bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malignant parotid tumors in 110 consecutive patients: Treatment results and prognosis
Authors: Pedersen Dorte , Overgaard Jens , Søgaard Helmer , Elbrønd Ole , Overgaard Marie 
Published: October 2006

AbstractThe UICC 1987 classification system was used to retrospectively analyze the treatment results and prognostic factors in 110 consecutive patients. All of the patients had malignant parotid tumors which had been diagnosed and treated during the period from 1970 to 1986. Treatment consisted of surgery, radiotherapy, or a combination. Malignant mixed tumors were seen in 28% of the patients, mucoepidermoid tumors in 18%, adenoid cystic tumors in 15%, acinic tumors in 13%, undifferentiated tumors in 11%, adenocarcinomas in 10%, and other types in 5%. Ten‐year corrected survival rate was 52%, and significant differences of survival were found between: 1. patients with disease stages I through IV (I: 85%; II: 69%; III: 43%; IV: 14%); 2. those with local tumor extension (34%) and without local tumor extension (79%); 3. patients with facial nerve palsy (0%) and without facial nerve palsy (57%); and 4. those with low‐ or intermediate‐grade malignant tumors (69% combined) and those with high‐grade malignant tumors (30%). After primary treatment, 45% of the patients were cured, and, additionally, 22% were salvaged after local or neck node recurrences.It is concluded that there is a good correlation between TNM classification of UICC 1987 (stage and local extension of tumor) and prognosis, and that facial nerve palsy and grade of malignancy are important prognostic factors.
Preservation of hearing and facial nerve function in resection of acoustic neuroma
Authors: Nadol Joseph B. , Chiong Charlotte M. , Ojemann Robert G. , Mckenna Michael J. , Martuza Robert L. , Montgomery William W. , Levine Robert A. , Ronner Steven F. , Glynn Robert J. 
Published: October 2006

AbstractThe surgical results in 78 recent cases of total removal of unilateral acoustic neuroma in which an attempt was made to preserve cochlear function have been added to the authors' previous series of 66 cases to evaluate the factors influencing the ability to preserve useful hearing. Useful hearing was defined by speech reception threshold no poorer than 70 dB and a discrimination score of at least 15%. Analysis using a logistic regression model showed that certain preoperative clinical parameters such as tumor size, speech discrimination score, and gender were significantly correlated with hearing outcome. Favorable outcome was significantly correlated with smaller tumor size, higher preoperative speech discrimination score, and male sex. From this data, an explicit formula was devised for predicting hearing outcome for an individual patient. In four cases with useful hearing preserved, there was improvement of greater than 15 percentage points in speech discrimination scores.While preoperative auditory brainstem responses were not predictive of hearing preservation, monitoring of intraoperative auditory evoked potentials was predictive of hearing outcome in selected cases. Specifically, when wave V was unchanged at the end of the operation, even if it may have been transiently lost during surgery, useful hearing was invariably preserved.
Same‐day‐stay head and neck surgery
Authors: Helmus Christian , Grin Mina , Westfall Rolleen 
Published: October 2006

AbstractThe purpose of this study was to determine if selective head and neck surgical procedures on a same‐day basis are justifiable. Two hundred consecutive head and neck same‐day procedures were reviewed, including 84 parotidectomies and 116 other procedures previously managed as inpatients. Of the 200 patients, 36 (18%) were admitted, 33 for overnight observation, and 164 (82%) were discharged the same day. There were no complications reported in the discharged patients and a later questionnaire showed that 97% of the patients were satisfied. The advantages of selective same‐day procedures outweigh the disadvantages for otolaryngologist and patient.The study shows that same‐day‐stay head and neck surgery for selective procedures is safe, reasonable, and cost‐effective, but the combined efforts of the otolaryngologists, nurses, and administrators are required. Because of rising healthcare costs, experts are predicting a significant increase in the next few years of outpatient surgery, including surgery of the head and neck.
Classification of laryngotracheal stenosis
Authors: V. McCaffrey Thomas 
Published: October 2006

