bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of effect of impaired renal function on lamivudine pharmacokinetics
Authors: Bouazza Naïm , Tréluyer Jean‐Marc , Ghosn Jade , Hirt Déborah , Benaboud Sihem , Foissac Frantz , Viard Jean‐Paul , Urien Saik 
Published: April 2014

AimsThis study aimed to describe lamivudine pharmacokinetics in patients with impaired renal function and to evaluate the consistency of current dosing recommendations.MethodsA total of 244 patients, ranging in age from 18 to 79 years (median 40 years) and in bodyweight from 38 to 117 kg (median 71 kg), with 344 lamivudine plasma concentrations, were analysed using a population pharmacokinetic analysis. Serum creatinine clearance (CLCR) was calculated using the Cockcroft–Gault formula; 177 patients had normal renal function (CLCR > 90 ml min−1), 50 patients had mild renal impairment (CLCR = 60–90 ml min−1), 20 patients had moderate renal impairment (CLCR = 30–60 ml min−1), and five patients had severe renal impairment (CLCR < 30 ml min−1).ResultsA two‐compartment model adequately described the data. Typical population estimates (percentage interindividual variability) of the apparent clearance (CL/F), central (Vc/F) and peripheral volumes of distribution (Vp/F), intercompartmental clearance (Q/F) and absorption rate constant (Ka) were 29.7 l h−1 (32%), 68.2 l, 114 l, 10.1 l h−1 (85%) and 1 h−1, respectively. Clearance increased significantly and gradually with CLCR. Our simulations showed that a dose of 300 mg day−1 in patients with mild renal impairment could overexpose them. A dose of 200 mg day−1 maintained an exposure close to that of adults with normal renal function. However, the current US Food and Drug Administration recommendations for lamivudine in other categories of patients (from severe to moderate renal impairment) provided optimal exposures.ConclusionsLamivudine elimination clearance is related to renal function. To provide optimal exposure, patients with mild renal impairment should receive 200 mg day−1 instead of 300 mg day−1.
Use of a Birth Plan within Woman‐held Maternity Records: A Qualitative Study with Women and Staff in Northeast Scotland
Authors: Whitford Heather M. , Entwistle Vikki A. , van Teijlingen Edwin , Aitchison Patricia E. , Davidson Tracey , Humphrey Tracy , Tucker Janet S. 
Published: April 2014

AbstractBackgroundBirth plans are written preferences for labor and birth which women prepare in advance. Most studies have examined them as a novel intervention or “outside” formal care provision. This study considered use of a standard birth plan section within a national, woman‐held maternity record.MethodsExploratory qualitative interviews were conducted with women (42) and maternity service staff (24) in northeast Scotland. Data were analyzed thematically.ResultsStaff and women were generally positive about the provision of the birth plan section within the record. Perceived benefits included the opportunity to highlight preferences, enhance communication, stimulate discussions, and address anxieties. However, not all women experienced these benefits or understood the birth plan's purpose. Some were unaware of the opportunity to complete it or could not access the support they needed from staff to discuss or be confident about their options. Some were reluctant to plan too much. Staff recognized the need to support women with birth plan completion but noted practical challenges to this.ConclusionsA supportive antenatal opportunity to allow discussion of options may be needed to realize the potential benefits of routine inclusion of birth plans in maternity notes.
Measuring Adequacy of Prenatal Care: Does Missing Visit Information Matter?
Authors: Kurtzman Jordan H. , Wasserman Erin B. , Suter Barbara J. , Glantz J. Christopher , Dozier Ann M. 
Published: April 2014

