bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating “ED STAT!”: A Novel and Effective Faculty Development Program to Improve Emergency Department Teaching
Authors: Sherbino Jonathan , Frank Jason , Lee Curtis , Bandiera Glen 
Published: September 2006

Abstract Objectives Effective clinical teaching in emergency departments (EDs) presents unique challenges. No validated approaches to enhancing ED teaching have been reported. The authors evaluated the effectiveness of a novel one‐day evidence‐based, skills‐oriented faculty development course tailored to ED teachers (ED STAT!). Methods The authors invited all inaugural course registrants to participate in this program evaluation study. The authors assessed participants' knowledge change and perceived change in teaching behavior using a multiple‐choice and short‐answer question examination, a teaching behaviors questionnaire, and a survey for satisfaction. Data were gathered before, immediately after, and one month after the course. Mean scores were compared using the Wilcoxon signed rank test, and qualitative results were analyzed via a grounded theory approach. Results Thirty‐one individuals from a variety of academic and community EDs completed the May 2005 course; 28 participated in the pre‐evaluation and postevaluation, and 22 participated in the one‐month postevaluation. Multiple‐choice scores increased from pre‐evaluation to one‐month postcourse by 15.1% (p < 0.001, effect size large: d = 1.53). Short‐answer scores increased by 17.2% (p = 0.001, effect size large: d = 0.90). After one month, 55% of participants reported an increased amount of teaching, 86% perceived this teaching to be of a greater quality, and 82% had shared new strategies with colleagues. The course would be recommended to a colleague by 96.3% of respondents. Conclusions ED STAT! improves participants' knowledge about ED‐specific teaching strategies, and this improvement is maintained at one month. Participants reported high satisfaction and a positive effect on teaching behavior.
A 10-year follow-up of postmenopausal women on long-term continuous combined hormone replacement therapy: update of safety and quality-of-life findings
Authors: Heikkinen Jorma , Vaheri Raija , Timonen Ulla 
Published: September 2006

Objective: To assess the safety and health-related quality of life (HRQOL) of continuous combined hormone replacement therapy (ccHRT) with estradiol valerate/medroxyprogesterone acetate (E2V/MPA) over nine years and at follow-up one year after discontinuation. Study design: A total of 419 women were randomized to one of four treatments: once-daily 1 mg E2V/2.5 mg MPA (1 + 2.5 group); 1 mg E2V/5 mg MPA daily (1 + 5 group); 2 mg E2V/2.5 mg MPA daily (2 + 2.5 group); 2 mg E2V/5 mg MPA daily (2 + 5 group) (Indivina, Orion Pharma). For the last six months, all received the 1 + 2.5 dosage. The 2 + 2.5 dosage was discontinued at the end of year 7. A total of 198 women continued after year 7. Results: Annualized percentage rates for cardiovascular, stroke, breast and endometrial cancer events were below national rates for Finland and those reported for the Women's Health Initiative. There were no serious events with the 1 + 2.5 dosage or after ccHRT discontinuation. Climacteric symptoms remained significantly below baseline values after dosage reduction; some symptoms recurred after discontinuation of ccHRT. HRQOL ratings improved with ccHRT, irrespective of dosage, including depressed mood, anxiety, health perception and sexual interest. Scores on a scale assessing daily functioning and enjoyment (Q-LES-Q) improved from year 7 to year 9. They deteriorated during follow-up in women not continuing ccHRT. Conclusions: Lower dosages of HRT were as effective as higher doses in improving climacteric symptoms and HRQOL ratings and had fewer safety concerns. Following discontinuation of ccHRT, patient satisfaction was variable, with 15% electing to continue or restart HRT and 7% resuming at follow-up. This supports the need for an individualized approach to therapy recommendations.
Methodologies and Algorithms for Group-Rankings Decision
Authors: Hochbaum Dorit S. , Levin Asaf 
Published: September 2006

The problem of group ranking, also known as rank aggregation, has been studied in contexts varying from sports, to multicriteria decision making, to machine learning, to ranking Web pages, and to behavioral issues. The dynamics of the group aggregation of individual decisions has been a subject of central importance in decision theory. We present here a new paradigm using an optimization framework that addresses major shortcomings that exist in current models of group ranking. Moreover, the framework provides a specific performance measure for the quality of the aggregate ranking as per its deviations from the individual decision-makers’ rankings. The new model for the group-ranking problem presented here is based on rankings provided with intensity—that is, the degree of preference is quantified. The model allows for flexibility in decision protocols and can take into consideration imprecise beliefs, less than full confidence in some of the rankings, and differentiating between the expertise of the reviewers. Our approach relaxes frequently made assumptions of: certain beliefs in pairwise rankings; homogeneity implying equal expertise of all decision makers with respect to all evaluations; and full list requirement according to which each decision maker evaluates and ranks all objects. The option of preserving the ranks in certain subsets is also addressed in the model here. Significantly, our model is a natural extension and generalization of existing models, yet it is solvable in polynomial time. The group-rankings models are linked to network flow techniques.
Chronic suppurative otitis media and the pathologic labyrinthine fistula
Authors: Ritter Frank N. 
Published: September 2006

