bluuebunny/crossref_metadata_2025_split huggingface dataset:
Body Mass Index and Cancer Screening in Older American Indian and Alaska Native Men
Authors: Muus Kyle J. , Baker‐Demaray Twyla , McDonald Leander R. , Ludtke Richard L. , Allery Alan J. , Bogart T. Andy , Goldberg Jack , Ramsey Scott D. , Buchwald Dedra S. 
Published: December 2008

ABSTRACT:
Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancer screening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancer screening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the prevalence of fecal occult blood testing (FOBT) and prostate‐specific antigen (PSA) testing among AI/AN men within the past year by age and rurality, and determine if body mass index (BMI) is associated with screening. Methods: A national cross‐sectional survey was administered face‐to‐face to 2,447 AI/AN men at least 55 years of age in 2004‐2005. Participants were asked when they last had FOBT and PSA testing. BMI was derived from self‐reported height and weight, and rurality of residence was defined by rural‐urban commuting area codes. We assessed the association of cancer screening and BMI with logistic regression models, adjusting for demographic and health factors. Findings: Prevalence of up‐to‐date FOBT and PSA testing were 23% and 40%, respectively. Older men were more likely than younger men to have FOBT and PSA testing. BMI was not associated with receipt of FOBT or PSA testing. Conclusions: This is the first study to examine obesity and health care in AI/ANs. As in other populations, FOBT and PSA testing were suboptimal. Screening was not associated with BMI. Studies of AI/AN men are needed to understand the barriers to receiving timely screenings for prostate and colorectal cancer.
Objective evaluation of tongue base snoring after the use of an oral appliance: a prospective case series
Authors: Abo‐Khatwa M.M. , Osman E.Z. , Hill P.D. , Lee B.W.V. , Osborne J.E. 
Published: December 2008

Summary:  Oral appliances have become increasingly popular for treatment of obstructive sleep apnoea especially for patients who are not able to tolerate continuous positive airway pressure devices. For simple snoring, oral appliances have become one of the treatments of choice despite a relative lack of scientific evidence of their efficiency.Objectives:  This study was designed to objectively evaluate the clinical effectiveness of oral appliance in the treatment of simple snoring.Design:  Prospective case series.Participants:  Fifteen patients with confirmed simple tongue base snoring had pre‐ and post‐oral appliance objective assessment of their snoring loudness and duration at home.Main outcome measures:  The Snore Index was calculated as the number of snores per hour slept. Patients bed partners were asked to rate the snoring severity on a Spouse Dissatisfaction Scale.Results:  Overall there was no significant difference in the Snore Index in the pre‐ and post‐oral appliance recordings. Subjectively, there was a statistically significant decrease in the Spouse Dissatisfaction Scale following the use of oral appliance.Conclusion:  Tongue base snorers had no significant reduction in their snoring with the oral appliances. There is a subjective benefit which may be due to the placebo effect.
Hemithyroidectomy for benign thyroid disease: who needs follow‐up for hypothyroidism?
Authors: Wormald R. , Sheahan P. , Rowley S. , Rizkalla H. , Toner M. , Timon C. 
Published: December 2008

Objective:  To identify the incidence and possible risk factors for the development of hypothyroidism following hemithyroidectomy and to determine a simple protocol for the post‐op monitoring of thyroid function.Design:  Prospective study.Setting:  Tertiary Referral Centre.Patients:  Eighty‐two consecutive patients who underwent hemi‐thyroidectomy between May 2003 and May 2005 were included. The clinical and pathological factors were obtained and statistically analysed.Results:  Eighteen per cent of patients became hypothyroid post‐operatively. Multivariate analysis demonstrated that risk factors for hypothyroidism following hemithyroidectomy included a pre‐operative [TSH] >1.6 μIU/L [P = 0.008, hazard ratio (HR) 14, 95% confidence interval (CI) 2–54] and lymphocytic infiltration graded 3+ or more (P < 0.001, HR 42, 95% CI, 8–195%). There was no relationship between age, sex or weight of resected tissue and the risk of hypothyroidism.Conclusion:  Patients with raised pre‐operative [TSH] or with lymphocytic infiltration of their thyroid specimen should undergo regular testing of thyroid function within the first year of surgery. In all other patients, thyroid function at 12 months is sufficient.
Treatment of non‐tuberculous mycobacterial cervicofacial lymphadenitis in children: critical appraisal of the literature
Authors: Timmerman M.K. , Morley A.D. , Buwalda J. 
Published: December 2008

