bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of accordance of magnetic resonance volumetric and flow measurements in determining ventricular stroke volume in cardiac patients
Authors: Jeltsch M. , Ranft S. , Klass O. , Aschoff A. J. , Hoffmann M. H. K. 
Published: May 2008

Background: Cardiovascular magnetic resonance imaging (CMR) has become an established noninvasive method for evaluating ventricular function utilizing three-dimensional volumetry. Postprocessing of volumetric measurements is still tedious and time consuming. Stroke volumes obtained by flow quantification across the aortic root or pulmonary trunk could be utilized to increase both speed of workflow and accuracy. Purpose: To assess accuracy of stroke volume quantification using MR volumetric imaging compared to flow quantification in patients with various cardiac diseases. Strategies for the augmentation of accuracy in clinical routine were deduced. Material and Methods: 78 patients with various cardiac diseases—excluding intra- or extracardiac shunts, regurgitant valvular defects, or heart rhythm disturbance—underwent cardiac function analysis with flow measurements across the aortic root and cine imaging of the left ventricle. Forty-six patients additionally underwent flow measurements in the pulmonary trunk and cine imaging of the right ventricle. Results: Left ventricular stroke volume (LVSV) and stroke volume of the aortic root (SVAo) correlated with r=0.97, and Bland-Altman analysis showed a mean difference of 0.11 ml and a standard error of estimation (SEE) of 4.31 ml. Ninety-two percent of the data were within the 95% limits of agreement. Right ventricular stroke volume (RVSV) and stroke volume of the pulmonary trunk (SVP) correlated with a factor of r=0.86, and mean difference in the Bland-Altman analysis was fixed at –2.62 ml (SEE 8.47 ml). For RVSV and SVP, we calculated r=0.82, and Bland-Altman analysis revealed a mean difference of 1.27 ml (SEE 9.89 ml). LVSV and RVSV correlated closely, with r=0.91 and a mean difference of 2.79 ml (SEE 7.17 ml). SVAo and SVP correlated with r=0.95 and a mean difference of 0.50 ml (SEE 5.56 ml). Conclusion: Flow quantification can be used as a guidance tool, providing accurate and reproducible stroke volumes of both ventricles. Combining both offers a highly accurate tool to gauge ventricular function in a routine clinical setting, increasing workflow speed.
Prostate cancer detection: comparison of t2-weighted imaging, diffusion-weighted imaging, proton magnetic resonance spectroscopic imaging, and the three techniques combined
Authors: Chen M. , Dang H.-D. , Wang J.-Y. , Zhou C. , Li S.-Y. , Wang W.-C. , Zhao W.-F. , Yang Z.-H. , Zhong C.-Y. , Li G.-Z. 
Published: May 2008

Background: Magnetic resonance (MR) imaging has been established as the best imaging modality for the detection, localization, and staging of prostate cancer on account of its high resolution of soft tissue and the possibilities of multiplanar and multiparameter scanning. Purpose: To evaluate T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), MR spectroscopy (MRS), and the combination of these three MR techniques in the diagnosis of prostate cancer, as correlated to histopathologic findings. Material and Methods: MR imaging, including T2WI, DWI, and MRS, was performed at 1.5T with a body coil combined with a spine coil in 42 cases. Diagnosis was confirmed by histopathology through systematic transrectal prostate biopsy. Apparent diffusion coefficient (ADC) maps were obtained with two b values (0 and 1000 s/mm2). The metabolic maps of 3D-MRS imaging were analyzed for the ratio of (Cho+Cre)/Cit in each sextant. All cases were evaluated by T2WI, DWI, and MRS, and then by the three methods combined. The statistical indicators and the receiver operating characteristic (ROC) curve analysis of each method were compared to the results of histopathology obtained by transrectal prostate biopsy. Results: 15 of 42 cases were confirmed to be cancerous, and 27 of 42 cases were noncancerous. All the 252 sextants were confirmed by biopsies, including 201 benign sextants and 51 malignant sextants. The sensitivity and the specificity for the detection of prostate cancer were 88.2% and 67.2% for T2WI, as the cutoff was 3; 82.4% and 81.6% for DWI, as the cutoff was 4; 84.3% and 98.0% for MRS, as the cutoff was 5; and 96.1% and 96.5% for the combined T2WI+DWI+MRS, as the cutoff was 4. In the ROC analysis, the correlative areas under the ROC curves (Az) were 0.848±0.030, 0.860±0.033, and 0.961±0.016 for T2WI, DWI, and MRS, respectively, and 0.978±0.009 for the combination of T2WI+DWI+MRS. Conclusion: The accuracy of the detection of prostate cancer is increased through a combination of the three techniques. Moreover, MRS demonstrated higher accuracy compared with T2WI or DWI.
Redistribution of multiple hepatic arteries into a single hepatic artery to perform repeated hepatic arterial infusion chemotherapy
Authors: Yamagami T. , Yoshimatsu R. , Matsumoto T. , Nishimura T. 
Published: May 2008