AbstractChronic suppurative otitis media is a dangerous illness. By location, it jeopardizes the middle ear ossicles, the facial nerve, the inner ear, and endocranially, the dural vessels, meninges and brain parenchyma. It is a regard for this infection and the prevention of these complications that dictates an eradication of the illness by surgical intervention; yet, on occasion, one or more of these complications occur and while the proper way to handle most of them has been stressed periodically in the recent literature, one complication, the labyrinthine fistula, has received little attention since the pre–antibiotic days;1,2 thus, surgery has a two–fold function, being therapeutic for the infection and prophylactic for the complications.
Actinomycosis of tongue as pseudotumor
Authors: Sodagar R. , Kohout E. 
Published: September 2006

AbstractActinomycosis or ray fungus was first described in 1877 by Bollinger, and in 1885, its pathogenesis in humans was reported by Israel.The organism causing this disease is mycelium forming and living in the soil or plant.Human infection may start from endogenous infection. These microorganisms can be isolated from the mouth, tonsil and GI tract, and the anaerobic type which is responsible for human infection lives in the mouth. Sixty percent of actinomycotic infection appears in cervicofacial form, which starts as a very slow growing induration and in the later stage there is multiple sinus formations which drain a seropurulent discharge containing the characteristic sulphur granules.In the tongue actinomycosis in early stages may mimic malignancy. Two patients have been seen in our hospital with a small tumor located in the lateral border of the tongue, of about six weeks' duration. These masses were deeply seated in tongue tissue in the anterior two‐thirds; they were slightly painful and were adherent to the muscles.They were excised and appeared to be actinomycotic. Choice of treatment in actinomycotic infection, is a high dosage of penicillin.
Fundamental aspects of incus transplantation
Authors: Kuijpers W. , Van Der Broek P. 
Published: September 2006

AbstractIn the present study, the results of experimental incus transplantations performed in a large number of rats are reported. The behavior of fresh autologous and homologous incudes and of incus grafts denatured by boiling or by preservation in alcohol, were studied up to survival times of more than two years. The incudes were transplanted orthotopically in the middle ear and heterotopically in the musculus tibialis anterior.Both fresh autologous and homologous incus grafts appeared to be well tolerated by the middle ear, although a substantial loss of osteocytes, most marked in the homografts, was observed after two years. No clear signs pointing to a transplantation reaction were observed in the homologous series. The denatured incudes appeared to retain their original shape in the middle ear after an observation period of more than two years, while in 40 percent of those incudes preserved in alcohol, new bone formation was observed.After heterotopical transplantation in muscle a clear transplantation reaction toward the fresh homologous incudes was found, while the autologous ossicles grossly retained their original shape and vitality. Extensive resorption was observed in the denatured incudes, although in the case of alcohol preserved ossicles, all specimens also showed areas of new bone formation.These experiments confirm the clinical evidence that the middle ear can be considered as one of the privileged sites of the body where transplantation reactions are absent or at least mitigated. Besides this, the results obtained with denatured incudes strongly suggest that new bone formation in the ossicles seems dependent not only upon the transplantation of osteogenic cells, but presumably also on the condition of the ground substance and or the presence of certain enzymes in the ossicle.
Radiologic changes in the formation of frontal sinus — muco‐pyocele
Authors: Pastore Peter N. 
Published: September 2006