Background:  Surgical excision has historically been the treatment of choice for non‐tuberculous mycobacterial cervicofacial lymphadenitis. Emerging data suggests antibiotic treatment alone could be an attractive alternative to surgery. We questioned (1) what treatment offers best cure rates in children with this condition and (2) the evidence for antibiotic treatment alone.Type of review:  Structured literature search according to the Evidence Based Medicine guidelines.Search strategy/methods:  A structured search was conducted in PubMed, Embase and the Cochrane Library from 1966 up to November 2007. Relevant papers were critically appraised.Results:  Six papers were included, one of which was a randomised controlled clinical trial (RCT). In general, treatment sequencing was not consistent. Surgery and medical treatment were often used in combination, resulting in high overall cure rates. In the RCT surgery and antibiotic treatment were compared as single modalities. The outcome of surgery was far superior (96%versus 66% cure rate, respectively). Other studies indicated that substantial cure rates (up to 67%) were achieved with medical management alone, but failed to identify factors predicting response.Conclusion:  Surgical excision still is the backbone in the management of cervicofacial non‐tuberculous mycobacterial lymphadenitis, although a considerable number of children can be cured with antibiotics alone or combined modality treatment. To date it is unclear which subset of patients can benefit from antibiotic treatment only.
Combined electro‐acoustic stimulation: a beneficial union?
Authors: Talbot K.N. , Hartley D.E.H. 
Published: December 2008

Background:  The most pressing problem facing cochlear implant research is no longer making artificial hearing a reality. Instead, it is to develop devices that can more clearly reflect the capabilities of the human auditory system. Current cochlear implants rarely provide adequate pitch perception. As hearing loss commonly affects higher, more than lower frequencies, a possible solution is to preserve acoustic hearing at low frequencies by inserting a short electrode array and thus deliver combined electro‐acoustic stimulation (EAS).Objective of review:  To determine whether individuals with severe‐to‐profound high‐frequency hearing loss have realised this predicted benefit of combined EAS, over conventional cochlear implants, with respect to pitch.Type of review:  A systematic review of publications pertaining to the benefits of combined EAS over conventional cochlear implantation, with specific reference to pitch perception.Search strategy:  A systematic literature search was conducted across multiple databases and supplemented by searching the reference lists of relevant trials and identified reviews.Results:  The included studies suggest an overall benefit of combined EAS, over conventional cochlear implants, with respect to pitch. In addition, (i) 13% sustained a total loss of low‐frequency hearing post‐implantation of the short electrode array and, (ii) 24% had >20 dB hearing loss across all frequencies and/or total hearing loss.Conclusions:  For patients with severe‐to‐profound high‐frequency hearing loss combined EAS appears to offer a significant, everyday, long‐term benefit. However, further clinical trials with larger numbers of candidates are necessary to confirm this finding. The risks involved cannot be ignored, but there is potential for a variety of strategies to improve the safety margin.
Sensitivity and responsiveness of the medical research council dyspnoea scale to the presence and treatment of adult laryngotracheal stenosis
Authors: Nouraei S.A.R. , Nouraei S.M. , Randhawa P.S. , Butler C.R. , Magill J.C. , Howard D.J. , Sandhu G.S. 
Published: December 2008

