nils-herrmann/clean_scirepeval huggingface dataset:
Cost of open versus laparoscopically assisted right hemicolectomy for cancer

The aim of this study was to estimate and compare the costs of open right hemicolectomy (ORHC) versus laparoscopically assisted right hemicolectomy (LARHC) performed for cancer. A retrospective cost analysis of 61 consecutive patients operated on between January 1992 and August 1994 for right-sided colonic cancer by either LARHC (n = 28) or ORHC (n = 33) was performed. The analysis focused on the cost (in Australian dollars) incurred from the date of operation to the date of discharge. LARHC was significantly more expensive than ORHC (total cost LARHC $9064, ORHC $7881; p < 0.001). LARHC was associated with a significantly longer operating room utilization time (LARHC 261 minutes, ORHC 203 minutes; p < 0.001) and a greater cost of disposables (LARHC $854, ORHC $189; p < 0.001). This study demonstrates no cost benefit for LARHC compared to ORHC when performed for cancer. Le but de cette étude a été d’évaluer et de comparer les coûts de la colectomie droite effectuée par laparoscopie de celle réaliséc de façon traditionnelle. On a ainsi étudié une série de 61 patients consécutifs opérés entre Janvier 1992 et Août 1994 pour un cancer du colon droit soit par laparoscopie assistée (LARHC, n = 28) soit de façon traditionnelle (ORHC, n = 33). L’analyse était centrée sur les coûts (en dollars australiens [$ Au]) à partir de la date de l’opération jusqu’à la date de la sortie. Les coûts de la LARHC étaient significativement plus élevés que ceux de l’ORHC (coûts totaux de la LARHC = 9064 $ Au vs ORHC = 7881 $ Au; p < 0.01). La durée de l’intervention était significativement plus longue (LARHC: 261 minutes vs ORHC: 203 minutes; p < 0.001) et on a utilisé significativement plus d’instruments à usage unique avec une différence de coûts de 854 $ Au vs 189 $ Au, p < 0.001). Cette étude démontre que la colectomie sous laparoscopie pour cancer colique ne présente aucun avantage économique par rapport à la colectomie classique. El propósito del presente estudio fue el de estimar y comparar los costos de la hemicolectomía derecha abierta versus la operación asistida por laparoscopia en pacientes con cáncer. Se hizo un análisis retrospectivo de 61 paciente consecutivos operados entre enero de 1992 y agosto de 1994 por cáncer del colon derecho: hemicolectomía derecha asistida por laparoscopia (HCDAL, n = 28) o hemicolectomía derecha abierta (HCDA, n = 33). El análisis se enfocó hacia e costo (en $AU) causados desde la fecha de la operación hasta la fecha del egreso. La HCDAL resultó significativamente más costosa que la HCDA (costo total de la HCDAL $9064, HCDA $7881; p < 0.001). La HCDAL se asoció con un tiempo más prolongado en la sala de operaciones (HCDAL 261 minutos, HCDA 203 minutos; p < 0.001) y un mayor costo de los elementos desechables (HCDAL $854, HCDA $189; p < 0.001). El estudio demuestra que no hay beneficio en cuanto a costo para la HCDAL en comparación con la HCDA, realizadas por cáncer.
An aneurysm at the site of the fenestration of the middle cerebral artery in a patient with multiple aneurysms: A case report

Middle cerebral artery (MCA) fenestration is a very rare anatomical variant of the MCA, incidentally found during magnetic resonance or computed tomography angiography. It has an incidence of 0.6%. Unlike fenestration of the posterior cerebral arterial circulation, fenestration of the anterior cerebral arterial circulation has not been well described.



We present the rare case of a patient who was admitted for a ruptured aneurysm of the MCA arising at the site of the fenestration of the MCA and also an unruptured fusiform aneurysm of the right posterior communicating artery and a distal anterior cerebral artery (ACA) aneurysm.



The patient underwent craniotomy with microsurgical aneurysm clipping and the previously undiagnosed ruptured aneurysm, at the site of the fenestration of the MCA, arose immediately. Postoperatively, the patient awoke without a deficit. After treatment of postoperative bacterial meningitis, he was discharged on the 26(th) postoperative day in good condition without any neurologic deficit. Six months after the first surgery, he was operated for the distal azygos ACA aneurysm.



