bluuebunny/crossref_metadata_2025_split huggingface dataset:
New clinical practice guidelines for venous thromboembolism prevention: orthopedic surgery as a paradigm
Authors: SAMAMA CHARLES‐MARC , ALBALADEJO PIERRE , LAVERSIN SABINE , MARRET EMMANUEL , MISMETTI PATRICK 
Published: October 2006

SUMMARYTo produce up‐to‐date clinical practice guidelines on the prevention of venous thromboembolism (VTE) in orthopedic surgery. A Steering Committee defined the scope of the topic, the questions to be answered, and the assessment criteria. A multidisciplinary working group performed a critical appraisal of the literature. The resultant reports and guidelines were submitted for comment and completion of the AGREE questionnaire to peer reviewers, before producing definite guidelines. The report answers the following questions: (i) What is the VTE incidence according to clinical and/or paraclinical criteria in the absence of prophylaxis? (with stratification of VTE risk into low, moderate and high categories); (ii) What is the efficacy and safety of the prophylactic measures used? (iii) When should prophylaxis be introduced and how long should it last? (iv) Does ambulatory surgery affect efficacy and safety of prophylaxis? Apart from answering the above questions, the guidelines provide a summary table. This table stratifies types of surgery into the three risk categories, specifies the recommended prophylaxis for VTE (pharmacological and/or mechanical) and grades each recommendation. In addition, whenever appropriate, the recommended prophylaxis is adjusted to low‐ and high‐risk patients.
Course of D‐dimer concentrations after total knee replacement surgery: effect of allogeneic and unwashed drainage blood transfusion
Authors: MUÑOZ MANUEL , GARCÍA‐ERCE JOSE A. , CUENCA JORGE , SOLANO VICTOR M. 
Published: October 2006

SUMMARYSalvage and return of unwashed filtered shed blood (USB) after unilateral total knee replacement (TKR) is a blood‐saving method frequently used to avoid allogeneic blood transfusion (ABT). However, the use of USB is controversial, as it may impair hemostasis when retransfused. We report on 1‐month follow‐up of fibrinolytic activity in TKR patients who received either ABT, USB or no transfusion. One hundred and six consecutive TKR patients entered the study: 88 received no transfusion (group 1), five received ABT (group 2), and 13 received USB (group 3). Blood samples were obtained on day of surgery and postoperative days 1, 7 and 30, and assayed for blood counts, C‐reactive protein (CRP), and D‐dimers. Demographic and clinical data were also collected. There were no differences in demographic data or postoperative infection rate between groups, but length of hospital stay was longer in group 2 (P < 0.05). Postoperative levels of D‐dimers increased on day 1, and remained elevated on day 30 in all groups, but on day 1 they were higher in group 3 (P < 0.05). There were no differences in perioperative levels of CRP between groups, and they correlated with D‐dimers both preoperatively and on day 30. Taken together, these data suggest that surgery for TKR induced an activation of coagulation and fibrinolysis. This situation lasts at least as late as 30 days after surgery, and is not modified by transfusion, except for a transitory induction of fibrinolysis by USB return in the early postoperative period.
Role of computed tomography in risk assessment for coronary heart disease
Authors: Mittal Tarun K , Barbir Mahmoud , Rubens Michael 
Published: October 2006

Abstract
Coronary heart disease is the most common cause of death in Western countries, with a rising incidence in developing countries. It is part of the spectrum of cardiovascular diseases that have common end points of myocardial infarction, stroke and death. As these end points often occur suddenly and often in those with no known disease, identification of those people at high risk is important. Besides the known traditional risk factors, direct imaging of the calcified plaque as a marker for atherosclerotic disease has been extensively studied with electron beam computed tomography and now with multislice computed tomography. This review discusses the role of computed tomography in assessment of cardiovascular risk in both people with or without symptoms.
Digital photography
Authors: Windsor J S , Rodway G W , Middleton P M , McCarthy S 
Published: October 2006

Abstract

Objective
The emergence of a new generation of “point-and-shoot” digital cameras offers doctors a compact, portable and user-friendly solution to the recording of highly detailed digital photographs and video images. This work highlights the use of such technology, and provides information for those who wish to record, store and display their own medical images.

Methods
Over a 3-month period, a digital camera was carried by a doctor in a busy, adult emergency department and used to record a range of clinical images that were subsequently transferred to a computer database.

Results
In total, 493 digital images were recorded, of which 428 were photographs and 65 were video clips. These were successfully used for teaching purposes, publications and patient records.

