bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility study of a wellness intervention for caregivers of patients undergoing hematopoietic stem cell transplantation: The Ready to CARE Intervention
Authors: Morency Jamme L , Caldon Kate L , Root Lynn , Hayes Christi A , Brighton Susan , Lyons Kathleen Doyle 
Published: September 2020

Introduction Caregivers of patients undergoing hematopoietic stem cell transplantation need encouragement to maintain their own wellbeing. This feasibility study explored a six-session wellness intervention for caregivers entitled Ready to CARE (Connect, Actively Relax, and Exercise). Method This study used a single-arm pre–post design to explore the feasibility and acceptability of the intervention and study procedures. The individual, participant-directed intervention was initiated at hospitalization for stem cell reinfusion. Caregivers completed telephone surveys on four occasions and engaged in one semi-structured interview to share their perceptions of the intervention. Results Twenty participants enrolled and completed the baseline survey, with 50%, 90%, and 80% completing the subsequent three surveys, respectively. Seventy-four percent completed all six sessions of the intervention. Caregivers most often used the sessions to set goals related to physical activity (36%), stress management (14%), sleep (13%), and caregiving tasks (11%). Caregivers reported appreciation of the intervention’s focus on supporting caregivers, taking action with goal-setting, and allowing caregivers to determine the focus of the goals. Scheduling the sessions was the most problematic aspect of the intervention. Conclusion While caregivers were open to a wellness intervention, a high degree of flexibility and tailoring is needed to engage and support busy caregivers. Clinical Trial Registration: NCT03210727
Onset of action in placebo-controlled migraine attacks trials: A literature review and recommendation
Authors: Tfelt-Hansen Peer , Diener Hans-Christoph 
Published: September 2020

Background Migraine patients want acute treatment to provide complete relief of the migraine attack within 30 minutes. Traditionally, “speed of onset of effect” is evaluated by estimating the time-point for first statistical separation of drug and placebo. The estimated onset of effect can be a few percent difference of patients being pain free in very large randomised, controlled trials. This difference, however, can be clinically irrelevant. Methods Placebo-controlled randomised, controlled trials with pain freedom results from 30 min to 2–4 hours were retrieved from the literature. For each time-point, the therapeutic gain (drug minus placebo) (TG) was calculated. Therapeutic gain for being pain free of 5% was chosen for the definition of “onset of action”, since this is approximately 1/3 of the 16% TG and 1/4 of 21% of TG for sumatriptan 50 mg and 100 mg, respectively. Results A total of 22 time-effect curves based on randomised, controlled trials were analysed. Based on the “onset of action” of 5% pain freedom, the evaluated drugs and administration forms can be classified as follows: i) Early time to onset, ≤30 min (three randomised, controlled trials); ii) medium time to onset, 60 min (nine randomised, controlled trials); iii) delayed time to onset, 90–120 min (10 randomised, controlled trials). Conclusion Only three non-oral administration forms with a triptan (subcutaneous sumatriptan and nasal zolmitriptan) resulted in an “onset of action” at ≥30 min; in the future, early onset of action should be a priority in the development of new drugs or new administration-forms for the treatment of acute migraine attacks.
Dialysis today: Methods, technologies and strategies
Authors: Vercellone A. , Segoloni G.P. , Triolo G. , Canavese C. , Messina M. 
Published: September 2020

Dialysis is a method of treatment which in over 30 years of progress has developed different technologies and strategies now to be unified in a single dialytic culture. In our experience we have decided to adopt an open policy as for the patient acceptance and the setting of modes of therapy, taking in account 5 fundamental criteria: i.e. dialytic adequacy, rehabilitation, safety, economy and working simplicity. Today short dialysis is the backbone schedule we have developed with an intensive participation of the patients to their treatment. Yet our results are not only the expression of a schedule but also a demonstration of how valuable may result some cautions in the management of the RDT patient.
15 years experience with 615 homograft and autograft aortic valve replacements
Authors: Wain W.H. , Greco R. , Ignegeri A. , Bodnar E. , Ross D.N. 
Published: September 2020