Anomalies of the intracranial vasculature are common, and we describe a rare case of left MCA fenestration with an associated ruptured aneurysm at the site of the fenestration. In the literature, cases of fenestration of the MCA are sporadically reported and are only incidental findings.
Testing mechanisms of action for intensive case management.

This study identified factors that predict, mediate or moderate the effects of intensive case management (ICM) on longer-term drug abstinence outcomes in women on welfare.



In a parent study women were assigned randomly to usual care (UC) or intensive case management (ICM). Treatment was provided for 12 weeks and follow-up continued for 15 months after study intake. A set of hypothesized mediators was assessed at month 3 and a rigorous four-step mediational model was tested using outcomes in months 4-15.



Participants were 302 drug-dependent women applying and eligible for federal welfare and not currently in drug abuse treatment.  ICM provided intensive treatment engagement including voucher incentives for treatment attendance and case management services; UC provided primarily referral to community treatment programs.



Substance use outcomes were assessed using the time-line follow-back interview and confirmed using biological and collateral measures.



Participants in ICM had more case manager contacts, better treatment engagement and more self-help attendance than did those in UC. Each of these variables predicted, and was shown to be a mediator of outcome, but case management contact was an especially robust mediator. Further, ICM effects were strongest for those who attended treatment least. Contrary to prediction, greater psychopathology and environmental stressors did not predict worse outcomes.



Findings suggest that case management is an active intervention that may both facilitate and substitute for formal drug abuse treatment.
Pilot attempt of advanced prostate cancer treatment T3NxMx−1 by intermittent more complete androgen blockade

The aim of the prospective pilot study was evaluating efficacy and tolerance of pharma-cological more complete androgen blockade (mMAB) by using Zoladex LA 10.8 mg, Casodex 50 mg and Proscar 5 mg in patients with advanced prostate cancer (T3,Nx Mx-1).  This five-year study involved 14 patients aged 67–82 years (average 73). Zoladex LA was administered subcutaneously every 3rd month of treatment, and every day 1 tablet Casodex and 1 tablet Proscar. In the time when PSA was <0.1 mg/ml Zoladex and Casodex were withdrawn, and only Proscar was left. The mMAB treatment was resumed when PSA 0.1 ng/ml. Before and every 3 months the following laboratory tests were made: PSA, sedimentation, bilirubine, transaminase, phosphatase, ultrasonography (USG); and adverse events were registered. The following criteria of assessment were adopted: CR – complete response – examination tests normal, improved condition, reduction of prostate dimension in USG and value of PSA < 0.1 ng/ml; PR – partial response i.e. no progression, the PSA level drops down to the reference values and a reduction of prostate dimension in USG occurs, NR – no response i.e. progression, increased prostate dimension in USG and/or metastases in scintygraphy, as well as PSA above normal.  The mean followup time was 60 months. After the initial 6 months two patients were off-therapy mMAB because they were qualified for radiotherapy. A successive patient (no. 5) was off-therapy (after 4 years) because he left Warsaw to go abroad. After 60 months results mMAB were based on 11 patients’ records, and a complete response was confirmed in 7 patients, partial response in 3 patients and no response in one patient.  Results of this study show that pharmacological intermittent mMAB is an efficient way of treating advanced prostate cancer. Side effects are low and occur in moderate intensity and do not oblige to treatment withdrawal.
Effects of vitamin D supplementation on the bone specific biomarkers in HIV infected individuals under treatment with efavirenz

