bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Diagnostic Criteria and a Staging System for Otogenic Skull Base Osteomyelitis
Authors: Takahashi Kuniyuki , Morita Yuka , Ogi Manabu , Nonomura Yoriko , Kitazawa Meiko , Yagi Chihiro , Yamagishi Tatsuya , Ohshima Shinsuke , Izumi Shuji , Horii Arata 
Published: July 2022

Abstract
Objective Diagnostic criteria for otogenic skull base osteomyelitis (SBO) have been conflicting among researchers. We aimed to propose clinically useful diagnostic criteria and a staging system for otogenic SBO that is associated with infection control and mortality.
Design The present study is designed as a retrospective one.
Setting This study was conducted at the University Hospital.
Participants Thirteen patients with otogenic SBO who met the novel rigorous diagnostic criteria consisted of symptomatic and radiological signs on high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI). Simple refractory external otitis was not included. A staging system according to disease extent revealed by HRCT and MRI is proposed: lesions limited to the temporal bone (stage 1), extending to less than half (stage 2), exceeding the midline (stage 3), and extending to the whole of the clivus (stage 4). All patients received long-term antibiotic therapy. Patients were divided into infection-uncontrolled or -controlled groups based on symptoms, otoscopic findings, and C-reactive protein level at the last follow-up. The mean follow-up period was 27.7 months.
Main Outcome Measures Possible prognostic factors, such as immunocompromised status and symptoms, including cranial nerve palsy, pretreatment laboratory data, and treatments, were compared between the infection-uncontrolled and -controlled groups. Disease stages were correlated with infection control and mortality.
Results The infection-uncontrolled rate and mortality rate were 38.5 and 23.1%, respectively. There were no significant differences in possible prognostic factors between the infection-uncontrolled and -controlled groups. HRCT-based stages significantly correlated with infection control and mortality.
Conclusion We proposed here the clinically useful diagnostic criteria and staging systems that can predict infection control and prognosis of otogenic SBO.
Modified Tunneling (Capsule Modification Technique) for Subcutaneous Placement of Ventriculo-Peritoneal Shunt in Patients with Hydrocephalus: Technical Note
Authors: Wani Wajid Nazir , Samad Heena , Bodeliwala Shaam , Jagetia Anita , Singh Daljit 
Published: July 2022

AbstractOne of the first procedures that a neurosurgical resident/trainee assists and performs is the placement of a ventriculoperitoneal shunt, the commonest being the Chhabra shunt system. However, no modification has been done or proposed in performing this procedure keeping in mind the position of the chamber of the Chhabra shunt system. As the tunneller has to pass through the subcutaneous plane having tight adhesions, it is essential to have a proper and adequate space for the chamber. Utilization of instruments such as artery forceps or Penfield dissectors for the same results in the creation of inappropriate or a roughly estimated space, which is either inadequate, causing kinking of tubing, or too roomy that results in the peri-catheter collection of cerebrospinal fluid with the risk of infection.We propose a novel method of utilizing a modified tunneller with a distal “Capsule” that provides just enough space both, at the appropriate distance and for adequate length, for the chamber to fit snugly and thus avoid procedure-related risks and complications as well as reduce the total duration of surgery, thereby decreasing the chances of infection.
Hypofractionated (2.75 Gy per fraction) versus Conventionally Fractionated Primary Radiotherapy for T2N0M0 Carcinoma of the Glottis
Authors: Kovarik Josef , Kelly Charles , Cunnell Michelle , Jamil Fatima , Iqbal Muhammad Shahid 
Published: July 2022

