bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung Injury after In Vivo Reperfusion
Authors: Matot Idit , Einav Sharon , Weiniger Carolyn F. , Pearl Ron G. , Abramovitch Rinat , Joshi Balachandra V. , Jacobson Kenneth A. 
Published: March 2009

Background
Although short-term findings after lung reperfusion have been extensively reported, in vivo animal studies have not described outcome beyond the immediate time period. Therefore, the authors evaluated lung injury 27 h after reperfusion. They also investigated whether attenuation of lung injury with the A3 adenosine receptor agonist MRS3558 was sustained beyond the immediate time period.

Methods
In intact-chest, spontaneously breathing cats in which the left lower lung lobe was isolated and subjected to 2 h of ischemia and 3 h of reperfusion, MRS3558 was administered before reperfusion. Animals were killed 3 or 27 h after reperfusion.

Results
When compared with 3 h of reperfusion, at 27 h the left lower lobe showed reduced apoptosis and no change in inflammation, but increased edema. Increased edema of the nonischemic right lung and hypoxemia were observed at 27 h after left lower lobe reperfusion. Increases in phosphorylated p38 levels were found at 3 h of reperfusion compared with control lung, with further increases at 27 h. The attenuation of injury observed with MRS3558 treatment at 3 h of reperfusion was sustained at 27 h.

Conclusions
Lung edema may worsen hours after the immediate postreperfusion period, even though lung apoptosis and inflammation are reduced or show no change, respectively. This was associated with further increases in phosphorylated p38 levels. The nonischemic lung may also be affected, suggesting a systemic response to reperfusion. In addition, early attenuation of injury is beneficial beyond the immediate period after reperfusion. Treatment aimed at inhibiting p38 activation, such as A3 receptor activation, should be further studied to explore its potential long-term beneficial effect.
New Strategies to Detect Alcohol Use Disorders in the Preoperative Assessment Clinic of a German University Hospital
Authors: Kip Miriam J. , Neumann Tim , Jugel Constanze , Kleinwaechter Robin , Weiss-Gerlach Edith , Guill Martin Mac , Spies Claudia D. 
Published: March 2009

Background
Although alcohol use disorders (AUDs) have enormous public health consequences, the rate of diagnosis of AUDs remains unsatisfactorily low. The primary aim of this study was to compare the detection of AUDs by anesthesiologists in a large preoperative assessment clinic to that by computerized self-assessment of the Alcohol Use Disorder Identification Test. Secondary outcome measures were to compare the actions taken by anesthesiologists upon a finding of an AUD.

Methods
One thousand five hundred fifty-six patients were included. Before preoperative assessment, patients were asked to complete the Alcohol Use Disorder Identification Test (positive scores: men > or = 8, women > or = 5) using a computer. The authors performed a retrospective chart analysis of the anesthesiologists' actions upon a finding of an AUD. The anesthesiologists were blinded to the results of the computer-based assessment and to the subsequent chart analysis.

Results
The prevalence rate of AUDs determined by the anesthesiologists was 6.9% (107 of 1,556), whereas the proportion of patients positive for an AUD using the computerised Alcohol Use Disorder Identification Test was 18.1% (282 of 1,556) (P < 0.001). The detection rate by the anesthesiologists of AUDs among men was significantly higher than among women (P < 0.001) as well as in the elderly compared with younger patients (P < 0.001). Action taken by anesthesiologists was mainly based on evaluating quantity of alcohol consumption.

Conclusion
The computer-based self-assessment increases detection rates of AUDs in busy settings such as a preoperative assessment clinic. Prevalence rates of AUDs are underestimated. Best-practice guidelines for detection of AUDs are not implemented in the daily clinical routine. Barrier analysis is urgently required.
Pretreatment Swallowing Exercises Improve Swallow Function After Chemoradiation
Authors: Carroll William R. , Locher Julie L. , Canon Cheri L. , Bohannon Isaac A. , McColloch Nancy L. , Magnuson J Scott 
Published: March 2009