AbstractBackgroundKotelchuck's Adequacy of Prenatal Care Utilization (APNCU) Index is frequently used to classify levels of prenatal care. In the Finger Lakes Region (FLR) of upstate New York, prenatal care visit information late in pregnancy is often not documented on the birth certificate. We studied the extent of this missing information and its impact on the validity of regional APNCU scores.MethodsWe calculated the “weeks between” a mother's last prenatal care visit and her infant's date of birth. We adjusted the APNCU algorithm creating the Last Visit Adequacy of Prenatal Care (LV‐APNC) Index using the last recorded prenatal care visit date as the end point of care and the expected number of visits at that time. We compared maternal characteristics by care level with each index, examining rates of reclassification and number of “weeks between” by birth hospital. Stuart‐Maxwell, McNemar, chi‐square, and t‐tests were used to determine statistical significance.ResultsBased on 58,462 births, the mean “weeks between” was 2.8 weeks. Compared with their APNCU Index score, 42.4 percent of mothers were reclassified using the LV‐APNC Index. Major movement occurred from Intermediate (APNCU) to Adequate or Adequate Plus (LV‐APNC) leaving the Intermediate Care group a more at‐risk group of mothers. Those with Adequate or Adequate Plus Care (LV‐APNC) increased by 31.6 percent, surpassing the Healthy People 2020 objective.ConclusionsIn the FLR, missing visit information at the end of pregnancy results in an underestimation of mothers’ prenatal care. Future research is needed to determine the extent of this missing visit information on the national level.
Histopathological characteristics of microfocal prostate cancer detected during systematic prostate biopsy
Authors: Guttilla Andrea , Zazzara Michele , Zattoni Fabio , Novara Giacomo , Zanin Martina , Gardiman Marina , Ficarra Vincenzo , Zattoni Filiberto 
Published: April 2014

ObjectiveTo evaluate the prevalence of adverse pathological features and the percentage of multifocal and/or bilateral disease in a series of patients who underwent radical prostatectomy (RP) for unique, microfocal prostate cancer (miPCa) detected on prostate biopsy in the pre‐active surveillance (AS) era.Patients and MethodsIn this retrospective, multi‐institutional study, we analysed the clinical records of 131 consecutive patients who underwent either retropubic or robot‐assisted RP for miPCa at two referral centres from January 2000 to December 2011. miPCa was defined as a neoplastic lesion present in ≤10% of core with biopsy Gleason score not applicable or biopsy Gleason score 6.ResultsThere were 17 (13%) pT3–4 prostate cancers and a single case (0.8%) of pN+ tumour. Moreover, 31 (24.1%) patients had a Gleason score of >6 in the RP specimen. Therefore, unfavourable pathological features (pT3–4/N+ and/or Gleason score >6) were present in 40 (30.5%) patients. The median (interquartile range) prostate‐specific antigen (PSA) density was 0.11 (0.09–0.17) and 0.16 (0.11–0.24) ng/mL/mL in patients with favourable and unfavourable pathological characteristics, respectively (P = 0.003). The receiver operating characteristic curve had an area under the curve value of 0.67 (95% confidence interval 0.56–0.77) for PSA density to predict the risk of unfavourable pathological features.ConclusionPatients with miPCa who are candidates for an AS protocol should be adequately informed that in ≈30% of cases the cancer might be locally advanced and/or with a Gleason score of >6. Those unfavourable pathological characteristics could be predicted by the PSA density value. Further studies should investigate the role of a more extensive biopsy sampling to reduce the risk of under‐staging and/or under‐grading in patients with an initial diagnosis of miPCa.
Vessel-associated myogenic precursors control macrophage activation and clearance of apoptotic cells
Authors: Bosurgi L , Brunelli S , Rigamonti E , Monno A , Manfredi A A , Rovere-Querini P 
Published: April 2014

SummarySwift and regulated clearance of apoptotic cells prevents the accumulation of cell remnants in injured tissues and contributes to the shift of macrophages towards alternatively activated reparatory cells that sustain wound healing. Environmental signals, most of which are unknown, in turn control the efficiency of the clearance of apoptotic cells and as such determine whether tissues eventually heal. In this study we show that vessel-associated stem cells (mesoangioblasts) specifically modulate the expression of genes involved in the clearance of apoptotic cells and in macrophage alternative activation, including those of scavenger receptors and of molecules that bridge dying cells and phagocytes. Mesoangioblasts, but not immortalized myoblasts or neural precursor cells, enhance CD163 membrane expression in vitro as assessed by flow cytometry, indicating that the effect is specific. Mesoangioblasts transplanted in acutely or chronically injured skeletal muscles determine the expansion of the population of CD163+ infiltrating macrophages and increase the extent of CD163 expression. Conversely, macrophages challenged with mesoangioblasts engulf significantly better apoptotic cells in vitro. Collectively, the data reveal a feed-forward loop between macrophages and vessel-associated stem cells, which has implications for the skeletal muscle homeostatic response to sterile injury and for diseases in which homeostasis is jeopardized, including muscle dystrophies and inflammatory myopathies.
Esthetic outcome and alterations of soft tissue around single implant crowns: a 2‐year prospective study
Authors: Gu Ying‐Xin , Shi Jun‐Yu , Zhuang Long‐Fei , Qiao Shi‐Chong , Xu You‐You , Lai Hong‐Chang 
Published: April 2014