Abstract
Introduction Radiotherapy provides excellent outcome in early stage glottic cancer; however, the optimal radiotherapy dose fractionation remains unknown.
Objective To investigate the outcome of patients with T2N0M0 treated with either hypofractionated (HypoFxn) or conventionally fractionated radical (ConFxn) radiotherapy.
Methods According to our institutional protocol, patients with T2N0M0 glottic cancer can be treated either with ConfFxn or HypoFxn radiotherapy, as per clinician's and patient's choice, following shared decision making discussing the advantages and disadvantages of both modalities. A total of 77 patients with T2N0M0 squamous cell carcinoma of glottis treated with either HypoFxn 55Gy in 20 fractions (n = 19) or ConFxn 63 to 65Gy in 30 fractions (n = 58) were included.
Results With median follow-up of 3.4 years, there was no significant difference in disease-free survival (median: HypoFxn = 65.2 months, and ConFxn = 75.3 months; p = 0.874), local recurrence free survival rates (median: HypoFxn = 78.8 months vs. ConFxn = 81.2 months; p = 0.274), and overall survival (median: HypoFxn = 65.9 months vs. ConFxn = 67.7 months; p = 0.532). Elective neck irradiation was given to 43 patients, all in the ConFxn group, and this was associated with poorer local control (p = 0.027). The use of radiotherapy modality, three-dimensional conformal radiotherapy (3DRT) versus intensity modulated radiotherapy (IMRT), was not a prognostic factor (p = 0.36). In the HypoFxn group, grade III acute dysphagia requiring nasogastric tube was 16%, compared with 25% in the ConFxn group (p = 0.446).
Conclusion HypoFxn radiotherapy provides a comparable treatment outcome with acceptable toxicity. The addition of prophylactic irradiation of the neck lymph nodes has no impact on regional control.
Knowledge of Physicians about the Interrelationship between Diabetes Mellitus and Periodontitis in the United Arab Emirates
Authors: Matrooshi Khawla Al , Raeesi Sireen Al , Tawfik Abdel R. , Khamis Amar H. , Bain Crawford , Atieh Momen , Shah Maanas 
Published: July 2022

Abstract
Objective Diabetes mellitus is a major cause of morbidity in the United Arab Emirates (UAE), highlighting a significant social and economic burden impacting the development of the country. Studies have shown a bidirectional relationship between diabetes and periodontal disease. The awareness of this relationship is imperative not only for dentists but also for the physicians who contribute toward enhancing a diabetic patient's health and lifestyle. There is a general need to highlight the importance of maintaining periodontal health and its positive effect on controlling diabetic health status. The purpose of this study is to investigate the knowledge of the physicians regarding diabetes and periodontal health.
Materials and Methods A cross-sectional study involving a questionnaire was distributed to the physicians who were attending the Arab Health Conference in Dubai in 2019.
Statistical Analyses A cross-tabulation analysis compared attitude, knowledge, and awareness across sector, gender, and country of graduation. A logistic regression model was used to explain the “knowledge” regarding possible confounding factors.
Results A total of 344 physicians with an average age of 38.11 (9.31) years, comprising of 186 (53.8%) males, participated in the survey. Of those participants, 285 (82.8%) were working in the government sector health care centers versus the private health care organizations. Also, 108 (31.4%) of the participants graduated within the universities based in the UAE, while the remaining 263 (68.6%) participants graduated from medical schools from other countries. At least 265 (77%) of the participants had positive outlook toward referring patients with diabetes to their dental colleagues, while 283 (82.3%) of the physicians acknowledge that diabetes affects periodontal health. While a majority of participants 261 (76%) treat diabetic patients in their clinical practice, only 50 (19%) of the participants admit to referring these patients for a dental consultation. In addition, the survey also revealed that 225 (65.5%) physicians comprehend the bidirectional relationship of periodontal disease and diabetes.
Conclusion An appropriate dental referral protocol is recommended for all diabetic patients who visit physicians. This survey demonstrated that although the physicians present with good knowledge, they rarely refer diabetic patients to receive proper periodontal care.
Acute Disseminated Encephalomyelitis with Prefrontal Cortex Involvement in a 9-Year-Old Child after COVID-19 Infection: A Case Report
Authors: Balik Ayse Özlem , Gurdal Kosem Esra 
Published: July 2022

