bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coblation Adenotonsillectomy: An Improvement Over Electrocautery Technique?
Authors: Glade Robert S. , Pearson Susan E. , Zalzal George H. , Choi Sukgi S. 
Published: May 2006

OBJECTIVESTo compare postoperative complication rates of coblation and electrocautery adenotonsillectomies.STUDY DESIGNRetrospective chart review.RESULTSFrom January 2000 to June 2004, 1997 pediatric patients underwent adenotonsillectomy. 745 coblation, and 1252 electrocautery tonsillectomies were performed. Primary bleed, secondary bleed, and dehydration were seen in 3, 35, and 23 coblation, and 9, 41, and 64 electrocautery tonsillectomies, respectively. Data analysis revealed no significant difference in primary and secondary hemorrhage rate, but a higher dehydration rate in the electrocautery group (P = 0.0423). A total of 602 coblation, 763 curette/cautery, and 632 electrocautery adenoidectomies were performed. Neck pain was seen in 0, 17, and 3 patients, respectively. Data analysis showed a higher incidence of neck pain with the curette/cautery technique compared with coblator and cautery techniques (P = 0.0006 and P = 0.0119, respectively).CONCLUSIONSCoblation tonsillectomy had similar rates of primary and secondary hemorrhage when compared with electrocautery tonsillectomy but a lower incidence of postoperative dehydration. Coblation adenoidectomy caused less postoperative neck pain than curette/cautery adenoidectomy without significant advantage over cautery adenoidectomy.EBM rating: B‐3b
Sudden Sensorineural Hearing Loss: Long‐term Follow‐up Results
Authors: Psifidis Anestis D. , Psillas George K. , Daniilidis Jiannis Ch. 
Published: May 2006

OBJECTIVEThis study describes the long‐term outcome of patients suffering from sudden sensorineural hearing loss (SSHL) after an initial combined therapy of steroids with vasodilators.STUDY DESIGN AND SETTINGEighty cases were retrospectively reviewed to evaluate the long‐term audiometric data and to statistically assess the value of specific clinical parameters. The persistent long‐term otoneurologic manifestations associated with SSHL were also reported.RESULTSIn the long‐term period, hearing level remained stable 2 months after the onset of SSHL. Patients complained of persistent tinnitus (36%), fluctuant hearing loss (8.7%), dizziness (8.7%), and classical Meniere's triad in 2.5% of cases. Profound and total SSHL associated with vertigo are poor prognostic indicators.CONCLUSIONSIn terms of cost‐effectiveness, a steroid‐vasodilator therapy for SSHL for >2 months is not recommended because no additional effect was evidenced. Persistent otoneurologic manifestations, mainly tinnitus or dizziness are relatively common, particularly in patients with severe to total SSHL.EBM rating: C‐4
Evaluation of Super‐High‐Dose Steroid Therapy for Sudden Sensorineural Hearing Loss
Authors: Aoki Daisuke , Takegoshi Hideki , Kikuchi Shigeru 
Published: May 2006

OBJECTIVETo determine the efficacy of a high‐dose steroid regimen for patients with sudden sensorineural hearing loss (SSNHL) and to evaluate the relationship between outcome and initial steroid dose.STUDY DESIGN AND SETTINGWe conducted a retrospective study of 112 patients presenting to Saitama Medical Center. Patients received tapering courses of hydrocortisone (HC) with an initial dose of either 1200 mg or 600 mg.RESULTSMore than 87% of patients had recovery of hearing. When hearing stabilized, there were no significant differences between the 1200 mg and 600 mg groups in terms of hearing outcome (P > 0.05). However, at completion of treatment, the 1200 mg group exhibited significantly superior complete recovery rate and improvement rate (P < 0.05).CONCLUSIONApplication of our treatment protocol of a tapered course of 1200 mg HC significantly and rapidly improves recovery outcomes in patients of SSNHL.EBM rating: C‐4
Nasal health in Down syndrome: A cross‐sectional study
Authors: Chen Margaret A. , Lander Timothy R. , Murphy Claire 
Published: May 2006

