authors: Kolerman Roni , Moses Ofer , Artzi Zvi , Barnea Eytan , Tal Haim 
Published: August 2010

Background: The crestal core elevation (CCE) technique is reportedly a less invasive procedure than the lateral window elevation technique. We retrospectively evaluated long‐term outcomes of CCE procedures over an 11‐year time period.Methods: Core preparations were made after extractions of 57 upper molars in 45 patients. Extraction sites were drilled with a calibrated trephine bur to an estimated distance of 1 mm from the sinus membrane. The trephined interradicular bone and underlying sinus membrane were imploded into the sinus. The surgical crater and residual extraction socket were filled with deproteinized bovine bone mineral or freeze‐dried bone allograft, stabilized, and protected with an absorbable collagen membrane and fully covered with coronally positioned flaps. Implants were placed 4 months later. Success was defined if ≥9 mm available bone height was available. Where the available bone height varied between 7 and 9 mm, implant placement was complemented using the bone‐added osteotome sinus floor elevation technique; those sites were defined as a “partial success.”Results: The CCE technique was successful in 31 (68.9%) out of 45 sites, and partially successful in six (13.3%) out of 45 sites. Eight sites failed (17.8%). Surgical failures were caused by core detachment resulting in large tears of the sinus membrane. Implants placed in successful sites presented a 100% survival rate during the study duration.Conclusions: CCE implemented simultaneously with molar extractions provided therapeutic benefits and clinical limitations. The subsequent implant placement using CCE revealed an excellent survival rate in the study population evaluated.
Role of Smoking and Type 2 Diabetes in the Immunobalance of Advanced Chronic Periodontitis
Authors: Duarte Poliana M. , Santos Vanessa R. , dos Santos Fernanda A. , de Lima Pereira Sanivia A. , Rodrigues Denise B.R. , Napimoga Marcelo H. 
Published: August 2010

Background: This study evaluates the tissue levels of interleukin (IL)‐17+, IL‐15+, Foxp3+ cells, fibrosis, and plasma B‐cell infiltration in sites with chronic periodontitis in smokers and subjects with type 2 diabetes.Methods: Gingival biopsies were harvested from the following groups: systemically and periodontally healthy subjects (healthy group, n = 10); non‐smokers and subjects with advanced periodontitis and without diabetes (non‐risk factor/periodontitis group, n = 10); heavy smokers with advanced periodontitis and without diabetes (smoking/periodontitis group, ≥20 cigarettes per day for at least the past 5 years, n = 10); and non‐smoking poorly controlled subjects with diabetes (glycated hemoglobin levels ≥9%) with advanced periodontitis (diabetes mellitus/periodontitis group [DMP], n = 10). The number of IL‐17+, IL‐15+, and Foxp3+ cells was analyzed by immunohistochemistry, whereas the amount of fibrosis and plasma B‐cell infiltration in gingival tissue was analyzed by histomorphometry.Results: The number of Foxp3+ cells was significantly higher in the periodontitis groups compared to the healthy group (P <0.05). The DMP group presented higher levels of Foxp3+ cells than other periodontitis groups (P <0.05). The levels of IL‐15+ and IL‐17+ cells and the amount of fibrosis were higher in the DMP group than in the other groups (P <0.05). There was a trend for a decreased B‐cell infiltration in the DMP group (P >0.05). There was a slightly significant negative correlation between B‐cell infiltration and the amount of fibrosis (P <0.05).Conclusion: Upregulation of IL‐17+, IL‐15+, and Foxp3+ cells and increased amounts of fibrosis were observed in chronic periodontitis sites in subjects with type 2 diabetes, suggesting that periodontitis development in these subjects may be influenced by the T helper 17/T regulatory axis.
Demineralization Removes Residual Alendronate in Allograft Bone Procured From Donors With a History of Bisphosphonate Use
Authors: Hunter Shawn A. , Orheim Robert , Sazon Mia , Newman Helen , Woll Judith E. , Bergevin Michael 
Published: August 2010

