bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognosis of elderly patients hospitalized in the cardiac ward
Authors: Cichocka-Radwan Anna , Pietka Inga , Lelonek Malgorzata 
Published: October 2012

Abstract
Introduction Cardiovascular diseases affect nearly 80% of the elderly, and they are the major cause of death in this population. The aim was to evaluate the clinical profile and prognostic factors for patients aged 80 years and more who have been hospitalized for cardiologic reasons. Material and Methods The study included 100 patients aged 80–91 years (46% men) referred to the Department of Cardiology. We analyzed the reasons and length of hospitalization, clinical factors, results of basic laboratory tests, echocardiography, angiography, comorbidities and number of deaths during the hospitalization and in one year of follow-up. Patients were divided and analyzed, depending on the total mortality rate.Results The most common causes of hospitalization were myocardial infarction (67%) and heart failure (10%). Coronary angiography was performed in 72% of patients and percutaneous coronary intervention in 81%. The most common cause of hospital deaths was myocardial infarction (67%). The proportion of deaths in hospital was 8%, and during a year of observation it was 26%. Deaths were found to be related to ventricular conduction blocks (OR=4.0; P=0.03) and atrial fibrillation (OR=11.15; P=0.04). Conclusions In the elderly hospitalized in cardiac wards, myocardial infarction was the most common cause of hospitalization and hospital death. The mortality rate was high and associated with ventricular conduction blocks and atrial fibrillation.
Ciprofloxacin susceptibility of Salmonella enteric serovar Typhi and Paratyphi A from blood samples of suspected enteric fever patients
Authors: Adhikari D , Acharya D , Shrestha P , Amatya R 
Published: October 2012

INTRODUCTION: Enteric fever caused by Salmonella enterica serovars Typhi and Paratyphi A is the common clinical diagnosis among febrile patients presenting to hospital in Nepal. The aim of this study was to evaluate the ciprofloxacin (CIP) and other antibiotics susceptibility patterns of Salmonella enterica serovars Typhi and Paratyphi A from blood samples of suspected enteric fever patients visiting KIST Medical College, Kathmandu. MATERIALS AND METHODS: Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method as per CLSI guidelines whereas MIC determination of ciprofloxacin was performed by agar dilution method. RESULTS: Altogether 64 presumptive Salmonella spp. were isolated from 840 blood samples of suspected enteric fever patients, of which 41 were S. Typhi and 23 were S. Paratyphi A. All Salmonella spp. isolates were sensitive to ceftriaxone and ofloxacin whereas 4 isolates were resistant to ciprofloxacin. One isolates each of S. Typhi and S. Paratyphi A were multidrug resistant. Fifty five isolates of Salmonella spp. were resistant to nalidixic acid (NA) with higher rate in S. Paratyphi A (91.3%) compared to S. Typhi (82.9%). MIC determination of ciprofloxacin revealed that majority of the isolates were resistant to ciprofloxacin and 2 isolates were resistant with MIC value of 4 µg/ml and 8 µg/ml. Importantly, we found simultaneous presence of NA resistance and decreased susceptibility to CIP suggesting that resistance to NA is a reliable indicator of decreased CIP susceptibility. CONCLUSIONS: Disc diffusion test failed to detect the reduced susceptibility of ciprofloxacin. Hence the MIC determination of ciprofloxacin against Salmonella spp. isolates would be important. DOI: http://dx.doi.org/10.3126/ijim.v1i1.6938Int J Infect Microbiol 2012;1(1):9-13
Biphasic Pattern of Depression and Its Predictors during Pegylated Interferon-Based Therapy in Chronic Hepatitis B and C Patients
Authors: Huang Yi-Wen , Hu Jui-Ting , Hu Fu-Chang , Chang Ching-Jui , Chang Han-Yu , Kao Jia-Horng , Yang Sien-Sing , Chen Ding-Shinn 
Published: October 2012

