bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post‐partum spontaneous coronary artery dissection and the use of veno‐arterial extra‐corporeal membrane oxygenation
Authors: Evans Rachel 
Published: May 2014

ABSTRACTAimsTo present a rare case of a post‐partum spontaneous coronary artery dissection (SCAD), a rarely seen condition which does not yet have a universally agreed treatment method and the role of the intensive care unit (ICU) nurse when caring for the adult ECMO patient.BackgroundThe use of extra‐corporeal membrane oxygenation (ECMO) for the adult patient has increased slowly since the first reported successful treatment in 1972 (Hill et al., 1972) and is seen increasingly as a successful therapy when conventional medical treatment has failed. In this case, a young lady 2 weeks post‐partum presented with acute coronary syndrome secondary to a SCAD. ECMO was used successfully as a bridge to myocardial recovery following coronary artery bypass grafts and cardiogenic shock.Design and methodA case study underpinned by a review of existing literature relating to spontaneous coronary artery dissection and extra‐corporeal membrane oxygenation.Results and conclusionsECMO is still a relatively new and invasive technology but continues to improve survival rates in critically ill patients where conventional medical treatment has failed. This article highlights requirement for further research into several aspects of care for the adult ECMO patient. Questions to be answered raised in this case study include recommendations for the weaning of inotropes and vasoconstrictors, frequency of blood gas sampling and whether it remains essential to have two nurses caring for the ECMO patient.Relevance to clinical practiceAs medical treatment progresses, there is an increasing demand for therapies such as ECMO to become more readily available for the care of the critically ill adult patient. This article highlights challenges that may be faced and what changes could be made to further improve standards of care and survival rates for ECMO patients.
Critical care nurses management of prolonged weaning: an interview study
Authors: Cederwall Carl‐Johan , Plos Kaety , Rose Louise , Dübeck Amanda , Ringdal Mona 
Published: May 2014

ABSTRACTBackgroundFor most critically ill patients requiring mechanical ventilation in the intensive care unit (ICU) weaning is uncomplicated. For the remainder, weaning is a challenge and may result in further complications and increased risk of mortality. Critical care nurses (CCNs) require substantial knowledge and experience to manage patients experiencing prolonged weaning.AimThe aim of this study was to explore CCNs approach for management of patients experiencing prolonged weaning in the ICU.DesignA descriptive qualitative design.MethodsSemi‐structured interviews with 19 experienced CCNs were conducted. Data were analysed using content analysis.ResultsParticipants used various strategies for weaning that were grouped into four categories: individualized planning for the weaning process, assessing patient's capacity, managing the process and team interaction. The overall theme that emerged was: CCNs drive the weaning process using both a patient centred and targeted approach.ConclusionCCNs in these ICUs performed weaning using a patient centred approach to plan, initiate, assess and establish a holistic weaning process. Team collaboration among all health care practitioners was important. CCNs have a key role in prioritizing weaning and driving the process forward.Relevance to clinical practiceCloseness to the patient and a key role in management of the mechanical ventilated patient in ICU gives the CCN unique potential to develop and create models and tools for prolonged weaning. These tools, specially designed for patients undergoing prolonged weaning, would give focus on continuous planning, collaborating, managing and evaluation in the process of liberating patients from mechanical ventilation.
Association of Quality of Life, Anxiety, and Depression with Left Atrial Ablation Outcomes
Authors: EFREMIDIS MICHAEL , LETSAS KONSTANTINOS P. , LIONI LOUIZA , GIANNOPOULOS GEORGIOS , KORANTZOPOULOS PANAGIOTIS , VLACHOS KONSTANTINOS , DIMOPOULOS NIKOLAOS P. , KARLIS DIMITRIOS , BOURAS GEORGIOS , SIDERIS ANTONIOS , DEFTEREOS SPYRIDON 
Published: May 2014

