bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of the Arteriovenous Fistula on Pulmonary Artery Pressure and Cardiac Output in Patients with Chronic Renal Failure
Authors: Beigi Ali Akbar , Sadeghi Amir Mir Mohammad , Khosravi Ali Reza , Karami Mehdi , Masoudpour Hassan
Published: January 2018

Introduction

Access to the vascular system is necessary in patients with chronic renal failure planned to undergo dialysis. One of the complications of end-stage renal disease patients is pulmonary hypertension (PHT). Temporary arterio-venous access closure and successful kidney transplantation causes a significant fall in cardiac output and pulmonary artery pressure (PAP), indicating the possibility that excessive pulmonary blood flow is involved in the pathogenesis of the disease. We attempted to study the relationship of PHT with arteriovenous fistula (AVF) creation, as well as to assess the relationship between AVF flow and fistula characteristics.

Methods

Fifty patients were included in the study. Echocardiography was used to evaluate systolic PAP, cardiac output (CO), and ejection fraction (EF) before creating the AVF. After a follow-up interval of at least 6 months, a second echocardiographic assessment and a Doppler sonographic assessment of their fistula flow were carried out. Complete data were available for 34 patients.

Results

Study data were collected from 34 patients, 28 males and 6 females with a mean age of 52 yrs ranging from 15–78 yrs. The data showed a statistically significant positive correlation between fistula flow and PAP2 and PAP changes (p<0.05). Mean fistula flow was 1322 ml/min in patients without PHt and 2750 ml/min in patients with PHT. this difference (1428 ml/ min) was statistically significant (p=0.03). We found a significant negative correlation between PAP1 and EF1 and PAP2 and EF2 (p<0.05). In addition, the mean EF2 in patients without PHT was 57% in contrast to 46% in patients with PHT. Mean fistula flow in radial fistulae (mean=422 ml/min, range: 370–474 ml/min) was significantly less than brachial fistulae (mean=1463 ml, range: 270–3300 ml/min) (p=0.03). Mean systolic PAP2 of 14.8 mmHg in transplanted patients was 5.9 mmHg less than those who were not transplanted (20.7 mmHg). Diabetes was the most common cause of renal failure and diabetics had a significant reduction in their EF (15.5%) compared with non-diabetic patients (1% reduction) (p=0.016).

Conclusion

Fistula flow, PAP and EF of all patients should be checked at least 6 months after fistula creation. Patients with higher fistula flow rates and patients with diabetes mellitus need to be more closely observed. In addition, elderly patients with significant cardiac and other comorbidities may be more prone to develop symptoms after AVF creation
Aggressive Approach to Salvage Non-Maturing Arteriovenous Fistulae: A Retrospective Study with follow-up
Authors: Miller Gregg A. , Goel Naveen , Khariton Aleksandr , Friedman Alexander , Savransky Yevgeny , Trusov Ilya , Jotwani Kiran , Savransky Eric , Preddie Dean , Arnold William Perry
Published: January 2018

Purpose

To establish a standardized approach for the maturation of non-maturing arteriovenous fistulae.

Methods

consecutive patients (n=122) with non-maturing fistulae presented to our outpatient vascular access center for percutaneous interventions to assist in maturation. The techniques used included flow rerouting, competing branch vein elimination, staged balloon angioplasty, and limited controlled extravasation.

Results

Successful fistula maturations were achieved in 118/122 patients. Fistulae were divided into two classes according to initial vessel size: class 1 (6.0–8.0 mm diameter, >6 mm deep) and class 2 (2.0–5.0 mm diameter) fistulae were evaluated for differences in technical procedures and clinically successful fistula maturation. Class 1 and class 2 fistulae were evaluated for mean number of procedures to maturation (1.6 and 2.6, respectively), and time to maturation (5 and 7 weeks, respectively). Follow-up for 109 of the initial 118 patients was achieved (mean=24 months, range=0.25–60 months). Class 1 and class 2 fistulae had primary patencies of 17 and 39% at 6 months; and secondary patencies of 72 and 77% at 12 months, 53 and 61% at 24 months, and 42 and 32% at 36 months, respectively. Primary and secondary patencies (Mann-Whitney test, p=0.44 and p=0.38, respectively) of class 1 and class 2 fistulae did not differ significantly, and secondary patencies were comparable to other fistula salvage studies.

Conclusion

Fistula salvage attempts should not be limited by factors such as a diffusely small diameter or an inaccessibly deep position.
Vascular access Localization Determines Regional Changes in Arterial Stiffness
Authors: Fischer Edmundo I. Cabrera , Bia Daniel , Valtuille Rodolfo , Graf Sebastián , Galli Cintia , Armentano Ricardo L.
Published: January 2018

Background

Vascular access (VA) dysfunction is a common cause of hospitalization in chronically hemodialyzed patients (CHP) limiting the improvement in health and has been largely studied in order to decrease the morbidity events that involves both the artery and the vein used in the construction of the fistula. In parallel, patients in end-stage renal failure show an increase in arterial stiffness.

Aim

The aims of this work were: (a) to evaluate arterial stiffness through pulse wave velocity (PWV) measurements in the carotid-brachial pathway where the arteriovenous fistulae (AVF) was constructed, and (b) to determine possible differences in arterial stiffness between the carotid-brachial pathway with and without VA.