Objectives:  To assess the sensitivity and responsiveness of the Medical Research Council (MRC) scale, a psychophysical dyspnoea assessment instrument to the presence and treatment of adult laryngotracheal stenosis.Design:  Prospective observational study.Settings:  Tertiary/National referral airway reconstruction centre.Participants:  Fourty tracheostomy‐free patients undergoing endoscopic airway examination/laryngotracheoplasty.Main outcome measures:  Demographic and clinical information, obtained from patient records, lesion severity, which was recorded intraoperatively, standard spirometry, which was measured preoperatively, and the MRC dyspnoea scale, which was administered preoperatively and at the first outpatient visit 4–6 weeks later.Results:  There were 16 males and 24 females. Mean age at presentation was 44 ± 14 years (± SD). Postintubation stenosis was the commonest aetiology (73%) followed by idiopathic subglottic stenosis and Wegener’s Granulomatosis. Six patients were examined post‐treatment and had minimal residual stenosis and the remaining patients had glottic stenosis (n = 11) or Myer–Cotton Grade I (n = 8), II (n = 7) or III (n = 8) tracheal stenoses. Pre‐treatment MRC dyspnoea scores and the degree of change in the MRC score following treatment strongly correlated with pre‐treatment stenosis severity (r = 0.75 and r = −0.71 respectively; P < .001). Moreover statistically significant correlations existed between preoperative peak expiratory flow and forced expiratory volume in 1 s and preoperative MRC dyspnoea scores (r = −0.34 and r = −0.35 respectively; P < 0.05).Discussion:  Exertional dyspnoea is the hallmark symptom of laryngotracheal stenosis and for many patients it is the primary cause of disability. These findings confirm that the MRC dyspnoea scale is an appropriate outcome instrument for assessing dyspnoea associated with this condition.
Speech perception in congenitally, pre‐lingually and post‐lingually deaf children expressed in an equivalent hearing loss value
Authors: Rotteveel L.J.C. , Snik A.F.M. , Vermeulen A.M. , Cremers C.W.R.J. , Mylanus E.A.M. 
Published: December 2008

Objectives:  To investigate the speech perception performance of children with a cochlear implant (CI) after 3 and 4 years of follow‐up and to study the influence of age at implantation, duration of deafness and communication mode on the variability in speech perception performance.Study design:  A broad battery of speech perception tests was administered to 67 children with a CI. The results were reduced into one measure: the ‘equivalent hearing loss (EHL)’. This outcome measure refers to the performance of a reference group of severely and profoundly hearing impaired children with conventional hearing aids.Participants:  The population comprised 35 congenitally, 17 pre‐lingually and 15 post‐lingually deaf children implanted between 1989 and 1999. The population was homogeneous with respect to cognition, residual hearing and support at home as a result of conservative inclusion criteria.Results:  During the first 2 years after implantation, post‐lingually deaf children showed the fastest rate of improvement in speech perception. After 3 years of implant use, the early implanted pre‐lingually deaf children and congenitally deaf children implanted under the age of 6 years caught up with the post‐lingually deaf children. Pre‐lingually deaf children implanted after a relatively long‐duration of deafness tended to show poorer performance than those with a shorter duration. Performance of congenitally deaf children implanted after the age of 6 years was poorer and progress was slower. In the congenitally deaf children, 36% of the variability in performance was explained by duration of deafness, whereas in the children with pre‐ and post‐lingually acquired deafness, communication mode explained 69% of the variance.Conclusions:  All children derived benefit from their CI for speech perception tasks, but performance varied greatly. Several children reached EHL levels around 70 dB; their speech perception was equal to that of a child with conventional hearing aids who has 70 dB HL. After early implantation, the levels of performance that were eventually achieved differed no more than 10 dB, irrespective of whether the onset of deafness was pre‐lingual or postlingual. In congenitally deaf children, duration of deafness played a major role in speech perception performance, whereas in the children with pre‐lingually and post‐lingually acquired deafness together, mode of communication was a major factor.
The inflammation produced by corticosteroid inhalers in the pharynx in asthmatics
Authors: Bhalla R.K. , Taylor W. , Jones A.S. , Roland N.J. 
Published: December 2008

