bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thrombocytopenia after hepatic cryotherapy for colorectal metastases: Correlates with hepatocellular injury
Authors: Cozzi Paul J. , Stewart Graham J. , Morris David L. 
Published: October 2004

AbstractPostoperative thrombocytopenia following hepatic cryotherapy has been well documented and shown to be significantly greater than in control patients who had an identical incision or major laparotomy. Serum aspartate transaminase (AST) levels have been used as a reliable indicator of hepatocellular destruction. This study reviews 65 consecutive hepatic cryotherapy operations. We have excluded all patients who had repeat cryotherapy to lesions (n=6), all who had a colonic or hepatic resection procedure (n=7), all who had tumors other than colorectal metastases (n=5), patients with inadequate data (n=9), and those who were asplenic (n=2). Of the remaining 36 patients, 14 were treated with a single freeze/thaw cycle, 12 were treated with a double freeze/thaw cycle, and 10 were treated with mixed single and double freezes. The most common platelet nadir was day 3 (n=21) followed by day 2 (n=11), with the remaining platelet nadirs being day 1 or 4 (n=4). The percentage fall in platelet count was found to correlate with the rise in day 1 AST level (r2=0.74, least squares linear regression). The double freeze/thaw cycle patients had a significantly greater fall in platelet count (p=0.01, Mann‐Whitney two sample test). Another institution has reported three deaths due to multiple problems, including coagulopathy in patients treated with double freeze/thaw cycle cryotherapy. The conclusions of this study are that a high AST level on day 1 is a good predictor of impending thrombocytopenia, and that double freeze/thaw cycle cryotherapy results in marked thrombocytopenia, which may be responsible for the coagulopathy seen in some of these patients.
Differences in unpleasantness induced by experimental pressure pain between patients with fibromyalgia and healthy controls
Authors: Petzke Frank , Harris Richard E. , Williams David A. , Clauw Daniel J. , Gracely Richard H. 
Published: October 2004

AbstractPain possesses both sensory and affective dimensions, which are highly correlated yet distinct. Comparison of these dimensions within experimental pain settings has resulted in the construct of relative unpleasantness. Relative unpleasantness is defined as the amount of affective unpleasantness elicited for a given sensory magnitude. The aim of this study was to determine the relationship between affective and sensory components of evoked pain in subjects with fibromyalgia (FM) and healthy controls. Here we show that patients with FM unexpectedly display less relative unpleasantness than healthy controls in response to random noxious pressure stimuli. Relative unpleasantness was not correlated with distress, anxiety, or depression, which were pronounced in the FM group. Clinical pain in patients with FM was perceived to be more unpleasant than the evoked pain stimuli. These results are consistent with the concept that chronic pain may reduce the relative unpleasantness of evoked pain sensations.
Object alternation test—is it sensitive enough to detect cognitive dysfunction in obsessive–compulsive disorder?
Authors: Katrin Kuelz Anne , Riemann Dieter , Zahn Roland , Voderholzer Ulrich 
Published: October 2004

AbstractA computerized version of the object alternation test (OAT) was employed in unmedicated obsessive–compulsive disorder (OCD) patients and matched healthy controls. OCD patients performed normally on the OAT but scored below controls on a task assessing visuo-spatial working memory. The results challenge the concept of the OAT as a sensitive instrument for orbitofrontal dysfunction in OCD.
What about psychiatrists' attitude to mentally ill people?
Authors: Lauber Christoph , Anthony Marion , Ajdacic-Gross Vladeta , Rössler Wulf 
Published: October 2004

AbstractObjectiveFirstly, to assess and, secondly, to compare experts' and lay attitudes towards community psychiatry and the respective social distance towards mentally ill people.MethodComparison of two representative Swiss samples, one comprising of 90 psychiatrists, the other including 786 individuals of the general population.ResultsThe psychiatrists' attitude was significantly more positive than that of the general population although both samples have a positive attitude to community psychiatry. The statement that mental health facilities devalue a residential area has revealed most agreement. Psychiatrists and the public do not differ in their social distance to mentally ill people. Among both samples, the level of social distance increases the more the situation described implies ‘social closeness’.ConclusionThe strategy to use psychiatrists as role models or opinion leaders in anti-stigma campaigns cannot be realised without accompanying actions. Psychiatrists must be aware that their attitudes do not differ from the general public and, thus, they should improve their knowledge about stigma and discrimination towards people with mental illnesses.
Effect of interpregnancy interval on birth outcomes: findings from three recent US studies
Authors: Zhu B.‐P. 
Published: October 2004