Methods

PWV, clinical and biochemical parameters were measured in 38 CHP. PWV was obtained in the carotid-femoral, and in the left and right carotid-brachial pathway.

Results

Carotid-brachial PWV determination in upper limbs with AVF (10.07 ± 2.43 m/s) showed significantly lower values than those observed in the contra-lateral arm without VA (11.55 ± 2.27 m/s). Curiously, the PWV value observed in arms with an AVF was significantly lower in diabetic than in non-diabetic hemodialyzed patients (NDHP) (8.00 ± 2.86 m/s and 10.38 ± 2.33 m/s; respectively). Measurements of PWV in the carotid-femoral pathway in CHP showed a mean value of 14.09 ± 3.12 m/s. Carotid-femoral PWV in NDHP (14.06 ± 2.44 m/s) was significantly lower than that observed in the diabetic patients (16.87 ± 3.42 m/s).

Conclusions

Carotid-brachial PWV values obtained in the upper limbs, in which VAs were constructed, were significantly lower than that measured in intact arteries in the contra-lateral pathway in CHP.
Should Fistulas Really be First in the Elderly Patient?
Authors: Richardson Albert I. , Leake Andrew , Schmieder Gregory C. , Biuckians Andre , Stokes Gordon K. , Panneton Jean M. , Glickman Marc H.
Published: January 2018

Background

The Kidney Disease Outcomes and Quality Initiative (K/DOQI) has developed guidelines from available data suggesting that arteriovenous fistulas (AVF) be performed in the majority of patients. Patient demographics were not included nor suggested in their recommendations. The purpose of this study is to analyze the outcomes of elderly patients, age greater than 70, undergoing first-time permanent access surgery.

Methods

A retrospective review of consecutive patients undergoing new, first time access procedures from January 2005 through December 2005 was performed. Patients with previous attempts at permanent Arteriovenous (AV) access were removed from analysis. Standard statistical methods were used and patency was determined with Kaplan-Meier curves.

Results

One hundred and sixty eight patients underwent first time AVF, 48 of whom were older than 70 years of age. Comparing elderly patients to younger ones, the 12 month primary assisted patency was 35% and 67%, respectively (p=0.002) and secondary patency was 36% and 67%, respectively (p=0.004). Of the 48 elderly patients, 48% had died in the subsequent follow up period as compared to just 20% of the 120 patients younger than 70. The 18-month survival for the elderly group was 50% versus 74% for the younger patients (p=0.004). Of the elderly group who died, the average time to death was 13.1 months and only 8 AVF were able to be accessed. Similar intervention rates per year were seen in both groups.

Discussion

With an aging population, more patients older than 70 are being evaluated for permanent vascular access. This group poses a difficult dilemma for surgeons attempting to adhere to K/DOQI guidelines. In light of the increased mortality and decreased patency of AVF, this data questions which form of permanent access should be first-line treatment in this subgroup of patients.

Conclusion

This data suggest in the elderly patients, autogenous fistulas may not be the best option for this set of patients.
Catheterization of a Persistent Left Superior Vena Cava
Authors: Parreira Lúcia F. , Lucas Carlos C. , Gil Célia C. , Barata José D.
Published: January 2018

Patency of the left superior vena cava, although uncommon, is the most frequent anomaly of the thoracic vessels. It has been diagnosed in 0.3–0.5% of the general population. A persistent left superior vena cava (PLSVC) results from the abnormal persistence of an embryological vessel that normally involutes into the coronary sinus during fetal life. Catheterization of this vessel, including hemodialysis (HD) catheter placement, appears to be safe if adequate drainage of the PLSVC to the right atrium exists. We present the case of a 50-year-old HD patient in which the placement of a catheter through the left internal jugular vein, needed for HD treatment, revealed a PLSVC. After the demonstration of adequate draining of the vessel into the right atrium, replacement of this catheter for a cuffed tunneled HD catheter was done, which has since been used successfully for HD.
Persistent Left Superior Vena Cava in Pediatric Patients
Authors: Caruselli Marco , Piattellini Gianmarco , Camilletti Gianfranco , Giretti Roberto , Pagni Raffaella
Published: January 2018

A persistent left superior vena cava (PLSVC) is a congenital anomaly of the systemic venous system. This anomaly is often discovered as an incidental result during central venous catheterization passing through the left subclavian or the left internal jugular vein. We report two cases of PLSVC in pediatric patients.
Land Use and Ambient Air Quality in Bahir Dar and Hawassa, Ethiopia
Authors: Kasim Oluwasinaayomi Faith , Abshare Muluneh Woldetisadik , Mukuna Truphena Eshibukule , Wahab Bolanle
Published: January 2018

