bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications of Metallic Stents in the Pediatric Airway
Authors: Lim Lynne H. Y. , Cotton Robin T. , Azizkhan Richard G. , Wood Robert E. , Cohen Aliza P. , Rutter Michael J. 
Published: October 2004

OBJECTIVEOur aim was to present our experience with complications caused by placement of metallic stents in the pediatric airway.DESIGN AND SETTINGWe conducted a retrospective study of the medical records of patients with complications resulting from metallic stent placement, managed by the senior authors between 1993 and 2002.RESULTSNine children had complications associated with the placement of metallic airway stents. Of these, 8 children required stent removal. Granulation tissue and tracheal stenosis were seen in all 7 children with long standing stent placement. There was 1 stent death in this series.CONCLUSIONSMetallic airway stents can cause significant complications in the pediatric airway. These complications may supersede the airway compromise that necessitated their initial placement. As such, metallic stent placement should be approached with caution. The likelihood and severity of complications increase with time, as do the difficulties encountered upon removal. The proportion of patients in whom metallic stents may be placed “permanently” without complications is not known. Therefore we recommend that metallic airway stents be considered a temporizing measure of limited duration.
Multivariate Predictors of Occult Neck Metastasis in Early Oral Tongue Cancer
Authors: Sparano Anthony , Weinstein Gregory , Chalian Ara , Yodul Mike , Weber Randal 
Published: October 2004

OBJECTIVESThe elective dissection of cervical lymph nodes from patients with early oral tongue cancer and a clinically negative neck (T1/T2N0), remains an unsettled issue that continues to be investigated. This study examines clinical and histopathologic factors through univariate and multi‐variate analysis to correlate the risk of neck micrometastasis in patients with T1/T2N0 squamous cell carcinoma of the oral tongue.STUDY DESIGN AND METHODSThe clinical files and histologic sections of tumor from 45 clinically determined N0 patients were retrospectively analyzed. The factors examined include degree of tumor cell differentiation, T1/T2 staging, presence of perineural invasion, presence of angiolymphatic invasion, type of invasion front, depth of muscle invasion, and tumor thickness.RESULTSIndependent correlates of positive occult neck metastasis included greater tumor thickness (P = 0.01), greater depth of muscle invasion (P = 0.01), T2 stage (P = 0.01), poorly differentiated tumors (P = 0.007), infiltrating‐type invasion front (P = 0.03), presence of perineural invasion (P = 0.001), and presence of angiolymphatic invasion (P = 0.005). The final multivariate model for estimation of an increased probability of occult neck disease included greater tumor thickness, presence of perineural invasion, infiltrating‐type invasion front, poorly differentiated tumors, and T2 stage.CONCLUSIONSThe clinical and histopathologic factors studied herein permit greater selectivity and more informed decision‐making than does presurgical evaluation, when addressing elective neck treatment for early N0 oral tongue cancer. The multivariate model derived from this study appears to be a more reliable method for determining the patients most likely to benefit from elective neck dissection.
Efficacy of Routine Bilateral Neck Dissection in the Management of Supraglottic Cancer
Authors: Chiu Robert J. , Myers Eugene N. , Johnson Jonas T. 
Published: October 2004

OBJECTIVEIn a previous study, we reported that the contralateral undissected neck was the most common site of failure in patients treated for squa‐mous cell carcinoma of the supraglottic larynx. Since then, we have altered our treatment of all patients with T2‐T4 supraglottic cancer and selective T1 cases to include routine bilateral neck dissection. In the present study, we compare the long‐term efficacy of routine bilateral neck dissections to historic controls in the treatment of patients with supraglottic cancer.STUDY DESIGN AND SETTINGA retrospective chart review on all patients undergoing primary surgery for supraglottic carcinoma between 1989 and 2000 was performed. All had undergone routine bilateral neck dissection. The most proximal area of recurrent disease was identified as the site of recurrence. Rates of recurrence, 2‐year overall survival, and 2‐year disease‐specific survival were calculated. Results were compared to historical data using Fisher's exact test.RESULTSOf 180 patients identified, 115 patients with minimum 2‐year follow‐up and meeting exclusion criteria were included in the analysis. Four patients (3.5%) experienced local recurrence, 9 patients (7.8%) had cervical recurrence, and 8 patients had distant spread (7.0%). Recurrence in the neck (7.8%) has been significantly reduced from the historical recurrence rate (20%) prior to instituting routine bilateral neck dissections (P = 0.009). The 2‐year survival increased from 72% to 82.6% (P = 0.0408).CONCLUSION AND SIGNIFICANCERoutine bilateral neck dissection decreases cervical recurrence and appears to improve survival in the management of supraglottic cancer.
Fatal Traumatic Brain Injury, West Virginia, 1989–1998
Authors: Adekoya Nelson , Majumder Ranjit 
Published: October 2004