OBJECTIVETo investigate peripheral nasal pathology as a contributor to olfactory impairment in DS.STUDY DESIGNTwenty DS and 16 non‐DS subjects were recruited. Nasal history and symptoms were assessed by self‐report or informant. Olfactory threshold, odor identification, and nasal endoscopy were assessed on each subject.RESULTSDS subjects were impaired on olfactory threshold (P < 0.0001) and odor identification (P < 0.001). Although DS subjects trended toward upper‐respiratory infections, sleep‐disordered breathing, and nasal itching, differences were not significant (P = 0.07, 0.06, and 0.058, respectively). There were no significant differences on self‐reported nasal history or symptoms. Endoscopy showed equivalent health in DS and control subjects.CONCLUSIONThis DS population shows olfactory impairment. However, nasal health is comparable in DS subjects and controls. Nasal dysfunction is unlikely to contribute to olfactory impairment in DS.SIGNIFICANCEOlfactory deficits in DS appear to be secondary to central, rather than rhinologic, pathology.EBM rating: B‐2b
Adult Spontaneous CSF Otorrhea: Correlation with Radiographic Empty Sella
Authors: Prichard Christopher N. , Isaacson Brandon , Oghalai John S. , Coker Newton J. , Vrabec Jeffrey T. 
Published: May 2006

OBJECTIVETo determine the prevalence of radiographic empty sella in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.STUDY DESIGN AND SETTINGRetrospective case series of adult patients with CSF otorhinorrhea at an academic tertiary medical center. Patients with history of skull base surgery, trauma, tumor, or chronic ear disease were excluded. Available imaging studies were reviewed with attention to the sella turcica.RESULTSEight patients were diagnosed with spontaneous CSF otorrhea. Five of seven patients with adequate imaging studies (71%) had a radiographic empty sella. Seven of eight patients were clinically obese, with a body mass index BMI >30 kg/m2.CONCLUSIONSEmpty sella is a common radiologic finding in patients with spontaneous CSF otorrhea. This supports the theory that increased intracranial pressure contributes to development of spontaneous CSF otorrhea.SIGNIFICANCERadiographic empty sella predicts elevated intracranial pressure, which may require further evaluation and treatment in patients with spontaneous CSF otorrhea.EBM rating: C‐4
A Survey of Parental Views Regarding their Child's Hearing Loss: A Pilot Study
Authors: Park Albert H. , Warner Jonathan , Sturgill Nanette , Alder Stephen C. 
Published: May 2006

OBJECTIVEAssess parental perceptions of their child's sensorineural hearing loss care.METHODSFamilies of pediatric patients diagnosed with a sensorineural hearing loss from 2000 to 2004 were sent a survey asking about their experiences with their child's hearing loss.RESULTSOne hundred eight of 389 families surveyed were studied. Thirteen percent did not know the results of the newborn screening. Twenty‐two percent of the primary care physicians were not involved in the child's hearing evaluation. Forty percent of the patients underwent 4 or more audiologic tests before a diagnosis. The most common reason for delayed diagnosis was difficulty in obtaining an appointment with an audiologist. Sixty‐two percent of families had difficulties obtaining hearing aids, and 58% noted difficulties obtaining cochlear implants.CONCLUSIONSFamilies reported multiple obstacles to obtain timely diagnosis and treatment. Otolaryngologists may need to be more involved in the evaluation and treatment of these patients.EBM rating: C‐4
Snoring Significance in Patients Undergoing Home Sleep Studies
Authors: Hunsaker Darrell H. , Riffenburgh Robert H. 
Published: May 2006

OBJECTIVETo analyze the impact of snoring, independent of obstructive sleep apnea syndrome on patients referred for home sleep studies and to report a new technology for the reporting of snoring, using sophisticated sound collection and noise‐canceling technology.STUDY DESIGN AND SETTINGA retrospective statistical review of consecutive anonymous data compiled from questionnaires and digital data of snoring loudness and duration measured at the upper lip during unattended home sleep studies in 4,860 patients referred for snoring and sleep‐disturbed breathing.RESULTSA strong relationship exists between a history of snoring and complaints of daytime sleepiness (80%), obesity (73%), and chronic fatigue (78%) (all yield P < 0.001). By contrast, only 42% to 48% of patients without these symptoms complain of snoring. In 3 multiple‐regression analyses, the percent of time snoring, average loudness, and peak loudness are all significantly predicted by the apnea hypopnea index (all P < 0.003), body mass index (all P < 0.001), and age (P = 0.014). Daytime sleepiness was strongly predicted by percent time snoring (P = 0.014), weakly by average loudness (P = 0.046), and not at all by peak loudness (P = 0.303).CONCLUSIONBy using a pair of microphones placed at the upper lip, one that samples breath sounds and the other ambient sound and artifact noise, the NovaSOM QSG measures snoring while canceling ambient noise. The clinical impact of snoring on the patient as well as the bed partner, independent of obstructive sleep apnea syndrome, is an unrecognized factor in sleep‐disturbed breathing.SIGNIFICANCEMeasurable criteria to define snoring are suggested. Snoring loudness is not measured in most laboratory Polysomnograms.EBM rating: B‐3b
Who chooses whom? Syndication, skills and reputation
Authors: Tykvová Tereza 
Published: May 2006