Land use, air pollution, and climate change are closely related. This article analysed the contributions of urban land use to ambient air quality in Bahir Dar and Hawassa cities. A total of 32 geo-referenced locations, 16 each in Bahir Dar and Hawassa, representing different land uses, were assessed for carbon monoxide (CO), carbon dioxide (CO2), and volatile organic compound (VOC). CO2 concentration (ppm) for Bahir Dar and Hawassa ranged from 385.10 ± 15.34 ppm (recreational land use) to 555.50 ± 80.79 ppm (commercial land use) and 388.07 ± 19.79 ppm (recreational land use) to 444.50 ± 54.05 ppm (industrial land use), respectively, whereas mean concentration of CO was 0.01 ± 0.01 ppm (recreational land use) to 2.59 ± 0.69 ppm (circulation land use) and 0.12 ± 0.11 ppm (recreational land use) to 4.66 ± 1.41 ppm (circulation land use), respectively. The VOC values were 882.10 ± 147.05 ppm (residential land use) to 1436.00 ± 932.06 ppm (institutional land use) and 1377.30 ± 233.23 ppm (institutional land use) to 2132.33 ± 739.71 ppm (circulation land use). Inadequate monitoring, occasioned by dearth of equipment, poor urban management strategy, fossil fuel combustion, and aged vehicles were some of the factors responsible for the observed concentrations. Elevated levels of CO, CO2, and VOC in the atmosphere have a significant impact on global warming, with adverse effects on human health. Capacity for monitoring, analysis, reporting, and validation of air quality data in the cities should be strengthened.
Subjectivity and discourse: Complementary topics for a critical psychology
Authors: González Rey Fernando L
Published: January 2018

This paper aims to discuss the rejection of subjectivity by psychologists dominantly oriented towards concepts like discourse and deconstruction, as well as communicative and relational activities. The recognition of the symbolic character of human phenomena by psychology occurred relatively late in relation to philosophy, linguistics and anthropology. Nonetheless, this entrance was so radical that it led psychologists to deny most of the concepts that have traditionally been used by psychology. This paper departs from theoretical traditions that advanced a step further in the comprehension of the human psyche as a cultural-historically engendered phenomenon. On this basis, a new definition of subjectivity is advanced as a phenomenon that emerges as a result of the symbolical forms which are socially and historically situated, from which concepts like discourse, deconstruction and dialogical-communicative systems also appeared. Subjectivity, as treated in this paper, is oriented toward specifying human processes that are not exhausted in these concepts, being complementary to them in a broader and complex approach to the study of human realities.
Expanding dialogical analysis across (sub-)cultural backgrounds
Authors: Jensen Mogens , Guimarães Danilo S
Published: January 2018

This paper aims to develop a diagram as a tool for analysing empirical data concerning the issue of difference of subcultural backgrounds and worldviews in the dialogue and its implications to the psychological practice in social work. From a theoretical view on dialogical and cultural psychology, we will trace the roots of selected contemporary dialogical and social representation theories and elaborate on it how distinct subcultures of interlocutors can produce misunderstandings when the professional interprets the utterance of the other. Focusing the social pedagogic practice, we will approach dialogues between people that belong to different cultural contexts as instances of the challenges in the communication, i.e. pedagogues and adolescents, doctors and patients, people belonging to different societies, etc. We argue that the theoretical approach presented and discussed here is part of a general understanding of communication processes, showing that despite mutual understanding will never be fully achieved in a dialogical situation, the possibility of sharing meanings and senses depends on the effort to take into consideration the worldview of the other in the background of what is presently uttered.
The social media political participation model: A goal systems theory perspective
Authors: Knoll Johannes , Matthes Jörg , Heiss Raffael
Published: January 2018

Although studies suggest that the use of social media can promote political participation (PP), there is a lack of theorizing about the psychological processes underlying this relationship. This article attempts to fill this gap by suggesting a social media political participation model. Taking a goal systemic perspective, the model specifies a set of interrelated processes that need to be realized so that social media use affects PP. Furthermore, key contingent conditions are outlined and insights into fostering PP are offered. The article explains ways of testing the model with surveys and experiments. Implications for future research are discussed.
Implications of metastereotypes for attitudes toward intergenerational contact
Authors: Fowler Craig , Gasiorek Jessica
Published: January 2018

Metastereotypes, the stereotypes a person believes that those outside of their group hold of a social group to which (s)he belongs, have been implicated in problematic intergroup relationships and communication. Using an online survey administered to participants (aged 18–30, or 65 and older) recruited via Amazon’s MTurk (final N = 311), we tested the degree to which eliciting positive versus negative age-based metastereotypes affected perceptions of interage distance and the desire to avoid interage contact. The results of conditional process model analyses suggest that metastereotype valence has an indirect effect on these outcomes via intergroup anxiety, but that this is only the case when individuals believe that age-related stereotypes are applied to them personally by members of an age-based outgroup. These findings suggest that thinking of positive metastereotypes rather than negative ones could be a route to facilitating or improving interage contact, and that personalization could amplify these potential benefits.
Short-term survival after colorectal cancer in a screened versus unscreened population
Authors: Syse Astri , Soneji Samir S. , Andrew Angeline S. , Tretli Steinar , Baili Paolo , Bynum Julie P.W.
Published: January 2018