AbstractSeventy‐two cases of laryngotracheal stenosis treated from 1981 through 1991 were reviewed to develop a system of classification which wouldbe useful in predicting the outcome of treatment. Decannulation and absence of dyspnea after exertion were the criteria of successful management. The probability of decannulation over time was computed using the Kaplan‐Meier technique. Cox multiple regression analysis was used to determine the effects of independent variables (age, sex, etiology, site of stenosis, length of stenosis, diameter of stenosis, and surgical technique) on treatment success. The only factors with a significant effect on the outcome were site of stenosis and diameter of stenosis. A classification into four clinical stages of stenosis based on site of lesion was shown to effectively predict the likelihood of successful decannulation.
The management of subglottic stenosis in patients with wegener's granulomatosis
Authors: Lebovics Robert S. , Hoffman Gary S. , Leavitt Randi Y. , Kerr Gail S. , Hallahan Claire , Rottem Menachem , Fauci Anthony S. , Travis William D. , Kammerer William 
Published: October 2006

AbstractWegener's granulomatosis (WG) is a multisystem inflammatory disease characterized by vasculitis, granuloma formation, and necrosis. Among 158 patients treated at the National Institutes of Health during the past 24 years, 145 (92%) had an otolaryngologic manifestation of their disease and 25 (16%) had subglottic stenosis (SGS). SGS varied from asymptomatic to life‐threatening. Sixteen (80%) of 20 patients with fixed SGS required surgical intervention, including manual dilations, carbon‐dioxide laser resections, and laryngotracheoplasty (LTP). LTP was performed with and without microvascular reconstruction. Thirteen of the patients required tracheostomy and all 13 were ultimately decannulated. Five patients who repeatedly failed dilations and/or endoscopic laser surgery underwent LTP. Since 1987, two patients have undergone LTP with microvascular free flaps. Both patients were subsequently decannulated. The authors' experience demonstrates that management of SGS in WG is complex, requiring individualized frequent multimodality interventions to achieve satisfactory results. Microvascular laryngotracheal reconstruction should be considered in the surgical armamentarium for patients with persistent stenoses.
Surgical management of the thyroid nodule: Patient selection based on the results of fine‐needle aspiration cytology
Authors: Bouvet Michael , Feldman Jeffrey I. , Nahum Alan M. , Robbins K. Thomas , Gill Gordon N. , Dillmann Wolfgang H. , Russack Valentina 
Published: October 2006

AbstractTo determine whether the routine use of fine‐needle aspiration (FNA) cytology reduces the rate of unnecessary surgery, the surgical pathology of 54 thyroidectomy patients who had preoperative FNA was compared to the results obtained with 24 thyroidectomy patients who did not have preoperative FNA.Twenty‐nine (85.3%) of the 34 patients who had a positive FNA were confirmed by histology to have a thyroid neoplasm; in 24 patients, the neoplasm was malignant. Two of the 17 patients who had a negative FNA but underwent thyroidectomy based on other factors were found to have thyroid cancer. Only 8 (33.3%) of the 24 surgical specimens of patients who did not have an FNA were found to be malignant. FNA had a sensitivity of 93.5% and a specificity of 75.0%.The results indicate that the routine use of FNA for patients with thyroid nodules reduces the incidence of unnecessary surgery. Furthermore, FNA alone is sufficient to identify most patients at risk and is, therefore, cost‐effective. However, the presence of other findings suspicious of malignancy should preclude clinical decision making based on FNA alone.
Petrous apex cholesteatoma: Diagnostic and treatment dilemmas
Authors: Atlas Marcus D. , Moffat David A. , Hardy David G. 
Published: October 2006

AbstractThe diagnosis and treatment of petrous apex cholesteatoma is a difficult surgical challenge. This study is a review of 14 cases of cholesteatoma involving the petrous apex. These cholesteatomas originated as a congenital primary lesion or secondary to an acquired lesion. The cases were evaluated according to the clinical features, the intraoperative findings, the radiological findings, and the surgical approaches. In this series, 83% of the patients presented with hearing loss and 50% presented with facial nerve weakness or paralysis ←House grade II to VI→. Intraoperative and radiological features revealed frequent direct labyrinthine and supralabyrinthine cell spread. The transpetrous surgical approach was used in all cases. The main factors affecting the surgical approach to be adopted are the inaccessible nature of the petrous apex, the extent of disease, the degree of facial nerve function, and the need for the prevention of cerebrospinal fluid leaks and the recurrence of the lesion.
Amyloid of the facial nerve
Authors: Braganza Rabindra A. , Tien Robert , Hoffman Henry T. , Haghighi Parviz H. 
Published: October 2006