Objective. The objective of this study was to describe fatal cases of traumatic brain injury (TBI) among West Virginia residents. Methods. The authors analyzed data from the National Center for Health Statistics Multiple Cause of Death tapes for the period 1989–1998. They compared West Virginia's annualized average TBI death rate with the rates of other states and with the rate among U.S. residents for the same period. U.S. Bureau of Census population estimates were used as denominators. Results. A total of 4,416 TBI deaths occurred in West Virginia in 1989–1998, for an annual average death rate of 23.6 per 100,000 population. From 1989 to 1998, TBI death rates declined 5% ( p=0.4042). Seventy-five percent ( n=3,315) of fatalities occurred among men. Adults ⩾65 years of age accounted for the highest percentage of fatal injuries ( n = 1,135). The leading external causes of fatal TBI were: firearm-related (39% of reported fatalities), motor vehicles–related (34%), and fall-related (10%). Firearm-related TBI became the leading cause of TBI fatalities in 1991, surpassing motor vehicle-related TBI. Seventy-five percent of firearm-related TBI deaths were suicides ( n = 1,302). West Virginia's TBI death rate (23.6 per 100,000) was higher than the national rate (20.6 per 100,000). In 23 states, the average TBI death rates over the 10-year period were higher than West Virginia's. Whereas modest declines in TBI death rates occurred for motor vehicle-related and firearm-related causes in West Virginia, a concomitant 38% increase occurred in the fall-related TBI death rate during the decade. Conclusion. Data presented in this report can be used to develop targeted prevention programs in West Virginia.
Worsening Trends in Adult Health-Related Quality of Life and Self-Rated Health—United States, 1993–2001
Authors: Zack Matthew M. , Moriarty David G. , Stroup Donna F. , Ford Earl S. , Mokdad Ali H. 
Published: October 2004

Objectives. Health-related quality of life and self-rated health complement mortality and morbidity as measures used in tracking changes and disparities in population health. The objectives of this study were to determine whether and how health-related quality of life and self-rated health changed overall in U.S. adults and in specific sociodemographic and geographic groups from 1993 through 2001. Methods. The authors analyzed data from annual cross-sectional Behavioral Risk Factor Surveillance System surveys of 1.2 million adults from randomly selected households with telephones in the 50 states and the District of Columbia. Results. Mean physically and mentally unhealthy days and activity limitation days remained constant early in the study period but increased later on. Mean unhealthy days increased about 14% during the study period. The percentage with fair or poor self-rated health increased from 13.4% in 1993 to 15.5% in 2001. Health-related quality of life and self-rated health worsened in most demographic groups, especially adults 45–54 years old, high school graduates without further education, and those with annual household incomes less than $50,000. However, adults 65 years old or older and people identified as non-Hispanic Asian/Pacific Islander reported stable or improving health-related quality of life and self-rated health. In 18 of the states and the District of Columbia, mean unhealthy days increased, while only North Dakota reported a decrease. Conclusion. Population tracking of adult health-related quality of life and self-rated health identified worsening trends overall and for many groups, suggesting that the nation's overall health goals as identified in the Healthy People planning process are not being met.
Retinal Endothelial Angiogenic Activity: Effects of Hypoxia and Glial (Müller) Cells
Authors: YAFAI YOUSEF , IANDIEV IANORS , WIEDEMANN PETER , REICHENBACH ANDREAS , EICHLER WOLFRAM 
Published: October 2004