Aims: United States’ (US) colorectal cancer (CRC) screening and treatment practices seek to reduce mortality. We examined the survival of US patients compared with patients in the virtually unscreened Norwegian population. Methods: We compared short-term survival after CRC between the US and Norway using relative survival (RS) and excess mortality (EMR) analyses. The CRC patients were aged 50 and older diagnosed in the US (Surveillance, Epidemiology and End Results registry, 2004, N=9511) and in Norway (Cancer Registry of Norway, 2003–2005, N=8256). Results: Death occurred within three years for 39% of the CRC patients. Stage distributions were more favorable for US patients. Stage-specific survival was similar for localized and regional cancers, but more favorable for US distant cancers. In multivariate models of patient, tumor and treatment characteristics, patients (especially below age 80) in the US experienced longer survival (EMR 0.9, CI 0.8–0.9). Stage-specific analyses showed, however, that survival for localized cancers was relatively shorter in the US than in Norway (EMR 1.4, CI 1.1–1.8), but longer for distant cancers (EMR 0.8, CI 0.7–0.8). Conclusions: The enhanced survival for US CRC patients likely reflects a screening-related earlier diagnostic stage distribution, as well as prioritized life extension for patients with metastatic cancers, reflecting vastly different health care systems in the two countries. CRC screening is currently under consideration in Norway. For survival outcomes, the current findings do not discourage such an implementation. Other screening-related aspects such as feasibility and cost-benefit are, however, also relevant and warrant further research within a socialized health system.
Bridging the gap: The need for a systems thinking approach in understanding and addressing energy and environmental performance in buildings
Authors: Shrubsole C. , Hamilton I. G. , Zimmermann N. , Papachristos G. , Broyd T. , Burman E. , Mumovic D. , Zhu Y. , Lin B. , Davies M.
Published: January 2018

Innovations in materials, construction techniques and technologies in building construction and refurbishment aim to reduce carbon emissions and produce low-energy buildings. However, in-use performance consistently misses design specifications, particularly those of operational energy use and indoor environmental quality. This performance gap risks reducing design, technology, sustainability, economic, health and well-being benefits. In this paper, we compare settings of the Chinese and the UK buildings sectors and relate their historical context, design, construction and operation issues impacting energy performance, indoor environmental quality, occupant health and well-being. We identify a series of key, common factors of ‘total’ building performance across these two settings: the application of building regulations, the balance between building cost and performance, skills, construction and operation. The dynamic and complex interactions of these factors are currently poorly understood and lead to building performance gaps. We contend that a systems approach in the development of suitable building assessment methods, technologies and tools could enable the formulation and implementation of more effective policies, regulations and practices. The paper illustrates the application of the approach to the UK and Chinese settings. A full application of a systems approach may help to provide a more dynamic understanding of how factor interactions impact the ‘total’ building performance gaps and help address its multiple causes.
Learning to parent from Google? Evaluation of available online health evidence for parents of preterm infants requiring neonatal intensive care
Authors: Dol Justine , Richardson Brianna , Boates Talia , Campbell-Yeo Marsha
Published: January 2018

The study aim was to identify and evaluate the reliability and quality of online resources for parents of preterm infants seeking health information about their infant using the DISCERN tool and Health on Net code. An Internet search ( www.google.com ) was used to identify websites for parents of preterm infants on their infants’ health and health issues. For each search, the top 100 “hits” were downloaded, yielding 1200 websites. After reviewing websites for exclusion criteria and duplicates, 197 websites remained and were analyzed. According to the DISCERN tool, the websites had a moderate reliability score (mean = 29.88, standard deviation = 4.88, range: 18–40), moderate treatment score (mean = 24.15, standard deviation = 5.79, range: 10–35), and moderate overall quality score (mean = 3.41, standard deviation = 0.89, range: 1–5). Only 24 (12.2%) websites had current Health on Net code approval and no other websites met full eligibility for certification. Overall, the reliability and quality of information available online to parents of preterm infants is lacking.
Lubrication efficiency of vegetable oil nano-lubricants and solid powder lubricants
Authors: Mashhadi Keshtiban Peyman , Sheydaei Govarchin Ghaleh Saeid , Alimirzaloo Vali
Published: January 2018

Reducing crude oil reserves and also environmental pollution caused by its excessive use has led to numerous researches to find alternatives to petroleum-based oils. Thus, owing to lower pollution and higher lubrication efficiency, the use of vegetable base lubricants has been widely considered. Due to the unique properties of different nanoparticles such as sphericality and high surface area besides low environmental risk, the subjected nanoparticles can be applied as additives to the base lubricants and create optimal tribological properties. In this study, in order to improve the lubricating efficiency of vegetable base lubricants, SiO2 nanoparticles with different weight concentrations were used in the cold forging process of aluminum alloy. Then, the lubrication proficiency of both nano-lubricants and conventional solid powder lubricants in the forging industry was evaluated. Friction coefficient was determined by standard compression test and friction calibration curves. In order to evaluate the lubricants’ efficiency, two key parameters, namely shear friction coefficient and surface roughness have been considered. Experimental results showed that the presence of SiO2 nanoparticles in the base lubricants significantly increased the lubrication efficiency of the base lubricants and notably reduced both the friction coefficient and surface roughness.
Thermodynamic efficiency assessment of gasoline spark ignition and compression ignition operating strategies using a new multi-mode combustion model for engine system simulations
Authors: Ortiz-Soto Elliott A , Lavoie George A , Wooldridge Margaret S , Assanis Dennis N
Published: January 2018