Background It remains unclear whether depression in chronic hepatitis B (CHB) and chronic hepatitis C (CHC) during pegylated interferon-based therapy is associated with the virus, drug or ethnic background. We aimed to perform a prospective study to evaluate the clinical course of depression and its predictors in consecutive non-cirrhotic CHB and CHC patients of the same ethnicity receiving pegylated interferon-based therapy. Methods The occurrence and severity of depression were actively assessed by the Hamilton Depression Rating Scale before therapy and at weeks 2, 4, 6, 8, 10, 12 and every 4 weeks during treatment until the end of therapy. Extensive numbers of variables (repeated measurements, time variables and interactions between all variables) were included in generalized estimating equations to analyse the predictors of depression. Results A total of 158 consecutive patients (73 CHB and 85 CHC patients) were enrolled. Depression (Hamilton Depression Rating Scale ≥11) occurred in a biphasic pattern at treatment weeks 2-10 and weeks 16-36. Treatment weeks <10 predicts more depression, and treatment weeks >12 predicts less depression, suggesting the predictability of the time variable during treatment on depression. Furthermore, CHC or pre-existing depression is an independent predictor of depression in these patients ( P<0.001). Conclusions Depression occurred in a biphasic pattern during pegylated interferon-based therapy and should be early and actively assessed, especially in patients with CHC or pre-existing depression.
Clinical profile of parkinsonian disorders in the tropics: Experience at Kano, northwestern Nigeria
Authors: Femi Owolabi Lukman , Ibrahim A , Aliyu S 
Published: October 2012

ABSTRACT
Background: No data exists on Parkinson’s disease (PD) and secondary Parkinsonism in Northwestern Nigeria. This study was designed to create a database, document the clinical profile of PD in Kano, northwestern Nigerian, and compare this to prior observations within and outside Nigeria. Materials and Methods: A database was documented on prospective patients presenting consecutively to the Neurology out-patients clinic of the two tertiary health facilities in Kano northwestern Nigeria over a period of 4 years. Demographic and clinical data at presentation were documented for all patients. Cases were classified as PD or secondary Parkinsonism. The severity at presentation and at last visit was classified using the H and Y scale. Results: Over a period of 4 years, out 1153 a total of 96 patients comprising 74 males and 22 females were enrolled. Eighty (83.3%) of them had clinically diagnosed PD while 16 (16.7%) had clinical features compatible with secondary Parkinsonism. The mean age at onset of symptoms in the PD patients (mean 58.2 ± 6.72 yrs ) was more than in secondary Parkinsonism (mean 51.4 ± 10.04 and P = 0.001). There was male preponderance in both idiopathic Parkinsonism (PD) (m:f = 3.2:1) and secondary Parkinsonism (m:f = 4.3:1). Out of the patients with secondary Parkinsonism, 10 (62.5%) and 5 (31.3%) had vascular Parkinsonism and drug-induced Parkinsonism, respectively. Duration of symptoms prior to presentation ranged between 3 months and 16 years. The mean (SD) time interval from the onset of motor symptoms to diagnosis of PD was 3.6 ± 3.4 yrs and time interval for men and women (male 3.8 ± 3.7; female 2.8 ± 2.1; P = 0.249). Conclusions: Clinical profile of patients with PD and secondary Parkinsonism in Kano is similar to that from other populations within Nigeria and other developing countries. However, delayed presentation, less frequent family history, lower frequency of Young-onset PD as well as treatment challenges occasioned by poverty, inadequacy of expert, and lack of newer drugs and treatment options contrasts the situation in western populations.
Tuberculum sellae meningiomas: A series of 41 cases; surgical and ophthalmological outcomes with proposal of a new prognostic scoring system
Authors: Palani Arun , Panigrahi Manas K , Purohit Anirudh K 
Published: October 2012

ABSTRACT
Context: Tuberculum sellae meningiomas have proved difficult to treat, partly because of their intimate association with the optic nerves and chiasma, hypothalamus, and internal carotid arteries. Aims: The aim of this study is to analyze the degree of influence of various prognostic factors affecting visual outcome; the pattern of visual recovery and develop a scoring system for prognostication. Settings and Design: This is a retrospective study carried out from January 2004 till June 2011. Materials and Methods: Patients were analyzed on the basis of clinical, radiological, and surgical factors that appeared to affect the outcome. A special scoring system (according to the guidelines of the German Ophthalmological Society) was adopted to quantify the extent of ophthalmological disturbances. Statistical Analysis Used: Comparison of categorical variables between the two was performed using chi-square test and a P value of ≤ 0.05 was considered significant. Logistic regression was used when multivariate analysis was required. Results: Vision improved in 27% and deteriorated in 7.3%. A prognostic scoring system (score 4–13) was developed depending on the degree of influence of significant prognostic factors. The patients with a score of ≤6 had improved vision postoperatively (44%), whereas none of those with a score > 6 improved. Completeness of visual recovery was perceived in 100% of patients within 3 months. Complete resectability was achieved in 73% of patients. Conclusions: The proposed scoring system is very useful in prognosticating the visual outcome of these patients. The patients with a score of ≤6 have the best visual outcome postoperatively. Complete resectability is better achieved with extended bifrontal and unilateral frontal approaches. Short-term postoperative visual outcome is a strong indicator of permanent visual outcome after surgery.
Spinal epidural angiolipoma: A rare cause of spinal cord compression
Authors: Ghanta Rajesh K , Koti Kalyan , Dandamudi Srinivas 
Published: October 2012