Conclusions
This study highlights the importance of informed consent, the selection of a suitable package of digital technology and the role of basic photographic technique in developing a successful digital database in a busy clinical environment.
Modernising Medical Careers foundation programme curriculum competencies: will all rotations allow the necessary skills to be acquired? The consultants' predictions
Authors: Higgins R , Cavendish S 
Published: October 2006

Abstract
The new UK Foundation Programme is competency based, with a trainee's progression dependent on achieving and demonstrating a range of competencies. However, we do not know whether all rotations, comprising different combinations of specialties, will enable the foundation programme trainees to acquire these competencies. Questionnaires were sent to 100 consultants from a range of specialties asking them to predict if a foundation year 1 or foundation year 2 doctor could acquire each competency when working in the consultant's specialty. Views on the competency framework as a whole were also sought. Results suggest that the competencies trainees may acquire depend on the specialties they experience in their rotation. Moreover, a range of competencies may prove difficult to acquire across most of the specialties. This has implications for the composition of foundation programme rotations, for educational and clinical supervision, and for the content and mode of curriculum delivery.
Using the nucleotide substitution rate matrix to detect horizontal gene transfer
Authors: Hamady Micah , Betterton M D , Knight Rob 
Published: October 2006

AbstractBackgroundHorizontal gene transfer (HGT) has allowed bacteria to evolve many new capabilities. Because transferred genes perform many medically important functions, such as conferring antibiotic resistance, improved detection of horizontally transferred genes from sequence data would be an important advance. Existing sequence-based methods for detecting HGT focus on changes in nucleotide composition or on differences between gene and genome phylogenies; these methods have high error rates.ResultsFirst, we introduce a new class of methods for detecting HGT based on the changes in nucleotide substitution rates that occur when a gene is transferred to a new organism. Our new methods discriminate simulated HGT events with an error rate up to 10 times lower than does GC content. Use of models that are not time-reversible is crucial for detecting HGT. Second, we show that using combinations of multiple predictors of HGT offers substantial improvements over using any single predictor, yielding as much as a factor of 18 improvement in performance (a maximum reduction in error rate from 38% to about 3%). Multiple predictors were combined by using the random forests machine learning algorithm to identify optimal classifiers that separate HGT from non-HGT trees.ConclusionThe new class of HGT-detection methods introduced here combines advantages of phylogenetic and compositional HGT-detection techniques. These new techniques offer order-of-magnitude improvements over compositional methods because they are better able to discriminate HGT from non-HGT trees under a wide range of simulated conditions. We also found that combining multiple measures of HGT is essential for detecting a wide range of HGT events. These novel indicators of horizontal transfer will be widely useful in detecting HGT events linked to the evolution of important bacterial traits, such as antibiotic resistance and pathogenicity.
High Smac/DIABLO expression is associated with early local recurrence of cervical cancer
Authors: Arellano-Llamas Abril , Garcia Francisco J , Perez Delia , Cantu David , Espinosa Magali , De la Garza Jaime G , Maldonado Vilma , Melendez-Zajgla Jorge 
Published: October 2006

Abstract

Background
In a recent pilot report, we showed that Smac/DIABLO mRNA is expressed de novo in a subset of cervical cancer patients. We have now expanded this study and analyzed Smac/DIABLO expression in the primary lesions in 109 cervical cancer patients.

Methods
We used immunohistochemistry of formalin-fixed, paraffin-embedded tissue sections to analyze Smac/DIABLO expression in the 109 primary lesions. Seventy-eight samples corresponded to epidermoid cervical cancer and 31 to cervical adenocarcinoma. The median follow up was 46.86 months (range 10–186).

Results
Smac/DIABLO was expressed in more adenocarcinoma samples than squamous tumours (71% vs 50%; p = 0.037). Among the pathological variables, a positive correlation was found between Smac/DIABLO immunoreactivity and microvascular density, a marker for angiogenesis (p = 0.04). Most importantly, Smac/DIABLO immunoreactivity was associated with a higher rate of local recurrence in squamous cell carcinoma (p = 0.002, log rank test). No association was found between Smac/DIABLO and survival rates.

Conclusion
Smac/DIABLO expression is a potential marker for local recurrence in cervical squamous cell carcinoma patients.
MR thermometry characterization of a hyperthermia ultrasound array designed using the k-space computational method
Authors: Al-Bataineh Osama M , Collins Christopher M , Park Eun-Joo , Lee Hotaik , Smith Nadine Barrie 
Published: October 2006

Abstract

Background
Ultrasound induced hyperthermia is a useful adjuvant to radiation therapy in the treatment of prostate cancer. A uniform thermal dose (43°C for 30 minutes) is required within the targeted cancerous volume for effective therapy. This requires specific ultrasound phased array design and appropriate thermometry method. Inhomogeneous, acoustical, three-dimensional (3D) prostate models and economical computational methods provide necessary tools to predict the appropriate shape of hyperthermia phased arrays for better focusing. This research utilizes the k-space computational method and a 3D human prostate model to design an intracavitary ultrasound probe for hyperthermia treatment of prostate cancer. Evaluation of the probe includes ex vivo and in vivo controlled hyperthermia experiments using the noninvasive magnetic resonance imaging (MRI) thermometry.