AbstractThe history, the gradual evolution of soft tissue changes as revealed by roentgenography and the gross and microscopic changes in the lining muco‐periosteums of two frontal sinuses which had been resected surgically, are presented.On the basis of these reports and that of past experience, the following generalizations in respect to these two cases seem valid:1. Radiographic mucosal changes in a frontal sinus may exist months or years without subjective symptoms.2. Obstruction of the fronto‐nasal opening with a subsequent gradually progressive increase in volume and pressure of the fluid contents of the sac or sinus, may eventually result in pressure absorption of the bony walls of the sinus.3. A mucocele does not cause sudden or acute symptoms, such as pain or fever, but objective signs such as a soft swelling above the eyebrow or the dislocation of the globe in the orbit, may appear and slowly increase.4. When in the presence of acute infection of the upper respiratory tract acute subjective or objective frontal sinus symptoms and signs become evident without previously recalled sinus disease or trauma and where prior radiographic study of the area has not been made, one cannot be certain that slowly developing changes of the sinal muco‐periosteum have not been present for a long time, and such pre‐existing disease might not have led to confused interpretation of the radiologic pictures, to misinterpretation of symptoms and signs and to a faulty diagnosis.5. The variation in the mucosal histological findings and sac or contents noted at the time of surgery will be those related to the nature of the causative or related organism, the degree of activity, the development time factor or duration of the condition, the effect of pressure on soft tissue surrounded by bone, and the circumstances precipitating the need for surgical treatment.6. Regardless of the origin, the muco‐pyocele of many years' duration under constant slowly expanding pressure may eventually result in sterile contents and loss of the original identity of the mucosal structure, making an exact disease classification difficult or impractical.7. The new although admittedly imaginative hypothesis that a previously undescribed type of disease of the frontal sinus of unknown etiology, may be present, is presented.8. This type of disease of the frontal sinus may be present more frequently than is reported, because of a “low‐index of suspicion” on the part of the rhinologist, because of the absence of signs and symptoms in the absence of infection and the lack of a history of (frequently hypothetical) trauma or infections in the past, such as are usually mentioned in the anamnesis of symptom producing unilateral frontal sinus disease.
Laser surgery of the vocal cordsAn experimental study with carbon dioxide lasers on dogs
Authors: Jako Geza J. 
Published: September 2006

AbstractIn experiments on dogs, a focused beam from a continuous wave surgical carbon dioxide laser integrated with an operating microscope was used selectively to evaporate predetermined amounts of normal vocal cord tissue through a laryngoscope. This mode of tissue removal was precise, rapid and practically bloodless. Microscopic laryngoscopy examinations and histological work‐up one, two and three weeks postoperatively indicated normal healing similar to that of clean surgical wounds.
Total glossectomy for advanced carcinoma of the base of the tongue
Authors: Sessions Donald G. , Stallings James O. , Brownson Richmond Jay , Ogura Joseph H. 
Published: September 2006

AbstractThe treatment of patients with advanced carcinoma of the base of the tongue is difficult. Selected patients with this lesion can be aided by an aggressive therapeutic approach to this problem. Combined therapy consisting of irradiation therapy followed by composite resection of the entire tongue and larynx and neck dissection may offer the best opportunity for cure or palliation in these patients. Reconstruction of the defect with a non‐delayed full forehead flap has provided a very satisfactory floor of the mouth. The postoperative functional abilities of these patients have clearly been compatible with useful life.
Disseminated coccidioidomycosis presenting as facial granulomas in pregnancy: A report of two cases and a review of the literature
Authors: Hadsall Franklin Job , Acquarelli Mario J. 
Published: September 2006

AbstractThe diagnosis of disseminated coccidioidomycosis was made in two pregnant women by the biopsy of facial granulomas. The unusual presentation and the problems associated with the management of this disease in pregnancy stimulated a literature review and a report of these two cases.The history of the discovery and elucidation of this disease is reviewed. Documentation of interhuman transmission of coccidioidomycosis by fomites is presented. Previous reports of disseminated coccidioidomycosis being found in the endolarynx, epiglottis and region of the head and neck are cited. The high incidence of fetal wastage, the high maternal mortality associated with dissemination and the role of Amphotericin B in the therapy of the disseminated disease are discussed.
The identification and protection of the laryngeal motor nerves during thyroid and laryngeal surgery: A new microsurgical technique
Authors: Kratz Robert C. 
Published: September 2006

AbstractSurgery in the area of the larynx often demands identification of laryngeal motor nerves. Stimulation of the recurrent laryngeal nerve caused observable movement of the mobilized larynx in 56 exposures on the right side and 52 exposures on the left, except in two cases. Failure of the larynx to move in two cases was explained by fixation of the larynx due to cancer in one case and fixation due to scar in the other. The use of the operating microscope and electrical stimulator is recommended as an improvement in the technique for the identification of the laryngeal motor nerves. A color motion picture with sound is presented in conjunction with this paper to demonstrate the technique.
Chemodectomas of the nasopharynx. An unusual case associated with unilateral ocular proptosis
Authors: Smith Curran J. , Kohut Robert I. , Million Rodney R. 
Published: September 2006

AbstractThe case report of a 66‐year‐old female with a chemodectoma involving the nasopharynx was presented. The unusual initial presentation of ocular proptosis was described and the possible origin of this tumor from the paraganglioma ciliare in the orbit discussed. The histologic response to radiotherapy was demonstrated by photomicrographs.
Tympanoplasty: Long‐term hearing results with incus grafts
Authors: Cody D Thane R. , Taylor William F. 
Published: September 2006