Advanced combustion strategies for gasoline engines employing highly dilute and low-temperature combustion modes, such as homogeneous charge compression ignition and spark-assisted compression ignition, promise significant improvements in efficiency and emissions. This article presents a novel, reduced-order, physics-based model to capture advanced multi-mode combustion involving spark ignition, homogeneous charge compression ignition and spark-assisted compression ignition operating strategies. The purpose of such a model, which until now was unavailable, was to enhance existing capabilities of engine system simulations and facilitate large-scale parametric studies related to these advanced combustion modes. The model assumes two distinct thermodynamic zones divided by an infinitely thin flame interface, where turbulent flame propagation is captured using a new zero-dimensional formulation of the coherent flame model, and end-gas auto-ignition is simulated using a hybrid approach employing chemical kinetics and a semi-empirical burn rate model. The integrated model was calibrated using three distinct experimental data sets for spark ignition, homogeneous charge compression ignition and spark-assisted compression ignition combustion. The results demonstrated overall good trend-wise agreement with the experimental data, including the ability to replicate heat release characteristics related to flame propagation and auto-ignition during spark-assisted compression ignition combustion. The calibrated model was assessed using a large parametric study, where the predicted homogeneous charge compression ignition and spark-assisted compression ignition operating regions at naturally aspirated conditions were representative of those determined during engine testing. Practical advanced combustion strategies were assessed relative to idealized engine simulations, which showed that efficiency improvements up to 30% compared with conventional spark-ignition operation are possible. The study revealed that poor combustion efficiency and pumping work are the primary mechanisms for efficiency losses for the advanced combustion strategies evaluated.
The (in)disputable ‘power’ of images of outrage: public acknowledgement, emotional reaction, and image recognition
Authors: Dahmen Nicole Smith , Mielczarek Natalia , Morrison Daniel D
Published: January 2018

A recent news image – that of a drowned 3-year-old Syrian boy washed ashore on the Turkish coast as a result of refugees fleeing the ongoing war in Syria – resonated with international audiences and world leaders, becoming a seeming catalyst for action. But, as time has shown, the effect was short-lived. Through survey data, this research explores iconic images and visual collective memory throughout history and into the era of digital news and social media. More specifically, the research considers connections between public acknowledgement, emotional reaction, and image recognition. Studying such relationships will help us to further understand the (in)disputable ‘power’ that famous photographs possess to imprint themselves onto people’s minds, thus leading to supposed effect and action.
VisHive: Supporting web-based visualization through ad hoc computational clusters of mobile devices
Authors: Cui Zhe , Sen Shivalik , Badam Sriram Karthik , Elmqvist Niklas
Published: January 2018

Current web-based visualizations are designed for single computers and cannot make use of additional devices on the client side, even if today’s users often have access to several, such as a tablet, a smartphone, and a smartwatch. We present a framework for ad hoc computational clusters that leverage these local devices for visualization computations. Furthermore, we present an instantiating JavaScript toolkit called VisHive for constructing web-based visualization applications that can transparently connect multiple devices—called cells—into such ad hoc clusters—called a hive—for local computation. Hives are formed either using a matchmaking service or through manual configuration. Cells are organized into a master–slave architecture, where the master provides the visual interface to the user and controls the slaves and the slaves perform computation. VisHive is built entirely using current web technologies, runs in the native browser of each cell, and requires no specific software to be downloaded on the involved devices. We demonstrate VisHive using four distributed examples: a text analytics visualization, a database query for exploratory visualization, a density-based spatial clustering of applications with noise clustering running on multiple nodes, and a principal component analysis implementation.
Intrasexual Competition and Height in Adolescents and Adults
Authors: Polo P. , Fernandez A. , Muñoz-Reyes J. A. , Dufey M. , Buunk A. P.
Published: January 2018

Intrasexual competition can be defined as the struggle between members of one sex to increase their access to members of the other sex as sexual partners. In our species, height is a sexually dimorphic trait probably involved in both intrasexual and intersexual selective processes. In the present research, we examined the relationship between height and individual differences in intrasexual competitiveness (i.e., the tendency to view same-sex interactions in general in competitive terms) in two populations of adolescents and adults of both sexes in Chile. According to our first prediction, among both adolescent and adult men, height was negatively associated with intrasexual competitiveness. In contrast, among women, height was not linearly nor quadratically related with intrasexual competitiveness as previously reported. Finally, adolescent men and women showed increased levels of intrasexual competitiveness compared to adult same-sex counterparts. Our results suggest that height is a relevant trait in mating competition among men. The lack of relationship between height and intrasexual competitiveness in women may suggest that the role of height in women mating competition may be more complex and mediated by other variables.
Is there a learning effect when the 6-minute walk test is repeated in people with suspected pulmonary hypertension?
Authors: Spencer Lissa , Zafiropoulos Bill , Denniss Wendy , Fowler Dot , Alison Jennifer , Celermajer David
Published: January 2018