AbstractObjectiveThe aim of this prospective study was to assess the esthetic outcome and alterations of peri‐implant soft tissue using tissue‐level implants. Furthermore, the influencing factors, including grafting and gingival biotype, of esthetic outcome of peri‐implant soft tissue were also evaluated.Materials and methodsOf 38 patients with single missing anterior tooth in maxilla were treated with a Straumann ® Standard Plus SLA implant. Bone augmentation was performed in 24 patients. Follow‐up was conducted at 12 and 24 months after definitive crowns placement. Esthetic outcome using the pink esthetic score/white esthetic score (PES/WES) and clinical parameters were evaluated.ResultsThe mean PES/WES value at baseline, 1‐year, and 2‐year examination was 13.79, 14.87, and 14.96. Significant improvement was found between baseline and 1‐year examination (P < 0.01). And the improvement between 1‐year and 2‐year examination was not significant (P = 0.40). The mean PES changing value in patients with thick biotype was significantly higher than those with thin biotype at 2‐year after definitive crowns placement (P = 0.03). Graft procedure had an unfavorable effect on mean PES value both at baseline and at follow‐up (P < 0.01). No implants were lost at 2‐year examination. Three patients experienced peri‐implant infection. No significant difference was found with the passage of time in modified plaque index (mPI), probing pocket depth (PPD), and modified bleeding index (mBI).ConclusionAccording to the present prospective clinical study, it can be concluded that it is feasible to use tissue‐level implant to support single crowns in esthetic area. Favorable short‐term esthetic outcome and stability of soft tissue around single implant crowns can be expected in patients with or without graft. However, graft procedures might have an unfavorable effect on the esthetic outcome. Gingival biotype can be considered as prognostic factor for esthetic outcome. RCTs with long‐term follow‐up are needed to provide evidence for the long‐term stability of peri‐implant soft tissue using tissue‐level implant systems.
Poor agreement between transcranial Doppler and near‐infrared spectroscopy‐based estimates of cerebral blood flow changes in sepsis
Authors: Toksvang Linea N. , Plovsing Ronni R. , Petersen Marie W. , Møller Kirsten , Berg Ronan M. G. 
Published: April 2014

SummaryBackgroundContinuous monitoring of cerebral blood flow (CBF) may be valuable in critically ill patients with sepsis. In this study, we compared spatially resolved near‐infrared spectroscopy (NIRS) to transcranial Doppler ultrasound (TCD)‐derived estimates of noradrenaline‐associated changes in CBF in such patients.MethodsMean arterial blood pressure (MAP) was elevated by increasing the noradrenaline infusion rate in eight mechanically ventilated, critically ill patients diagnosed with severe sepsis or septic shock. The associated changes in CBF were assessed by simultaneous ipsilateral NIRS (ScO2) and TCD (middle cerebral artery blood flow velocity, MCAv) measurements.ResultsA total of fifteen simultaneous NIRS‐ and TCD‐derived assessments of noradrenaline‐associated changes in CBF were obtained. MAP was increased from 74 (median; interquartile range (IQR), 71–90) to 100 (median; IQR, 93–115) mmHg (P<0·05), which was associated with an increase in MCAv of 14% (median; IQR, 2–22; P<0·05), whereas no changes were observed in ScO2; 1% (median; IQR, [−4]–3; P = 0·96). A Bland–Altman plot was used to compare the two methods and showed a poor agreement between NIRS‐ and TCD‐derived estimates with a relative bias of 14% and limits of agreement of −18% to 45% change in CBF.ConclusionOur findings stress that TCD and NIRS cannot be used interchangeably for monitoring changes in cerebral haemodynamics in critically ill patients with sepsis receiving vasopressor treatment with noradrenaline.
The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention
Authors: Henriksen Ulrik L. , Henriksen Jens H. 
Published: April 2014

SummaryIn subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin,99mTc‐DTPA,51Cr‐EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy between the total plasma clearance and the urinary plasma clearance. This is owing to delayed indicator distribution to smaller or larger parts of the interstitial space, which in patients with ascites may simulate a peritoneal dialysator. In patients with fluid retention, urinary plasma clearance should be assessed to obtain a correct measurement of the glomerular filtration rate (GFR). In theory, total plasma clearance with late samples (24‐h, 48‐h) may be applied in patients with fluid retention, but validation hereof has not been performed. Until such studies are completed, it is recommended that patients with fluid retention have theirGFRmeasured by a urinary plasma clearance technique with controlled quantitative urinary sampling within a few hours after indicator injection.
Cardiac remodelling and functional alterations in mild‐to‐moderate renal dysfunction: comparison with healthy subjects
Authors: Asp Anna M. , Wallquist Carin , Rickenlund Anette , Hylander Britta , Jacobson Stefan H. , Caidahl Kenneth , Eriksson Maria J. 
Published: April 2014