AbstractObjectives/Hypothesis: Swallowing dysfunction is a devastating complication of chemoradiation therapy (CRT) for head and neck squamous cell carcinoma. We have previously demonstrated that pretreatment swallowing exercises improve posttreatment swallowing‐related quality of life. This study evaluates the effect of pretreatment swallowing exercises on posttreatment swallow function as measured by videofluoroscopy.Study Design: Retrospective case control.Methods: Eighteen patients with advanced squamous cell carcinoma of the oropharynx, hypopharynx, and larynx treated at University of Alabama at Birmingham with CRT were included in the study. Nine patients received pretreatment swallowing exercises prior to CRT, and nine patients received swallowing exercises during routine posttreatment management. Approximately 3 months after completing treatment, standard videofluoroscopy examinations were conducted. Outcomes measured by the videofluoroscopy examinations included hyoid elevation, epiglottis inversion, tongue base movement, cricopharyngeal opening, and Rosenbeck aspiration score. Percutaneous endoscopic gastrostomy (PEG) tube use was assessed at 12 months after treatment.Results: Epiglottis inversion was better maintained (P = .05) in patients receiving pretreatment swallowing therapy. The position of the tongue base during swallowing was also significantly closer to the posterior pharyngeal wall (P = .025) for patients receiving pretreatment exercises. PEG tube removal rates did not significantly differ between groups.Conclusions: Performing pretreatment swallowing exercises produces measurable improvements in posttreatment swallowing function in patients who undergo organ‐preservation CRT for head and neck cancer. This study provides an initial foundation for the development of noninvasive, cost‐effective, evidence‐based interventions in this group of vulnerable patients.
Ultrasound‐Guided Fine Needle Aspiration Biopsy of Thyroid Nodules Performed in the Office
Authors: Seiberling Kristin A. , Dutra Jose C. , Gunn James 
Published: March 2009

AbstractIntroduction: The majority of thyroid fine needle aspiration biopsies (FNAB) today are performed in the office freehand by palpation. Not infrequently, patients are sent to radiology for an ultrasound‐guided FNAB (USG‐FNB). Real‐time ultrasound (US) allows for continuous visualization of the needle during insertion and sampling. Historically, USG‐FNAB has been a procedure performed by a radiologist in a designated radiology suite. In more recent years, with the development of smaller more portable US machines, there has been a push for clinicians other than radiologists to perform the procedure.Objective: To evaluate the accuracy and specimen adequacy of thyroid FNAB performed in the office under US guidance by one senior otolaryngologist.Methods: Retrospective chart review of 203 patients who underwent ultrasound‐guided USG‐FNA of the thyroid gland between September, 2005, to February, 2007, in the office setting by one senior otolaryngologist. Specimens were reviewed onsite at the time of biopsy for cellular adequacy by a cytotechnologist.Results: A total of 203 patients, 176 females and 27 males, underwent USG‐FNA of the thyroid gland. The average age of the females was 52 years, and 59.4 years for the males. A total of 271 FNA biopsies were performed. Two hundred and twenty FNAB were satisfactory specimens (81.2%), 26 were unsatisfactory (9.6%), and 25 (9.2%) were limited due to blood clotting or hypocellularity. Of the FNA specimens that had enough cells to evaluate, 159 were benign, 48 were indeterminate for malignacy, and 13 were positive for malignancy. Of the nodules biopsied, 143 were greater than 1.5 cm (average 2.59 cm, unsatisfactory rate 12.6%), and 128 were less than 1.5 cm (average 1.21 cm, unsatisfactory rate 6.3%).In 44 patients, one or more nodule was biopsied at the same office visit.Discussion: Thyroid US is an indispensable tool in the workup and diagnosis of thyroid disease. It may be used to help identify pathology and physical features suspicious for malignancy and guide FNAB of suspicious nodules. The availability of an office US machine allows the referring physician to perform a service that is normally done in a different department. This ultimately frees up time for both the patient and physician and reduces health care costs by eliminating extra office visits. More importantly, it allows the primary physician to be more knowledgeable and hands on with the patient's overall care.Conclusion: This study shows that a trained physician may perform a USG‐FNA of the thyroid gland in the office with results comparable to that in the radiology literature.
The Residency Experience in Pediatric Otolaryngology
Authors: Kerscher Kara , Tabaee Abtin , Ward Robert , Haddad Joseph , Grunstein Eli 
Published: March 2009