The aim of the study was to determine if there was a difference in 6-minute walk distance (6MWD) when two 6-minute walk tests (6MWTs) were performed at the initial assessment prior to attendance at the pulmonary hypertension (PH) clinic and at the 6-month follow-up. Two 6MWTs were performed at both visits on a 32-m continuous track in the physiotherapy hospital outpatient setting using standard instructions and encouragement. Two hundred and fourteen participants completed two 6MWTs at the initial assessment and 71 participants at the 6-month follow-up (mean (standard deviation) age: 57 (16) years; body mass index: 27 (6) kg/m2). Using the better 6MWT, the mean distances walked were 429 (136) and 447 (130) m, respectively. There was a significant increase in 6MWD when a second 6MWT was performed at initial assessment (mean difference [95% confidence interval (CI)]: 19 m (14–24), p < 0.001) and at the follow-up (mean difference [95% CI]: 19 m (10–27), p < 0.001) but not in those who walked <300 m at the initial assessment (mean difference [95% CI]: 9 m (−5 to 22), p = 0.208). There were no adverse events during testing. Prior to attendance at the PH Clinic when people are asked to perform the 6MWT for the first time and at the 6-month follow-up, two walk tests should be performed in order to eliminate a learning effect and to ensure accuracy of measurement.
Poverty and Health Disparities: What Can Public Health Professionals Do?
Authors: Price James H. , Khubchandani Jagdish , Webb Fern J.
Published: January 2018

More than a tenth of the U.S. population (13% = 41 million people) is currently living in poverty. In this population, the socioeconomic, cultural, and environmental conditions have detrimental health effects such as higher rates of chronic diseases, communicable illnesses, health risk behaviors, and premature mortality. People living in poverty are also deprived of social, psychological, and political power, leading to continuation of worsening health and chronic deprivation over generations. The health of individuals living in poverty poses greater challenges from policy, practice, and research standpoints. Public health professionals are poised uniquely to be advocates for the marginalized, be the resource persons for health education, implement health promotion programs, and conduct research to understand health effects of poverty and design tailored and targeted public health interventions. In this article, we summarize the opportunities for public health practice with individuals living in poverty.
Precise Retrograde Supera Stenting of the Ostium (PRESTO) of the Superficial Femoral Artery for Complex Femoropopliteal Occlusions: The PRESTO Technique
Authors: Palena Luis M. , Diaz-Sandoval Larry J. , Raja Laiq M. , Morelli Luis , Manzi Marco
Published: January 2018

Purpose: To describe a novel technique designed to safely and precisely deploy the Supera stent accurately at the ostium of the proximal superficial femoral artery (SFA) without compromising the profunda and common femoral arteries. Technique: After antegrade crossing of the chronic total occlusion (CTO) at the SFA ostium and accurate predilation of the entire SFA lesion, a retrograde arterial access is obtained. The Supera stent is navigated in retrograde fashion to position the first crown to be released just at the SFA ostium. Antegrade dilation is performed across the retrograde access site to obtain adequate hemostasis. The technique has been applied successfully in 21 patients (mean age 78.1±8.2 years; 13 men) with critical limb ischemia using retrograde Supera stenting from the proximal anterior tibial artery (n=6), the posterior tibial artery (n=2), retrograde stent puncture in the mid to distal SFA (n=2), the native distal SFA/proximal popliteal segment (n=6), and the distal anterior tibial artery (n=5). No complications were observed. Conclusion: Distal retrograde Supera stent passage and reverse deployment allow precise and safe Supera stenting at the SFA ostium.
Open to Exploration? Association of Personality Factors With Complementary Therapy Use After Breast Cancer Treatment
Authors: Toivonen Kirsti I. , Tamagawa Rie , Speca Michael , Stephen Joanne , Carlson Linda E.
Published: January 2018

Purpose: Many cancer survivors seek complementary therapies (CTs) to improve their quality of life. While it is well-known that women who are younger, more highly educated, and have higher incomes are more likely to use CTs, individual differences such as personality factors have been largely unexplored as predictors of CT use. Methods: In a secondary analysis of a larger study, 270 women with stage I to III breast cancer completed self-report measures of demographic and illness-related information, personality variables, and use of several different types of CTs. A series of logistic regression models were used to explore whether demographic, illness-related, and personality variables predicted different types of CT use. Results: Prior relationships between education and CT use were replicated. There were no significant relationships between illness-related variables and different types of CT use. Of the 5 personality factors, only openness to experience was a significant predictor of multiple types of CT use. Conclusions: Openness to experience may represent an individual difference variable that predicts CT use among cancer survivors. CTs themselves may represent a form of intellectual curiosity and novelty seeking. Further studies are needed to replicate and examine the generalizability of the relationship between openness to experience and CT use in oncology populations.
Soluble Selectin Levels in Patients with Lung Cancer
Authors: Roselli M. , Mineo T.C. , Martini F. , Mariotti S. , Ambrogi V. , Spila A. , D'Alessandro R. , Basili S. , Guadagni F. , Ferroni P.
Published: January 2018

Increased expression of selectins has been found on endothelial cells of venules and capillaries in the tumor stroma of non-small cell lung cancer, suggesting their functional role in the process of chemotaxis for tumor cells. The present study was aimed at analyzing the role of both soluble (s)P-selectin and sE-selectin levels in association with clinico-pathological variables in 116 patients with lung cancer, 38 patients with benign diseases and 59 healthy donors. The results obtained showed that sP-selectin and sE-selectin levels were higher in patients with lung cancer compared to normal donors (p<0.02 and p<0.005, respectively). No differences were observed among patients with various benign diseases for both selectins. Increased levels of sP-selectin and sE-selectin were significantly associated with squamous lung cancer at late stages (p<0.05), but not adenocarcinoma. Both sP- and sE-selectin were independently related to the stage of squamous lung cancer by stepwise regression analysis (p<0.02 and p<0.03, respectively), while only sE-selectin was independently related to the presence of distant metastasis in the same histotype (p<0.02). These results suggest that measurement of plasma soluble selectins might represent a useful laboratory parameter in the management of patients with squamous lung cancer.
Analysis of PSA Velocity in 1666 Healthy Subjects Undergoing Total PSA Determination at Two Consecutive Screening Rounds
Authors: Ciatto S. , Bonardi R. , Lombardi C. , Zappa M. , Gervasi G. , Cappelli G.
Published: January 2018