AbstractAlthough facial nerve paralysis has been reported in association with amyloidosis, histologic confirmation of facial nerve involvement with amyloid has not been previously demonstrated. A case of localized primary amyloidosis of the facial nerve is presented, and a new magnetic resonance technique for imaging the facial nerve is described.
Complementary and Alternative Therapies for the Management of Dyslipidemia
Authors: Nies Leslie K , Cymbala Alicia A , Kasten Sheila L , Lamprecht Donald G , Olson Kari L 
Published: October 2006

Objective: To review the literature on select alternative therapies for the management of dyslipidemia. Data Sources: Searches of MEDLINE and PubMed (1965–March 2006) were conducted using the key terms omega-3-fatty acids, policosanol, plant stands and sterols, flaxseed, red yeast rice, guggulipid, garlic, fiber, almonds, and cholesterol and/or lipids. Study Selection and Data Extraction: Meta-analyses, published in English and involving adults, that incorporated randomized, controlled trials on alternative therapies for dyslipidemia were reviewed. Additionally, trials published subsequent to the meta-analyses were reviewed. Articles deemed relevant were included in this review. Data Synthesis: Of the aforementioned alternative therapies, randomized controlled trials were found for omega-3-fatty acids, policosanol, plant stanols and sterols, flaxseed, red yeast rice, guggulipid, garlic, fiber, almonds, and soy. Studies for each of these agents report varying degrees of lipid reduction. Based on published data, effective therapeutic options for lipid-lowering include intake of fiber, intake of plant stanols/sterols, replacement of animal protein with soy protein, and substitution of foods high in saturated fat with those with monounsaturated fatty acids (eg, dry roasted almonds). Adding omega-3-fatty acids is effective for reducing triglycerides in patients with hypertriglyceridemia. Well-designed studies with long-term outcome data are necessary to further define the role for guggul, red yeast rice, policosanol, garlic, and flaxseed in the management of dyslipidemia. Conclusions: Alternative therapeutic approaches with complementary therapies are becoming increasingly popular among patients. It is important for healthcare providers to be familiar with the safety and efficacy of these agents to facilitate optimal outcomes for patients with dyslipidemia.
Antibiotic Prophylaxis in Cholecystectomies in a Teaching Hospital in Brazil
Authors: Zanotto Angelo R , Heineck Isabela , Ferreira Maria B 
Published: October 2006

Background: Medical literature reports that adequate prophylaxis with antibiotics can reduce the incidence of postoperative infections. Objective: To investigate the impact of adopting multiple practices for improving the rational use of antibiotic prophylaxis in patients undergoing cholecystectomy and evaluate, during 2 periods, compliance with the hospital Drug Committee's recommendation and guidelines published in the medical literature. Methods: Data were collected from patients' medical records at the Hospital de Clíniacas de Porto Alegre (HCPA), Brazil, in 2003. We evaluated 222 procedures as set by guidelines published in the literature and the hospital's recommendation. Results: In 24.5% of the cases, the choice of whether to use the prophylactic antibiotic was not made according to the guidelines. The choice of the antibiotic agent, prophylaxis duration, dose administered, and time for administration was appropriate in 95%, 80.5%, 100%, and 81.8% of cases, respectively. A significant improvement in guideline compliance was observed since multiple practices were adopted to improve the rational use of antibiotic prophylaxis. Conclusions: Compliance with the guidelines for antibiotic prophylaxis for cholecystectomy, in combination with a greater integration among the professionals involved in the HCPA Infection Control Service, resulted in a more appropriate use of these prophylactic agents. Improving physicians' awareness of the importance of meeting guidelines is critical and will benefit patients and the hospital as a whole.
Topiramate for Binge-Eating Disorder Associated with Obesity
Authors: Tata Asha L , Kockler Denise R 
Published: October 2006