AbstractObjectives: To assess the residency experience in pediatric otolaryngology, determine the impact of pediatric fellowship programs on residency training, and evaluate the need for fellowship training in pediatric otolaryngology.Design: An anonymous, web‐based survey of chief residents in otolaryngology.Methods: Respondents described their experience in pediatric otolaryngology using a 5‐point Likert scale and reported their comfort levels (yes/no) with various medical and surgical issues in pediatric otolaryngology.Results: The survey was successfully completed by 70 respondents, representing a response rate of 26%. The majority of the respondents reported positive experiences with regard to the following aspects of pediatric otolaryngology training: didactics (81%), clinical research opportunities (78%), positive faculty role models (87%), career mentorship (74%), independent medical (84%) and surgical (81%) decision‐making, and overall comprehensive residency experience (87%). Basic science research opportunities (50%) were reported as less available than clinical research opportunities (78%) (P = .002). Compared with other surveyed issues, a lower comfort level was reported for management of craniofacial anomalies (P < .001), excision of large lymphatic malformations (P < .001), cochlear implantation (P < .001), laryngotracheal reconstruction (P < .001), and surgical correction of velopharyngeal insufficiency (P < .001). No statistically significant difference was noted in responses based on the presence of a fellowship program at the institution.Conclusions: The residency experience in pediatric otolaryngology is perceived as comprehensive by graduating chief residents participating in this survey. The presence of a fellowship program does not appear to negatively impact the residency experience. Based on the reported comfort levels, the management of complex issues in pediatric otolaryngology may require additional training.
Who Is Performing Stapedectomy Surgery? Implications for Residency and Fellowship Training
Authors: Ruckenstein Michael J. , Staab Jeffrey P. 
Published: March 2009

AbstractObjectives: To demonstrate that 1) recent graduates of training programs in otorhinolaryngology–head and neck surgery are less likely to recommend/perform stapedectomy than more senior otolaryngologists; and 2) when surgery is recommended, referral is most commonly made to an otologist/neurotologist.Study Design: Survey of 500 regional otolaryngologists pertaining to their treatment of patients with hearing loss secondary to otosclerosis.Methods: Otolaryngologists in community practice were provided with written surveys pertaining to their treatment of otosclerosis.Results: Data were obtained from 179 general otolaryngologists treating adults and children in solo or group private practices in our geographic region. The majority (66%) diagnosed one to five new cases per year. Ten percent of surgeons graduating in the 1970s, 25% graduating in the 1980s, 50% graduating in the 1990s, and 90% of graduates in the 2000s never performed stapedectomy as part of their practices (P < .001). Similarly, a significant number of surgeons who formerly performed stapedectomies no longer do this surgery. A trend toward greater use of hearing aids for the treatment of otosclerosis was seen in more recent graduates (P < .08). When surgery was recommended, otologists/neurotologists received the majority of referrals (75%) from the practitioners surveyed.Conclusions: Stapedectomy is performed and recommended less often by more recent graduates of otolaryngology training programs. Training requirements for both general otolaryngologists and neurotologists may need modification given current practice patterns for stapes surgery.
Oral Insulin Enhances Cell Proliferation and Decreases Enterocyte Apoptosis During Methotrexate‐induced Mucositis in the Rat
Authors: Sukhotnik Igor , Shehadeh Naim , Coran Arnold G , Mogilner Jorge G , Karry Rahel , Shamian Benhoor , Ure Benno M , Shamir Raanan 
Published: March 2009

ABSTRACTObjective:Oral insulin (INS) has been shown to protect intestinal epithelial cells from injury caused by ischemia‐reperfusion and endotoxemia. In the present study, we tested whether oral insulin can protect gut epithelial cells from methotrexate (MTX)‐induced intestinal damage.Materials and Methods:Adult male Sprague‐Dawley rats were divided into 3 experimental groups. Control rats were treated with normal saline given intraperitoneally (CONTR), MTX rats were treated with a single dose (20 μg/kg) of MTX given intraperitoneally, and MTX‐INS rats were treated with oral insulin given in drinking water (1 U/mL) 72 hours after IP injection of a single dose of MTX (similar to MTX rats). Three days after either MTX or saline injection, rats were killed. Intestinal mucosal damage (Park injury score), mucosal structural changes, enterocyte proliferation, and enterocyte apoptosis were measured. Reverse transcription polymerase chain reaction was used to determine the level of bax and bcl‐2 mRNA expression.Results:MTX‐INS rats demonstrated a greater jejunal and ileal mucosal weight, ileal mucosal DNA, greater jejunal villus height, greater jejunal and ileal crypt depth, greater enterocyte proliferation index in ileum, and lower enterocyte apoptosis in ileum than did MTX‐nontreated animals. Treatment with insulin did not change the injury score grade in comparison with MTX animals. A significant decrease in cell apoptosis was observed in MTX‐INS rats (vs MTX) and also a decrease in a bax mRNA expression and decrease in a bax/bcl‐2 ratio.Conclusions:In a rat model of MTX‐induced mucositis, oral insulin supplementation does not prevent mucosal injury but improves intestinal recovery and enhances enterocyte survival.
Lactose and Lactase—Who Is Lactose Intolerant and Why?
Authors: Montgomery Robert K , Krasinski Stephen D , Hirschhorn Joel N , Grand Richard J 
Published: March 2009