It was reported that antiretroviral drugs such as efavirenz can increase the catabolism of vitamin D in HIV infected individuals. We have not found any study that evaluated effects of vitamin D supplementation on the bone specific biomarkers in HIV positive patients under treatment with antiretroviral regimen containing efavirenz. Vitamin D deficiency was detected in 88.4 % of included patients. Baseline osteocalcin, but not collagen telopeptidase, serum levels were lower than normal range in all of these individuals. Both bone biomarkers’ concentrations increased significantly (p < 0.001 for both of them) after supplementation of vitamin D and it was more predominant for osteocalcin. Vitamin D deficiency was detected in 88.4 % of included patients. Baseline osteocalcin, but not collagen telopeptidase, serum levels were lower than normal range in all of these individuals. Both bone biomarkers’ concentrations increased significantly (p < 0.001 for both of them) after supplementation of vitamin D and it was more predominant for osteocalcin. In the HIV-infected patients under treatment with efavirenz, vitamin D deficiency is prevalent. After supplementation with single dose of 300,000 IU vitamin D in this population, the activation of osteoblasts and osteoclasts stimulates bone formation and resorption respectively with favorable bone formation without any adverse event. Significant percent of HIV infected individuals are vitamin d deficient that could benefit from vitamin D supplementation.
Peptic ulcer bleeding: comparison of two hemostatic procedures

Bleeding is a serious complication of peptic ulcer. Endoscopic injection therapy is accepted as a homeostatic endoscopic treatment in acute nonvariceal of upper GI hemorrhages, particularly in bleeding peptic ulcers. The risk of rebleeding is predicted by the endoscopic appearance of ulcer features classified according to Forrest's criteria.Two hundred twenty-three patients were selected from 1,003 emergency upper endoscopies for GI bleeding. According to Forrest's criteria, 99 well-matched patients with ulcers F1 and F2 were considered at risk of rebleeding; 54 patients (group A) received local ulcer injection of epinephrine solution 1:10,000, whereas (group B) patients were treated with local epinephrine injection and then with endoscopic Hemoclips.1 We considered the control of bleeding, the number of rebleeding episodes, the need for emergency surgery, and mortality.Bleeding ulcers stopped completely in 83.3% group A patients, and in 95.6% group B patients (p = not significant). In a subset of F1b patients the rebleeding rate was 31% for group A and 0% for group B (p < 0.05). There was no mortality as a result of the procedure. There was a trend toward reducing surgery in favor of the combined therapy (0% vs 7.4%). No differences were found in transfusion requirements or mean hospitalization days.We conclude that endoscopic injection of 1:10,000 epinephrine solution alone and epinephrine solution plus application of Hemoclips are equivalent therapies in treating bleeding and rebleeding from peptic ulcers. There was no difference between therapies in terms of need for surgery or mortality. Possibly combination therapy is more effective in treating ulcers that are actively oozing.
The role of a structured exercise training program on cardiac structure and function after acute myocardial infarction: study protocol for a randomized controlled trial

Exercise training is effective in improving functional capacity and quality of life in patients with coronary artery disease, but its effects on left ventricular systolic and diastolic function are controversial. Diastolic dysfunction is a major determinant of adverse outcome after myocardial infarction and, contrary to systolic function, no therapy or intervention has proved to significantly improve diastolic function. Data from animal studies and from patients with diastolic heart failure has suggested that exercise training can have a positive effect on diastolic function parameters. This trial aims to evaluate if a structured exercise training program can improve resting left ventricular diastolic and systolic function in patients who have had an acute myocardial infarction.



This is a phase II, prospective, randomized, open-label, blinded-endpoint trial that will include at least 96 consecutive patients who have had an acute myocardial infarction one month previously. Patients will be randomized (1:1) to an exercise training program or a control group, receiving standard of care. At enrolment, and at the end of the follow-up period, patients will be submitted to an echocardiography (with detailed assessment of diastolic and systolic function using recent consensus guidelines), cardiopulmonary exercise testing, an anthropometric assessment, blood testing, and clinical evaluation. Patients randomized to the intervention group will be submitted to an eight-week outpatient exercise program, combining endurance and resistance training, for three sessions per week. The primary endpoint will be the change in lateral E' velocity immediately after the eight-week exercise training program. Secondary endpoints will include other echocardiographic parameters of left ventricular diastolic and systolic function, cardiac structure, metabolic and inflammation biomarkers (high-sensitivity C-reactive protein and pro-BNP), functional capacity (peak oxygen consumption and anaerobic threshold) and anthropometric measurements.



New strategies that can improve left ventricular diastolic function are clinically needed. This will be the first trial to evaluate, in patients who have had an acute myocardial infarction, the effects of a structured program of exercise training on diastolic and systolic function, assessed by novel echocardiographic parameters.
Relatives' participation in everyday care in special care units for persons with dementia.