The study purpose was to assess PSA velocity (PSAV) in healthy subjects in order to establish a reliable cutoff for the differential diagnosis of prostate cancer in a screening setting. We studied a series of 1666 healthy men aged 55 to 74 years undergoing two total PSA determinations at a four-year interval within a population-based randomized screening trial at the Centro per lo Studio e la Prevenzione Oncologica of Florence. First and second screening round PSA assays (PSA1 and PSA2) were carried out with the same method and by the same laboratory. PSAV (PSA1–PSA2/year) was determined in non-cancer subjects in the overall series or in specific age and PSA subgroups, and in subjects with cancer detected at the second screening round. Average PSAV in 1648 non-cancer subjects was 0.07 ng/mL/year (range −2.18+5.99, 95% CI 0.05–0.09); at least one third of subjects showed a decrease in PSA (negative PSAV), mostly of limited magnitude and in the low PSA range. Average PSAV in the 18 cancer patients was 1.16 ng/mL/year (range 0.10–5.6, 95% CI 0.56–1.77), which is significantly higher (p<0.01) than in non-cancer subjects. None of the cancer patients showed a PSA decrease over time. Whatever cutoff was taken for PSAV, its power to discriminate cancer was limited: in particular the previously used PSAV cutoff of 0.75 ng/mL/year would have included only 42 of the 1648 non-cancer subjects (specificity 97.5%) but excluded eight of the 18 cancer patients (sensitivity 55.5%). At best, with the adopted screening protocol PSAV (cutoff 0.10 ng/mL/year) could have spared 27.9% of non-cancer subjects with PSA ≥2.5 ng/mL further diagnostic assessment and 22.7% of non-cancer subjects with PSA ≥4 ng/mL random sextant biopsy, while missing no cancers. This study provides a reliable estimate of PSAV based on a large unbiased population sample. PSAV is widely variable over time, particularly at low PSA values. PSAV might be of value as an indicator for diagnostic assessment and random sextant biopsy in a screening setting.
Production of a Monoclonal Antibody Directed against the Recombinant SEL1L Protein
Authors: Orlandi R. , Cattaneo M. , Troglio F. , Campiglio M. , Biunno I. , Ménard S.
Published: January 2018

SEL1L, highly similar to the C. elegans sel-1 gene, is a recently cloned human gene whose function is under investigation. SEL1L is differentially expressed in tumors and normal tissues and seems to play a role in tumor growth and aggressiveness. We used the recombinant N-terminus of the SEL1L protein to immunize a Balb/c mouse and produce a monoclonal antibody. A hybridoma secreting an antibody specifically reacting on the SEL1L recombinant fragment was selected. This monoclonal antibody, named MSel1, recognizes the SEL1L protein by Western blotting, immunofluorescence and immunohistochemistry on normal and tumor cells. MSel1 is able to recognize SEL1L even on archival tumor specimens and is therefore particularly appropriate to study SEL1L involvement in tumor progression.
Serum and Cerebrospinal Fluid Human Chorionic Gonadotropin (hCG) and alpha-fetoprotein (AFP) in Intracranial Germ Cell Tumors
Authors: Seregni E. , Massimino M. , Molteni S. Nerini , Pallotti F. , van der Hiel B. , Cefalo G. , Spreafico F. , Fossati F. , Bombardieri E.
Published: January 2018

We report a retrospective study on serum and cerebrospinal fluid (CSF) alpha-fetoprotein (AFP) and β-human chorionic gonadotropin (βhCG) determination in a series of 30 patients bearing intracranial germ cell tumors. At diagnosis five patients had high serum and CSF AFP levels. No patient had positive serum AFP and negative CSF AFP or vice versa. Twelve of 30 patients had serum βhCG levels above 5 mIU/mL, eight had high βhCG only in CSF, and ten were completely negative. During treatment and follow-up both markers were accurate indicators of the response to therapy, decreasing rapidly and often becoming normal already after the first phase of treatment. We conclude that these two markers, and mostly βhCG, may be useful in the diagnosis and monitoring of the response to therapy of patients with intracranial germ cell tumors.
Clinical Significance of Pepsinogen C Tumor Expression in Patients with Stage D2 Prostate Carcinoma
Authors: Díaz M. , Rodríguez J.C. , Sánchez J. , Sánchez M.T. , Martín A. , Merino A.M. , Vizoso F.
Published: January 2018