AbstractThe aim of the study was to present the rare co-occurring radiological findings of a child presenting with acute disseminated encephalomyelitis (ADEM) with a spinal cord and prefrontal cortex involvement after coronavirus disease 2019 (COVID-19) illness. The patient, who had COVID-19 a few weeks earlier, presented with progressive weakness in the right upper and lower extremities. Neurological examination of the patient was performed, and cranial magnetic resonance imaging (MRI) was taken on the same day. Serum severe acute respiratory syndrome coronavirus immunoglobulin M antibody testing was positive. MRI of the brain parenchyma and thoracic spine revealed fluid-attenuated inversion recovery and T2-weighted hyperintense lesions. Additionally, mild contrast enhancement was observed in both the prefrontal cortexes. The patient was discharged 10 days later with complete clinical recovery. Unlike other post-COVID-19 ADEM cases presenting in the literature, prefrontal cortex involvement makes our case rare.
Perceptions of Geriatric Medicine and Care of the Elderly: An Exploratory Survey of Physicians from the Middle East and Africa
Authors: Beshyah Salem A. , Hafidh Khadija , Abdulrahman Husen , Hammami Sonia Ouali 
Published: July 2022

AbstractBackground The number of older people is growing in the Middle East and Africa (MEA). We aimed to explore the attitudes of MEA's physicians toward the care of the elderly and nursing homes.Methods We surveyed 137 doctors practicing in the MEA region in 2017 using an online questionnaire that included attitude scales of geriatrics and nursing homes.Results Most respondents were senior (47.1%) or in middle grades (35.3%), in public facilities (77.4%), and practiced internal medicine and subspecialties. More respondents (86%) agreed with what was perceived as the most exciting and entertaining qualities of most older people in their accounts of their past experiences. Also, 69.0% of respondents disagreed that older people need/demand no more attention or love than younger people. At the same time, 43.6% of respondents were neutral on the question relating to older people's power in business and politics. Positive attitudes, that is, older people's willingness to continue working for as long as possible, and that wisdom with age scored 61.5% was supported by 85.1 and 61.5% of the respondents, respectively.On the other hand, 53.7% of respondents agreed that older people could not adjust and change with changing circumstances, 70.9% disagreed that older people make neighborhoods less favorable. However, only 15.5% disagreed with the statement that older people cannot adjust and change with changing circumstances. Nearly two-thirds thought nursing homes were not well developed (63.0%) in the MEA region. Also, 59.8% said that the expected reimbursement is low, 57.7% were concerned about complicated medical problems, and 57.3% highlighted the deficits in training. There was low satisfaction with providing nursing home care despite agreeing that they may feel professionally satisfied providing nursing home care (49.5%). The respondents were neutral (47.3%) or somewhat agreed (42.9%) about enjoying nursing home care.Conclusion There is a suboptimal attitude of practicing physicians to geriatrics that needs improvements.
Writing and Reading Skills in Children with Benign Childhood Epilepsy with Centrotemporal Spikes: Systematic Review
Authors: Teixeira Joana , Santos Maria Emília , Oom Paulo 
Published: July 2022

AbstractIn this study, we present the results from a systematic literature review that aimed to gather information about the writing and reading capacities of children with benign childhood epilepsy with centrotemporal spikes. This research comprises studies published between 2005 and 2016 in PubMed, Science Direct, and PsycInfo that included the keywords “benign childhood epilepsy with centrotemporal spikes”/ “rolandic epilepsy” with “written language”/ “reading” / “writing” / “literacy”/ “learning disabilities.” The study selection criteria were: (i) conducted with children with this epileptic syndrome aged between 5:11 and 16; (ii) involving children with active epilepsy or in remission; (iii) assessing written language or learning skills involving reading and writing; and (iv) published in journals with scientific refereeing. From the articles that met all the criteria defined, we compiled and synthesized the information about written language abilities. Reading problems appear to have higher incidence in this population, mostly with regard to the speed and reading accuracy and the ability to comprehend a written text. Fewer limitations were found in writing skills, but some studies showed difficulties in words writing, punctuation/ accentuation, and spontaneous writing coherence and cohesion. We also found disparities in the results regarding the relationship between writing skills and the clinical variables associated with epilepsy. Despite the heterogeneity of this population, it was possible to synthesize and define more precisely the written language variations presented. However, more concrete information is needed about written language disorders in this population, to present valid data to support clinical and pedagogical practices.
Rationale and Initiative of the Impella in Cardiac Surgery (ImCarS) Register Platform
Authors: Niemann Bernd , Stoppe Christian , Wittenberg Michael , Rohrbach Susanne , Saeed Diyar , Billion Michael , Potapov Evgenij , Oezkur Mehmet , Akhyari Payam , Schmack Bastian , Schibilsky David , Bernhardt Alexander M. , Schmitto Jan D. , Hagl Christian , Masiello Paolo , Böning Andreas 
Published: July 2022