ABSTRACTObjective: To explore the impact of retinal glial (Müller) cells on survival and neovascularization‐related activities of cultured retinal endothelial cells under normoxic and hypoxic conditions.Methods: Bovine retinal endothelial cells (BRECs) were cultured under normoxia or hypoxia (0.5% O2) either alone, together with the human Müller cell line MIO‐M1, or in normoxia‐ or hypoxia‐conditioned media of MIO‐M1 cells. Cell number, proliferation, apoptotic cell death, and migration of BRECs were determined.Results: Exposure of BRECs to hypoxia for 24 h decreased the number of adherent cells and the proliferation rate, but increased apoptosis and cell migration. Increased apoptosis and decreased proliferation of the BRECs occurred also in the presence of conditioned media of MIO‐M1 cells. Under normoxic conditions, co‐culture with MIO‐M1 cells resulted in increased proliferation, but decreased apoptosis and migration rates of BRECs. Under hypoxic conditions, the Müller cells released elevated amounts of VEGF but their presence decreased proliferation, apoptosis and the migration rates of BRECs.Conclusions: Hypoxia inhibits the proliferation of retinal endothelial cells. Müller cells release soluble mediators that enhance this hypoxia‐mediated effect but, under certain conditions (i.e., in co‐culture), may protect retinal endothelial cells from apoptosis, thus supporting their survival. Altogether the findings indicate that the key signal necessary to trigger retinal endothelial proliferation under hypoxia remains to be determined.
Ethanol Binging Enhances Hepatic Microvascular Responses to Acetaminophen in Mice
Authors: ITO YOSHIYA , ABRIL EDWARD R. , BETHEA NANCY W. , MCCUSKEY ROBERT S. 
Published: October 2004

ABSTRACTObjective: Chronic alcoholism has been considered to be a risk for acetaminophen (APAP) hepatotoxicity, but little is known about the effect of binge alcohol drinking on APAP‐induced liver injury. The present study was conducted to examine the effect of ethanol binging on APAP‐induced hepatic microcirculatory dysfunction.Methods: Male C57Bl/6 mice received 3 weekly ethanol binges (4 g/kg every 12 h × 5 doses/ week) or water binges. At 12 h after the last gavage, APAP (300 mg/kg) was given by oral gavage. In one group of mice, gadolinium chloride (GdCl3, 10 mg/kg) was intraperitoneally administered 2 and 1 days before the start of each weekly ethanol binge.Results: Ethanol binging enhanced APAP‐induced liver injury as indicated by ALT levels. Intravital microscopic study showed that APAP further increased the area occupied by infiltrated erythrocytes into the extrasinusoidal space as well as Kupffer cell phagocytic activity in ethanol‐binged mice when compared with water‐binged mice, while no significant differences in sinusoidal perfusion and leukocyte adhesion were observed. ALT levels after APAP were exacerbated in ethanol‐binged mice treated with GdCl3, but APAP‐induced hepatic microcirculatory dysfunction was not changed significantly.Conclusions: These results suggest that ethanol binging increases APAP‐induced liver injury by exacerbating infiltration of the Disse space with blood cells. Kupffer cells exert a protective role in the liver against APAP intoxication following ethanol binging.
Interspecific competition among urban cockroach species
Authors: Boyer Stéphane , Rivault Colette 
Published: October 2004

AbstractThe aim of this study was to quantify and to compare the effects of intraspecific and interspecific competition among pairs of urban cockroaches [Blatta orientalisL.,Periplaneta americana(L.), andPeriplaneta australasiaeFabricius (Dictyoptera: Blattodea)] in relation to the limitation of resources such as shelter or food. Our approach was to assess whether the presence of one species affected the resource exploitation of another. A reduction in access to shelters or to food for one species revealed dominant/subordination relationships among species and induced spatial segregation in shelters and temporal segregation during food exploitation. The fragmentation of available resources facilitated spatial segregation and the access of more individuals of the subordinate species. Individuals of each species were aware of the presence of non‐conspecifics. The outcome of interspecific competition under laboratory conditions should help us to understand how segregated spatial distributions occur under natural conditions in urban areas.
Response of alate aphids to green targets on coloured backgrounds
Authors: Döring T.F. , Kirchner S.M. , Kühne S. , Saucke H. 
Published: October 2004