Background: Bisphosphonate‐associated osteonecrosis (BON) of the jaw is a growing concern in the dental community, but the possible presence of residual bisphosphonates in demineralized allograft bone from bisphosphonate‐using tissue donors and the clinical implications of using such bone are unclear. The objectives of this study are to determine whether alendronate remained in demineralized bone matrix (DBM) procured from donors with a documented history of oral bisphosphonate use and to examine whether the demineralization process removes alendronate from allograft bone.Methods: A gas chromatography–mass spectrometry method was developed and validated to quantify residual alendronate in allograft bone. Alendronate levels in DBM procured from tissue donors with a history of oral bisphosphonate use were compared to alendronate levels in DBM procured from donors without a history of bisphosphonate use. In addition, mineralized and demineralized bone was soaked in alendronate at concentrations of 0.002, 2.0, and 2,000 ng/mg bone and analyzed to examine the effect of the demineralization process.Results: Residual alendronate was not detected in the DBM from either group, nor was it detected in any of the DBM samples soaked in alendronate solutions. Soaked mineralized bone contained measureable alendronate, but the substance was removed by demineralization.Conclusions: The demineralization process effectively removed residual alendronate from allograft bone. These results may relieve anxieties regarding the use of DBM in dental patients because it is unlikely to trigger BON of the jaw.
Retrospective Evaluation of Crestal Bone Changes Around Implants With Reduced Abutment Diameter Placed Non‐Submerged and at Subcrestal Positions: The Effect of Bone Grafting at Implant Placement
Authors: Koutouzis Theofilos , Fetner Michael , Fetner Alan , Lundgren Tord 
Published: August 2010

Background: There is limited information regarding the effect of grafting of the osteotomy after subcrestal implant placement. The primary aim of this study is to retrospectively evaluate the effect of bone grafting of the defect between the bone crest and the coronal aspect of implants with reduced abutment diameter placed non‐submerged and at subcrestal positions.Methods: Records of 50 consecutive patients treated with subcrestally placed dental implants grafted with a xenograft (Group A) and 50 consecutive patients with subcrestally placed dental implants without any grafting material (Group B) were reviewed. For each implant, the radiographs after placement were compared to images from the last follow‐up visit and evaluated regarding the following: 1) degree of subcrestal positioning of the implant, 2) changes of marginal hard‐tissue height over time, and 3) whether marginal hard‐tissue could be detected on the implant platform at the follow‐up visit.Results: The mean marginal loss of hard tissues was 0.11 ± 0.30 mm for Group A and 0.08 ± 0.22 mm for Group B. Sixty‐nine percent of the implants in Group A and 77% of the implants in Group B demonstrated hard tissue on the implant platform. There were no statistically significant differences between the groups regarding marginal peri‐implant hard‐tissue loss.Conclusion: The present study fails to demonstrate that grafting of the remaining osseous wound defect between the bone crest and the coronal aspect of the implant has a positive effect on marginal peri‐implant hard‐tissue changes.
Perforation of a malignant ovarian tumor into the recto‐sigmoid colon
Authors: Bats Anne‐Sophie , Rockall Andrea G. , Singh Naveena , Reznek Rodney H. , Jeyarajah Arjun 
Published: August 2010

AbstractOvarian cancer often presents at an advanced stage, but tends to be an intra‐peritoneal disease that respects peritoneal planes. Thus, colo‐rectal perforation of the tumor is an extremely rare presentation. The surgical treatment of malignant colo‐ovarian fistula should include complete cyto‐reduction at the same time as the treatment of the fistula. However, prognosis remains poor, because of the advanced stage of neoplasia. We report the case of a patient with an ovarian malignant tumor perforating into the recto‐sigmoid colon. CT scan was the cornerstone of the radiological diagnosis. We managed to perform a complete cyto‐reduction, including an en‐bloc resection of the uterus, the mass, adnexa and recto‐sigmoid with removal of the associated pelvic abscess.
Isolated Fallopian tube torsion: a series of six cases
Authors: Wong Sze‐Wai A. , Suen Sik‐Hung S. , Lao Terence , Chung Kwok‐Hung T. 
Published: August 2010

AbstractIsolated Fallopian tube torsion is a rare gynecological cause of acute lower abdominal pain. Currently, there are no pathognomonic symptoms, clinical findings, imaging or laboratory characteristics for this condition, and the diagnosis can rarely be made before operation. We have identified six cases of isolated Fallopian tube torsion treated over a period of 3 years. It was observed that acute onset of abdominal pain with gastrointestinal symptoms can be the initial presenting features. Clinical and laboratory findings included positive peritoneal signs, fever, tachycardia and leucocytosis. Most of the women had preoperative ultrasound showing tubular adnexal masses of heterogeneous echogenicity with cystic component and the presence of free fluid. In contrast to the belief that isolated Fallopian tube torsion is more common in the right side, in five of our cases it occurred in the left side.
Methotrexate‐based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy
Authors: Liang Fengbing , He Jing 
Published: August 2010