Abstract
Objectives Cardiac support systems are being used increasingly more due to the growing prevalence of heart failure and cardiogenic shock. Reducing cardiac afterload, intracardiac pressure, and flow support are important factors. Extracorporeal membrane oxygenation (ECMO) and intracardiac microaxial pump systems (Impella) as non-permanent MCS (mechanical circulatory support) are being used increasingly.
Methods We reviewed the recent literature and developed an international European registry for non-permanent MCS.
Results Life-threatening conditions that are observed preoperatively often include reduced left ventricular function, systemic hypoperfusion, myocardial infarction, acute and chronic heart failure, myocarditis, and valve vitia. Postoperative complications that are commonly observed include severe systemic inflammatory response, ischemia-reperfusion injury, trauma-related disorders, which ultimately may lead to low cardiac output (CO) syndrome and organ dysfunctions, which necessitates a prolonged ICU stay. Choosing the appropriate device for support is critical. The management strategies and complications differ by system. The “heart-team” approach is inevitably needed.However despite previous efforts to elucidate these topics, it remains largely unclear which patients benefit from certain systems, when is the right time to initiate (MCS), which support system is appropriate, what is the optimal level and type of support, which therapeutic additive and supportive strategies should be considered and ultimately, what are the future prospects and therapeutic developments.
Conclusion The European cardiac surgical register ImCarS has been established as an IIT with the overall aim to evaluate data received from the daily clinical practice in cardiac surgery. Interested colleagues are cordially invited to join the register.
Clinical registration number: DRKS00024560.
Positive Ethics Vote: AZ 246/20 Faculty of Medicine, Justus-Liebig-University-Gießen.
Bypass Grafting to Circumflex: Left Internal Thoracic Artery versus Saphenous Vein
Authors: Uchino Gaku , Murakami Hirohisa , Mukohara Nobuhiko , Tanaka Hiroshi , Nomura Yoshikatsu , Miyahara Shunsuke 
Published: July 2022

Abstract
Background This study aimed to compare the short- and long-term outcomes of saphenous vein grafts (SVGs) and in situ left internal thoracic artery (LITA) grafts to the left circumflex artery (LCX) territory.
Methods This study included 678 patients who underwent LITA-left anterior descending (LAD) + SVG-LCX grafts and 286 patients who underwent right internal thoracic artery (RITA)-LAD + in situ LITA-LCX grafts from January 2002 to December 2020. Short-term and long-term clinical outcomes were compared using inverse probability of treatment weighting adjustment to reduce selection bias.
Results In-hospital mortality was significantly higher for the SVG-LCX group (p = 0.008), whereas deep sternal wound infection was significantly higher in the LITA-LCX group (p = 0.013).Survival rates at 5 and 10 years were 83.12 and 71.45% in the SVG-LCX group, whereas 75.24 and 65.54% in the LITA-LCX group (log-rank p = 0.114). Rates of freedom from cardiac events at 5 and 10 years were 92.82 and 85.24% in the SVG-LCX group, whereas 94.89 and 89.46% in the LITA-LCX group (log-rank p = 0.179).Univariate and multivariate logistic regression analysis showed that proximal severe stenosis was significantly protective against graft dysfunction before discharge (odds ratio, 0.43; 95% confidence interval, 0.23–0.81).
Conclusion Deep sternal wound infection was significantly higher for LITA to LCX bypass whereas in-hospital mortality was higher for SVG to LCX. In situ LITA to LCX bypass grafting exhibited similar long-term outcomes with SVG to LCX bypass grafting in adjusted patient cohorts. Proximal severe stenosis of LCX was protective against graft dysfunction.
Office-Based Lymphatic Supermicrosurgery: Supermicrosurgical Lymphaticovenular Anastomosis at an Outpatient Clinic
Authors: Yamamoto Takumi , Yamamoto Nana 
Published: July 2022

