bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative Analysis of Medicare Claims in the Last 3 Years of Life: A Pilot Study
Authors: Barnato Amber E. , Labor Renee E. , Freeborne Nancy E. , Jayes Robert L. , Campbell Diane E. , Lynn Joanne 
Published: December 2004

Objectives: To study end‐of‐life care of a representative sample of older people using qualitative interpretation of administrative claims by clinicians and to explore whether this method yields insights into patient care, including continuity, errors, and cause of death.Design: Random, stratified sampling of decedents and all their Medicare‐covered healthcare claims in the 3 years before death from a 5% sample of elderly fee‐for‐service beneficiaries, condensation of all claims into a chronological clinical summary, and abstraction by two independent clinicians using a standardized form.Setting: United States.Participants: One hundred Medicare fee‐for‐service older people without disability or end‐stage renal disease entitlement who died in 1996 to 1999 and had at least 36 months of continuous Part A and Part B enrollment before death.Measurements: Qualitative narrative of the patient's medical course; clinician assessment of care continuity and apparent medical errors; cause, trajectory, and place of death.Results: The qualitative narratives developed by the independent abstracters were highly concordant. Clinicians felt that 75% of cases lacked continuity of care that could have improved the quality of life and the way the person died, and 13% of cases had a medical error identified by both abstracters. Abstracters disagreed about assignment of a single cause of death in 28% of cases, and abstracters and the computer algorithm disagreed in 43% of cases.Conclusion: Qualitative claims analysis illuminated many problems in the care of chronically ill older people at the end of life and suggested that traditional vital statistics assignation of a single cause of death may distort policy priorities. This novel approach to claims review is feasible and deserves further study.
Prediction of On‐Road Driving Performance in Patients with Early Alzheimer's Disease
Authors: Brown Laura B. , Ott Brian R. , Papandonatos George D. , Sui Yunxia , Ready Rebecca E. , Morris John C. 
Published: December 2004

Objectives: Physicians and family members frequently are asked to provide information about driving ability in patients with Alzheimer's disease (AD), yet there has been little research on the validity of their assessments of driving performance.Design: Cross‐sectional.Setting: Participants were recruited from the neurology department of a community hospital affiliated with Brown Medical School.Participants: Participants included 75 older adults (17 with mild AD, 33 with very mild AD, and 25 elderly controls).Measurements: The participant him/herself, an informant, and an experienced neurologist rated each participant's driving ability on a 3‐point rating scale (safe, marginal, unsafe). A professional driving instructor also completed a standardized 108‐point on‐road driving assessment of each participant and then rated driving ability on the 3‐point scale. Ratings were compared with the on‐road driving score and with each other.Results: Only the neurologist's rating of the participants' driving abilities was significantly related to on‐road driving score. When related to the instructor's safety rating, the neurologist's ratings were the most sensitive and specific. Mini‐Mental State Examination score was a borderline covariate for the neurologist's rating. Overall, the instructor was the most stringent rater of participant driving ability, followed by the neurologist, the informant, and the participant.Conclusion: An experienced neurologist's assessment of driving competence may be a valid predictor of driving performance of patients with early AD.
Combination vincristine and plasma exchange as initial therapy in patients with thrombotic thrombocytopenic purpura: one institution's experience and review of the literature
Authors: Ziman Alyssa , Mitri Michael , Klapper Ellen , Pepkowitz Samuel H. , Goldfinger Dennis 
Published: December 2004