Objectives:  To investigate inflammation of the pharyngeal mucosa caused by inhaled corticosteroids.Design:  Prospective, cross‐sectional, single‐blinded study.Setting:  University Hospital Aintree, Liverpool, UK.Patients:  Fifty adults were recruited from two local general practices and from general ENT clinics at our University hospital. Patients were allocated to one of four groups according to use of inhaled corticosteroids and the presence of adverse local side effects.Main outcome measures:  Scores achieved on a respiratory symptom questionnaire. Histological markers of inflammation and their correlation with pharyngitis. Statistical modelling included univariate and multivariate analyses, which included multiple linear and logistic regression, and discriminant analysis.Results:  The regular use of inhaled corticosteroids predisposed subjects to hoarseness, weakness of voice, sore throat and throat irritation (P < 0.0001). Pharyngitis was significantly different between the groups (P < 0.0001). Furthermore, those not using an inhaled corticosteroid regularly had little or no clinically apparent pharyngitis, whereas those using an inhaled corticosteroid regularly had significantly higher pharyngitis scores (P = 0.0204). Similarly, weakness of voice (P = 0.0234), hoarseness (P < 0.001) and sore throat (P < 0.001) were also more common in those patients that used an inhaled corticosteroid on a regular basis. To our surprise, however, cellular markers of inflammation did not corroborate the appearances of clinical examination. We found that the five most important discriminators, between those that were using inhaled corticosteroid therapy regularly and those that were not, to be intra‐epithelial inflammatory cells (scdf −1.2939); age (scdf 0.8389); use of a spacer device (scdf 0.5456); sore throat (scdf 0.4230) and throat irritation (scdf 0.4015). The groups were significantly different (P < 0.0001). The statistical model used, classified 68% of the cases correctly into their respective groups.Conclusions:  Inhaled corticosteroids predispose to pharyngitis and an inflammatory infiltrate. However, the clinical diagnosis of pharyngitis does not correlate well with cellular inflammatory infiltrate and is therefore, not a reliable measure of underlying inflammation. We advocate caution in the use of pharyngeal erythema as a measure of underlying inflammation.
Transimmunization for immunotherapy of head and neck squamous cell carcinoma (HNSCC)
Authors: Prasad S. , Cody V. , Hanlon D. , Roberts S. , Filler R. , Edelson R.L. , Dobrucki W. , Sinusas A. , Girardi M. , Birchall M.A. 
Published: December 2008

Objective.  To establish proof of principle of transimmunization (T.I.) in an animal model prior to use in a dendritic cell (DC)‐based immunotherapy clinical trial for HNSCC.Methods.  Pooled blood from syngeneic Fischer 344 rats was photoactivated in the presence of 8‐methoxypsoralen and Ultraviolet‐A, followed by overnight incubation to facilitate conversion of monocyte precursors to DC. Cells were matured using pathogen associated molecular patterns (PAMPs) – LPS, CpG DNA, flagellin and Poly I: C. Cells were either labeled with Indium‐111 and injected peritumorally followed by in vivo tracking using micro‐Single Photon Emission CT (micro‐SPECT), or used unlabeled in randomized double‐blinded vaccination studies in tumor‐bearing animals. Treatment groups included: T.I. cells ± PAMPs, T.I. cells + lysate ± PAMPs and T.I. cells + tumor lysate (TL) containing‐NP ± PAMPs. Outcome measures included: mean tumor size, survival and ELISA to study differences in production of IFN‐γ and IL‐10.Results.  There were statistically significant differences in mean tumor size at 2 weeks post‐injections (P = 0.033) and overall survival (P = 0.009) in the group treated with T.I. cells alone. Addition of PAMPs made no significant impact on outcome measures. Micro‐SPECT images indicated that T.I. cells remain at the site of injection between 24 and 96 h.Conclusions.  (1) Immature T.I. cells on their own appear to be significantly more effective than those loaded with antigen, or mature ones. (2) T.I. cells remain at the site of injection for at least 24 h prior to migration to regional lymph nodal area for classical antigen cross‐presentation.
A systematic review of the role of mutant p53 in predicting outcome or response to treatment in head and neck squamous cell carcinoma (HNSCC).
Authors: Tandon S. , Tudur‐Smith C. , Ghosh S. , Boyd M. , Jones T.M. 
Published: December 2008