AbstractWe develop a model focusing on the dynamic aspect of syndication, namely, the know‐how transfer between syndication partners and their ability to learn. The core of the analysis checks whether reputational concerns outweigh the temptation to renege on a given contract. Throughout the paper, we investigate two key topics. The first consists of the conditions under which investors syndicate their deals. The second focuses on who chooses whom. Sometimes, the syndication is impeded because the financier believes that his partner has strong incentives to either renege on a contract (hold‐up problem) or to shirk (moral hazard problem).
Cost analysis of an open low-field (0.23t) MRI unit: effect of procedure shares in combined imaging, interventional, and neurosurgical use
Authors: Ronkainen J. , Tervonen O. 
Published: May 2006

Purpose: To analyze the cost structure of procedures performed in a multipurpose interventional magnetic resonance imaging (IMRI) unit and to analyze the effect of procedure shares on cost structure. Material and Methods: During a 1-year period, 691 procedures were performed in the IMRI unit, of which 563 were diagnostic MRI examinations, 89 MRI-guided interventions, and 39 MRI-guided neurosurgical operations. Three alternative utilization models of IMRI were created to simulate different local institutions by adjusting the proportions of different procedures. The costs of procedures were calculated by activity-based cost analysis. Results: The cost of the main procedure (imaging, biopsy, injection, or operation) was the most significant item in all procedures, accounting for 66–89% of the total costs. The volume of imaging has a major effect on unit costs. Volume is not such a deterministic factor in interventions due to the high material costs. The volume of neurosurgical use of IMRI has a major effect on the costs of radiological procedures due to the long operation times. Conclusion: The volumes of different procedures done on an IMRI unit have significant effects on the unit costs of the procedures.
Magnetic resonance imaging in linburg-comstock anomaly
Authors: Karalezli N. , Haykir R. , Karakose S. , Yildirim S. 
Published: May 2006

Purpose: To determine the usefulness of magnetic resonance imaging (MRI) in detecting the tendinous connection in Linburg-Comstock anomaly. Material and Methods: The study comprised 52 patients attending the orthopedic clinic for different hand problems. They were also examined for the presence of Linburg-Comstock anomaly, which was present in nine, and these patients were examined by MRI. Results: The tendinous connection between flexor pollicis longus and flexor digitorum longus in all patients was shown by MRI. The connections were in the wrist, just proximal to the radiocarpal joint or distal forearm. Conclusion: MRI can show localization of the connection in this anomaly and helps the surgeon perform the operation with a limited incision. The operation time is therefore shorter and wound scarring less prominent.
Hepatocellular carcinoma in association with hepatic focal nodular hyperplasia
Authors: Langrehr J. M. , Pfitzmann R. , Hermann M. , Radke C. , Neuhaus P. , Pech M. , Denecke T. , Felix R. , Hänninen E. L. 
Published: May 2006

Purpose: To report the association between hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia (FNH) and the possible impact on clinical decision-making with regard to resective approaches in patients with FNH.Material and Methods: We retrospectively analyzed the findings in 77 adult patients who underwent liver resections for FNH between October 1989 and September 2001 at our center. HCC within the confines of FNH was found in two patients. We demonstrate the magnetic resonance imaging (MRI) and macroscopic and microscopic findings.Results: Presurgical MRI demonstrated heterogeneous signal characteristics of moderately hyperintense FNH on T2-weighted images and, after IV administration of super-paramagnetic iron oxide particles, HCC in FNH was barely delineable. Both patients underwent successful right hemihepatectomy to remove the suspicious FNH with diameters of 12 and 14 cm; intralesional HCC diameters were 3 and 5 cm, respectively. Patients could be rapidly dismissed. However, one patient died after recurrence of HCC 1.5 years after surgery, whereas the other patient continues tumor-free 4 years after surgery. Alpha-feto-protein was normal in both patients.Conclusion: In FNH with rapid growth tendency and heterogenic MR appearance, surgical removal should be considered to overcome the risk of inadequate therapy in the very rare group of patients with HCC in association with FNH.
Effects of high‐dose sublingual immunotherapy on quality of life in patients with cypress‐induced rhinitis: a placebo‐controlled study
Authors: Di Rienzo V. , Pucci S. , D'Alò S. , Di Cara G. , Incorvaia C. , Frati F. , Romano A. 
Published: May 2006