BACKGROUND:  Thrombotic thrombocytopenic purpura (TTP) was once a highly fatal disease with mortality reaching nearly 95 percent; however, application of therapeutic plasma exchange (TPE) has dramatically increased survival. Nevertheless, mortality remains substantial (10%‐30% in many published reports), requiring the search for more efficacious treatments. Vincristine (VCR) has been generally reserved for refractory TTP. Despite its effectiveness in a salvage mode, VCR has not been widely advocated as first‐line therapy in conjunction with TPE. We previously reported improved survival when VCR and TPE were administered at presentation in patients treated from 1979 to 1994. Utilizing this standardized approach, outcomes of an additional group of patients and the results of a literature review of VCR therapy for TTP are reported.STUDY DESIGN AND METHODS:  Medical records of all patients with a diagnosis of TTP treated between 1995 and 2002 at Cedars‐Sinai Medical Center were reviewed. TPE was performed daily, exchanging 1.25 plasma volumes, until the platelet count normalized. Patients received VCR 1.4 mg/m2, (up to 2.0 mg total dose) after the first TPE. A literature review of all publications utilizing VCR in the management of TTP was performed with MEDLINE.RESULTS:  Twelve consecutive patients meeting the diagnostic criteria received treatment with VCR and TPE. All patients achieved durable remission. Patients tolerated VCR without significant complications.CONCLUSION:  Our 100 percent survival rate, as well as evidence garnered from the literature review, suggests that combination therapy with VCR and TPE at presentation might be more effective than TPE alone and therefore warrants consideration as first‐line therapy for TTP patients.
A novel cis‐AB allele derived from a unique 796C>A mutation in exon 7 of ABO gene
Authors: Tzeng Cheng‐Hwai , Chen Ying‐Ju , Lyou Jau‐Yi , Chen Pei‐Shan , Liu Hsueng‐Mei , Hu Hui‐Yu , Lin Jeong‐Shi , Yu Lung‐Chih 
Published: December 2004

BACKGROUND:  The cis‐AB phenotype is very rare, and only three genotypes that correspond to specific ABO allele changes have been reported. Cis‐AB01 involves the A102 allele with a nonsynonymous substitution G803C in exon 7, whereas cis‐AB02 and cis‐AB03 involve different nonsynonymous substitutions A796C and C700T, respectively, on the B101 allele background. The nucleotide substitutions give rise to a change of the respective glycosyltransferase, resulting in varying bifunctional AB transferase activities.STUDY DESIGN AND METHODS:  Two cis‐AB phenotypes were identified in a Taiwanese C. family and two unrelated individuals, respectively. Serologic studies, molecular cloning, and sequencing of exon 6 and exon 7 were carried out to determine their respective phenotypic characteristics and cis‐AB alleles. A cohort of 300 AB‐phenotype, healthy random individuals served as controls.RESULTS:  A novel cis‐AB allele is uncovered out of the three family members, of which a 796C>A substitution occurs predicting an amino acid change at residue 266 of leucine to methionine on the background of A102 allele. It is serologically like cis‐AB03, an A2B phenotype, but molecularly different. Both of the two unrelated individuals are of cis‐AB01 allele, and all of the 300 AB blood group controls are excluded cis‐AB phenotype.CONCLUSION:  The C. family described carries a novel cis‐AB allele that differs molecularly from all previously reported cis‐AB alleles.
Particulated bone grafts – effectiveness of bone cell supply
Authors: Springer Ingo N.G. , Terheyden Hendrik , Geiß Stefan , Härle Franz , Hedderich Jürgen , Açil Yahya 
Published: December 2004

Abstract
Objective: The objective of this study was to measure the amount of viable bone cells present in different types of bone graft.Material and methods: Bone chips were harvested from the trabecular or cortical bone of the mandible or the iliac crest and either milled or not. The average size of unmilled bone particles was 5×5×5 mm and that of milled was 2×2×2 mm. Drill sludge was obtained using either a ball reamer, a diamond ball or an implant drill (the latter from mandibular bone and of average dimension 1×1×1 mm). A measure of 0.5 g of each category was cultured in Dulbecco's modified Eagle's medium with additives for four weeks. Cell counts were performed. An analysis of the osteocalcin synthesis, the alkaline phosphatase (ALP) activity, the collagen types and the concentration of bone‐specific collagen cross‐links in medium supernatants was performed.Results: Cells stained positively for osteocalcin and ALP in all groups. Bone‐specific collagen cross‐links could be quantified and collagen of types I and V was present with no difference in all groups. Unmilled spongy bone chips revealed greater cell counts than milled (P<0.05). Spongy bone chips revealed greater cell counts than cortical bone chips (P<0.05). Drill sludge obtained by hard alloy ball reamer showed the least amount of viable cells (P<0.05).Conclusions: Bone milling reduces the quantity of osteoblasts. Bone obtained by the ball reamer supplies a smaller number of cells than bone obtained by other methods. Unmilled spongy bone chips appear to offer the greatest amount of viable osteoblasts.
Microbiological and clinical effects of chlorhexidine enclosed in fixtures of 3I‐Titamed® implants
Authors: Groenendijk Edith , Dominicus Jan J. K. , Moorer Wilfred R. , Aartman Irene H. A. , Van waas Marinus A. J. 
Published: December 2004