AbstractWe have evaluated the efficacy of methotrexate‐based bilateral uterine arterial chemoembolization for treating cesarean scar pregnancy (CSP) in 52 women between January 2005 and December 2009. Ten patients experienced massive vaginal hemorrhage after a misdiagnosis and subsequent curettage. Bleeding in these patients was reduced after chemoembolization. Dilation and curettage was not done in five of these patients because ultrasound scanning showed sparse or no blood flow in the previous gestational sac area. The five remaining patients, along with additional 42 patients who were diagnosed with CSP, underwent ultrasound‐guided dilation and curettage within 24–48 hours following chemoembolization. Patients tolerated the procedure well and only mild bleeding occurred. The positive clinical outcomes in these patients support the use of bilateral uterine artery chemoembolization for the treatment of CSP.
Medical students learning the pelvic examination: evaluation of a clinical patient model
Authors: Wånggren Kjell , Pettersson Gunilla , Gemzell‐Danielsson Kristina 
Published: August 2010

AbstractObjective. To evaluate a clinical patient (CP) model for training in pelvic examination. Design. Prospective clinical study. Population. Students attending the course in obstetrics and gynecology and patients at Karolinska University Hospital, Stockholm, Sweden. Main outcome measures. Feelings, attitudes and skills of medical students and ratings from CPs in connection to training in the pelvic examination. Methods. Each student participated in two training sessions at an outpatient clinic. The student participants answered questionnaires after each clinical session to measure different aspects of experiencing distress and to themselves rate the technical performance of the examination as well as the interaction with the CP. The CP answered questions about the examination, communication, information provided by the student and how they felt about participating in a teaching session. Results. The students rated their own performance high including both interpersonal communication and the technical examination. It was felt that the teacher as well as the CP gave good support and guidance. The CPs rated interpersonal communication skills by the students high. The teaching session was regarded as important and useful by both students and CPs. Conclusions. We recommend the use of this type of training sessions where students are allowed to work more independently and train in the role as a doctor under supervision of the teacher.
Foot Function After Fusion of the First Metatarsophalangeal Joint
Authors: Doeselaar Dimitri J. van , Heesterbeek Petra J.C. , Louwerens Jan Willem K. , Swierstra Bart A. 
Published: August 2010

Background: We measured with a validated score the operative outcome in patients without concomitant foot surgery who underwent fusion of the first metatarsophalangeal (MTP) joint for hallux rigidus (HR) and hallux valgus (HV). We also examined whether there is a correlation between foot function and hallux position to try to formulate an optimum fusion angle. Materials and Methods: Between 2002 and 2005, a consecutive series of 62 patients underwent crossed screw fusion of the first MTP joint (27 HR and 35 HV) without concomitant surgery of the same or contralateral foot or had previous surgery of the same foot. Foot function was measured by the Dutch Foot Function Index (FFI) pre- and postoperatively. Hallux valgus and dorsiflexion angles were measured on standing radiographs before operation and at followup. Results: Postoperatively the median hallux valgus angle was 14 (range, −2 to 33) degrees and the median dorsiflexion angle was 23 (range, 7 to 45) degrees. The median FFI score improved from 38 (range, 0 to 80) to 8 (range, 0 to 59) ( p < 0.001). The FFI score was not different between the HV and HR groups. There was no correlation between postoperative foot function, dorsiflexion angles and hallux valgus angles. Conclusion: Fusion of the first MTP joint in HR and HV results in improved function according to the validated FFI. There was no significant correlation between foot function and hallux position. This could be due to the fact that the desired position of the hallux was most often achieved. Level of Evidence: II, Prospective Comparative Study
Scarf Osteotomy for Correction of Tailor's Bunion: Mid- to Long-Term Followup
Authors: Maher Anthony J. , Kilmartin Timothy E. 
Published: August 2010