Methods
A 3D acoustical prostate model was created using photographic data from the Visible Human Project®. The k-space computational method was used on this coarse grid and inhomogeneous tissue model to simulate the steady state pressure wavefield of the designed phased array using the linear acoustic wave equation. To ensure the uniformity and spread of the pressure in the length of the array, and the focusing capability in the width of the array, the equally-sized elements of the 4 × 20 elements phased array were 1 × 14 mm. A probe was constructed according to the design in simulation using lead zerconate titanate (PZT-8) ceramic and a Delrin® plastic housing. Noninvasive MRI thermometry and a switching feedback controller were used to accomplish ex vivo and in vivo hyperthermia evaluations of the probe.

Results
Both exposimetry and k-space simulation results demonstrated acceptable agreement within 9%. With a desired temperature plateau of 43.0°C, ex vivo and in vivo controlled hyperthermia experiments showed that the MRI temperature at the steady state was 42.9 ± 0.38°C and 43.1 ± 0.80°C, respectively, for 20 minutes of heating.

Conclusion
Unlike conventional computational methods, the k-space method provides a powerful tool to predict pressure wavefield in large scale, 3D, inhomogeneous and coarse grid tissue models. Noninvasive MRI thermometry supports the efficacy of this probe and the feedback controller in an in vivo hyperthermia treatment of canine prostate.
Factors contributing to intervention fidelity in a multi-site chronic disease self-management program
Authors: Perrin Karen M , Burke Somer Goad , O'Connor Danielle , Walby Gary , Shippey Claire , Pitt Seraphine , McDermott Robert J , Forthofer Melinda S 
Published: October 2006

Abstract

Background and objectives
Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design.

Methods
The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance.

Results
This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation.

Conclusion
Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.
Ossifying fibroma of the head and neck: Involvement of the temporal bone — an unusual and challenging site
Authors: Levine Paul A. , Wiggins Robert , Archibald Robert W. R. , Britt Richard 
Published: October 2006

AbstractOssifying fibroma of the head and neck is most commonly described in the mandible and maxilla. A few isolated reports in the literature exhibit the rare existence of this lesion in the nasal bones, orbit, ethmoid sinus, sphenoid sinus, occiput, and in only two well‐documented cases, the temporal bone. We present the case of an extensive ossifying fibroma of the temporal bone that presented as a suspected case of hypertosis of the external auditory canal and conductive hearing loss, without any cosmetic deformity. A review of the recent literature concerning the sites, radiologic presentation, difficulty of pathologic differentiation, and modality of therapy is discussed.
Avulsion of the upper lateral cartilage: Etiology, diagnosis, surgical anatomy and management
Authors: Parkes Morey L. , Kanodia Raj 
Published: October 2006

AbstractRelatively little has been published about upper lateral cartilage abnormalities, trauma, and management in rhinoplastic literature. In this paper we would like to present a relatively common problem seen either by trauma or as a result of rhinoplasty.The upper lateral cartilages are a pair of triangular cartilages, one on each side of the dorsum, which comprise the upper cartilaginous vault with the septum and can be avulsed due to direct trauma. This results in loss of their attachments and resultant healing in a new angulated position. The middle third of the nose, being relatively mobile, is less susceptible to trauma than the upper third which is rigid and comprised of bone, and that frequently is the reason for less incidence of avulsion of the upper lateral cartilages compared to fractured nasal bones. The surgical treatment of the structures adjacent to the upper lateral cartilage during the process of rhinoplasty severs many attachments of these cartilages and frequently causes them to be free floating. This may not be recognized and not treated. Lack of appropriate realignment in the normal anatomical position may heal the cartilage in a distorted angulated position. Irrespective of etiology, when distortions of the upper lateral cartilage occur, they may cause significant concavity and “hollowed out” appearance on the side of the avulsion which functionally may impede the nasal airway by encroachment and/or “flutter valve” effect. During inspiration this unsupported upper lateral cartilage may interfere with anatomy, physiology and efficiency of the internal nasal valve function.Avulsion of the upper lateral cartilage is a definite entity and should be recognized and treated appropriately to realign the lateral cartilage in its normal anatomical position for a functional as well as a good cosmetic result.
Surgery on the only hearing ear
Authors: Althaus Sean R. 
Published: October 2006

AbstractModern otosurgical tools and techniques have greatly improved the outlook for hearing improvement in otologic surgery, while decreasing the risk of severe and irreversible hearing loss complicating the surgical procedure. Nevertheless, even a minimal risk operation must be weighed differently in an only hearing ear situation.This paper reviews the author's experience and philosophy regarding only hearing ear surgery for chronic otitis media, endolymphatic hydrops, perilymph fistulas and acoustic neuromas.
Bilateral primary malignant neoplasms of the maxillary sinus: Report of a case and statistical analysis of the reports in japan
Authors: Ichimura Keiichi , Nozue Michihiko , Hoshino Tomoyuki , Yano Jun 
Published: October 2006