SummaryThe efficacy of specific immunotherapy and particularly of sublingual immunotherapy (SLIT) in subjects allergic to Cupressaceae pollen is well defined, but no study assessed its effects on quality of life (QoL). We evaluated the effectiveness of SLIT with a standardized, high‐dose extract of Juniperus ashei in patients with cypress‐induced rhinitis, using QoL as the major outcome measure. Thirty‐four patients, 20 males and 14 females, mean age 33.8 years, with allergic rhinitis (AR) from cypress pollen were randomly assigned to receive an allergen extract standardized in index of reactivity (IR) of J. ashei (19 patients) or a placebo (15 patients). The schedule was pre‐coseasonal, with a build‐up phase in 12 days and a maintenance treatment with 300 IR a day up to the end of the cypress pollen season. All patients registered in diary cards their symptoms, drug consumption and side‐effects. The QoL was measured before and after SLIT by the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) by Juniper during the peak of the cypress pollen season. QoL significantly improved in respect to baseline in actively (P=0.017) but not in placebo‐treated patients, and there was a significant difference in favour of actively treated patients during the pollen season (P=0.02). Actively and placebo‐treated patients had comparable symptom–medication scores in the period from 15 February to 15 March, corresponding to the peak pollen season, but placebo‐treated patients showed an uneven drug consumption compared with actively treated patients. Side‐effects were relatively common, but mostly with local short‐lasting symptoms, and no systemic reaction was reported. These findings show that SLIT with high doses of J. ashei in subjects with cypress‐induced rhinitis significantly improves QoL and confirm previous observations on the disagreement between QoL – which assesses patient's perception – and medical parameters used in trials.
Quality of life in allergic rhinitis
Authors: Passalacqua G. , Baiardini I. 
Published: May 2006

SummaryQuality of life (QoL)or, better, health‐related quality of life, is now recognized as a crucial aspect in assessing the impact of a given disease on the general well‐being of patients. This fact was ascertained in the last 10 years also for respiratory allergy (asthma and rhinitis). In particular, it was shown that allergic rhinitis (AR), although not life threatening, profoundly affects many aspects of everyday life. In this regard, a number of specific questionnaires (instruments) have been developed and validated to assess the quality of life in adults, adolescents and children. Although the concept of QoL is easy to understand, the development and validation process of questionnaires is quite complex and time consuming.The literature provided strong evidence of the effects of AR and its treatments on QoL, but also evidenced some controversial points, including the weak correlation of QoL with objective parameters. It has therefore become clear that QoL questionnaires measure aspects of the disease that partially differ from the routinely evaluated parameters and that quality of life should integrate, not replace, the objective measurements. In the near future, ‘sharper’ instruments are expected to be developed for the evaluation of quality of life and of the effects of treatments in AR.
Quality of life in allergic rhinitis and impact of high‐dose sublingual immunotherapy: a real‐life study
Authors: Ariano R. , Amoroso S. , Astarita C. , Bassi M. , Bonadonna P. , Campi P. , Di Gioacchino M. , Musarra A. , Quercia O. , Russello M. , Venuti A. , Zambito M. , Di Cara G. , Incorvaia C. , Puccinelli P. , Frati F. 
Published: May 2006