Homograft valve replacement of the diseased aortic valve with a homologous aortic valve inserted in the sub-coronary position was first performed in July 1962 (Ross 1962). The procedure of transferring the patients autologous pulmonary valve to the aortic position has been used since 1967 (Ross 1967). The long term performance of homograft valves has not been regarded as satisfactory in some centres (Cope-land 1977, Anderson & Hancock 1977) whereas others have shown it to be an excellent valve replacement (Barratt-Boyes, 1977, Bodnar et al 1979). The differing experiences may be the results of alternative methods of sterilization, preservation and surgical insertion. This paper presents information on isolated aortic valve replacements with either homograft or autograft valves over a 15 year period.
A prosthetic myocardium for repair of localized defects of the left ventricle: Concept and hemodynamic feasibility
Authors: Kantrowitz A. , Igari T. , Hayashi I. , Freed P.S. 
Published: September 2020

As an approach to the treatment of patients with large but circumscribed akinetic or dyskinetic regions in the left ventricular myocardium as sequelae of acute myocardial infarction, excision of the defect and implantation of a mechanical functional equivalent of myocardium is suggested. Experimental investigation of this technique is described. Hemodynamic data from a series of dog experiments indicate that activation of the prosthetic myocardium after excision of the left ventricle is followed by improvement in various hemodynamic parametres of interest Although substantial experimental work must be completed and difficult bioengineering problems solved, preliminary results have encouraged us to continue our investigations of the prosthetic myocardium. An imposing array of treatment methods is now available to the clinician who must deal with the sequelae of acute myocardial infarction. Selecting from pharmacologic, electrophysiologic, and surgical approaches the physician can in many instances design a treatment plan precisely tailored to the clinical problem. Large left ventricular aneurysms and their functional equivalents of ventricular dyskinesis or hypokinesis continue, however, to represent a class of problems in which established techniques have been less then satisfactory. Surgical excision with closure of the defect is regarded as effective for small aneurysms, but such procedures may so compromise cardiac output in patients with large ones as to be unacceptable. Unfortunately, it is just the latter group in which medical palliation is least likely to be effective in managing congestive failure, angina, and other pathophysiologic manifestations. A relatively unsual approach derived from in-series techniques of mechanical assistance to the failing circulation (1) offers the theoretical possibility of a treatment tailored to the problem of a large ventricular aneurysm. Experimental investigation of this technique in the Surgical Research Laboratory at the Sinai Hospital of Detroit has progressed to the point that a report of our experiences to date may be of interest.
Prosthetic creation of a double outlet left ventricle: Clinical experience of five cases
Authors: Cotrufo M. , Nappi G.A. , d'Angelo A. , Scar-done M. , de Vivo F. 
Published: September 2020

Five clinical cases were treated with the implantation of an apical-aortic conduit. Two adult patients were affected by obstructive myocardiopathy associated to subaortic membrane in one case, and three children by different forms of aortic stenosis (subaortic tunnel in one case; subaortic tunnel associated to severe coartation of the thoracic aorta in one case; aortic annulus hypoplasia in one case). A double outlet left ventricle has been created in all cases by implanting a composite prosthesis between the apex of the left ventricle and the aorta. The extracardiac conduit consisted of an apical curved connector and a valved dacron tubular prosthesis. The site of implantation was the supraceliac abdominal aorta in three cases and the ascending aorta in two cases. All patients survived the operation and one late mortality was observed for cerebral bleeding. The surviving patients have been restudied with satisfactory data.
Hemofiltration —Technique and clinical application
Authors: Quellhorst E. , Scheunemann B. , Hildebrand U. 
Published: September 2020