ABSTRACTLactase‐phlorizin hydrolase (LPH) is expressed only in the small intestine and is confined to absorptive enterocytes on the villi with a tightly controlled pattern of expression along the proximal to distal and crypt‐villus axes of the intestine. LPH expression is regulated mainly at the level of lactase (LCT) gene transcription that directs 2 phenotypes: a decline in LCT activity (LCT nonpersistence) in mid‐childhood in the majority of the world's population, and maintenance of the lactase levels found in infancy (LCT persistence) in people of northern European extraction and scattered populations elsewhere. The molecular mechanisms that regulate these phenotypes are not completely understood. A population genetic association of lactase persistence with 2 single nucleotide polymorphisms in the distal 5′‐flanking region of LCT (−13.9T and −22A) has been confirmed in northern Europeans, but this fails to explain lactase persistence found in some African groups. Any hypothesis for the control of lactase expression must reconcile the presence of high levels of activity in early life in all humans and the characteristic loss of activity found subsequently in many but not all people.
Body Mass Index and Elbow Range of Motion in a Healthy Pediatric Population: A Possible Mechanism of Overweight in Children
Authors: Golden Daniel W , Wojcicki Janet M , Jhee Jeffrey T , Gilpin Susan L , Sawyer Jeffrey R , Heyman Melvin B 
Published: March 2009

ABSTRACTBackground:Childhood overweight has become a serious health problem among children and adolescents in the United States. No previous study, to our knowledge, has analyzed the effect of body mass index (BMI) on range of motion and carrying angle of the elbow joint in a healthy pediatric population. The primary objective of this study was to determine the effect of BMI on orthopedic parameters of the elbow joint, including range of motion, flexion, extension, and carrying angle.Study Participants and Methods:Healthy children age 2 to 18 years (mean 12.0 ± 3.9 years) were recruited at an urban pediatric orthopedic clinic as pediatric orthopedic patients or as the siblings or friends of patients. Measures of range of motion (flexion and extension) and carrying angle of 226 elbows and of BMI from 113 study participants were analyzed.Results:BMI was negatively correlated with right and left elbow range of motion (r = −0.54, P < 0.01; r = −0.43, P < 0.01) and right and left elbow flexion (r = −0.59, P < 0.01; r = −0.50, P < 0.01). BMI had a positive correlation with right elbow extension (r = 0.20, P = 0.04). BMI did not correlate with left elbow extension or right or left carrying angle. After adjustment for age, sex, and ethnic group, BMI was associated with right (P < 0.01) and left (P < 0.01) elbow range of motion.Conclusions:These data demonstrate that increased BMI in children is negatively correlated with range of motion of the elbow joint. Further studies are needed to evaluate the consequences of impaired range of motion associated with overweight on activity levels and energy expenditure in growing children and adolescents.
Orthostatic Intolerance and Gastrointestinal Motility in Adolescents With Nausea and Abdominal Pain
Authors: Antiel Ryan M , Risma Justin M , Grothe Rayna M , Brands Chad K , Fischer Philip R 
Published: March 2009