AbstractAlthough double primary malignant neoplasms of bilateral maxillary sinuses were regarded as extremely rare, there have been 50 patients described in Japan since 1937. Among them only eight cases showed the histologic distinction between both sides.A 64‐year‐old man with double primary carcinomas had a mucoepidermoid carcinoma of the left maxillary sinus and a papillary adenocarcinoma of the right one with an interval of three years. He was treated with a combination of surgery, radiotherapy and regional chemotherapy. The histologic combination of these tumors could not be found so far. The advantage of this combination treatment for the carcinoma of the maxillary sinus is stressed.
Neck dissection: Is it worthwhile?
Authors: Desanto Lawrence W. , Holt James J. , Beahrs Oliver H. , O'Fallon W. Michael 
Published: October 2006

AbstractData on 1,048 neck dissections in 881 patients were studied to evaluate the effectiveness of treatment in controlling cervical metastasis. Of the 881 patients, 74.5% were treated by surgery alone, and most of the reMaynder had either planned preoperative or postoperative radiation to the primary site and the entire neck. Planned preoperative or postoperative radiation was defined as the delivery of 4,000 rads or more to the entire neck 123 days before (preoperative) or after (postoperative) neck dissection. In these groups, most patients received more than 5,000 rads. Ninety‐six patients received preoperative radiation that did not satisfy these criteria and were grouped separately. The group with neck dissection alone had recurrence rates in the dissected side at 2 years of 7.5, 20.2, and 37.4%, respectively, for No, N1, and N2 staged necks. There were no differences in recurrence rates for the groups with radiated necks in the stage II (N2) necks compared with each other or with the group having surgery alone. Most recurrences, when they occurred in the neck, were manifest by 2 years. Mean follow‐up in the entire study was 3.5 years. Two patients were lost to follow‐up and were presumed to have died from cancer. When compared with pathologic staging, clinical staging was imprecise in one‐third of the cases.
A specimen mount for small laryngeal biopsies
Authors: Holinger Lauren D. , Miller Iii Alexander W. 
Published: October 2006

AbstractAccurate histologic interpretation of small laryngeal biopsies is often obfuscated by tangential sectioning of the specimen. The natural tendency of the tissue specimen to curl and suboptimnl orientation of the specimen account for the tangential cuts. Use of a biopsy specimen mount eliminates this problem. The biopsy specimen mount also permits accurate determination of tumor involvement of deep and peripheral margins, a useful feature in the management of small areas of leukoplakia of the vocal cords. The biopsy specimen mount is therefore helpful in the endoscopic surgical management of early glottic malignancy (T1s, T1), since therapy can be individualized and planned rationally with precise determination of margin involvement.
Occupational hearing loss: An ontario perspective
Authors: Alberti P. W. , Blair R. L. 
Published: October 2006

AbstractIn the past 11 years over 6,500 patients referred by the Workmen's Compensation Board for evaluation of hearing loss of possible industrial etiology have been evaluated at Mount Sinai Hospital. Various groups of workers have been studied from the audiological, otological, and epidemiological standpoint. Problems of assessment include the accurate quantification of hearing loss which may be difficult for a number of reasons including lack of understanding of the test and lack of willingness to cooperate. An accurate diagnosis may be difficult to achieve because of lack of previous history, poor memory, etc. The method of use in Ontario for quantifying hearing loss will be reviewed and its relationship to handicap discussed. The success of rehabilitation by means of hearing aid use will be analyzed. This is surprisingly good.
Computerized tomography of the temporal bone
Authors: Valvassori Galdino E. , Mafee Mahmood F. , Dobben Glen D. 
Published: October 2006

AbstractComputerized tomography is acquiring an increasingly important role in the radiographic assessment of the temporal bone. In the latest generation of CT scanners, spacial resolution has been reduced to 0.1 cu mm and slice thickness to 1.5 mm.The Mayn advantages of computerized tomography in comparison to multidirectional tomography are the improved contrast of the images and above all the clear demonstration of soft tissue structures and masses within or adjacent to the temporal bone.The following three applications of computerized tomography will be discussed

Evaluation of intratemporal soft tissue masses. Computerized tomography allows differentiation of fluid filled from solid masses and vascular tumors.
Assessment of lesions extending outside the temporal bone or into the temporal bone from adjacent structures. In these cases CT will demonstrate the temporal bone involvement and the presence and extension of the intra or extra cranial component of the lesion.
Study of the cerebellopontine angle. Computerized tomography with infusion and combined with pneumocisternography comprise the procedure of choice for the diagnosis of acoustic neuromas and other lesions occurring in this area.