The elimination of uremic substances is achieved in hemodialysis by diffusion from the blood to a modified Ringer's solution. In contrast to this effect, in which the elimination rate of substances is directly correlated to their molecular weight, the removal of waste products in hemofiltration is achieved by means of a convective transport, which is independent of the molecular weight, but dependent on the cutoff of the membrane and the filtrate flow. Hemofiltration, thus, resembles the filtration process of the natural kidney more closely than hemodialysis and peritoneal dialysis do. Having obtained promising results in the course of a pilot study (1), a study to compare hemodialysis with hemofiltration under standardized conditions was started in 1978 under the auspices of the NIH. Two groups of patients with stable chronic renal failure, were treated on an A-B-A (group I) and a B-A-B (group II) sequence (A=hemodialysis and B=hemofiltration). Each treatment period lasted for 5 months.
Biochemical investigations of CAPD: Plasma levels of trace elements and amino acids and impaired glucose tolerance during the course of treatment
Authors: Armstrong V.W. , Buschmann U. , Ebert R. , Fuchs C. , Rieger J. , Scheler F. 
Published: September 2020

Investigations have been initiated into the effect of CAPD on the plasma concentrations of trace elements and amino acids, and in particular the response of patients to an oral glucose tolerance test (OGTT) during the course of treatment. Six months CAPD had no effect on the plasma concentrations of aluminium, fluoride, zinc and copper. Levels of aluminium and fluoride were above the normal range. Loss of amino acids in the dialysate correlated with their plasma concentrations. No changes were observed in the E/NE, Val/Gly or Tyr/Phe ratios during nine months treatment. Five CAPD patients demonstrated an impaired glucose tolerance in response to an OGTT after one month of treatment and a further deterioration occurred in the glucose tolerance of three patients after another six months CAPD. In a preliminary investigation with fructose substituted for glucose in the dialysate of one patient, an improvement in the OGTT and rate of insulin secretion was observed after 3 days dialysis against fructose.
Design of a transonic centrifugal compressor for High-speed turbomachinery
Authors: Pakle Sagar , Jiang Kyle 
Published: September 2020

The paper presents a design of a small-scale centrifugal compressor to match the performance of up to 20% larger diameter compressor in order to meet the demands for a higher mass flow rate and wide operating range for turbocharging applications. This development considers the 44 mm diameter impeller design involving transonic blading and state-of-the-art blade features. In the course of design, the investigation on the inducer blade angle [Formula: see text] and blade inducer-to-outlet radius ratio has shown to have a dominant influence on the magnitude of inlet relative Mach number. Diffuser width and volute A/R ratio are also observed to be parameters affecting the overall performance of the compressor stage. Based on the diffuser parametric study, the most efficient diffuser width equal to 70% of the blade exducer width is observed. The performance of the present compressor stage is analyzed with computational fluid dynamics simulations and experimental tests. The comparison of the predicted and measured results of the 44 mm compressor stage shows a good agreement for overall performance. Besides, the 44 mm compressor stage having the most efficient diffuser width and enlarged volute A/R ratio shows a good overlap of performance with approximately 20% larger diameter (52 mm) compressor stage performance. This development demonstrates that the impeller with state-of-the-art design features are likely to contribute to enhancement of the compressor performance.
Treatment Effect of Niaspan, a Controlled-release Niacin, in Patients with Hypercholesterolemia: A Placebo-controlled Trial
Authors: Morgan John M. , Capuzzi David M. , Guyton John R. , Centor Robert M. , Goldberg Ronald , Robbins David C. , DiPette Donald , Jenkins Sarah , Marcovina Santica 
Published: September 2020