Objective: To review the use of topiramate for the treatment of binge-eating disorder (BED) associated with obesity. Data Sources: MEDLINE (1966–July 2006) and the Cochrane Database (2006, issue 3) were used to conduct an English-language literature search. Key search terms included eating disorder, binge-eating, and topiramate. Bibliographies of identified articles were examined for additional references. Data Synthesis: BED is characterized by excessive food intake with lack of control during eating episodes, but without subsequent compensatory weight loss mechanisms, and is often associated with obesity and psychiatric disorders. Evidence suggests that topiramate may have mood-stabilizing properties and cause decreased appetite and weight. One case series, 1 case report, 2 open-label studies, and 1 placebo-controlled trial have described the use of topiramate for BED associated with obesity. Doses ranging from 50 to 1400 mg/day were stated to be effective in these reports. Adverse reactions included paresthesias, cognitive impairment, somnolence, and gastrointestinal distress. Although these adverse effects were transient, they may interfere with patients' tolerability of topiramate therapy. Conclusions: Albeit limited, evidence suggests that topiramate may be a viable short- and long-term treatment alternative for BED associated with obesity for patients with limited options. Further controlled trials are necessary to establish topiramate's place in therapy, optimal dosing, and length of treatment for this eating disorder.
GI Risk Factors and Use of GI Protective Agents Among Patients Receiving Nonsteroidal Antiinflammatory Drugs
Authors: Harris Crystal L , Raisch Dennis W , Abhyankar Upendra , Marfatia Shalaka , Campbell Heather M , Sather Mike R 
Published: October 2006

Background: Patient characteristics increase the risk of gastrointestinal (GI) complications associated with nonsteroidal antiinflammatory drugs (NSAIDs). Patients at risk may not be prescribed protective therapies that might mitigate their risk of NSAID-associated GI complications. Objective: To assess GI risk among Veterans Affairs (VA) patients on NSAID therapy, determine whether therapy conformed to VA guidelines for lessening the risk of GI complications, and identify patient risk factors associated with conformance. Methods: Using databases from 3 VA medical centers, we retrospectively identified patients receiving NSAIDs and obtained data regarding age, history of GI bleed over 8 years, GI adverse effects associated with NSAIDs, diagnoses, and medication history over one year. We inferred health status from age-adjusted Charlson comorbidity index values. Each patient's risk of developing GI complications over one year was calculated using these data. Among patients at significant or substantial risk, we assessed conformance to VA guidelines. We used logistic regression to identify risk factors associated with conformance and determine adjusted ORs (AORs) with 95% CIs for each risk factor. Results: There were 19122 patients receiving NSAIDs. Of 4589 patients at significant risk and 1246 at substantial risk, 1161 (25.3%) and 356 (28.6%), respectively, were prescribed guideline-conformant therapy. Risk factors associated with conformance (p s 0.001) among patients at significant risk were rheumatoid arthritis (AOR 1.34; 95% CI 1.13 to 1.58) and GI adverse effects (AOR 1.53; 95% CI 1.42 to 1.64). For substantial risk patients, risk factors associated with conformance (p s 0.031) were rheumatoid arthritis (AOR 1.65; 95% CI 1.37 to 1.98), concomitant corticosteroids (AOR 1.21; 95% CI 1.02 to 1.43), GI hospitalization (AOR 2.01; 95% CI 1.57 to 2.59), and GI adverse effects (AOR 1.79; 95% CI 1.47 to 2.18). Conclusions: Many patients at risk for GI adverse events do not receive guideline-conformant therapy. Educational interventions to improve conformance could focus on specific risk factors for GI complications.
Systematic Review of Antipsychotics for the Treatment of Hospital-Associated Delirium in Medically or Surgically III Patients
Authors: Lacasse Hélène , Perreault Marc M , Williamson David R 
Published: October 2006