Background: The purpose of the study was to evaluate the increased correction possible with a mid shaft rotational osteotomy with the stability and ease of fixation associated with a scarf osteotomy. Materials and Methods: Between September 1999 and September 2006, 63 patients underwent operative repair of 77 Tailor's bunion deformities. Twenty eight patients (36 feet) were available for a final review (nine males and 19 females). A further seven patients (nine feet) completed a questionnaire. The mean followup period for the 28 patients reviewed in clinic was 6.5 years, (79.5 months; SD, 22). Results: Eighty-six percent were completely satisfied, 11.4% were satisfied with reservations and 3% were dissatisfied. Ninety-one percent considered themselves better than before their surgery while 8.6% felt they were no better. Ninety-one percent of patients said they would undergo surgery under the same conditions again. Preoperatively, the mean 4–5 intermetatarsal angle measured on weightbearing X-rays was 9.9 degrees (SD, 2.2), the mean postoperative intermetatarsal angle was 5.7 degrees (SD, 2.0). The mean preoperative AOFAS score was 44.1 (SD, 14.5) and the mean postoperative score at 6-month review was 91.8 (SD, 20.2). The AOFAS score at final review was 88.1 (SD, 11.6). Conclusion: The rotational scarf osteotomy was a reliable procedure for the correction of Tailor's bunion deformities. The osteotomy allowed for early mobilization and had few associated complications. The rotational scarf osteotomy facilitated correction of the intermetatarsal angle while maintaining excellent sagittal and transverse plane stability. Level of Evidence: IV, Case Series
Insertional Achilles Tendinopathy Management: A Systematic Review
Authors: Kearney Rebecca , Costa Matthew L. 
Published: August 2010

Background: Achilles tendinopathy is a common problem and its management remains controversial. However, many clinicians consider that the sub-group of patients with insertional Achilles tendinopathy are even more difficult to manage. The aim of this systematic review was to review evidence for interventions specific to insertional Achilles tendinopathy. Materials & Methods: Medline and the Cochrane library were searched using a pre-defined search strategy. All study designs were included except case studies, narrative reviews, technical notes and letters/personal opinion. The results were evaluated independently by two reviewers and assessed against the inclusion/exclusion criteria. All included articles were assessed for methodological quality and study characteristics were extracted into a table. Results: One hundred eighteen articles were identified through the search strategy, of which 11 met the eligibility criteria. Six studies evaluated operative techniques following failed conservative management and five evaluated conservative interventions only. The overall level of evidence was limited to case series evaluations and one randomized controlled trial. Conclusion: There is a consensus that conservative methods should be used before operative interventions. Current evidence for conservative treatment favors eccentric loading and shock wave therapy, although there is limited evidence by which to judge their effectiveness. Evaluation of operative interventions has been mostly retrospective and remains inconclusive. Level of Evidence: III, Systematic Review of Level III and IV Studies
Apolipoprotein E gene polymorphism and total serum cholesterol level in Iranian population
Authors: Bazzaz JT , Nazari M , Nazem H , Amiri P , Fakhrzadeh H , Heshmat R , Abbaszadeh S , Amoli MM 
Published: August 2010

Background:
Apolipoprotein E (APOE) is known as a major regulator of blood lipid levels in humans. A number of APOE gene allelic variants have been reported including E2, E3 and E4. Recent studies suggested a role for APOE in obesity and increased Body Mass Index (BMI) and plasma lipid levels in obese children.

Aim:
The aim of this study was to examine the association between APOE genetic variants and the BMI and lipid profile in an Iranian cohort. Setting and Design: Samples were obtained from subjects who participated in a study based on the WHO-designed MONICA (multinational monitoring of trends and determinants in cardiovascular disease) study for coronary artery disease risk assessment in Zone 17 of Tehran. The study was approved by the local ethical committee. Informed consent was obtained from all subjects included in this study. Materials and Methods: Subjects (n=320) were recruited. The level of triglyceride (TG) and total serum cholesterol was tested for all subjects in this study. Genotyping for APOE was carried using polymerase chain reaction-Restriction fragment length polymorphism (PCR-RFLP)technique.

Statistical Analysis:
Levels of significance were determined using contingency tables by either Chi-square or Fisher exact analysis using the STATA (v8) software. The analysis of regression and significance of differences for level of cholesterol and TG was established by one-way analysis of variance followed by Dunnett post hoc multiple comparison tests using SPSS software Version 11.5.

Results:
The frequency of allele E2 was significantly higher in patients with total serum cholesterol level <200 mg/dl (P 0.01 OR 2.1 95% CI 1.1-4.2).