AbstractTo study the effect of background colour on aphid landing on green targets (water pan traps), two field experiments were set up in Hessen, Germany, in 2003. Traps were put onto coloured plastic sheets (13 colours, straw mulch, transparent foil, and uncovered soil, Experiment 1). In Experiment 2, green water pans were again put on coloured plastic sheets (red, white, green, and yellow), and the sheets were either sprayed with insect glue or not. Backgrounds and traps were spectrally characterised with a field radiometer (320–950 nm). Aphid catches were highest in the traps on the uncovered background, and lowest in the traps on white or silver backgrounds. For Brevicoryne brassicae, Myzus persicae (Homoptera: Aphididae, Macrosiphini) and five further aphid species, there was a significant negative correlation between UV‐reflectance (320–400 nm) and log(N + 1)‐transformed number of individuals. However, the effect of straw mulch (reduced aphid catches with straw compared to the uncovered background), could not be attributed to differences in UV‐reflectance, as UV was almost identical in soil and straw. High numbers of alate aphids were caught in traps with dark backgrounds (e.g. black, dark green), a result which was attributed to the high contrast between the background and target. The substantially higher aphid numbers from targets with bare soil than from targets with spectrally similar black backgrounds were thought to be caused by the structure of the background surface: for alate aphids, landing close to the target on smooth surfaces may induce probing, and the lack of appropriate substrate will result in take‐off, whereas soil will not induce probing, and aphids will continue to move towards the green targets.
Pegylated interferons: chemical and clinical differences
Authors: Foster G. R. 
Published: October 2004

SummaryPegylated interferon therapy for the treatment of chronic hepatitis C virus provides significant increases in sustained virological response rates compared with standard interferons. Two pegylated interferons are now available and are used in conjunction with ribavirin to maximize response rates in infected patients. The two pegylated interferons, peginterferonα‐2a and peginterferonα‐2b, differ substantially in terms of their chemical and structural characteristics, pharmacokinetic and pharmacodynamic properties, and dosing and administration. A full understanding of the differences between the two drugs is important to maximize the clinical benefits. Controlled studies designed to characterize the effects of the two drugs on viral kinetics and sustained virological response rates are emerging and may help to shed additional light on the use of these compounds in patients with chronic hepatitis C.
Non‐cardiac chest pain: predictors of health care seeking, the types of health care professional consulted, work absenteeism and interruption of daily activities
Authors: Eslick G. D. , Talley N. J. 
Published: October 2004

SummaryAims : To determine the predictors of health care seeking, assess the types of health care professional consulted and to calculate the work absenteeism rates and interruptions to daily activities among non‐cardiac chest pain patients.Methods : A total of 212 patients who presented to a Tertiary Hospital Emergency Department over a 1‐year period with acute chest pain were assessed according to a standard diagnostic protocol and completed the Chest Pain Questionnaire (CPQ).Results : In the previous 12 months prior to presentation to the Emergency Department, 78% of patients had seen a health care professional for chest pain. The main health care professionals seen were general practitioners (85%), cardiologists (74%) and gastroenterologists (30%). Work absenteeism rates because of non‐cardiac chest pain were high (29%) as were interruptions to daily activities (63%). Multiple logistic regression found that acid regurgitation was the only independent predictive symptom associated with consulting for non‐cardiac chest pain (OR = 3.97, 95% CI: 1.25–12.63).Conclusions : Consulting for chest pain is common is this group of patients. The type of health care professional seen appears to be moderated by the frequency and severity of reflux symptoms among these chest pain patients. Work absenteeism and interruptions to daily activities is high among chest pain sufferers.
Treatment of Budd‐Chiari syndrome in a Liver Transplant Unit, the role of transjugular intrahepatic porto‐systemic shunt and liver transplantation
Authors: Attwell A. , Ludkowski M. , Nash R. , Kugelmas M. 
Published: October 2004