Background: In patients with two or more intrahepatic arteries, multiple intrahepatic arteries should be converted into a single intrahepatic artery before repeated hepatic arterial infusion chemotherapy. However, the number of reports investigating this has been scanty. Purpose: To evaluate the usefulness of the redistribution of multiple hepatic arteries into a single hepatic artery for repeated hepatic arterial infusion chemotherapy (HAIC) through an indwelling port-catheter system for unresectable liver malignancies. Material and Methods: In 76 patients with unresectable advanced liver cancer, redistribution of multiple hepatic arteries into one hepatic artery was performed prior to port-catheter system implantation. Investigated were distribution in the liver, as evaluated with computed tomography (CT) during arteriography via the port after implantation, and management of cases in which distribution in the entire liver was not achieved. Results: In 64 patients, good distribution in the entire liver was confirmed on CT arteriography via the port. In the remaining 12 patients, contrast material was heterogeneously distributed. The segments with poor distribution were segments VI, VII, VIII, and I. In the five patients with tumors in segments having poor distribution, the right inferior phrenic artery was successfully embolized and good distribution throughout the entire liver was thereafter achieved in all five. Conclusion: In cases with multiple hepatic arteries, redistribution procedures allow application of repeated HAIC through a single indwelling catheter while maintaining distribution over the entire liver. However, care regarding hepatopetal flow of the right inferior phrenic artery is necessary.
Magnetic resonance features of cerebral malaria
Authors: Yadav P. , Sharma R. , Kumar S. , Kumar U. 
Published: May 2008

Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm2, and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients.
Imaging of the inflammatory response in reperfusion injury after transient cerebral ischemia in rats: correlation of superparamagnetic iron oxide-enhanced magnetic resonance imaging with histopathology
Authors: Kim J. , Kim D. I. , Lee S.-K. , Kim D. J. , Lee J. E. , Ahn S. K. 
Published: May 2008

Background: Acute inflammatory responses have been thought to play a central role in ischemia-reperfusion injury after acute ischemic stroke. Superparamagnetic iron oxide (SPIO) particles have been known to enable in-vivo monitoring of macrophage infiltration by magnetic resonance imaging (MRI) in the experimental ischemic rat brain. Purpose: To determine whether the accumulation of macrophages could be seen in vivo in a reperfusion animal model after focal cerebral ischemia using SPIO-enhanced MRI. Material and Methods: Thirty-four adult male rats were enrolled in this study. SPIO particles were injected into the rats at different time points after 1-hour transient occlusion of the middle cerebral artery, and three-dimensional (3D) T2*-weighted magnetic resonance (MR) images with a gradient-echo sequence were performed 24 hours later. Histochemical iron staining was compared with T2* signal abnormalities. Results: At days 3 and 4 post-reperfusion, focal areas of signal loss indicating local accumulation of SPIO particles appeared in a part of the damaged brain. Areas of signal loss corresponded to local accumulation of iron-laden macrophages in histologic sections, and SPIO-induced signal loss indicated active macrophage transmigration into the reperfused brain. Conclusion: SPIO-enhanced MRI demonstrated through in-vivo monitoring that macrophages participate in reperfusion injury at early stages of injury development. SPIO-enhanced MRI could be a useful tool to examine the inflammatory mechanisms involved in reperfusion brain injury.
Color doppler appearance of penile cavernosal-spongiosal communications in patients with high-flow priapism
Authors: Bertolotto M. , Zappetti R. , Pizzolato R. , Liguori G. 
Published: May 2008