Background The present study was designed to determine the efficacy and safety of Niaspan (Kos Pharmaceuticals, Inc, Hollywood, FL), a new controlled-release formulation of niacin, in the treatment of primary hyperlipidemia, the occurrence and severity of flushing events, and potential adverse effects, particularly hepatotoxicity. Methods and Results The study was conducted as a multicenter, randomized, double-blind, placebo-controlled, parallel comparison of Niaspan in doses of 1000 mg/day and 2000 mg/day, administered once a day at bedtime. One hundred twenty-two patients with low-density lipoprotein cholesterol levels > 4.14 mM/L (160 mg/dL) with dietary intervention and high-density lipoprotein cholesterol ≤ 1.81 mM/L (70 mg/dL) were randomized to one of three treatment groups: placebo, and 1000 mg/day or 2000 mg/day of Niaspan. Safety and efficacy measures included 12-hour serum fasting lipid and lipoprotein concentrations, serum analyte levels for major organ function, flushing diaries, and adverse event records. The placebo group demonstrated no significant changes in serum lipoprotein concentrations over the treatment period of 12 weeks, except for a slight 4% increase in high-density lipoprotein cholesterol. Niaspan significantly lowered low-density lipoprotein cholesterol levels by 6% and 14% for the 1000 mg/day and 2000 mg/day doses, respectively. High-density lipoprotein cholesterol levels rose significantly, with a 17% increase occurring at the 1000 mg/day dose and a 23% increase occurring at the 2000 mg/day dose. Niaspan (2000 mg/day) produced significant decreases of 27% and 29%, respectively, for serum lipoprotein(a) and triglyceride concentration. Although the incidence of flushing was significant, these episodes were generally well tolerated. Conclusion Niaspan administered in doses of 1000 mg/day and 2000 mg/day at bedtime were well tolerated with few side effects and produced favorable effects on the major circulating lipoproteins of patients with primary dyslipidemias as specified by the enrollment criteria.
Class III Antiarrhythmic Effects of Dofetilide in Rabbit Atrial Myocardium
Authors: Pallandi Regan T. , Lovell Nigel H. , Campbell Terence J. 
Published: September 2020

Background Dofetilide is a new class III antiarrhythmic agent with demonstrated efficacy in ventricular and atrial tachyarrhythmias. We investigated its class HI actions and their modulation by stimulation rate in rabbit atrial myocardium. Methods and Results Standard microelectrode techniques were used to record action potentials from rabbit atrial tissue at varying stimulation rates. Dofetilide produced a dose-dependent prolongation of action potential duration at concentrations from 1 nM to 1 μM at an interstimulus interval of 1000 ms. Action potential duration at 90% repolarization (action potential duration) was prolonged from 116 ± 11.7 ms in control solutions to 148 ± 13.9 ms at 1nM dofetilide and 186 ± 49.3 ms at 1 μM dofetilide ( P < .05 for 1 nM vs control; P < .01 for 1 μM vs control). Reduction of interstimulus interval to 500 ms had no significant effect on action potential duration prolongation by dofetilide. At faster rates than this, and particularly at an interstimulus interval less than 330 ms, a marked “reverse rate dependence” of the class III effect was observed. Specifically, the high therapeutic concentration of 10 nM showed no effect on action potential duration at interstimulus interval of 250 ms or 200 ms, and even at a concentration of 30 nM, the small class III effect was no longer statistically significant at these rates. Conclusion Dofetilide prolongs action potential duration in rabbit atrial myocardium, but this effect is significantly attenuated at stimulation rates above 2 Hz.
Reduction of Carnitine Content by Inhibition of Its Biosynthesis Results in Protection of Isolated Guinea Pig Hearts against Hypoxic Damage
Authors: Dhar Pradip K. , Grupp Ingrid L. , Schwartz Arnold , Grupp Gunter , Matlib Mohammed A. 
Published: September 2020