SummaryIntroductionLeft ventricular (LV) hypertrophy (LVH) and reduced LV function correlate with poor prognosis in patients with chronic kidney disease (CKD). Our aim is to investigate whether mild‐to‐moderate CKD is associated with cardiac abnormalities.MethodsEchocardiography, including tissue Doppler imaging, was performed in 103 patients with CKD at stages 2–3 and 4–5, and in 53 healthy controls. The systolic (s′) and diastolic myocardial velocity (e′), and the transmitral diastolic flow velocity (E) were measured, and E/e′ was calculated.ResultsPatients with chronic kidney disease had higher mean E/e′ than controls (mean E/e′: controls 5·00 ± 1·23 versus CKD 4–5 6·36 ± 1·71, P<0·001 and versus CKD 2–3 5·69 ± 1·47, P = 0·05), indicating altered diastolic function in the patients. The CKD groups showed lower longitudinal systolic function than controls, as assessed by atrio‐ventricular plane displacement and s′ (mean s′: controls 11·5 ± 1·9 cm s−1 versus CKD 4–5 10·4 ± 2·1 cm s−1, P = 0·03 and versus CKD 2–3 10·4 ± 2·1 cm s−1, P = 0·02). The prevalence of LVH was higher in patients with CKD than in controls (controls 13% versus CKD 4–5 37%, P = 0·006 and versus CKD 2–3 30%, P = 0·03).ConclusionAlterations in systolic and diastolic myocardial function can be seen in mild‐to‐moderate CKD compared with controls, indicating that cardiac involvement starts early in CKD, which may be a precursor of premature cardiac morbidity.
Influence of skin blood flow and source‐detector distance on near‐infrared spectroscopy‐determined cerebral oxygenation in humans
Authors: Hirasawa Ai , Yanagisawa Shintaro , Tanaka Naoki , Funane Tsukasa , Kiguchi Masashi , Sørensen Henrik , Secher Niels H. , Ogoh Shigehiko 
Published: April 2014

SummaryMost near‐infrared spectroscopy (NIRS) apparatus fails to isolate cerebral oxygenation from an extracranial contribution although they use different source‐detector distances. Nevertheless, the effect of different source‐detector distances and change in extracranial blood flow on the NIRS signal has not been identified in humans. This study evaluated the extracranial contribution, as indicated by forehead skin blood flow (SkBF) to changes in the NIRS‐determined cerebral oxyhaemoglobin concentration (O2Hb) by use of a custom‐made multidistance probe. Seven males (age 21 ± 1 year) were in a semi‐recumbent position, while extracranial blood flow was restricted by application of four different pressures (+20 to +80 mmHg) to the left temporal artery. The O2Hb was measured at the forehead via a multidistance probe (source‐detector distance; 15, 22·5 and 30 mm), and SkBF was determined by laser Doppler. Heart rate and blood pressure were unaffected by application of pressure to the temporal artery, while SkBF gradually decreased (P<0·001), indicating that extracranial blood flow was manipulated without haemodynamic changes. Also, O2Hb gradually decreased with increasing applied pressure (P<0·05), and the decrease was related to that in SkBF (r = 0·737, P<0·01) independent of the NIRS source to detector distance. These findings suggest that the NIRS‐determined cerebral oxyhaemoglobin is affected by change in extracranial blood flow independent of the source‐detector distance from 15 to 30 mm. Therefore, new algorithms need to be developed for unbiased NIRS detection of cerebral oxygenation.
Predictors of post‐traumatic psychological growth in the late years after lung transplantation
Authors: Fox Kristen R. , Posluszny Donna M. , DiMartini Andrea F. , DeVito Dabbs Annette J. , Rosenberger Emily M. , Zomak Rachelle A. , Bermudez Christian , Dew Mary Amanda 
Published: April 2014