Conclusion:
The association found in this study between allele E2 and lower total cholesterol level had been reported in previous studies. We have also observed that the frequency of genotype E2/E3 and E2/E4 was significantly higher in patients with normal total serum cholesterol level compared to patients with abnormal cholesterol (P=0.003 OR 2.4 95% CI; 1.3-4.6). Our data needs to be repeated in a larger population with more information for serum LDL and HDL levels and their subgroups.
Maternal indicators and obstetric outcome in the north Indian population
Authors: Kumar A , Chaudhary K , Prasad S 
Published: August 2010

Background:
Understanding the effect of maternal parameters on obstetric outcome has public health importance because these indicators are associated with infant health and survival and influence development and health in later life.

Aim:
To determine the effects of various maternal indicators on pregnancy outcome in north-Indian women. Settings and Design: A prospective study of all consecutive women with singleton pregnancy, who were registered in the first two months of pregnancy and delivered in the hospital.

Materials and Methods:
Maternal indicators such as age, height, prepregnancy weight, body mass index (BMI), hemoglobin and parity were correlated with pregnancy outcome. The women with a medical disorder or complication that developed during the course of pregnancy were excluded.

Results:
A total of 2027 women were analyzed. Maternal height, weight, BMI and parity had a positive significant correlation with birth weight of the newborn (r=0.081, P value < 0.001, r=0.148, P value <0.001, r = 0.121, P value < 0.001 and r = 0.099, P value < 0.001, respectively). Maternal height, weight and period of gestation were significant indicators for low birth weight on multivariate logistic regression. The rate of preterm delivery was significantly higher in women with hemoglobin < 7 g% and women with parity >3. The chances of caesarian section increased significantly with increase in maternal height, weight and BMI.

Conclusions:
A prepregnancy weight of more than 40 kg, BMI of more than 19.8 and hemoglobin of at least 7g% or more favor good obstetric outcome.
Statins
Authors: Sanmukhani J , Shah V 
Published: August 2010

Background and Aims:
Coronary heart disease (CHD) is the leading cause of death in India resulting in loss of young Indians. Statins have proved to reduce the CHD mortality in various clinical trials. The aim of the study is to find the cost-effectiveness ratio (CER) for each major coronary event averted and a coronary death avoided by use of statins in different clinical settings based on the data from the major clinical trials on statins.

Materials and Methods:
Using electronic database and as per our inclusion and exclusion criteria we selected the West of Scotland Coronary Prevention Study (WOSCOPS), the Air Force Coronary Atherosclerosis Prevention Study (AFCAPS) and the Anglo-Scandinavian Cardiac Outcomes Trial—Lipid Lowering Arm (ASCOT-LLA) study for primary prevention; the Cholesterol and Recurrent Events Trial (CARE), the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) Study and the Scandinavian Simvastatin Survival Study (4S) for secondary prevention and two studies, the Heart Protection Study (HPS) and the Pravastatin in elderly individuals at risk of vascular disease (PROSPER) study for high-risk patients. The results of these studies were used for cost-effectiveness analysis of statins in different patient groups.

Statistical Analysis:
Absolute risk reduction, Number Needed to Benefit (NNTB), NNTB/year for total sample and in subgroups of males, females and age >65 was derived. CER for branded and generic versions was calculated by using the prices of statins listed in Indian Drug Review Triple i.

Results:
Cost-effectiveness ratio (CER) in primary prevention studies i.e., the WOSCOPS, the AFCAPS and the ASCOT-LLA was Rs. 25.8 lacs, Rs. 23.8 lacs and Rs. 7.9 lacs per major coronary event averted respectively. CER in secondary prevention studies i.e., the CARE and the LIPID was approximately Rs. 20 lacs per major coronary event averted while it was Rs. 52.4 lacs and Rs. 37 lacs per coronary heart disease (CHD) death avoided. CER from the 4S was Rs. 6.9 lacs per major coronary event and Rs. 16.9 lacs per CHD death averted. CER in the HPS and the PROSPER study was Rs. 17.9 lacs and Rs. 27.1 lacs per major coronary event avoided in high-risk patients.

Conclusion:
Cost associated with the use of statins is higher in primary prevention as compared to secondary prevention. More studies are needed to confirm the cost-effectiveness of statins to make any decision for health policy.