Background 3-(2,2,2-trimethylhydrazinium) propionate (THP or mildronate) is an inhibitor of carnitine biosynthesis. This study was carried out to determine whether feeding of guinea pigs with THP results in decreased myocardial-free carnitine content and, as a result, attenuates hypoxic damage in isolated and paced work-performing hearts. Methods and Results Guinea pigs were administered either distilled water or 100 mg THP/kg/day orally for 10 days. The treatment resulted in about a 50% decline in myocardial-free carnitine content, from 11.1 ± 0.2 (n = 5) to 5.6 ± 0.2 (n = 5) μM/g dry weight of the heart. The left ventricular contractile function of the hearts was measured during normoxic perfusion (PO2 = 590 mmHg), hypoxic perfusion (PO2 = 149 mmHg), and reperfusion (PO2 = 590 mmHg). In both untreated and THP-treated groups, the rate of development of intraventricular pressure (+dP/dt) under normoxic perfusion was similar; however, +dP/dt declined to about 10% of the initial rate within 20 minutes of hypoxic perfusion. In the THP-treated group of hearts, the initial decline was slower than that of the untreated animal hearts. After 20 minutes of normoxic reperfusion following 60 minutes of hypoxic perfusion, the recovery of +dP/dt and -dP/dt was greater in the THP-treated group than in the untreated group. The elevation of end-diastolic pressure during hypoxia was completely reversed by normoxic reperfusion of the THP-treated group but not in the untreated group. Mitochondria isolated from hearts from the THP-treated group after normoxic reperfusion following hypoxic perfusion exhibited better respiratory function than those from untreated hearts. Conclusion The data suggest that feeding guinea pigs with THP results in reduced myocardial-free carnitine content and attenuation of hypoxic and reperfusion injury in isolated hearts.
Case report on 5-fluorouracil induced cerebrovascular accident
Authors: Karthikeyan Kavya , Babu Christy M , Shaji Shintu , Ashok Ashwin M , Madhu CS 
Published: September 2020

Introduction 5-Fluorouracil is an antineoplastic agent generally used to treat various types of solid tumors. The common adverse drug reaction associated with 5-fluorouracil are myelosuppression, mucositis, diarrhea, and hand-foot syndrome. Neurological side effects such as headache, dizziness, convulsion, encephalopathy, and acute cerebellar syndrome are rare in nature. Case presentation We report a case of 5-fluorouracil induced cerebrovascular accident (CVA) in a patient with no risk factors for CVA before chemotherapy. A 37 years old female patient diagnosed with carcinoma rectum underwent six cycles of chemotherapy with 5- fluorouracil- calcium leucovorin- irinotecan (FOLFIRI regimen). After completing the last cycle, she developed headache, vomiting, and facial deviation along with high blood pressure (260/160 mmHg). MRI brain was done, and it revealed acute non-hemorrhagic lacunar infarct in the left half of pons. 5-fluorouracil induced CVA was suspected and was managed with dual antiplatelet, statin, and antihypertensives. Conclusion The clinicians and clinical pharmacists must be aware about the potential of 5-FU to induce rare side effects such as CVA even in low risk patients in order to avoid permanent harm to the patient
Revisiting same day administration of pegfilgrastim in the age of biosimilars: A review of literature
Authors: Gerberich Amanda J , Attilio Mark R , Svoboda Alison 
Published: September 2020

Purpose Since 2018, several pegfilgrastim biosimilars were approved, which may affect insurance reimbursement. Guidelines recommend pegfilgrastim be administered the days following chemotherapy to prevent hematopoietic toxicity. To date, only the reference pegfilgrastim product has an available autoinjector-device. This has contributed to logistical issues in administering biosimilar agents per guideline recommendations. Administration on the same day as chemotherapy may be a potential alternative when logistical issues are present. This review will assess current evidence on this practice to inform clinical decisions. Data sources: A comprehensive literature search was performed in PubMed/Medline for studies examining the administration of pegfilgrastim on the same day as chemotherapy. Data summary: Several studies were identified, including a systematic review, retrospective reviews, and insurance claim data. Studies had significant limitations, and chemotherapy regimens and cancer types varied among studies. Studies showed inconsistent results in terms of incidence, duration, and severity of febrile neutropenia. In studies with patients with head and neck, urothelial, gynecologic, gastrointestinal, and prostate cancer, no difference in outcomes was detected or outcomes supported the feasibility of same-day administration. In patients with breast cancer, outcomes were worse with same-day administration. Outcomes were mixed in studies with non-Hodgkin’s lymphoma, non-small cell lung cancer, and various solid tumors. Conclusion Administration of pegfilgrastim on the same day as chemotherapy may be safe and an acceptable alternative, if logistics prohibit a patient from receiving administration the days after chemotherapy. Clinicians should consider patient risk factors and prescribed chemotherapy regimens, along with available evidence when contemplating administration of same-day pegfilgrastim.