BackgroundAtrial fibrillation (AF) is associated with significant impairment of quality of life (QoL). Anxiety and depression are common in AF patients and might predispose to AF. We sought to investigate associations of preablative QoL and stress parameters with AF ablation outcomes, as well as possible changes in QoL, anxiety, and depression parameters after ablation.MethodsA total of 57 consecutive patients with paroxysmal AF underwent pulmonary vein (PV) antral isolation. The Short‐Form Life Survey‐36 items (SF‐36), the State‐Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI) were assessed before and at 6 months after ablation.ResultsAfter a mean follow‐up of 8.0 ± 2.5 months, 41 patients (71.9%) remained free from arrhythmia. Baseline mental health summary QoL SF‐36 score was significantly lower in patients with AF recurrence (53.2 ± 10.3 vs 69.7 ± 17.9; P = 0.001), while the physical health summary score did not differ significantly between patients with and without recurrence. Patients with recurrence had higher baseline STAI‐trait (41.9 ± 1.5 vs 34.7 ± 4.9) and BDI (17.3 ± 9.7 vs 5.4 ± 3.0) scores (P < 0.001 for both). In multivariable analysis, SF‐36 mental health summary, STAI‐trait, and BDI scores remained significant predictors of recurrence after adjustment for age, gender, body mass index, diabetes, and hypertension. Mental and physical domain SF‐36 summary scores were significantly improved 6 months after ablation (P = 0.001) and a significant reduction in symptoms of depression (P = 0.001) and anxiety (P = 0.001) was observed.ConclusionsBaseline QoL, anxiety, and depression metrics were associated with AF recurrence following PV antral isolation. Furthermore, there was a significant improvement in QoL, anxiety, and depression after left atrial ablation.
Implantable Cardioverter Defibrillator System with Floating Atrial Sensing Dipole: A Single‐Center Experience
Authors: IORI MATTEO , GIACOPELLI DANIELE , QUARTIERI FABIO , BOTTONI NICOLA , MANARI ANTONIO 
Published: May 2014

BackgroundThe concept of a single‐lead dual‐chamber implantable cardioverter defibrillator (ICD) with floating sensing atrial dipole has been proven safe and functional. We report a single‐center experience with this ICD system; the major focus of the work is on the recorded atrial activation and its stability on a medium term follow‐up.MethodsThirteen patients received a DX ICD (BIOTRONIK SE & Co, Berlin, Germany) with the Linox Smart S DXProMRI ICD lead; the implantation data were reported. Daily P‐ and R‐wave sensing amplitude was collected and followed up during 200 days; their coefficient of variance (CV) was calculated. In addition, all the atrial and ventricular high‐rate episodes were analyzed.ResultsThe total x‐ray exposure time was 3.9 ± 1.8 minutes. The overall mean sensing was 4.2 ± 1.9 mV for P wave and 12.9 ± 4.5 mV for R wave. The CV was significantly higher for the P‐wave amplitude than for the R‐wave one (0.25 ± 0.11 vs 0.08 ± 0.06; P < 0.001). A total of 27 high ventricular rate episodes were recorded and correctly discriminated by the device. Fifty‐six high atrial rate episodes were recorded, 49 were true arrhythmic events.ConclusionsThe single‐lead ICD system with floating atrial dipole provides reliable atrial sensing amplitude over time. The physician, without the implantation of an additional lead, has the atrial information that may be used for the discrimination of supraventricular tachyarrhythmia/ventricular tachycardia, for the early detection of atrial fibrillation episodes and for the evaluation of changes in the patient's heart status.
Strategies for preventing side effects of systemic opioid in postoperative pediatric patients
Authors: Jitpakdee Thanaporn , Mandee Sahatsa 
Published: May 2014

SummaryBackground and ObjectivesOpioid is the gold standard for treating moderate‐to‐severe pain in pediatric patients. However, its undesirable side effects lead to unsatisfied postoperative pain management outcome (Pediatr Anesth, 17, 2007, 756). The most commonly reported opioid‐related side effects are vomiting (40%), pruritus (20–60%) (Anesthesiology, 77, 1992, 162; Drugs, 67, 2007, 2323), and constipation (15–90%) (Int J Clin Pract, 61, 2007, 1181). The potential life‐threatening adverse event, respiratory depression, is less common (0.0013%) (Pediatr Anesth, 20, 2010, 119). The aim of this review was to evaluate prevention strategies that have been shown to decrease opioid side effects in pediatric patients during the postoperative period.MethodsLiterature searches were conducted from 1984 to February 2013. Meta‐analysis, systematic review, and randomized, placebo‐controlled studies were obtained from PubMed and the Cochrane Library. The medical subject heading (MeSH) terms were opioid analgesics, adverse effects, pediatrics, children, side effects, and postoperative pain.Results and conclusionData from 62 studies were reviewed. The strategies that could effectively prevent and reduce opioid side effects in pediatric patients during the postoperative period included minimizing the amount of opioid consumption by a multimodal approach, opioid titration, using local anesthetic techniques and providing the specific prophylaxis for each side effect.
Maternal Prepregnancy Body Mass Index and Risk of Spontaneous Preterm Birth
Authors: Shaw Gary M. , Wise Paul H. , Mayo Jonathan , Carmichael Suzan L. , Ley Catherine , Lyell Deirdre J. , Shachar Bat Zion , Melsop Kathryn , Phibbs Ciaran S. , Stevenson David K. , Parsonnet Julie , Gould Jeffrey B. ,   March of Dimes Prematurity Research Center at Stanford University School of Medicine
Published: May 2014