AbstractThe relationship between interpregnancy interval and adverse birth outcomes (i.e., low birth weight, preterm birth, and small size for gestational age) was examined in three recent studies conducted in Utah and Michigan of the United States. These studies were conducted among different populations, used different study designs (i.e., cross‐sectional and retrospective cohort designs), and addressed several other methodological limitations in the previously published literature. In addition, the data were stratified by, and controlled for, several maternal reproductive risk factors. A J‐shaped relationship between interpregnancy interval and adverse birth outcomes was observed in all three studies. The risk for adverse birth outcomes is lowest when the interpregnancy interval was 18–23 months and increased when the interval departed from 18–23 months. This J‐shaped relationship existed at levels of maternal reproductive risk factors and after these risk factors were controlled for using logistic regression. Based on the consistency of the findings from all three studies, it appears that the J‐shaped relationship between interpregnancy interval and adverse birth outcomes is causal. This information can be used by health care providers and public health programs to counsel and educate women who recently gave births on reducing the risk for adverse birth outcomes by means of appropriate pregnancy spacing.
Is the Delay in Starting Postoperative Radiotherapy a Key Factor in the Outcome of Advanced (T3 and T4) Laryngeal Cancer?
Authors: Marshak Gideon , Rakowsky Erica , Schachter Jacob , Shvero Jacob , Feinmesser Rafael , Sulkes Aaron , Brenner Baruch 
Published: October 2004

OBJECTIVETo identify factors influencing the outcome of postoperative radiotherapy in patients with advanced laryngeal cancer.DESIGNThe files of 44 patients with advanced laryngeal cancer who were treated by surgery followed by radiotherapy (24 with pT3 and 20 with pT4) were reviewed. Median delay in starting radiotherapy was 50 days (range, 19–150 days). Treatment variables, in addition to certain patient and tumor characteristics, were analyzed in terms of locoregional control and survival.SETTINGMajor referral tertiary center in central Israel.RESULTSLocoregional control rates were 86% and 81% at 2 and 5 years, respectively, and corresponding survival rates were 82% for both. Only nodal involvement retained statistical significance for both locoregional control as well as survival on multivariate analysis (P= 0.0009 andP= 0.0004, respectively).CONCLUSIONSThis is the first study showing that delay in postoperative radiotherapy in advanced laryngeal cancer is not a significant predictor of locoregional control or survival in advanced laryngeal cancer. Only lymphatic spread was found to have a significant influence on treatment outcome.
Laser Cryptolysis for the Treatment of Halitosis
Authors: Finkelstein Yehuda , Talmi Yoav P. , Ophir Dov , Berger Gilead 
Published: October 2004

OBJECTIVETo evaluate the tonsils as a source of halitosis and to assess the efficacy of laser CO2 cryptolysis for the treatment of oral bad breath caused by chronic fetid tonsillitis.METHODSFifty‐three patients with halitosis originating from chronic fetid tonsillitis, who completed laser cryptolysis were enrolled in the study. The origin of halitosis was demonstrated by Finkelstein's tonsil smelling test, which included massaging the tonsils and smelling the squeezed discharge. All patients were treated by laser cryptolysis, an office procedure done under topical anesthesia. Subjective and objective postoperative assessment was based on self‐and‐family report and clinical assessment. Patients were reexamined 4 to 6 weeks post‐treatment, and when the need for further laser treatment was determined.RESULTSComplete elimination of halitosis required one session in 28 patients (52.8%), 2 sessions in 18 patients (34%), and 3 sessions in 5 patients (9.4%). Follow‐up period ranged from 3 to 36 months (mean, 20.8 ± 8.5 months). No adverse effects or complications were encountered.CONCLUSIONSAfter excluding dental or periodontal, sinonasal, oral, pulmonary, or gastroenterological diseases as the origin of halitosis, chronic fetid tonsillitis remains a common cause of halitosis. Patients suffering from halitosis should be treated relying on their examination including Finkelstein's tonsil smelling test. Laser CO2 cryptolysis is an effective, safe, and well‐tolerated procedure for the treatment of halitosis.
A New Assay to Screen for Head and Neck Squamous cell Carcinoma Using the Tumor Marker Metallopanstimulin
Authors: Lee Wha‐Joon , Keefer K. , Hollenbeak C. S. , Stack B. C. 
Published: October 2004