ABSTRACTSpinal epidural angiolipomas are rare, benign tumors composed of mature lipocytes admixed with abnormal blood vessels. Only 128 cases of spinal epidural angiolipomas have been reported in literature till now. Spinal angiolipomas are predominantly located in the mid-thoracic region. We report a case of dorsal epidural angiolipoma in a 56-year-old male who presented with paraparesis and was diagnosed to have D4-5 epidural angiolipoma. Total surgical excision of the epidural angiolipoma was done and his paraparesis gradually improved.
Epidermoid cyst causing hemifacial spasm epidermoid cyst in cerebellopontine angle presenting with hemifacial spasm
Authors: Alemdar Murat 
Published: October 2012

ABSTRACTHemifacial Spasm (HS) occurs idiopathically or secondary to the lesions compressing the root exit zone of the facial nerve symptomatically. Symptomatic HS is generally due to vascular compression. We report on a 23-year-old male with right sided HS for a month. Magnetic resonance imaging (MRI) of the brain revealed a well-demarcated epidermoid cyst in the right cerebellopontine cistern. It was hypointense on T1-weighted imaging, hyperintense on T2-weighted imaging without contrast enhancement, hyperintense on DWI, and slightly hypointense on ADC relative to the brain. Although it caused shifting of the pons and medulla to the left side and compression of the right cerebellar peduncles and fourth ventricle, the sole symptom of the patient was HS. Clinicians are advised to request MRI/scan for brainstem lesions from the patients with HS. Epidermoid cysts in cerebellopontine cistern may present with HS as the sole symptom.
Cervical Subependymoma: A rare case report with possible histogenesis
Authors: Krishnan Shyam Sundar , Panigrahi Manas , Pendyala Swetha , Rao Satish I. , Varma Dandu R. 
Published: October 2012

ABSTRACTSubependymomas are extremely rare lesions of the spinal cord. Only 33 cases including ours have been reported in the cervical cord. These are typically benign slow growing tumors occurring eccentrically within the cord, producing minimal neurological deficits. The clinical, radiological, and histopathological aspects of this unusual lesion have been reviewed in detail. As the histogenesis of this tumor is much debated, we propose an alternate origin for the same.
Myxoid chondrosarcoma of sphenoid bone
Authors: Chowhan Amit K. , Rukmangadha Nandyala , Patnayak Rashmi , Reddy Mandyam Kumaraswamy , Prasad Bodapati Chandra Mouliswara , Bodagala Vijaya Laxmi 
Published: October 2012

ABSTRACTThe myxoid variant of chondrosarcoma is usually seen in soft tissues where it is known as chordoid sarcoma or parachordoma. Rarely, it involves bone and when it does, cranial bones are the preferred location. This tumor is frequently amalgamated with the chondroid variant of chordoma, especially when the lesion occurs in the sphenoid bone/spheno-occipital region, because of their similar clinical presentations, anatomical locations, radiological findings, and mistaken histopathological features. It is essential to distinguish myxoid chondrosarcoma from the chondroid variant of chordoma, because of the different treatment protocol and prognostic importance. We present such a location-based diagnostic dilemma, solved successfully with ancillary immunohistochemistry.
A visit to the stroke belt of the United States
Authors: Bathala Lokesh 
Published: October 2012