AbstractBackgroundAlthough lung transplantation improves quality of life, most psychosocial research focuses on adverse psychological and social functioning outcomes. Positive effects, particularly in the late‐term years as physical morbidities increase, have received little attention. We provide the first data on a psychological benefit – post‐traumatic growth (PTG) – and we focused on long‐term (>5 yr) survivors.MethodsAmong 178 patients from a prospective study of mental health during the first two yr post‐transplant, we recontacted survivors 6–11 yr post‐transplant. We assessed PTG (i.e., positive psychological change resulting from the transplant) and examined its relationship to other patient characteristics with multivariable regression analyses.ResultsSixty‐four patients (86% of survivors) were assessed (M = 8.1 yr post‐transplant, SD = 1.2). Mean PTG exceeded the scale's midpoint (M = 38.6, SD = 10.0; scale midpoint = 25). Recipients experiencing greater PTG were female (p = 0.022), less educated (p = 0.014), and had a history of post‐transplant panic disorder (p = 0.005), greater friend support (p = 0.048), and better perceived health (p = 0.032). Neither other pre‐ or post‐transplant mood and anxiety disorders nor transplant‐related morbidities (acute rejection, bronchiolitis obliterans syndrome) predicted PTG.ConclusionsPTG exceeded levels observed in other chronic disease populations, suggesting that lung transplantation may uniquely foster positive psychological change in long‐term survivors. PTG occurs despite physical and psychiatric morbidities. Whether PTG promotes other positive post‐transplant psychosocial outcomes deserves attention.
Post‐transplant malignancy: a burdensome complication in renal allograft recipients in Korea
Authors: Kim Ji Hyun , Kim Seon‐Ok , Han Duck Jong , Park Su‐Kil 
Published: April 2014

AbstractCancer has been a serious complication of kidney transplantation ever since the outcome of this procedure improved. The incidence of cancer among kidney transplant (KT) recipients is increasing, and these patients have a higher risk of developing cancer than the general population. The present retrospective cohort study compared the cancer rate of kidney recipients in a single transplantation center in Korea with that in healthy Korean individuals using the standardized incidence ratio (SIR). The medical records of all 2365 patients who underwent renal transplantation between 1989 and 2009 were reviewed retrospectively. During the study period, 136 renal allograft recipients developed 140 malignancies. The cumulative cancer incidence one, five, 10, and 15 yr post‐transplantation was 0.60%, 3.24%, 5.69%, and 8.90%, respectively. Non‐Hodgkin lymphoma (NHL) and thyroid cancer were the most common cancers after renal transplantation, occurring significantly more frequently than in the general Korean population. The SIR of all cancers was 1.9 (women: 2.4; men: 1.6). Comparison with similar studies in Korea and other countries suggests transplant center‐related differences dictate post‐transplant malignancy incidence more strongly than ethnic or geographic factors. Early surveillance programs for de novo malignancies after kidney transplantation focusing on kidney‐transplantation‐related tumors and postoperative time period should be established.
Serum liver‐type fatty acid‐binding protein predicts recovery of graft function after kidney transplantation from donors after cardiac death
Authors: Kawai Akihiro , Kusaka Mamoru , Kitagawa Fumihiko , Ishii Junichi , Fukami Naohiko , Maruyama Takahiro , Sasaki Hitomi , Shiroki Ryoichi , Kurahashi Hiroki , Hoshinaga Kiyotaka 
Published: April 2014

AbstractKidneys procured by donation after cardiac death (DCD) may increase the donor pool but are associated with high incidence of delayed graft function (DGF). Urinary liver‐type fatty acid‐binding protein (L‐FABP) level is an early biomarker of renal injury after kidney transplantation (KTx); however, its utility is limited in DGF cases owing to urine sample unavailability. We examined whether serum L‐FABP level predicts functional recovery of transplanted DCD kidneys. Consecutive patients undergoing KTx from living related donors (LD), brain‐dead donors (BD), or DCD were retrospectively enrolled. Serum L‐FABP levels were measured from samples collected before and after KTx. Serum L‐FABP decreased rapidly in patients with immediate function, slowly in DGF patients, and somewhat increased in DGF patients requiring hemodialysis (HD) for >1 wk. Receiver‐operating characteristic curve analysis demonstrated that DGF was predicted with 84% sensitivity (SE) and 86% specificity (SP) at cutoff of 9.0 ng/mL on post‐operative day (POD) 1 and 68% SE and 90% SP at 6.0 on POD 2. DGF >7 d was predicted with 83% SE and 78% SP at 11.0 on POD 1 and 67% SE and 78% SP at 6.5 on POD 2. Serum L‐FABP levels may predict graft recovery and need for HD after DCD KTx.