Abstract: This double‐blind study used a split‐mouth design to investigate the microbio‐logical and clinical effects of 0.2% chlorhexidine enclosed in fixtures. Twelve patients had 46 fixtures implanted. At second‐stage surgery, a microbiological sample (baseline sample) of the inner parts of the fixtures was taken. Then, a 0.2% chlorhexidine solution was applied into the inner space of 23 fixtures (test group), and in 23 fixtures saline was applied (control group). Abutments were installed and gingival index, plaque index and crevicular fluid flow were monitored weekly. After 6 weeks, a second microbiological sample of the inner part of the fixtures was taken.At baseline, viable bacteria were detected within 46% of the fixtures. After 6 weeks, bacteria were found in 87% of the fixtures. The numbers of bacteria in the control group were significantly higher than those in the test group. The results indicate that, after first‐stage surgery, contamination of the inner spaces of the fixtures is commonplace. Application of a 0.2% chlorhexidine solution at second‐stage surgery inhibits growth or acquisition of bacteria in the fixtures. In both test and control groups, the crevicular fluid flow as well as the gingival index decreased during the experimental period. At 4, 5 and 6 weeks after chlorhexidine application, these values in the test group appeared lower, but did not attain statistical significance.
Association between periodontal and peri‐implant conditions: a 10‐year prospective study
Authors: Karoussis Ioannis K. , Müller Samuel , Salvi Giovanni E. , Heitz‐mayfield Lisa J.A. , Brägger Urs , Lang Niklaus P. 
Published: December 2004

Abstract:Objectives: The aims of this study were to (1) compare prospectively the clinical and radiographic changes in periodontal and peri‐implant conditions, (2) investigate the association of changes in periodontal parameters and peri‐implant conditions over a mean observation period of 10 years (8–12 years) after implant installation, and (3) evaluate patient risk factors known to aggravate the periodontal conditions for their potential influence on the peri‐implant tissue status.Materials and methods: Eighty‐nine partially edentulous patients with a mean age of 58.9 years (28–88 years) were examined at 1 and 10 years after implant placement. The patients contributed with 179 implants that were placed after comprehensive periodontal treatment and restored with crowns or fixed partial dentures. One hundred and seventy‐nine matching control teeth were chosen as controls. Also, the remaining teeth (n=1770) in the dentitions were evaluated. Data on smoking habits and general health aspects were collected at 1 and 10 years as well.Results: At 10 years, statistically significant differences existed between implants and matching control teeth with regard to most of the clinical and radiographic parameters (P<0.01) with the exception of plaque index (PII) and recession. Multiple regression analyses were performed to associate combinations of periodontal diagnostic parameters to the peri‐implant conditions: probing attachment level (PAL) at implants at 10 years was associated with implant location, full‐mouth probing pocket depth (PPD) and full‐mouth PAL (P=0.0001, r2=0.36). PPD at implants at 10 years correlated to implant location, full‐mouth PPD and full‐mouth PAL (P<0.001, r2=0.47). Marginal bone level at implants at 10 years was significantly associated to smoking, general health condition, implant location, full‐mouth PAL and change over time in full‐mouth PPD (P<0.001, r2=0.39).Conclusions: These results present evidence for the association between periodontal and peri‐implant conditions and the changes in these tissues over 10 years in partially edentulous patients.
Effect of GBR in combination with deproteinized bovine bone mineral and/or enamel matrix proteins on the healing of critical‐size defects
Authors: Donos Nikolaos , Lang Niklaus P. , Karoussis Ioannis K. , Bosshardt Dieter , Tonetti Maurizio , Kostopoulos Lambros 
Published: December 2004