AbstractBackgroundFindings from studies examining risk of preterm birth associated with elevated prepregnancy body mass index (BMI) have been inconsistent.MethodsWithin a large population‐based cohort, we explored associations between prepregnancy BMI and spontaneous preterm birth across a spectrum of BMI, gestational age, and racial/ethnic categories. We analysed data for 989 687 singleton births in California, 2007–09. Preterm birth was grouped as 20–23, 24–27, 28–31, or 32–36 weeks gestation (compared with 37–41 weeks). BMI was categorised as <18.5 (underweight); 18.5–24.9 (normal); 25.0–29.9 (overweight); 30.0–34.9 (obese I); 35.0–39.9 (obese II); and ≥40.0 (obese III). We assessed associations between BMI and spontaneous preterm birth of varying severity among non‐Hispanic White, Hispanic, and non‐Hispanic Black women.ResultsAnalyses of mothers without hypertension and diabetes, adjusted for age, education, height, and prenatal care initiation, showed obesity categories I–III to be associated with increased risk of spontaneous preterm birth at 20–23 and 24–27 weeks among those of parity 1 in each race/ethnic group. Relative risks for obese III and preterm birth at 20–23 weeks were 6.29 [95% confidence interval (CI) 3.06, 12.9], 4.34 [95% CI 2.30, 8.16], and 4.45 [95% CI 2.53, 7.82] for non‐Hispanic Whites, non‐Hispanic Blacks, and Hispanics, respectively. A similar, but lower risk, pattern was observed for women of parity ≥2 and preterm birth at 20–23 weeks. Underweight was associated with modest risks for preterm birth at ≥24 weeks among women in each racial/ethnic group regardless of parity.ConclusionsThe association between women's prepregnancy BMI and risk of spontaneous preterm birth is complex and is influenced by race/ethnicity, gestational age, and parity.
Characterization of sexual reproductive processes in Chara braunii (Charales, Charophyceae)
Authors: Sato Machiko , Sakayama Hidetoshi , Sato Mamiko , Ito Motomi , Sekimoto Hiroyuki 
Published: May 2014

SummaryChara braunii is distributed worldwide and is the most common charalean species in Japan. This species is monoecious and produces numerous sets of sex organs, each of which consists of one antheridium and one oogonium, under laboratory culture conditions. In this study, we report that light intensity strongly affected the vegetative phase and sexual reproductive phase of this species. Under high‐light conditions (70.0 μmol photons m−2 s−1), thalli grew but did not form reproductive organs. Under a low‐light intensity (10.0 μmol photons m−2 s−1), algal bodies formed many reproductive organs. In addition, antheridia without the corresponding oogonia (lone antheridia) were observed under low‐light conditions. The absence of oogonium primordia adjacent to the lone antheridium was confirmed by several microscopic approaches. The addition of liquid fertilizer increased the total number of sex organs and growth; however, the number of lone antheridia decreased with increasing fertilizer concentrations. Exogenously applied gibberellin did not affect the number of lone antheridia. These results suggest that regulatory mechanisms for the appropriate allocation of resources exist in this alga, similar to those reported in some land plants.
Assessing quality of healing in skin: Review of available methods and devices
Authors: Junker Johan P. E. , Philip Justin , Kiwanuka Elizabeth , Hackl Florian , Caterson Edward J. , Eriksson Elof 
Published: May 2014

AbstractThe process of wound healing is dynamic and takes place over months to years, during which there is a resolution of angiogenesis, continued wound contraction, and connective tissue remodeling. The outcome of this process is most commonly the formation of a scar, defined as a fibrous tissue replacing normal tissues destroyed by injury or disease. Scars often have a lowered or total loss of vital skin functions and imbue a large burden on both the patient and the health care system as a whole. Scar treatments are plentiful but are often unsatisfactory or inconsistent. No single treatment method has been universally adopted. To evaluate the clinical treatment as well as research focused on developing novel methods for scar management, objective studies of the progression of scar formation and the properties of mature scars are needed. Several parameters, including barrier function as well as mechanical and physiological properties, need to be taken into account when both categorizing and treating healing wounds and scars. To date, there is no available methodology that provides a comprehensive evaluation of a scar's properties. This review aims at presenting an overview of available scar assessment methods and devices, ranging from analysis of collagen properties in tissue biopsies to noninvasive methods for studies of mechanical parameters such as breaking strength and skin elasticity. In the cases where conclusive studies have been performed, the differences between normal skin and scar with respect to the above parameters are presented. Furthermore, this review highlights areas where the development of additional modalities are needed.
Negative pressure wound therapy is associated with up‐regulation of bFGF and ERK1/2 in human diabetic foot wounds
Authors: Yang Shao‐Ling , Han Rui , Liu Yu , Hu Li‐Ye , Li Xiao‐Ling , Zhu Lv‐Yun 
Published: May 2014