ABSTRACTSoutheastern part of United States has been called the Stroke Belt due to a much higher incidence of stroke compared to the rest of the country. In this article, I summarize my 2 weeks of observations as a clinical preceptor at the Comprehensive Stroke Center, University of Alabama Hospital, Birmingham, AL. 57 patients were admitted during these 2 weeks, 61% had ischemic strokes, and 23% received intravenous recombinant tissue plasminogen activator (IV rt-PA). Endovascular neuro-interventionalists were performing diagnostic catheter angiography in 14% and emergent revascularization procedures in 7% of consecutive patients. Also, the stroke team enrolled 6 patients into National institute of health (NIH) funded clinical trials (3 Argatroban tPA stroke study (ARTSS), 2 Safety study of external counter pulsation as a treatment for acute ischemic stroke (CUFFS), 1 stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis (SAMMPRIS). In my opinion, these observations provided me with useful knowledge how to develop a cutting edge, proactive stroke treatment system. In particular, availability 24 × 7 and consistent application of a curative, “finding reasons to treat approach” coupled with state-of the-art technologies and skilled operators could make a huge difference.
Duplicate Orders: An Unintended Consequence of Computerized provider/physician order entry (CPOE) Implementation
Authors: Forrer C. , Shaha S. , Magid S. 
Published: October 2012

SummaryObjective: Computerized provider/physician order entry (CPOE) with clinical decision support (CDS) is designed to improve patient safety. However, a number of unintended consequences which include duplicate ordering have been reported. The objective of this time-series study was to characterize duplicate orders and devise strategies to minimize them.Methods: Time series design with systematic weekly sampling for 84 weeks. Each week we queried the CPOE database, downloaded all active orders onto a spreadsheet, and highlighted duplicate orders. We noted the following details for each duplicate order: time, order details (e.g. drug, dose, route and frequency), ordering prescriber, including position and role, and whether the orders originated from a single order or from an order set (and the name of the order set). This analysis led to a number of interventions, including changes in: order sets, workflow, prescriber training, pharmacy procedures, and duplicate alerts.Results: Duplicates were more likely to originate from different prescribers than from same prescribers; and from order sets than from single orders. After interventions, there was an 84.8% decrease in the duplication rate from weeks 1 to 84 and a 94.6% decrease from the highest (1) to the lowest week (75). Currently, we have negligible duplicate orders.Conclusions: Duplicate orders can be a significant unintended consequence of CPOE. By analyzing these orders, we were able to devise and implement generalizable strategies that significantly reduced them. The incidence of duplicate orders before CPOE implementation is unknown, and our data originate from a weekly snapshot of active orders, which serves as a sample of total active orders. Thus, it should be noted that this methodology likely under-reports duplicate orders.Citation: Magid S, Forrer C, Shaha S. Duplicate Orders: An unintended consequence of computerized provider/physician order entry (CPOE) implementation. Analysis and mitigation strategies. Appl Clin Inf 2012; 3: 377–391http://dx.doi.org/10.4338/ACI-2012-01-RA-0002
How can we measure endometriosis-associated pelvic pain?
Authors: Gerlinger Christoph , Schumacher Ulrike , Wentzeck René , Uhl-Hochgräber Kerstin , Solomayer Erich F. , Schmitz Heinz , Faustmann Thomas , Seitz Christian 
Published: October 2012

Purpose The aim of our work was to explore which of the most commonly used pain scales is best suited to assess treatment success in endometriosis therapy and, therefore, qualifies best to be used as primary endpoint for clinical studies in this indication. Methods We compared patient's responses on the different pain scales Visual Analog Scale, Biberoglu and Behrman Score, and SF-36 Bodily Pain Subscale with the Clinical Global Impression score. Parametric and non-parametric correlation coefficients and effect sizes were calculated. Results A total of 428 patients with endometriosis-associated pelvic pain from three studies were included in our analyses. Their mean age was 31.4±6.3 years and their mean pain score on the visual analog scale was 58.1±21.9 at baseline. The highest correlation with the Clinical Global Impression score was observed for the visual analog scale followed by the B&B pelvic pain item. The highest effect sizes were found for dysmenorrhea and SF-36 bodily pain subscale followed by the visual analog scale. Conclusions A general measure of endometriosis-related pain can be recommended as primary endpoint in clinical trials to assess painful symptoms of endometriosis. In addition, a disease-specific quality of life tool is recommended to help interpret impact on patients’ daily activities.
Des rencontres de proximité : le prendre soin de soi des intervenants au coeur de l’intervention solidaire pour joindre les jeunes en marge
Authors: Aubin Diane , Abdel-Baki Amal , Baret Caroline , Cadieux Christiane , Glaize Axel , Hill Terri , Lafortune David , Létourneau Pierre , Monast Danielle , Tiberghien Candice 
Published: October 2012