AbstractObjectives: To evaluate the effect of guided bone regeneration (GBR) in combination with or without deproteinized bovine bone mineral (DBBM) and/or an enamel matrix derivative (EMD) on the healing of critical‐size calvarial defects.Material and methods: Forty rats were used. In all animals, a standardized critical‐size calvarial defect was created surgically. The animals were randomly allocated into 4 groups of 10 animals each. Group A: One calvarial defect was left untreated, while the galeal and the cerebral aspect of the contralateral defect were covered with a bioresorbable membrane (GBR). Group B: One calvarial defect was filled with EMD, while the contralateral defect was treated with GBR and EMD. Group C: One defect was filled with DBBM, while the contralateral defect was treated with combination of GBR and DBBM. Group D: One defect was filled with DBBM combined with EMD, while the contralateral defect was treated with combination of GBR, DBBM and EMD. The healing period was 4 months. Five specimens from each group were macerated and the length, the width and the vertical dimension (thickness) of the remaining defect were evaluated by a stereomicroscope. The remaining specimens in each group were analyzed histologically.Results: The defects of the macerated specimens that were left untreated or were treated only by EMD, DBBM and combination of EMD and DBBM did not present predictably complete healing of the defects. All the defects where GBR was applied alone or combined with DBBM and/or EMD presented always complete healing (P<0.05). The combined use of GBR with EMD and/or DBBM did not offer any significant advantage above GBR alone in terms of healing of the length and the width of the defect. However, the vertical dimension of the defect was significantly higher (P<0.05) in the GBR‐treated specimens of Groups C and D. The histological analysis supported these findings.Conclusion: The predictability of bone formation in critical‐size defects depends mainly on the presence or absence of barrier membranes (GBR). The combined use with deproteinized bovine bone mineral and/or enamel matrix proteins did not significantly enhance the potential for complete healing provided by the GBR procedure.
Growth‐associated protein‐43 immunoreactivity in human oral mucosa in dentate subjects, in edentulous patients and after implant‐anchored rehabilitation
Authors: Ramieri Guglielmo A. , Schierano Gianmario , Spada Maria Cristina , Giovando Maria Luisa , Verzè Laura , Preti Giulio 
Published: December 2004

Abstract Objectives: This study investigates expression of the neural growth‐associated protein 43 (GAP‐43) in the oral mucosa of (A) normal dentate subjects, (B) edentulous patients rehabilitated with conventional denture and (C) those rehabilitated with mandibular implant‐retained overdentures (MIR‐OVD), in the long term. This study evaluates morphological changes in the distribution and representation of sensory terminations and corpuscles in the alveolar mucosa under the action of different masticatory or prosthetic loads, in the three clinical groups.Material and methods: GAP‐43 immunoreactivity (‐ir) was compared with the distribution of nerves fibres in the mucosa, as visualised using anti‐protein gene product 9.5 (PGP 9.5), a general marker for peripheral nerves and terminals.Results: GAP‐43‐ir was found to be highly expressed in the corium and submucosa in specimens from edentulous subjects wearing conventional denture and presenting a reduced number of PGP 9.5‐ir nerves in the mucosa, but not in specimens from control subjects or patients wearing MIR‐OVD, which on the contrary show a higher number of PGP 9.5‐ir mucosal sensory fibres.Conclusion: As the mucosa under traditional denture has been shown to possess reduced innervation and the histological aspect of chronic overloading, these results may be considered indicative of a tentative induction to nerve re‐growth in the under‐innervated epithelium, or as a response to chronic inflammation. The detection of GAP‐43‐ir suggests that human oral mucosa presents signs of potential nerve plasticity also in the elderly, and that the type of rehabilitation and the condition of masticatory load transfer to the mucosa have important effects on the nerves underneath.
Grafting of deproteinized bone particles inhibits bone resorption after maxillary sinus floor elevation
Authors: Xu Hui , Shimizu Yoshinaka , Asai Sumito , Ooya Kiyoshi 
Published: December 2004

AbstractObjectives: To evaluate the value of deproteinized bone particles on bone resorption in the augmented space after maxillary sinus floor elevation in rabbits.Material and methods: A total of 20 rabbits underwent bilateral grafting, using blood clots (control group) and deproteinized bone particles (experimental group), and followed with histologic and histomorphometric analysis.Results: Two weeks after grafting, the augmented space was almost completely obliterated by both newly formed bone and fibrous connective tissue in the control group. Some osteoclasts were found on the surface of newly formed bone, especially near the elevated sinus membrane. In the experimental group, newly formed bone was found along the elevated sinus membrane, the cortical wall of the augmented space, and the surface of deproteinized bone particles near the cortical wall. Some osteoclasts were found along the deproteinized bone particles and a few adhered to the surface of the newly formed bone. Eight to 10 weeks after implantation in the control group, most of the newly formed bone had been resorbed. In the experimental group, newly formed bone was found in most parts of the convex augmented space. Histomorphometrical analysis showed that the augmented height was significantly higher in the experimental group than in the control group at all evaluation times. Bone area was significantly higher in the experimental group than in the control group at 6, 8, and 10 weeks after implantation. The area of grafted deproteinized bone particles did not change significantly from 2 to 10 weeks.Conclusion: Slowly resorbed deproteinized bone particles contribute to stable augmentation of the maxillary sinus floor by inhibiting bone resorption.
Does excessive occlusal load affect osseointegration? An experimental study in the dog
Authors: Heitz‐Mayfield L. J. , Schmid B. , Weigel C. , Gerber S. , Bosshardt D. D. , Jönsson J. , Lang N. P. , Jönsson J. 
Published: December 2004