SummaryAllergic rhinitis (AR) may significantly impair quality of life (QoL), and therefore it is important to evaluate the effectiveness of the available treatments on such a parameter. We studied QoL by a real‐life model in a large group of patients with rhinitis caused by the most common aeroallergens and assessed the effects of high‐dose sublingual immunotherapy (SLIT). An overall number of 452 subjects (229 males, 223 females, mean age 25±13 years) was included in the study. Of them, 208 were allergic to house dust mites, 196 to grass pollen, 104 to Parietaria pollen, 48 to olive pollen, 28 to ragweed pollen, and two to cypress pollen. QoL was measured before and after SLIT with the specific questionnaire Rhinoconjunctivitis Quality‐of Life‐Questionnaire (RQLQ) introduced and validated by Juniper. At the same time, patients evaluated their clinical status by visual analogue scale (VAS) from 0 (worst) to 10 (best). SLIT was performed by extracts from Stallergénes standardized in index of reactivity (IR) by a build‐up phase in 11 days and a maintenance phase with 300 IR three times a week for the duration of the study. All side‐effects were registered. The mean RQLQ was 2.93±1.04 before SLIT and 1.50±0.98 after SLIT (P<0.001), with comparable improvement in the different allergen treatments. The respective mean VAS score was 4.47±2.11 and 6.92±1.64 (P<0.001). SLIT was completely tolerated in 395 patients (87.4%), while in 57 (12.6%) it gave rise to slight reactions, mostly at the local level in the mouth or in the gastrointestinal tract. High dose SLIT, administered in a clinical model comparable with routine application, provides significant improvement of both clinical status and QoL in patients with AR caused by common aeroallergens.
New therapeutic strategies: a chimeric human–cat fusion protein inhibits allergic reactivity
Authors: Terada T. 
Published: May 2006

SummaryWe have undertaken to develop new therapies for allergic diseases by taking advantage of negative signalling via immunoreceptor tyrosine‐based inhibition motif (ITIM)‐containing receptors. Bi‐functional molecules that indirectly crosslink Fcɛ receptors to FcγII receptors on targeted cells were constructed. This approach employed coaggregation of FcɛRI and FcγRII using an antigen‐specific chimeric fusion protein (GFD) composed of human Fcγ and the major cat allergen Fel d 1. GFD was designed to block mediator release by directly attaching to Fcγ receptors and at the same time indirectly binding to FcɛRI via Fel d 1 antigen‐specific IgE already bound to that receptor. GFD was expected to function as a safe form of antigen‐specific immunotherapy by blocking acute reactivity to Fel d 1; i.e. by functioning as an immunogen but not as allergen.GFD inhibited passive cutaneous anaphylaxis (PCA) reactivity to Fel d 1 in transgenic mice but did not induce skin reactivity at sensitized sites. Balb/c mice sensitized to Fel d 1 and challenged intratracheally (IT) on days 28 and 42 showed lowered temperature and increased lung resistance, indicating systemic and pulmonary allergic reactions, respectively. On the other hand, mice given GFD 5 μg SQ on days 7, 14, and 21 showed inhibition of systemic reactivity to IT challenge on days 28 and 42. Hence GFD inhibited Fel d 1‐induced allergic response in mice.This chimeric γ‐allergen protein platform may provide allergen‐specific therapy with an enhanced safety profile that might be critical in situations such as food allergy. Overall, we have developed new therapeutic strategies that are antigen‐specific and provide novel yet distinctive approaches for the potential therapy of human allergic disease.
Morphological and functional changes of epithelial cells in allergic rhinitis
Authors: Takeuchi K. , Suzuki S. , Majima Y. 
Published: May 2006

SummaryThe functions of epithelial cells in the nose can be summarized as follows: (1) building a physical barrier to prevent allergens and foreign bodies from penetrating into the subepithelial layers; (2) secreting airway fluid by transepithelial ion transport and mucin production; and (3) responding to various stimuli by producing mediators that recruit lymphocytes, eosinophils, and mast cells to the nasal mucosa. However, in the setting of allergic rhinitis (AR) various morphological and functional changes occur in these cells, and the physical barrier of epithelial cells becomes vulnerable, which enables allergens to penetrate into the subepithelial layers. Histamine and thrombin are factors that influence the physical barrier. Although it is believed that epithelial damage in AR is less extensive than that in bronchial asthma, continued allergen exposure does damage epithelial cells in allergic animal models. Changes in ion transport during acute allergic reactions in vivo can be studied by nasal transepithelial potential difference. Comparison of nasal potential differences during pollen season has revealed lower values in allergic patients than in normal control subjects; the lowest value was reached 15 min after nasal allergen challenge. In vitro studies revealed that various factors including leukotrienes increase mucin gene transcription. These changes may lead to abnormalities of nasal secretion during allergic reactions.