Research concerning relatives' participation in the everyday care related to persons living in special care units for persons with dementia is limited.



To examine relatives' participation in their near one's everyday care, the level of burden experienced and important factors for participation, in this special context.



The study had a cross-sectional design, and data collection was carried out by means of a study-specific questionnaire.



A total of 233 relatives from 23 different special care units participated.



The study was approved by the Norwegian Social Science Data Services.



A great majority of relatives reported that they visited weekly and were the resident's spokesperson, but seldom really participated in decisions concerning their everyday care. Participation was seldom reported as a burden.



This study indicated that relatives were able to make a difference to their near one's everyday life and ensure quality of care based on their biographical expertise, intimate knowledge about and emotional bond with the resident. Since knowing the resident is a prerequisite for providing individualised care that is in line with the resident's preferences, information concerning these issues is of utmost importance.



This study prompts reflection about what it is to be a spokesperson and whether everyday care is neglected in this role. Even though relatives were satisfied with the care provided, half of them perceived their participation as crucial for the resident's well-being. This indicated that relatives were able to offer important extras due to their biographical expertise, intimate knowledge about and emotional bond with the resident. Good routines securing that written information about the residents' life history and preferences is available and used should be implemented in practice.
Ion chromatography combined with online electrochemical derivatization and fluorescence detection for the determination of carbamazepine in human plasma.

This paper describes the determination of carbamazepine (CBZ) in human plasma using ion chromatography combined with online electrochemical derivatization and fluorescence detection. Separation of CBZ with anion exchange column was demonstrated to be feasible using either basic (10 mM NaOH) or acidic (0.1 M H(3)PO(4)) reagent with a small amount of acetonitrile (ACN) added as eluent. Electrochemical derivatization of CBZ into a strongly fluorescent product, which could be carried out only under the acidic condition, was investigated via the previously reported electrolytic cell (EC), as well as two modes of acidification. The linear range of CBZ for human plasma was between 10-2000 μg L(-1) under the optimized experimental conditions. The limit of detection (LOD, S/N=3) was 1.3 μg L(-1) and the relative standard deviation (RSD, n=7) was 2.6%. Better sensitivity and selectivity of the present method were demonstrated in comparison with ion chromatography with ultraviolet detection (IC-UV). The spiked recoveries of CBZ in 2 human plasma samples were 78.5 and 114%, respectively.
2426 /-Blockade With Bucindolol in Heart Failure Caused by Ischemic Versus Idiopathic Dilated Cardiomyopathy

We investigated the effects of bucindolol, a nonselective, non-ISA j-blocker with mild vasodilatory properties, in patients with congestive heart failure from ischemic dilated cardiomyopathy (ISCDC, n=27) and compared the results with those in subjects with heart failure from idiopathic dilated cardiomyopathy (IDC, n=22).  Patients were randomized in a double-blind fashion to receive 12 weeks' treatment with either bucindolol or placebo, with randomization stratified for IDC or ISCDC. Invasive (right heart catheterization) and noninvasive (echo, MUGA, central venous norepinephrine, exercise treadmill studies, and symptom scores) tests of heart failure severity were determined at baseline and end of the study. For all subjects (ISCDC plus IDC), relative to placebo treatment, bucindolol-treated patients had significant improvement in ejection fraction, left ventricular size and filling pressure, stroke work index, symptom score, and central
A double-blind, placebo-controlled trial of maraviroc in treatment-experienced patients infected with non-R5 HIV-1.

Maraviroc, a CCR5 antagonist, is active against R5 but not X4 or dual- or mixed-tropic strains of human immunodeficiency virus type 1 (HIV-1). A phase 2b study was conducted to determine the safety and efficacy of maraviroc in combination with optimized background therapy in treatment-experienced patients infected with dual- or mixed-tropic HIV-1.



Treatment-experienced patients with an HIV-1 RNA level 5000 copies/mL who had received 3 classes of drugs and/or were infected with virus resistant to 2 drug classes and were infected with non-R5 HIV-1 were randomized to receive optimized background therapy plus maraviroc (once or twice daily) or placebo. The primary end point was change in HIV-1 RNA level from baseline to 24 weeks.