AbstractThe purpose of this study was to analyze long‐term hearing results in 122 tympanoplasties with incus repositioning and in 64 tympanoplasties using a homograft incus. The mean postoperative follow‐up period in the autograft incus group was 56 months (range 18 to 95 months) and in the homograft incus group 54 months (range 28 to 87 months). Results were compared after incus placement between the tympanic membrane‐malleus complex and stapes head and placement between the tympanic membrane‐malleus complex and stapes footplate. In each group, hearing results tended to be better after malleus‐to‐stapes head placement. There was no statistically significant difference in the results achieved when similar incus placements in the two groups were compared. When the data on malleus‐to‐stapes head tympanoplasty (152 patients) and malleus‐to‐stapes footplate tympanoplasty (34 patients) in each group were combined, the results with malleus‐to‐stapes head placements were considerably better (P = 0.01). The best hearing results were not satisfactory, however, with only 54 percent of the malleus‐to‐stapes head placements achieving a socially adequate hearing level and the air‐bone gap being closed to within 15 db on only 32 percent.Hearing results were also analyzed for three subgroups. The autograft and homograft incus groups were combined. The first subgroup consisted of 30 patients who had no additional surgery other than ossicular chain reconstruction; the second subgroup consisted of 53 patients who in addition to ossicular chain reconstruction had closure of the tympanic membrane perforation; the third subgroup consisted of 103 patients who in addition to ossicular chain reconstruction had tympanic membrane perforation repair and mastoidectomy. There was no statistically significant difference in the hearing results among the three subgroups.Eleven percent of the autograft incus group and 13 percent of the homograft incus group initially had excellent hearing results and then, at various times after the operation, developed gradual deterioration in auditory acuity, which eventually resulted in an unsatisfactory hearing level. In revision operations, the most common cause of failure was non‐attachment of the incus to the head of the stapes. Second in frequency was fixation of the ossicular chain by fibrous tissue and impaction of the incus against the posterior bony annular rim. The most serious complication was depression in cochlear reserve, which occurred in 5 percent of the 186 tympanoplasties. This analysis of the long‐term hearing results achieved with incus grafts revealed that the results were far from satisfactory.
Dentoalveolar fistulas of the cervical region
Authors: Singleton Earl F. 
Published: September 2006

AbstractThe otolaryngologist is very familiar with inflammatory lesions occurring in the head and neck. The chronic draining fistula is somewhat less common, and its origin may be obscure. A case presentation illustrates some of the typical problems of a fistula in the submandibular triangle which proved to be of dental origin. Knowledge of the spread of periapical infection helps to understand the development and location of cutaneous, dentoalveolar fistulas. Recognition of the source of the fistula is essential as treatment must be directed primarily to the underlying dental infection.
Gold foil closure of oroantral fistulas
Authors: Meyerhoff William , Christiansen Thomas , Rontal Eugene , Boerger William 
Published: September 2006

AbstractA variety of surgical procedures have been devised for the closure of the oroantral fistula. The majority of these methods have employed buccal or palatal mucoperiosteal flaps or combinations of both. Though generally successful in closing the oroantral fistula, these flap procedures occasionally fail, especially in those cases with unusually large openings. These flaps may also alter the intra‐oral anatomy making the construction of intra‐oral appliances difficult. After eliminating those failures due to persistant infection or inadequate drainage of the maxillary sinus, there remains that group of patients whose oroantral fistula closure fails, due to inherent inadequacies of the procedure used; therefore, we have endeavored to find a surgical technique that will give us more reliable results.Through our endeavors we found a simplified technique for the closure of oroantral fistulas using gold foil, a method recently advocated in the dental literature. The surgical procedure consists of denuding the margins of the oroantral fistula of all mucoperiosteum and covering the opening with an overlapping margin of 36‐gauge gold foil. The mucoperiosteal flaps elevated to expose the bony margins of the fistula are then sutured loosely over the foil to act as an envelope holding the gold in place. Mucosa from the maxillary sinus migrates across the inner surface of the foil providing closure on one side. Gradually, the mucoperiosteal flap retracts, exposing the gold foil but still maintaining it in its proper position. After several weeks the foil is removed, showing an intact sinus mucosal lining. In an additional few weeks the mucoperiosteum grows over the sinus mucosa giving a two‐layered closure. We have had successful results in seven patients treated by this method, some of whom were failures of a standard flap technique and all of which were quite large. The advantages of this procedure are that it is a safe, simple and physiologic method of closing oroantral fistulas without distorting intra‐oral anatomy, and we feel that it should receive wider attention by otolaryngologists in the future.