Le travail de proximité auprès des jeunes en situation de grande précarité soulève chez les aidants beaucoup d’émotions et d’interrogations tout en les confrontant à leur propre souffrance et à leurs fragilités. Afin de les aider à aider et contrer le risque de traumatisation vicariante, des espaces de parole et des lieux d’échange avec un tiers ont été créés dans divers milieux d’intervention. L’objectif étant de permettre aux intervenants d’élaborer ce que leur travail leur fait vivre, et de préserver ainsi leur équilibre et leur capacité de penser. Par le biais de discussions cliniques de groupe ou individuelles, ces échanges favorisent la prise de distance et autorise de nouvelles perspectives du travail d’intervention. C’est pourquoi le soutien entre pairs est apparu un élément incontournable pour les psychologues et thérapeutes qui soutiennent non seulement les jeunes mais les intervenants qui les aident. La mise sur pied de nos rencontres de proximité, fruit de ce constat, permet de maintenir la flamme sans se brûler. La question de la marginalité des intervenants qui travaillent auprès des jeunes sans domicile fixe — de même que la nôtre — est soulevée. Tantôt par l’absence de lieu fixe de rencontre symbolisant traditionnellement la stabilité, tantôt par la flexibilité requise du cadre d’intervention pour joindre cette population, tantôt par l’ouverture à l’altérité et plus précisément à la différence qui dérange quand elle soulève l’angoisse que cet être désaffilié pourrait bien être soi ! S’agit-il vraiment de marginalité ou d’un positionnement particulier visant une dénonciation constructive de la stigmatisation, de l’exclusion injuste que subissent les jeunes qui présentent des problèmes de santé mentale et de toxicomanie qui les mettent à risque d’itinérance ? Ni missionnaires, ni sauveurs, simplement des accompagnants pleins d’espoir aux côtés d’individus qui veulent se tenir debout et avoir une place dans notre société.
Design of a Compact and Versatile Bench Scale Tubular Reactor
Authors: Prasad Ram , Rattan Gaurav 
Published: October 2012

A compact and versatile laboratory tubular reactor has been designed and fabricated keeping in view of reducing capital cost and minimising energy consumption for gas/vapor-phase heterogeneous catalytic reactions. The reactor is consisted of two coaxial corning glass tubes with a helical coil of glass tube in between the coaxial tubes serving as vaporiser and pre-heater, the catalyst bed is in the inner tube. A schematic diagram of the reactor with detailed dimensions and working principles are described. The attractive feature of the reactor is that the vaporiser, pre-heater and fixed bed reactor are merged in a single compact unit. Thus, the unit minimises separate vaporiser and pre-heater, also avoids separate furnaces used for them and eliminate auxiliary instrumentation such as temperature controller etc. To demonstrate the system operation and illustrate the key features, catalyst screening data and the efficient collection of complete, and accurate intrinsic kinetic data are provided for oxidation of CO over copper chromite catalyst. CO oxidation is an important reaction for auto-exhaust pollution control. The suitability of the versatile nature of the reactor has been ascertained for catalytic reactions where either volatile or vaporizable feeds can be introduced to the reaction zone, e.g. oxidation of iso-octane, reduction of nitric oxide, dehydrogenation of methanol, ethanol and iso-propanol, hydrogenation of nitrobenzene to aniline, etc. © 2009 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0)
Copolymerization of ε-caprolactone with Epichlorohydrin by a Green Catalyst, Maghnite
Authors: Bouchama Abdelghani , Ferrahi Mohammed Issam , Belbachir Mohamed 
Published: October 2012

Most of the cationic initiators used in the synthesis of copolymers are expensive. They may be poisoned by products of the reaction or impurities present in the monomer feed, and contain heavy metals, such as chromium, mercury, antimony, etc., that presents environmental disposal problems for the user. Maghnite is a montmorillonite sheet silicate clay that is exchanged with protons to produce Maghnite-H+ (Mag-H+). This non-toxic and cheaper cationic catalyst was used for the copolymerization of ε-caprolactone (CL) with epichlorohydrin (ECH). The effects of the amounts of Mag-H+ and the temperature on the synthesis of poly (ε-caprolactone-co-epichlorohydrin) were studied. Increasing Maghnite-H+ proportion and temperature produced the increase in copolymerization yield. The copolymer obtained was characterized by 1H-NMR and IR spectroscopy. © 2012 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0)