Background: Superselective embolization of the torn artery is currently considered the treatment of choice for patients with high-flow priapism. After embolization, however, the arterial-sinusoidal fistula is still patent in a significant percentage of patients, despite arteriographic evidence of occlusion. Purpose: To investigate the prevalence and flow characteristics of penile cavernosal-spongiosal communications (CSCs) in patients with high-flow priapism, and to establish whether the recognition of these vessels before and after angiographic embolization has a role in predicting the outcome of therapy. Material and Methods: Twelve consecutive patients with high-flow priapism underwent penile color Doppler ultrasound before and after angiographic embolization of the arterial-sinusoidal fistula. The prevalence of CSCs feeding the fistula was evaluated before and after embolization. Results: Before angiographic embolization, color Doppler ultrasound identified five CSCs in 3/12 patients. One CSC was proximal to the fistula, and 4/5 were distal. After angiographic embolization, the fistula was not completely closed in these patients, fed by the distal CSCs. However, spontaneous closure occurred within 1 month. The fistula was also fed by CSCs in another two patients in whom these vessels were not evident before embolization. In one case, the fistula closed spontaneously within 1 week, while in the other case the fistula remained patent, fed by other collateral vessels. Conclusion: The type of vessels that are involved in refilling the fistula after embolization is of concern for the outcome of the patients. In our series, the fistulas supplied only by CSCs closed spontaneously within 1 month. Watchful waiting should be preferred to repeated embolization to avoid the risk of unnecessary procedures.
Contrast medium dose-to-gfr ratio: a measure of systemic exposure to predict contrast-induced nephropathy after percutaneous coronary intervention
Authors: Nyman U. , Björk J. , Aspelin P. , Marenzi G. 
Published: May 2008

Background: The contrast medium (CM) dose-to-eGFR (estimated glomerular filtration rate) ratio has recently been advocated to express systemic exposure to CM in assessing the risk of contrast medium-induced nephropathy (CIN). Purpose: To evaluate how CIN risk might vary with decreasing eGFR at fixed CM-dose/eGFR ratios and other CIN risk factors, and to find a relatively safe CM-dose/eGFR ratio. Material and Methods: 391 patients underwent primary coronary angioplasty for ST-segment elevation acute myocardial infarction. CM dose (grams iodine; g I), eGFR (ml/min), and preprocedural CIN risk factors were entered into a multiple logistic regression model. From the established statistical model, the probability of CIN (≥44.2 µmol/l serum creatinine rise or oliguria/anuria) was calculated at various eGFR levels based on g-I/eGFR ratios of 1:2, 1:1, 2:1, and 3:1. Results: At a g-I/eGFR ratio <1 the risk of CIN was 3%, while it was 25% at a g-I/eGFR ratio ≥1. Independent predictors of CIN were CM dose, eGFR, left ventricular ejection fraction (LVEF) and cardiogenic shock (ROC area =0.87). An estimated CIN risk of 10% would for example occur at a g-I/eGFR ratio of 1.5:1 in patients with 50% LVEF without shock. At a 1:2, 1:1, 2:1, and 3:1 g-I/eGFR ratio with 50% LVEF without shock, the CIN risk was about 2, 6, 18, and 30%, respectively, over a wide range of eGFR values (30–90 ml/min). At a 1:1 g-I/eGFR ratio with 50% LVEF+shock, 25% LVEF without shock, or 25% LVEF+shock, the CIN risk was 20, 55, and 80%, respectively. Conclusion: Relating CM dose to eGFR appears to be an attractive pharmacotoxic model to assess CIN risk. At fixed CM-dose/eGFR ratios, CIN risk increased marginally with decreasing eGFR. Limiting the CM dose in g I numerically to the eGFR value in ml/min or less may be relatively safe with regard to CIN, unless multiple risk factors are present.
Magnetic resonance evaluation of adnexal masses
Authors: Guerra A. , Cunha T. M. , Félix A. 
Published: May 2008