Abstract
Background Supermicrosurgical lymphaticovenular anastomosis (LVA) has become popular for the treatment of compression-refractory lymphedema. With advancement of navigation tools, LVA can be performed with more ease and safety, allowing office-based LVA at an outpatient clinic.
Methods Office-based LVA was performed on patients with compression-refractory secondary extremity lymphedema by a well-experienced supermicrosurgeon (T.Y.) under local infiltration anesthesia. Indocyanine green (ICG) lymphography and vein visualizer were used to localize vessels preoperatively. A stereoscopic microscope (Leica S6E, Leica Microsystems, Germany) or a relatively small operative microscope (OPMI pico, Carl Zeiss, Germany) was used for LVA. Operative records and postoperative results were reviewed to evaluate feasibility of office-based LVA.
Results LVAs were performed on 27 arms and 42 legs, which resulted in 131 anastomoses via 117 incisions. ICG lymphography stage included stage II in 47 limbs, and stage III in 22 limbs. Time required for one LVA procedure (from skin incision to skin closure in one surgical field) ranged from 13 to 37 minutes (average, 24.9 minutes). One year after LVA, all cases showed significant volume reduction (lymphedematous volume reduction; 0.5–23.6%, average 13.23%). No postoperative complication was observed.
Conclusion LVA can be performed with safety and effectiveness outside an operation theater. Patient selection, precise preoperative mapping, and experience of a surgeon are key to successful office-based LVA.
Social Skills Differences in Children with Epilepsy and Nonepileptic Seizures
Authors: Levan Ashley , Fegter Ollie , Gale Shawn D. 
Published: July 2022

AbstractResearch has shown that children experiencing epileptic seizures (ES) or non-ESs (NES) exhibit cognitive and behavioral deficits, but no research has examined social skills differences between the two groups. A better understanding of social skills differences between these two groups might allow for the development of more targeted interventions. The purpose of this study was to examine social skills differences between children with ES and children with NES, using the Social Skills Improvement Scale (SSIS). A total of 43 children were recruited from the epilepsy monitoring units at Phoenix Children's Hospital and Primary Children's Medical Center. The epilepsy group consisted of 28 participants (50% female, mean age at testing = 11.79, standard deviation [SD] = 3.12), and the NES group consisted of 15 participants (67% female; mean age at testing = 12.62, SD = 3.33). Parents and children completed the SSIS Rating Scales. No group differences were found between children with ES and children with NES on social skills measures. However, children in both groups rated their social skills as being in the average range, while parents of children in both groups rated their children's social skills as being in the below average range. Limitations to this study and directions for future research are discussed.
Endovascular Management of Intracranial Pial Arteriovenous Fistula with Giant Venous Varix: Case Report and Review of Literature.
Authors: Yadav Nishtha , Kumar Ambuj , Hedaoo Ketan , Pande Sonjjay 
Published: July 2022

Abstract:
Background: Intracranial pial arteriovenous fistulas (AVFs) are rare intracranial vascular malformation and their treatment is challenging because of high-flow pial supply of the lesion. We report a case of intracranial pial AVF with associated giant venous varices managed successfully by embolization.
Case Description: A 25-year-old male presented with sudden onset headache and altered sensorium. Computed tomographic scan was suggestive of frontal lobar hematoma that had dissected into the third ventricle with associated intraventricular hemorrhage. Magnetic resonance imaging revealed presence of large vascular channels with the presence of multiple flow voids in bilateral frontal location. Digital subtraction angiography revealed pial fistula with arterial supply from hypertrophied left anterior cerebral artery. Treatment was done using combined coil and onyx embolization after careful analysis of angioarchitecture of the lesion using three-dimensional rotational angiogram cross-sectional reconstructions. Postprocedure angiogram revealed closure of fistula and giant varices.
Conclusion: Pial AVFs with giant venous varix in adults are rare vascular malformation and understanding the angioarchitecture with exact identification of fistulous point is important to plan for surgical/endovascular management strategies. Combined strategy of embolization using coils and onyx is a safe option in such cases with giant varices.