Abstract Aim: The purpose of this study was to evaluate the effect of excessive occlusal load following placement of titanium implants in the presence of healthy peri‐implant mucosal tissues.Materials and methods: Mandibular bilateral recipient sites in six Labrador dogs were established by extracting premolars and molars. After 3 months, two TPS (titanium plasma sprayed) implants and two SLA (sandblasted, large grit, acid etched) implants were placed on each side of the mandible in each dog. Three implants were lost in the initial healing phase, leaving 45 implants for evaluation. Following 6 months of healing, gold crowns were placed on implants on the test side of the mandible. The crowns were in supra‐occlusal contact with the opposing teeth in order to create excessive occlusal load. Implants on the control side were not loaded. Plaque control was performed throughout the experimental period. Clinical measurements and standardised radiographs were obtained at baseline and 1, 3 and 8 months after loading. At 8 months, the dogs were killed and histologic analyses were performed.Results: At 8 months, all implants were osseointegrated. The mean probing depth was 2.5±0.3 and 2.6±0.3 mm at unloaded and loaded implants, respectively. Radiographically, the mean distance from the implant shoulder to the marginal bone level was 3.6±0.4 mm in the control group and 3.7±0.2 mm in the test group. Control and test groups were compared using paired non‐parametric analyses. There were no statistically significant changes for any of the parameters from baseline to 8 months in the loaded and unloaded implants. Histologic evaluation showed a mean mineralised bone‐to‐implant contact of 73% in the control implants and 74% in the test implants, with no statistically significant difference between test and control implants.Conclusion: In the presence of peri‐implant mucosal health, a period of 8 months of excessive occlusal load on titanium implants did not result in loss of osseointegration or marginal bone loss when compared with non‐loaded implants.
Chlorhexidine spray versus mouthwash in the control of dental plaque after implant surgery
Authors: Francetti Luca , Fabbro Massimo Del , Basso Matteo , Testori Tiziano , Taschieri Silvio , Weinstein Roberto 
Published: December 2004

AbstractBackground/purpose: This randomized clinical trial was aimed at comparing two different means of delivering chlorhexidine digluconate (CHX) for plaque control during the 2 weeks following implant surgery.Materials and Methods: Twenty patients selected for implant therapy were randomly divided into two groups: 10 subjects used 15 ml of 0.12% CHX mouthrinse (control group) and 10 used 0.2% CHX spray (test group). Professional oral hygiene was carried out immediately before surgery. During the 14 days following surgery mechanical oral hygiene was performed only at the teeth not surgically involved. Plaque index (PI), stain index (SI), modified gingival index and taste alteration were assessed on the 7th and 14th day after surgery. The clinical parameters were evaluated at four tooth surfaces by a single examiner. Teeth proximal to surgical site and teeth not involved were statistically compared.Results: In both groups, the PI increased similarly, with respect to the baseline, at days 7 and 14. There was no significant difference between the two groups at either time point. On the contrary, in the control group, the SI increased significantly when compared with baseline over the 14 days both at teeth nearest to surgical sites and at not‐involved sites. In the test group pigmentation was consistent only at teeth proximal to the surgical site. When considering not‐involved sites, tooth staining was significantly lower in the test with respect to the control group.Conclusions: The present study indicates that the efficacy of CHX spray in the post‐surgical control of dental plaque is similar to that of CHX mouthwash. Tooth staining, however, is significantly lower in the spray group at sites not surgically involved. These effects might be related to the route of CHX delivery, as well as the total dose administered that was significantly lower in the spray group with respect to the rinse group.