Background: Accurate evaluation of adnexal masses allows correct surgical procedure, avoiding unnecessary surgery. Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of malignancy of adnexal lesions. Material and Methods: We retrospectively reviewed the pelvic MRI scans of 161 patients with 199 surgically confirmed adnexal masses, between November 1998 and June 2005. The criteria for adnexal malignancy were contrast-enhanced solid lesions, contrast-enhanced solid components in mixed lesions (except those with low-signal-intensity solid components on T2-weighted imaging [T2WI]), contrast-enhanced papillary projections in cystic lesions (except those with low-signal-intensity papillary projections on T2WI), or septal thickness ≥3 mm. Ascites, peritoneal metastasis, and pelvic adenopathy were also regarded as criteria for malignancy. Results: On MRI evaluation, 97 adnexal lesions were malignant and 102 were non-malignant. Thirty-two percent of patients with ascites had benign lesions. Histopathologic evaluation of the adnexal lesions showed that 83 were malignant (true positives), 100 were non-malignant (true negatives), and seven were uncertain malignant potential tumors; two were false negative and seven were false positive. The MRI sensitivity and specificity for malignancy were 98% and 93%, respectively. MRI reached an accuracy of 95%, with a positive predictive value of 0.92 and a negative predictive value of 0.98 for malignant adnexal lesions. The kappa coefficient was 0.906, indicating almost perfect agreement between MRI and histological results. Conclusion: MRI is an accurate method for evaluating the malignancy of adnexal lesions.
Có vay có tra’ (What goes around comes around): culture, risk and vulnerability to blood‐borne viruses among ethnic Vietnamese injecting drug users
Authors: HO HIEN THI , MAHER LISA 
Published: May 2008

AbstractIntroduction and Aims. Ethnic and cultural differences in vulnerability to drug‐related harms have received little attention in Australia. The current study aimed to explore the influence of cultural beliefs and practices on vulnerability to blood‐borne viral infections (BBVIs) among ethnic Vietnamese IDUs and to identify barriers to this group accessing health and preventive programmes. Design and Methods. Observational fieldwork and in‐depth interviews (n = 58) were conducted in South Western Sydney. Participants were recruited using a mix of snowball and theoretical sampling strategies. Open coding was used to inductively classify data into themes and data examined for regularities and variations in relationships between and within themes. Results. Participants embraced pluralistic approaches to prevention, diagnosis and treatment, relying on co‐existing layers of beliefs and utilising both traditional and western remedies. Four main cultural characteristics influenced vulnerability to BBVIs: trust and obligation, stoicism, the importance of ‘face’ and beliefs in fate. Other factors influencing injecting risk included low levels of knowledge, being in a state of withdrawal, availability of sterile injecting equipment and environmental constraints. Barriers to accessing services included stigma and discrimination, concerns in relation to confidentiality, long waiting times, resistance to pharmacotherapy treatment and language and financial barriers. Discussion and Conclusions. Results indicate a need for interventions based on culturally specific meanings and contexts of health, illness and risk. By understanding how culture impacts risk and protective behaviours among ethnic Vietnamese IDUs, clinicians and other service providers will be better equipped to meet the needs of this vulnerable group.
Why are alcohol‐related emergency department presentations under‐detected? An exploratory study using nursing triage text
Authors: INDIG DEVON , COPELAND JAN , CONIGRAVE K. M. , ROTENKO IRENE 
Published: May 2008