ABSTRACTObjective:To describe the relationships between gastric emptying, autonomic function, and postural tachycardia in adolescent patients with nausea and/or abdominal discomfort. It was hypothesized that patients with both gastrointestinal symptoms and symptoms of orthostatic intolerance are more likely to show abnormal tilt table results and delayed gastric emptying.Patients and Methods:A retrospective review was conducted of adolescent patients who came to a pediatric referral center because of nausea and dyspepsia and who subsequently underwent both autonomic reflex screening and gastric emptying testing. Patients with a heart rate change of 30 or more beats per minute on the heads‐up tilt table test were assigned to the postural orthostatic tachycardia syndrome (POTS) group (n = 21), and those with a heart rate change of fewer than 30 beats per minute on the heads‐up tilt table test were assigned to the non‐POTS group (n = 10).Results:There was no significant difference between the POTS and non‐POTS groups with regard to presenting symptoms (P > 0.05). Overall, 13 (42%) individuals had abnormal gastric emptying results (delayed in 6, accelerated in 7), but gastric emptying scores were similar between the POTS and non‐POTS groups. Furthermore, there was no correlation between an individual's gastric emptying results at 1, 2, and 4 hours and that person's heart rate change on HUT (r = −0.05, −0.15, and −0.19).Conclusions:Although altered gastric emptying and postural tachycardia are common in a referral population of adolescents with nausea and/or abdominal discomfort, the clinical presentation was not predictive of test results. Furthermore, delayed gastric emptying was not correlated with the current definition of postural tachycardia.
Peculiarities of Norovirus and Rotavirus Infections in Hospitalised Young Children
Authors: Narkeviciute Irena , Tamusauskaite Indre 
Published: March 2009

ABSTRACTObjectives:To investigate the features of norovirus infection in hospitalised children under the age of 3 and to compare the results with those of rotavirus infection.Patients and Methods:Case notes were randomly selected and retrospectively analysed for 70 norovirus‐ and 70 rotavirus‐infected children. All of the children were treated in Vilnius University Children's Hospital in 2005. The norovirus antigen was assayed using enzyme‐linked immunosorbent assay, the rotavirus using immunochromatography diagnostic assay.Results:In young children, norovirus infection manifested as vomiting (94% of all cases), diarrhoea (81%), and fever (66%). It presented as gastroenteritis with fever (47%) or without fever (30%). However, 19% of cases were without diarrhoea. During rotavirus infection, fever was present in 97% of cases and 81% of them were >38°C. However, in norovirus infection, the percentages were 66% and 48%, respectively (P < 0.0001). Intensive diarrhoea (≥7 times/day) more frequently appeared in children with rotavirus infection than with norovirus (P < 0.0001). Repeated vomiting (≥4 times/day) has been more common for children with norovirus infection. As opposed to norovirus infection, which has 2 main syndromes (gastroenteritis with fever and without fever), rotavirus infection is dominated by just 1 clinical syndrome—gastroenteritis with fever (P < 0.0001).Conclusions:Norovirus infection in young children can present as gastroenteritis with or without fever. Norovirus and rotavirus infections had statistically significant differences in the presence and the degree of fever, and the intensity of diarrhoea and vomiting, as well as frequency of different syndromes.
Is Visceral Hypersensitivity Correlated With Symptom Severity in Children With Functional Gastrointestinal Disorders?
Authors: Castilloux Julie , Noble Angela , Faure Christophe 
Published: March 2009

ABSTRACTBackground:Abdominal pain related to irritable bowel syndrome (IBS) and functional abdominal pain (FAP) is frequent in children and can be of variable severity. Both IBS and FAP are associated with rectal hypersensitivity. We hypothesized that in children with IBS and FAP, the rectal sensory threshold for pain (RSTP) is associated with symptom severity.Paitents and Methods:A total of 47 patients (34 girls; median age, 14.2 years) with IBS (n = 29) and FAP (n = 18), according to the Rome II criteria, underwent a rectal barostat examination to determine their RSTP. Gastrointestinal symptom severity was assessed by validated questionnaires. During the rectal barostat exam, symptoms were documented using a visual analog scale and by measuring the area coloured on a human body diagram corresponding to painful sensations.Results:The median RSTP was 16 mmHg and was similar in IBS and FAP patients. Eighty‐three percent of the patients had rectal hypersensitivity (RSTP ≤ 30.8 mmHg, the 5th percentile of control children studied in our laboratory). Fifty‐one percent and 36%, respectively, reported missing school and social activities at least once per week. Increased frequency of pain, missed days of school, missed social activities, and pain during the barostat examination were not associated with lower RSTP values in either the whole group or in the subset of children with rectal hypersensitivity.Conclusions:Rectal hypersensitivity is not proportional to the severity of symptoms in children with IBS and FAP, indicating that symptom severity is influenced by other factors in addition to visceral hypersensitivity.