OBJECTIVETo date, no serologic marker has proven effective as a diagnostic test for head and neck squamous cell carcinoma (HNSCC). Levels of metallopanstimulin (MPS), as measured by a difficult to reproduce radioimmunoassay, are significantly elevated in untreated HNSCC patients. Our objective was to develop a simpler MPS assay.METHODSSerum was obtained from HNSCC patients through Institutional Review Board approved protocols at the Penn State University College of Medicine and healthy volunteers donating blood at the hospital blood bank from 2000 to present. Serum MPS was immunoprecipitated, slot blotted, and Western blotted. MPS levels were quantified by densitometry.RESULTSForty‐eight blood donors and 45 known HNSCC patients were studied. The MPS level was 14 ng/mL ± 1 (SEM) for blood donors and 36 ng/mL ± 3 (SEM) for known HNSCC patients. The difference was statistically significant (P < 0.0001).CONCLUSIONSlot blot analysis of MPS is a safe, effective, and reproducible assay that may be used to screen for HNSCC in high‐risk populations.
Quality of Life in Hearing‐Impaired Adults: The Role of Cochlear Implants and Hearing Aids
Authors: Cohen Seth M. , Labadie Robert F. , Dietrich Mary S. , Haynes David S. 
Published: October 2004

OBJECTIVETo compare the quality‐of‐life (QOL) benefit received from cochlear implants (CIs) and hearing aids (HAs) among hearing‐impaired adults.STUDY DESIGNHealth‐related questionnaire.METHODSTwenty‐seven CI users compared to control group of 54 HA users, both older than 49. Questionnaires for the pre‐rehab state (without HA or CI use) and post‐rehab state (after HA or CI for 12 months) were mailed 2 weeks apart.RESULTSTwenty‐six (96.3%) CI and 30 (55.6%) HA users responded (P < 0.001, chi‐square). Compared to HA patients, CI users showed twice as much overall QOL improvement (P = 0.082, multiple linear regression) as HA users. Multivariate analysis of variance showed greater QOL benefit in CI than HA users across the physical, psychological, and social subdomains (P = 0.03).CONCLUSIONCochlear implants provide at least comparable benefit for those with profound hearing loss as hearing aids bring for those with less severe hearing loss.
Pediatric Temporal Bone Fractures in a Rural Population
Authors: Ort Stuart , Beus Kirt , Isaacson Jon 
Published: October 2004

OBJECTIVETo examine pediatric temporal bone fractures in a rural population.STUDY DESIGN AND SETTINGA retrospective chart review of pediatric temporal bone fractures between January 1, 1996, and December 31, 2000, at a rural academic medical center.RESULTSA total of 108 patients were identified. Common etiologies include falls, bicycle‐related injuries, and motor vehicle accidents. Animal‐related injuries were identified primarily in patients under 5. Facial nerve injuries were noted in 7%, hearing loss in 16%, additional skull base fractures in 65%, and intracranial injuries in 75%.CONCLUSIONSTemporal bone fracture etiology in the rural pediatric population is associated with age. Young children may suffer fractures secondary to animal‐related accidents. Patterns of injury differ little between rural and urban settings.SIGNIFICANCEAnimal‐related accidents may be a significant cause of temporal bone trauma in rural young children. Our data remain unique in that we report additional skull base fractures as well as intracranial injuries in this population.
The Importance of Etiology on the Clinical Course of Neck Abscesses
Authors: Biller Jason A. , Murr Andrew H. 
Published: October 2004