AbstractIntroduction and Aims. This study examined two methods of detecting alcohol‐related emergency department (ED) presentations, provisional medical diagnosis and nursing triage text, and compared patient and service delivery characteristics to determine which patients are being missed from formal diagnosis in order to explore why alcohol‐related ED presentations are under‐detected. Design and Methods. Data were reviewed for all ED presentations from 2004 to 2006 (n = 118 881) for a major teaching hospital in Sydney, Australia. Each record included two nursing triage free‐text fields, which were searched for over 60 alcohol‐related terms and coded for a range of issues. Adjusted odds ratios were used to compare diagnostically coded alcohol‐related presentations to those detected using triage text. Results. Approximately 4.5% of ED presentations were identified as alcohol‐related, with 24% of these identified through diagnostic codes and the remainder identified by triage text. Diagnostic coding was more likely if the patient arrived by ambulance [odds ratio (OR) = 2.35] or showed signs of aggression (OR = 1.86). Failure to code alcohol‐related issues was more than three times (OR = 3.23) more likely for patients with injuries. Discussion and Conclusions. Alcohol‐related presentations place a high demand on ED staff and less than one‐quarter have an alcohol‐related diagnosis recorded by their treating doctor. In order for routine ED data to be more effective for detecting alcohol‐related ED presentations, it is recommended that additional resources such as an alcohol health worker be employed in Australian hospitals. These workers can educate and support ED staff to identify more clearly and record the clinical signs of alcohol and directly provide brief interventions.
Satisfaction guaranteed? What clients on methadone and buprenorphine think about their treatment
Authors: MADDEN ANNIE , LEA TOBY , BATH NICKY , WINSTOCK ADAM R. 
Published: May 2008

AbstractIntroduction and Aims. A consumer satisfaction survey was conducted among clients receiving methadone or buprenorphine treatment for opioid dependence. The survey aimed to assess client perceptions across a number of treatment domains, including the clinic environment, service provision, clinical relationships, medication and treatment outcomes. Design and Methods. Participants were 432 clients receiving treatment at nine public clinics in New South Wales, Australia. An interviewer‐administered questionnaire was utilised, designed by the researchers. Participation was voluntary and anonymous. All participants received $10 remuneration. Results. Seventy‐eight per cent of participants were on methadone treatment. Overall satisfaction with treatment was high (mean: 3.8; very satisfied = 5). Participants were mainly satisfied with service provided by the clinic, although had concerns over the inflexibility associated with the clinic atmosphere, frequency of clinic attendance, dosing hours and lack of takeaway doses. While relationships with prescribers and case managers were rated positively, 16% and 21% of participants wanted to see their prescriber and case manager more often, respectively; 53% reported that they did not have input into their care plan. Regarding the helpfulness of case managers in assisting clients with problems experienced in identified domains of case management (e.g. drug use, physical and mental health, psychosocial supports), the mean rating was 5.2 (excellent = 10). Discussion and Conclusions. While participants reported being mainly satisfied with their treatment, results must be viewed within the context of what a consumer reasonably expects to receive from a service. The concept of ‘expectation’ and ‘relative experience’ is crucial in measuring consumer satisfaction among pharmacotherapy consumers.
How large must a treatment effect be before it matters to practitioners? An estimation method and demonstration
Authors: MILLER WILLIAM R. , MANUEL JENNIFER KNAPP 
Published: May 2008

AbstractIntroduction and Aims. Treatment research is sometimes criticised as lacking in clinical relevance, and one potential source of this friction is a disconnection between statistical significance and what clinicians regard to be a meaningful difference in outcomes. This report demonstrates a novel methodology for estimating what substance abuse practitioners regard to be clinically important differences. Design and Methods. To illustrate the estimation method, we surveyed 50 substance abuse treatment providers participating in the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Practitioners identified thresholds for clinically meaningful differences on nine common outcome variables, indicated the size of effect that would justify their learning a new treatment method and estimated current outcomes from their services. Results. Clinicians judged a difference between two treatments to be meaningful if outcomes were improved by about 10 – 12 points on the percentage of patients totally abstaining, arrested for driving while intoxicated, employed or having abnormal liver enzymes. A 5 percentage‐point reduction in patient mortality was regarded as clinically significant. On continuous outcome measures (such as percentage of days abstinent or drinks per drinking day), practitioners judged an outcome to be significant when it doubled or halved the base rate. When a new treatment meets such criteria, practitioners were interested in learning it. Discussion and Conclusions. Effects that are statistically significant in clinical trials may be unimpressive to practitioners. Clinicians' judgements of meaningful differences can inform the powering of clinical trials.