SummaryBackground : Budd‐Chiari syndrome is an uncommon cause of liver failure usually associated with an underlying hypercoagulable state.Aim : To evaluate current trends in management of Budd‐Chiari syndrome at our institution.Methods : Twenty‐two patients with Budd‐Chiari syndrome underwent transjugular intrahepatic porto‐systemic shunt, liver transplantation, or both in between 1992 and 2001. We analysed underlying diagnosis, medical therapy, complications, follow‐up and overall outcomes.Results: Five patients (17%) presented with fulminant liver failure and 17 patients (83%) with new‐onset ascites or chronic liver disease. Seventeen patients (74%) underwent transjugular intrahepatic porto‐systemic shunt: improvement or stabilization occurred initially in 14 (82%), whereas the other three patients died within a month. At a mean 3 years follow‐up eight patients (47%) continued to do well clinically and four have died (23.5%); seven have required transjugular intrahepatic porto‐systemic shunt revisions (mean 2.3 interventions), five have experienced transjugular intrahepatic porto‐systemic shunt occlusion managed with new transjugular intrahepatic porto‐systemic shunt placement and five patients underwent subsequent transplantation. Of the 10 patients who underwent liver transplantation, patient and graft survival are 80% at a mean 5.7 years of follow‐up. No patient developed post‐transplant Budd‐Chiari syndrome.Conclusions : Transjugular intrahepatic porto‐systemic shunt is usually feasible in patients with Budd‐Chiari syndrome, and is best suited as a bridge to more timely liver transplantation. Long‐term success of transjugular intrahepatic porto‐systemic shunt is limited and usually requires revision, placement of a new shunt or liver transplantation. Liver transplantation with chronic anticoagulation offers excellent short‐ and medium‐term patient and graft survival. In our series, there was no recurrence of Budd‐Chiari syndrome after liver transplantation.
Increased incidence of azathioprine‐induced pancreatitis in Crohn's disease compared with other diseases
Authors: Weersma R. K. , Peters F. T. M. , Oostenbrug L. E. , van den Berg A. P. , van Haastert M. , Ploeg R. J. , Posthumus M. D. , Homan van der Heide J. J. , Jansen P. L. M. , van Dullemen H. M. 
Published: October 2004

SummaryBackground : Azathioprine is widely used in Crohn's disease. A major drawback is the occurrence of side‐effects, especially acute pancreatitis. Acute pancreatitis is rarely seen when azathioprine is used for other diseases than Crohn's disease.Aim : To survey side‐effects of azathioprine after liver or renal transplantation, for systemic lupus erythematosis, Wegener's granulomatosis, autoimmune hepatitis, rheumatoid arthritis, ulcerative colitis or Crohn's disease.Methods : A computerized search using the term ‘azathioprine’ or ‘imuran’ was performed on the Hospital Information System of the university hospital Groningen, resulting in 1564 patients matching our criteria.Results : Eleven of 224 patients with Crohn's disease experienced acute pancreatitis (4.9%) compared with two of 129 (1.5%) with autoimmune hepatitis, two of 388 (0.5%) after renal transplantation, one of 254 (0.4%) after liver transplantation. Acute pancreatitis was more prevalent in Crohn's disease compared with any other disease. Azathioprine‐toxicity necessitating withdrawal occurred significantly (P < 0,05) more in rheumatoid arthritis(78 of 317), ulcerative colitis (20 of 94) and Crohn's disease (52 of 224) compared with systemic lupus erythematosis (five of 73), Wegener's granulomatosis (six of 85), autoimmune hepatitis (eight of 129), after liver transplantation (17 of 254) and after renal transplantation (22 of 388).Conclusions : Acute pancreatitis is strongly associated with Crohn's disease and rarely occurs with other underlying conditions. Overall azathioprine‐induced toxicity and the necessity of withdrawal is more common in inflammatory bowel disease and rheumatoid arthritis compared with other diseases.
The effects of cryoanalgesia combined with thoracic epidural analgesia in patients undergoing thoracotomy
Authors: Yang M. K. , Cho C. H. , Kim Y. C. 
Published: October 2004

SummaryThis study was performed to evaluate the effects of cryoanalgesia combined with thoracic epidural analgesia on pain and respiratory complications in patients undergoing thoracotomy. Ninety patients were prospectively randomised to epidural analgesia alone (n = 45) or epidural analgesia and cryoanalgesia combined (n = 45). We monitored the use of rescue pain medication and changes in forced vital capacity and forced expired volume in 1 s, and recorded pain and opioid‐related side‐effects during the immediate postoperative period. The incidence of post‐thoracotomy pain and numbness were also assessed up to the sixth month after surgery. Cryoanalgesia combined with thoracic epidural analgesia was associated with earlier recovery in pulmonary function, less pain during movement and a lower daily requirement for rescue analgesia one week after surgery. However, the combination of cryoanalgesia and epidural analgesia failed to decrease the incidence of long‐term pain and numbness. In view of its associated long‐term morbidity, cryoanalgesia combined with thoracic epidural analgesia is not recommended for patients undergoing thoracotomy.