Pepsinogen C is an aspartyl protease mainly involved in the digestion of proteins in the stomach, and an androgen-inducible protein in breast cancer cells. The aims of this study were to evaluate the expression and clinical significance of this enzyme in the primary tumors of prostate cancer patients with bone metastasis who were scheduled to receive antiandrogenic therapy. This study was prospectively performed in 28 stage D2 prostate cancer patients who, after diagnosis, received maximum androgen blockade. Pepsinogen C tumor expression was analyzed in samples (24 from needle biopsy cylinders and four from transurethral resection specimens) from primary tumors using an immunohistochemical assay. Twelve prostate carcinomas (42.8%) were positive for pepsinogen C. Pepsinogen C was a significant prognostic factor to predict a longer overall survival in the patients of our study (p<0.01). Pepsinogen C can be a new prognostic factor and a useful biological marker of androgen dependency in prostate cancer.
Serum Chromogranin-A Immunoradiometric Assay in the Diagnosis of Pheochromocytoma
Authors: Giovanella L. , Ceriani L.
Published: January 2018

Background

The diagnosis of pheochromocytoma is based on laboratory tests that demonstrate an increase in urinary excretion of catecholamines or their metabolites. Chromogranin A (CgA) is a member of the granin family and is widely distributed in neuroendocrine cells and particularly in chromaffin adrenal cells. Consequently, serum CgA increases in patients affected by pheochromocytoma and other diseases of the chromaffin system.

Aim

This study investigated the performance of serum CgA assay in the diagnosis of pheochromocytoma and compared serum CgA with 24-hour urinary epinephrine (E), norepinephrine (NE), vanillylmandelic acid (VMA) and metanephrines (MNs).

Methods

We enrolled 15 patients with histologically proven pheochromocytoma; 100 healthy blood donors and 148 patients with essential hypertension were enrolled as controls. Serum CgA was assayed by a specific immunoradiometric method (IRMA). Urinary tests were done with high performance liquid chromatography (HPLC).

Results

Circulating CgA showed a higher sensitivity (1.00), specificity (0.96) and accuracy (0.96) than all other tests. Serum levels of CgA clearly increased from blood donors and patients with essential hypertension to patients with pheochromocytoma (p<0.0001). Furthermore, a strong relationship between serum CgA and tumor mass was found (p<0.0001). In conclusion, our data suggest that the CgA assay might be used as a single test for the diagnosis of pheochromocytoma.
Interleukin-6 is Increased in Breath Condensate of Patients with Non-Small Cell Lung Cancer
Authors: Carpagnano G.E. , Resta O. , Foschino-Barbaro M.P. , Gramiccioni E. , Carpagnano F.
Published: January 2018

Despite recent advances in the diagnosis and treatment of non-small cell lung cancer (NSCLC), most patients still present with advanced stage disease at the time of diagnosis. Recent studies suggest that IL-6 is involved in the development of lung cancer. The aim of the present study was to investigate whether the measurement of IL-6 levels in the breath condensate of NSCLC patients could be used to bring forward the moment of diagnosis and to monitor the progression of the disease. Twenty patients with histological evidence of NSCLC (14 men and 6 women, age 63±8 years) and 15 healthy controls (8 men and 7 women, age 45±6 years) were enrolled in the study. IL6 was measured in the exhaled breath condensate of patients and controls by means of a specific enzyme immunoassay kit. Higher concentrations of exhaled IL-6 were found in NSCLC patients (9.6±0.3 pg/mL) than in controls (3.5±0.2 pg/mL). A statistically significant difference was observed between patients with NSCLC at different stages: higher concentrations of IL-6 (10.9±0.5 pg/mL) were found in patients with metastatic disease than in those with stage III (9.7±0.4 pg/mL), stage II (8.9±0.3 pg/mL) and stage I disease (7.9±0.3 pg/mL). These findings suggest that the measurement of IL-6 in the breath condensate of patients with NSCLC could be proposed as a parameter to take into account in early diagnosis and disease monitoring.
The Impact of Intraoperative Manipulation of the Prostate on Total and Free Prostate-Specific Antigen
Authors: Oberpenning F. , Schmid H.-P. , Fuchs-Surdel W. , Hertle L. , Semjonow A.
Published: January 2018

Objectives

It is well documented that mechanical manipulation of the prostate can elevate total PSA (t-PSA) levels in serum. However, less is known about its effects on free PSA (f-PSA) and the free-to-total PSA ratio (f/t-PSA). We therefore examined the impact of prostate manipulation on t-PSA and f-PSA during surgical procedures involving the prostate.

Methods

Intraoperative blood samples for t-PSA and f-PSA measurement (Hybritech) were collected every 15 min during 14 radical retropubic prostatectomies (RRP) and 10 radical cystoprostatectomies (RCP).

Results

Prostatic manipulation induced significant elevations in t-PSA and f-PSA during RRP and RCP. Postmanipulatory peaks were markedly higher for f-PSA than for t-PSA. The mean maximum f-PSA levels showed a 4.3- (RRP) and 7.9-fold (RCP) increase, followed by a rapid decline after prostate removal. t-PSA increased 1.2- (RRP) and 1.3-fold (RCP), and declined more slowly. Postmanipulatory f/t-PSA ratios also increased significantly, reaching mean elevations of +0.29 and +0.28 over preoperative ratios during RRP and RCP, respectively.

Conclusions

Prostate manipulation can induce transient increases in t-PSA, f-PSA and f/t-PSA in benign and malignant prostates. The extent of these alterations and their course over time must be taken into account when postmanipulatory changes in PSA forms are investigated. Timing of postmanipulatory venipunctures and the molar response ratio of t-PSA assays used (equimolar versus nonequimolar) seem to have substantial impact on the results of such studies.