OBJECTIVEFormation of neck abscesses from injecting illicit drugs continues to be a common problem in the United States. We sought to determine whether neck abscesses resulting from direct inoculation differ in their clinical course and severity from those that arise from direct spread through inflamed tissue, as in pharyngitis or odontogenic infections.STUDY DESIGN AND SETTINGPatients were separated based on the cause of their neck abscess into either an injection drug use group or a noninjection drug use group. We retrospectively compared both groups of patients by examining multiple clinical endpoints, including the number of operations, length of hospital stay, and requirement for emergent airway intervention.RESULTSInjection drug use was the most common cause of neck abscess. Only 1 of these patients needed more than 1 drainage procedure, and no patients required emergent airway intervention or an intensive care unit (ICU) stay. The majority of the patients in the noninjection drug group had a neck abscess as a result of unknown causes; nearly one half required an emergent operation for airway management and the mean ICU stay was 2.5 days.CONCLUSIONNeck abscesses formed by direct inoculation have a relatively more benign clinical course than those resulting from spread through inflamed tissue. The latter require a longer hospital stay, more days in the ICU, and more emergent intervention.
The Effect of Maxillary Sinus Antrostomy Size on Xenon Ventilation in the Sheep Model
Authors: Brumund Kevin T. , Graham Scott M. , Beck Kenneth C. , Hoffman Eric A. , McLennan Geoffrey 
Published: October 2004

OBJECTIVEA major goal of maxillary antrostomy is to increase sinus ventilation. Limited data exist regarding the effect of maxillary antrostomy size on sinus ventilation. We sought to quantify the effect of uncinectomy, small antrostomy, and large antrostomy on maxillary sinus ventilation using xenon‐enhanced CT in the sheep model.MATERIALS, STUDY DESIGN, AND METHODSA xe‐non‐oxygen‐air mixture was delivered to 8 fresh cadaveric sheep heads while repeated CT scans were performed through the maxillary sinuses. Baseline and postoperative studies were performed after an endoscopic uncinectomy, small antrostomy, or large antrostomy was created. Images were analyzed to measure the density of the xenon gas in the maxillary sinus as a function of time, generating a time constant.RESULTSThe time constants for both small antrostomy and large antrostomy were significantly different compared to baseline (P = 0.003 for both). The time constant comparison between small antrostomy and large antrostomy was not significant (P = 0.948).CONCLUSIONSA small antrostomy produces a statistically significant increase in maxillary sinus ventilation over baseline. No significant further ventilation increase is obtained by creating a large antrostomy in the sheep model. This lends credence to the use of small antrostomies to improve maxillary sinus ventilation in human sinus surgery.
Medicaid Outpatient Utilization for Waterborne Pathogenic Illness following Hurricane Floyd
Authors: Setzer Christian , Domino Marisa Elena 
Published: October 2004

Objectives. Flooding provides an opportunity for epidemics of waterborne viral, protozoan, or bacterial diseases to develop in affected areas. Epidemic levels of disease may translate into higher than average levels of health services use, depending in part on help-seeking behaviors. The authors investigated whether the flooding that occurred as a result of Hurricane Floyd in September 1999 was associated with an increase in outpatient visits for waterborne diseases among Medicaid enrollees in eastern North Carolina. Methods. Using a difference-in-differences estimation technique, the authors examined the change in outpatient visits by North Carolina Medicaid enrollees for selected waterborne diseases following the hurricane. The study focused on counties with high concentrations of hog farming that were mildly/moderately or severely affected by the hurricane, using unaffected counties and the year before the hurricane as controls. Results. Small increases in Medicaid-covered outpatient visits were found in severely affected counties for two of the six pathogens selected for analysis, relative to unaffected counties. Larger increases in visits were found for nonspecific intestinal infections in both severely and moderately affected counties following the hurricane, relative to unaffected counties. Conclusions. The large increase in visits for ill-defined intestinal infection is noteworthy. The relative lack of increase in visits with specific pathogenic diagnoses may be attributable, at least in part, to a number of factors, including incomplete diagnostic information provided by treating clinicians, low treatment-seeking behavior, and use of non-Medicaid-funded emergency services.
The Interface Between the Practice of Medical Genetics and Human Genetic Research: What Every Genetic Counselor Needs to Know
Authors: Markel Dorene S. , Yashar Beverly M. 
Published: October 2004