AbstractChronic foot wounds are a leading cause of morbidity and hospitalization for patients with diabetes. Negative pressure wound therapy (NPWT) is known to promote healing of diabetic foot wounds, but the underlying molecular mechanisms remain elusive. We propose to gain molecular insights into the wound healing promoting signals underlying the effects of NPWT on diabetic foot wounds in humans. We assessed 30 patients with diabetic foot ulcers. Of these cases, 15 were treated with NPWT, while 15 patients were treated with traditional gauze therapy. Granulated tissue was harvested before and after treatment in both patient groups and histologically analyzed with hematoxylin & eosin as well as Masson's trichrome staining methods. Immunohistochemistry and Western blot analysis was performed to evaluate expression of basic fibroblast growth factor (bFGF) and extracellular signal‐regulated kinase (ERK)1/2, previously associated with promoting cellular growth and/or wound healing. Unlike controls, the wounds in the NPWT‐treated diabetic patients developed characteristic features of granulated tissue with increased collagen deposition. Immunohistochemical analysis also revealed an increase in bFGF levels in NPWT‐treated patients. Western blot analysis further showed a significant up‐regulation of bFGF and phosphorylated ERK1/2 protein levels in the NPWT‐treated diabetic patients vs. controls. Our studies reveal that NPWT is associated with an up‐regulation of bFGF and ERK1/2 signaling, which may be involved in promoting the NPWT‐mediated wound healing response.
Zinc Finger Endonuclease Targeting
PSIP1
Inhibits HIV-1 Integration
Authors: Badia Roger , Pauls Eduardo , Riveira-Munoz Eva , Clotet Bonaventura , Esté José A. , Ballana Ester 
Published: May 2014

ABSTRACT

Genome editing using zinc finger nucleases (ZFNs) has been successfully applied to disrupt CCR5 or CXCR4 host factors and inhibit viral entry and infection. Gene therapy using ZFNs to modify the
PSIP1
gene, which encodes the lens epithelium-derived growth factor (LEDGF) protein, might restrain an early step of the viral replication cycle at the integration level. ZFNs targeting the
PSIP1
gene (ZFN
LEDGF
) were designed to specifically recognize the sequence after the integrase binding domain (IBD) of the LEDGF/p75 protein. ZFN
LEDGF
successfully recognized the target region of the
PSIP1
gene in TZM-bl cells by heteroduplex formation and DNA sequence analysis. Gene editing induced a frameshift of the coding region and resulted in the abolishment of LEDGF expression at the mRNA and protein levels. Functional assays revealed that infection with the HIV-1 R5 BaL or X4 NL4-3 viral strains was impaired in LEDGF/p75 knockout cells regardless of entry tropism due to a blockade in HIV-1 proviral integration into the host genome. However, residual infection was detected in the LEDGF knockout cells. Indeed, LEDGF knockout restriction was overcome at a high multiplicity of infection, suggesting alternative mechanisms for HIV-1 genome integration rather than through LEDGF/p75. However, the observed residual integration was sensitive to the integrase inhibitor raltegravir. These results demonstrate that the described ZFN
LEDGF
effectively targets the
PSIP1
gene, which is involved in the early steps of the viral replication cycle; thus, ZFN
LEDGF
may become a potential antiviral agent for restricting HIV-1 integration. Moreover, LEDGF knockout cells represent a potent tool for elucidating the role of HIV integration cofactors in virus replication.
Case Report and Cohort Analysis of Drug-Induced Liver Injury Associated with Daptomycin
Authors: Bohm Nicole , Makowski Charles , Machado Mario , Davie Adam , Seabrook Nelson , Wheless Lee , Bevill Benjamin , Clark Bradley , Kyle T. Rogers 
Published: May 2014