Objectives.  To systematically review whether the presence of mutant p53 alters patients’ prognosis in HNSCC.Method.  Systematic searches of Medline, the Cochrane database of randomised controlled trials, Embase, review of conference abstracts and bibliographies of retrieved articles were performed. Studies were included if they; (1) considered biopsy proven primary HNSCC from the larynx, oropharynx, hypopharynx, or oral cavity. (2) Reported on the outcome following treatment that included radiotherapy, chemotherapy, surgery or a combination of these. (3) Attempted to assess p53 status and compared this with survival outcomes. (4) Measured survival outcomes at a minimum of 2 years post primary treatment. Primary outcome measures were overall survival (OS) and disease free survival (DFS). Hazard ratio (HR) with 95% confidence intervals (CI), was calculated from available data comparing outcome in mutant versus wild type p53 groups; initially for each study prior to aggregation.Results.  205 papers were fully scrutinised, of these 36 were suitable for meta‐analysis. Larynx: OS HR = 1.00 (95% CI 0.82–1.22); DFS HR = 1.27 (95% CI 0.99–1.63). Oral Cavity: OS HR = 1.50 (95% CI 1.15–1.95), DFS HR = 1.46 (95% CI 1.12–1.91). Oropharynx: OS HR = 1.26 (95% CI 0.92–1.73), DFS HR = 0.45 (95% CI 0.28–0.73). Hypopharynx: OS HR = 1.59 (95% CI 1.07–2.35), no papers had sufficient information from which DFS results could be calculated.Conclusions.  The results suggest a survival benefit for the p53 negative group, however there is marked heterogeneity between these studies, so any final conclusion should remain guarded.
Effect of conductive hearing loss on the activation pattern of the primary auditory cortex as assessed by functional MRI
Authors: Wild D.C. , Foster J.R. , Hall D.A. 
Published: December 2008

Objectives.  To investigate the activation pattern of the human auditory cortex to monaural sound stimuli using functional magnetic resonance imaging (fMRI) in volunteers with normal hearing or unilateral conductive hearing loss.Method.  Ten normal hearing volunteers and seven volunteers with unilateral conductive hearing loss were subjected to a random sequence of monaural sound stimuli and silence, whilst undergoing fMRI in a 3 Tesla scanner. The sound stimuli consisted of narrowband noise (250 Hz and 4000 Hz), as well as wideband noise (250–4000 Hz). A signal averaging algorithm was used to detect the response in the primary auditory cortex. A laterality index was calculated and compared between the study groups.Results.  In the normal hearing group the auditory areas of both hemispheres showed activity in response to monaural stimuli, but the responses were consistently greater in the contralateral primary auditory cortex. Wideband stimuli produced the greatest degree of contralaterality and the largest response across the auditory cortex. The responses to high and low frequency stimuli were found to be conform with established tonotopic organization of the primary auditory cortex. There was no difference in the laterality index between the study groups.Conclusions.  We have developed a non‐invasive way to investigate the response pattern of the primary auditory cortex to sound stimuli using fMRI. A similar activation pattern of the auditory cortex was found in both study groups suggesting a preservation of the organisation of the ascending auditory pathways and auditory cortex in unilateral conductive hearing loss.
Closure of nasal septal perforation: vertical mattress sutures to approximate bilateral advancement flaps
Authors: Wong S. , Raghavan U. 
Published: December 2008

Objectives.  The aim of this study is to assess the closure success rate and symptoms control in the management of septal perforation using bilateral advancement flaps and porcine collagen.Method.  In a prospective study, twenty‐eight patients underwent treatment for nasal septal perforation by the same surgeon in our institute between 2005 and 2007. Twelve were females and 16 were males with an average age of 45 years (range: 21–76). The mean follow up was 16 months (range: 6–24). The severity of symptoms was assessed pre and post‐operatively by the same assessor using the validated visual analogue score (VAS). The average vertical and horizontal diameters of the perforations were 22 mm (range: 10–35) and 27 mm (range: 10–37) respectively. The nasal valve angle was assessed pre, and post‐operatively by two independent assessors.Results.  At the final follow up, there were statistically significant differences between the pre and post‐operative mean VAS scores in the open rhinoplasty group for epistaxis P < 0.0001, crusting P < 0.001, whistling P < 0.001 and nasal obstruction P < 0.002. One out of the 28 (4%) patients in this group had a 1×2 mm residual perforation but had significant symptoms improvement. Therefore, the closure success rate in the open rhinoplasty group was 96% despite a 100% improvement in relieving symptoms of epistaxis, crusting, and whistling, and a 92% nasal blockage symptom improvement.Conclusions.  We conclude that the use of open rhinoplasty mucosal advancement flaps and porcine collagen sandwich may prove to be a pertinent and reliable alternative in the management of nasal septal perforation.