Objective: To determine which antipsychotic is associated with the greatest efficacy and safety when used for the pharmacotherapeutic management of delirium in medically or surgically ill patients. Data Sources: MEDLINE, Current Contents, Cumulative Index of Nursing and Allied Health Literature, PsyclNFO, Biological Abstracts, Cochrane Central Register of Controlled Trials, and EMBASE databases (all to July 2006) were searched for trials evaluating the pharmacologic treatment of delirium in medically or surgically ill patients. The key terms used included delirium, agitation, or acute confusion, and antipsychotics, phenothiazine, butyrophenone, perphenazine, fluphenazine, clozapine, trifluorophenazine, loxapine, thioridazine, pimozide, molindone, haloperidol, methotrimeprazine, chlorpromazine, prochlorperazine, droperidol, risperidone, quetiapine, ziprasidone, amisulpride, or olanzapine. Study Selection and Data Extraction: Prospective, randomized, controlled trials comparing the clinical effects of antipsychotic therapy with placebo or comparing 2 antipsychotic treatments in an acute care setting were selected. Studies involving dementia-associated delirium, Alzheimer's disease-associated delirium, emergency department-associated acute agitation, acute brain trauma-associated agitation, or agitation secondary to underlying psychiatric afflictions such as depression or schizophrenia were excluded. All studies were evaluated independently by the 3 authors using a validated evaluation tool. Outcomes related to both efficacy and safety were collected. Four prospective trials were included in this systematic review. Data Synthesis: Antipsychotic agents, either atypical or typical, were effective compared with baseline for the treatment of delirium in medically or surgically ill patients without underlying cognitive disorders. Oral haloperidol was associated with more frequent extrapyramidal side effects, but overall, all agents were well tolerated. Interpretation of the published evidence is limited by the small sample sizes, varied patient populations, and comparative agents of the studies reviewed. Conclusions: The comparative studies evaluated here suggest that antipsychotic drugs are efficacious, when compared with baseline, and safe for the treatment of delirium. Haloperidol remains the most studied agent. Recommendation of one antipsychotic over another as a first-line pharmacologic intervention in the treatment of hospital-associated delirium is limited by the quality and quantity of data available. Better designed and larger studies evaluating the addition of antipsychotic agents to nonpharmacologic treatments are needed to measure the true effect of pharmacologic treatment.
Groups generated by affine perspectivities
Authors: Ho Chat Yin 
Published: October 2006

Abstract
Let G be a collineation group of a finite translation plane such that G is generated by perspectivities fixing a point 0. Let M be a non-abelian minimal normal subgroup of G. We show that M is uniquely determined, that the translation plane has characteristic 2, and that M ≅ L
2(q), q even, or M ≅ Sz(q).
The self in time: Reversing the irreversible in Martin Amis's Time's Arrow
Authors: Głaz Adam 
Published: October 2006

Abstract
Martin Amis's novel (or novella) Time's Arrow turns back the life history of an Auschwitz doctor by beginning with his death, portrayed as awakening, and ending at the moment when he enters his mother's womb. The reversal of time has different effects on the consciousness of the protagonist and that of the narrator, although the two share the same body. The ensuing splits and mergers of personality are interpreted here in terms of the reversals of the thermodynamic and psychological time's arrows (vide the book's title). An analysis of the world of the novel couched within the framework of cognitive grammar leads one to a recognition of two narrative personas, involved in multifarious relationships with the protagonist, memory, and the flow of conceived and processing time.
Adherence relations in literary and non-literary discourse
Authors: Wood Tahir 
Published: October 2006

Abstract
This article is intended as a new departure in the theory of the constitution and comprehension of discourse. It begins by extending the notions, familiar in the field of text linguistics, of cohesion and coherence, in such a way as to explain the kinds of necessary relations that exist amongst texts to create larger bodies of discourse that are cognitively real, in just the way that texts are cognitively real. The theoretical approach that has been adopted for this purpose is the Cognitive Discourse Analysis approach of Teun van Dijk. It depends upon the constitutive role of propositions. I go on to claim that the potential in this approach for explaining the nature of texts, their relations within broader realms of discourse, and their subjective comprehension extends to some notoriously difficult areas of research, including the nature of the so-called abstract concepts. Furthermore, it seems that the hypotheses advanced here are eminently testable. What I find especially promising in an approach based on a theory of propositions and intertextual relations is that it potentially opens up the way to a foundational theory that is universally applicable to texts of all conceivable types. For example, where literature has been conceived of as existing in opposition to other non-literary genres, and therefore requiring a branch of theory all its own, the attempt here is rather to show that texts of all types are mutually implicated in interesting ways and that identifying a separate cognitive function of ‘literariness’ is not always and everywhere the best way to understand literature. In the later pages of this article I will attempt to show how narrative genres exemplify certain of the discourse processes I have in mind, particularly how narrative (macro) propositions supply meanings that can be nominalised as abstract nouns.