ABSTRACT

A patient receiving daptomycin developed asymptomatic transaminitis and hyperbilirubinemia without concurrent multiorgan dysfunction or elevation of his creatinine kinase level. After ruling out other etiologies, the liver injury was attributed to daptomycin and was subsequently resolved. A single-center retrospective cohort analysis of baseline and follow-up liver function panels (
n
= 614) from all admissions from 2008 to 2013 during which daptomycin was administered did not reveal any other cases of probable or definite drug-induced liver injury associated with daptomycin.
Draft Genome Sequence of Erwinia mallotivora BT-MARDI, Causative Agent of Papaya Dieback Disease
Authors: Redzuan R. Ahmad , Abu Bakar N. , Rozano L. , Badrun R. , Mat Amin N. , Mohd Raih M. F. 
Published: May 2014

ABSTRACT

Erwinia mallotivora
was isolated from papaya trees infected with dieback disease, which were planted at the Malaysian Agricultural Research and Development Institute (MARDI), Malaysia. Here, we report a draft genome sequence of
E. mallotivora
BT-MARDI, which offers an important source of information for understanding pathogen and host interaction during papaya dieback development.
Genome Sequence of Chlamydia suis MD56, Isolated from the Conjunctiva of a Weaned Piglet
Authors: Donati Manuela , Huot-Creasy Heather , Humphrys Michael , Di Paolo Maria , Di Francesco Antonietta , Myers Garry S. A. 
Published: May 2014

ABSTRACT

Chlamydia suis
is a natural pathogen of pigs (
Sus scrofa
) and causes conjunctivitis, pneumonia, enteritis, and various reproductive disorders that adversely impact this economically important animal. Here, we report the first
C. suis
genome, that of
C. suis
MD56, isolated from a conjunctival swab of a weaned piglet.
Electroacupuncture Exerts An Anti-Inflammatory Effect in a Rat Tissue Chamber Model of Inflammation via Suppression of Nf-κB Activation
Authors: Liu Fang , Fang Jianqiao , Shao Xiaomei , Liang Yi , Wu Yuanyuan , Jin Yabei 
Published: May 2014

Objective Electroacupuncture (EA) has beneficial effects in patients with various inflammatory diseases. However, the underlying mechanism remains unclear. As the kappa B inhibitor/nuclear factor-kappa B (IκB/NF-κB) pathway exerts a pivotal role in the mammalian immune response, we examined the involvement of the IκB/NF-κB pathway in EA-induced anti-inflammation. Methods Ninety tissue chamber implanted rats were randomly divided into control (C), model (M) and EA (E) groups. Physiological saline and human recombinant interleukin-1β (hr IL-1β) were injected into the rats in groups C and M, respectively, and EA treatment was applied to the rats in group E after IL-1β injection. Nuclear staining of p65 (a subunit of NF-κB) was quantified in the exudate cells by immunohistochemical analysis and IκBα expression in the cytoplasm was quantified by western blot analysis. Results Our results showed that, compared with group C, the percentage of cells with nuclear-localised p65 was increased in group M by 71.3%, 50.7% and 33.1% at 1, 5 and 24 h time points (p<0.01), respectively. This increase was fully inhibited in group E at 5 and 24 h time points (p<0.01). The expression of IκBα was stably enhanced in group M (p<0.05) during the test period. Compared with group M, greater expression of IκBα in group E was only observed at the 1 h time point (p<0.01). Conclusions Collectively, our data suggest that EA inhibits the nuclear translocation of p65 and increases the expression of IκBα, which leads to the suppression of NF-κB activation in a rat tissue chamber model of inflammation.
Comparing population attributable risks for heart disease across the adult lifespan in women
Authors: Brown Wendy J , Pavey Toby , Bauman Adrian E 
Published: May 2014

BackgroundRecent estimates suggest that high body mass index (BMI), smoking, high blood pressure (BP) and physical inactivity are leading risk factors for the overall burden of disease in Australia. The aim was to examine the population attributable risk (PAR) of heart disease for each of these risk factors, across the adult lifespan in Australian women.MethodsPARs were estimated using relative risks (RRs) for each of the four risk factors, as used in the Global Burden of Disease Study, and prevalence estimates from the Australian Longitudinal Study on Women's Health, in 15 age groups from 22–27 (N=9608) to 85–90 (N=3901).ResultsRRs and prevalence estimates varied across the lifespan. RRs ranged from 6.15 for smoking in the younger women to 1.20 for high BMI and high BP in the older women. Prevalence of risk exposure ranged from 2% for high BP in the younger women to 79% for high BMI in mid-age women. In young adult women up to age 30, the highest population risk was attributed to smoking. From age 31 to 90, PARs were highest for physical inactivity.ConclusionsFrom about age 30, the population risk of heart disease attributable to inactivity outweighs that of other risk factors, including high BMI. Programmes for the promotion and maintenance of physical activity deserve to be a much higher public health priority for women than they are now, across the adult lifespan.