AbstractGenetic counselors have historically used human genetic research as an advanced information resource for their patients. Most commonly, this has been via access to information provided by gene identification studies in advance of commercial testing. More recently genetic counselors have been participating in human genetic research studies as part of the investigative team. This review provides a framework to help genetic counselors in research and clinical practice understand the historical perspectives, ethical principles, and federal regulations that govern the current practice of human subject research. Special consideration is given to∼the IRB process and unique issues in human genetic research. This overview is intended to help improve the ability of genetic counselors to act as advocates for their patients.
Patients' Knowledge of Cystic Fibrosis: Genetic Determinism and Implications for Treatment
Authors: Chapman Elizabeth , Bilton Diana 
Published: October 2004

AbstractThis paper uses the self‐regulation model of illness perceptions (Leventhal et al., 1984) to consider the implications of different ways of thinking about the causes of illness. The relationship between anxiety/depression and knowledge or denial of illness is also considered. These issues are explored using adherence to treatment in cystic fibrosis (CF) as an example. Twenty‐six CF patients took part in semistructured interviews and completed a standardized anxiety and depression scale (HAD, Zigmond and Snaith, 1983). Interview data were analyzed using Interpretative Phenomenological Analysis (Chapman and Smith, 2002). HAD data were analyzed using SPSS. The respondents displayed widely differing levels of knowledge of their condition. Some deterministic comments were also reported. Findings are discussed in relation to the information that physicians might provide to patients and families in the light of increasing knowledge about genetics in society and the genotyping of individuals with genetic conditions specifically. Any important gaps in patient knowledge could usefully be discussed at transition from pediatric to adult care and issues relating to control and genetic determinism discussed with the patients individually.
Does Receiving Genetic Counseling Impact Genetic Counselor Practice?
Authors: Peters Elizabeth , Veach Patricia McCarthy , Ward Erin E. , LeRoy Bonnie S. 
Published: October 2004

AbstractThis study was an investigation of whether genetic counselors have received genetic counseling and if so, how they believe it affects their practice. One thousand genetic counselors were mailed surveys about the nature of genetic counseling services received, impact on their clincal practice, frequency and reasons for disclosing about their receipt of counseling to their clients, and demographics. Ninety‐three of the 510 respondents reported receiving genetic counseling. Of these, almost three‐fourths were practicing genetic counselors while receiving services. Reasons for services include prenatal concerns, family history of cancer, and history/risk of other genetic conditions. Frequently endorsed effects on practice include increased empathy and understanding of client decisions, feeling more connected with clients, greater emphasis on psychosocial support, and sympathy. Forty‐six respondents disclosed to clients about their receipt of genetic counseling. Prevalent reasons include client asked, help clients feel they are not alone, demonstrate counselor understanding, decrease client anxiety, build rapport, and normalize client feelings. Practice and research recommendations are given.
Analyzing the Process and Content of Genetic Counseling in Familial Breast Cancer Consultations
Authors: Butow Phyllis N. , Lobb Elizabeth A. 
Published: October 2004

AbstractA detailed examination of the process of genetic counseling has been identified as a priority area for research by previous authors. This multicenter longitudinal study examined the process and content of genetic counseling in initial consultations with women from high‐risk breast cancer families. One hundred and fifty‐eight consultations with women unaffected and affected with breast cancer were audio taped and transcribed verbatim. A detailed coding system was developed. Clinical geneticists and genetic counselors demonstrated consistently good practice in giving detailed information on essential aspects related to familial breast cancer such as screening and management, genetic testing, breast cancer genetics, and prophylactic surgery. Eliciting emotional concerns and facilitating communication were found to be inconsistently present. As clinical practice guidelines and the general communication literature emphasize the importance of these factors, this is an area where training in or self‐monitoring of such behaviors may assist consultants to further develop these skills.