Among 167 patients infected with dual- or mixed-tropic HIV-1, baseline mean HIV-1 RNA levels were >5 log(10) copies/mL and median CD4(+) cell counts were <50 cells/microL. From baseline to 24 weeks, patients who received placebo demonstrated a mean decrease in HIV-1 RNA levels of 0.97 log(10) copies/mL, compared with mean decreases of 0.91 and 1.20 log(10) copies/mL for those who received maraviroc once (P =.83) or twice (P +.38) daily, respectively. Mean increases in CD4(+) cell counts from baseline were 36 cells/microL for patients who received placebo, 60 cells/microL among patients who received maraviroc once daily, and 62 cells/microL among patients who received maraviroc twice daily. The incidences of serious adverse events were similar among groups.



In this exploratory study involving extensively treatment-experienced patients with advanced, non-R5 HIV-1 infection, neither superiority nor noninferiority was statistically demonstrated for either maraviroc dosage compared with placebo at 24 weeks of treatment.
Relationships of methacholine and adenosine monophosphate responsiveness with serum vascular endothelial growth factor in children with asthma.

Airway hyperresponsiveness, which is a characteristic feature of asthma, is usually measured by means of bronchial challenge with direct or indirect stimuli. Vascular endothelial growth factor (VEGF) increases vascular permeability and angiogenesis, leads to mucosal edema, narrows the airway diameter, and reduces airway flow.



To examine the relationships between serum VEGF level and airway responsiveness to methacholine and adenosine monophosphate (AMP) in children with asthma.



Peripheral blood eosinophil counts, serum eosinophil cationic protein (ECP) concentrations, and serum VEGF concentrations were measured in 31 asthmatic children and 26 control subjects. Methacholine and AMP bronchial challenges were performed on children with asthma.



Children with asthma had a significantly higher mean (SD) level of VEGF than controls (361.2 [212.0] vs 102.7 [50.0] pg/mL; P < .001). Blood eosinophil counts and serum ECP levels significantly correlated inversely with AMP provocation concentration that caused a decrease in forced expiratory volume in 1 second of 20% (PC20) (r = -0.474, P =.01; r = -0.442, P =.03, respectively), but not with methacholine PC20 (r = -0.228, P = .26; r = -0.338, P =.10, respectively). Serum VEGF levels significantly correlated with airway responsiveness to AMP (r = -0.462; P = .009) but not to methacholine (r = -0.243; P = .19).



Serum VEGF levels were increased in children with asthma and were related to airway responsiveness to AMP but not to methacholine. Increased VEGF levels in asthmatic children may result in increased airway responsiveness by mechanisms related to airway inflammation or increased permeability of airway vasculature.
Ambulatory photodynamic therapy using low irradiance inorganic light-emitting diodes for the treatment of non-melanoma skin cancer: an open study.

Conventional photodynamic therapy (PDT) can be inconvenient and uncomfortable. We studied low irradiance PDT using an ambulatory inorganic light-emitting diode.



Fifty-three patients with 61 lesions [superficial basal cell carcinoma (n = 30), Bowen's disease (n = 30), and actinic keratosis (AK; n = 1)] were studied. Two treatments of ambulatory PDT were undertaken 1 week apart (one treatment for AK). Clinical response was determined at 3 months, and the treatment cycle was repeated if there was residual disease. The endpoints assessed were pain during treatment (numerical rating scale (NRS); 0-10) and outcome at 1 year. Twenty-three of these patients also received conventional PDT to separate lesions.



The median NRS pain scores during first and second treatment were 2 (range 0-9) and 4 (0-9), respectively. Lesion clearance rate at 1 year after ambulatory PDT was 84% (21/25 lesions in 22 patients). Of the twenty-three patients treated with both ambulatory and conventional PDT, the median NRS was 1 (0-7) and 5 (1.5-9), respectively, with most patients preferring ambulatory PDT.



Ambulatory PDT is effective for superficial non-melanoma skin cancer, with 1 year clearance rates comparative to conventional PDT. Low irradiance ambulatory PDT may be less painful and more convenient than conventional PDT.