bluuebunny/crossref_metadata_2025_split huggingface dataset:
Body mass index—predictor of outcome after coronary artery bypass grafting
Authors: Shahabuddin Syed , Perveen Shazia , Furnaz Shumaila , Fatimi Saulat , Sami Shahid , Sharif Hasanat 
Published: May 2013

Objective: Increased body mass index has been associated with increased postoperative morbidity. We studied the effect of body mass index in our population, using a modified scale suggested by the World Health Organization. Methods: From January 2006 to December 2008, 1019 patients undergoing first-time isolated elective coronary artery bypass grafting were selected from our cardiac surgery database. Data were analyzed by univariate and multivariate analyses. Results: Of the 1019 elective coronary artery bypass patients, 168 (15.8%) had a normal body mass index (18.5–22.9 kg·m−2) and 894 (84.2%) had a high body mass index (≥23.0 kg·m−2). There were 921 (86.7%) patients with 3-vessel disease, and 1012 (95.3%) had internal mammary artery grafts. The 30-day mortality was 0.8%. Multivariate analysis revealed age, hospital stay, perfusion time, and renal failure were significantly associated with hospital complications. High body mass index was not significantly associated with morbidity or mortality. The model had an adequate fit at p = 0.708 by the Hosmer and Lemeshow test. Conclusion: Increased body mass index alone is not a predictor of increased mortality and morbidity. In fact, these outcomes were associated with advanced age, hospital stay, perfusion time, and renal failure.
How to distinguish an active air leak from a pleural space effect
Authors: Marasco Rita Daniela , Giudice Gabriella , Lequaglie Cosimo 
Published: May 2013

Aim: We aimed to distinguish a pleural space effect from an active air leak, using a digital chest drain system that provided continuous air flow and pleural pressure checks. Methods: between March 2010 and October 2011, we employed 144 digital drains for 138 thoracic surgical procedures. Results: We observed 18 (12.5%) active air leaks, among which 4 (2.8%) were prolonged air leaks characterized by high differential pleural pressure due to increased mean expiratory pressure (>1 cm H2O; p < 0.0001), and 3 (2.1%) late air leaks, all long-lasting ( p < 0.0001), predicted by pressure curve divergence before the air flow appearance. We also reported 25 (17.4%) pleural space effects characterized by a high differential pleural pressure, but mainly due to a lower mean inspiratory pressure (<20 cm H2O; p < 0.0001), and especially related to surgical pleurodesis procedures ( p < 0.0003) and wide lung resections ( p < 0.0002); there was no increasing pneumothorax after provocative clamping. Conclusions: A digital chest drain system, ensuring continuous air flow and pleural pressure measurement, could clearly identify a pleural space effect, avoiding the frequent misinterpretation of an active air leak, and allowing safe removal of the chest tube at the right time.
Evaluation of plethysmography for diagnosis of postintubation tracheal stenosis
Authors: Jamaati Hamid Reza , Shadmehr Mohammad Behgam , Aloosh Oldouz , Radmand Golnar , Mohajerani Seyed Amir , Hashemian Seyed Mohammadreza 
Published: May 2013

Objectives: Post-intubation tracheal stenosis is a serious disease caused by cuff pressure during tracheal intubation. The reported prevalence of post-intubation tracheal stenosis is 10%–22% in intubated patients. Invasive diagnostic methods based on fiberoptic or rigid bronchoscopy are suggested for initial assessment and treatment. This study aimed to evaluate plethysmography as an alternative diagnostic tool for post-intubation tracheal stenosis. We also assessed the relationship between plethysmography and bronchoscopy findings in patients with post-intubation tracheal stenosis. Methods: The sample included 30 patients who were admitted to our intensive care unit or surgical ward during the course of a year, and diagnosed with post-intubation tracheal stenosis. All patients underwent plethysmography and rigid bronchoscopy. The relationship between the plethysmography and bronchoscopy findings was examined. Results: Stricture intensity had the strongest correlation with upper airway resistance ( p = 0.001). The relationship of length of stricture to forced expiratory volume in 1 s and maximum expiratory flow 50 and 75 was significant in univariate analysis, and to reserve volume and total lung capacity in multivariate analysis. Conclusion: Significant relationships were found between plethysmography variables and rigid bronchoscopy findings in patients with post-intubation tracheal stenosis, and some formulas were developed to give an alternative estimate of stricture severity, without bronchoscopy.
Traumatic thoracobiliary (pleurobiliary and bronchobiliary) fistula
Authors: Andrade-Alegre Rafael , Ruiz-Valdes Maylin 
Published: May 2013

Background: Traumatic thoracobiliary fistula is a rare but serious complication. A series of thoracobiliary fistulas secondary to penetrating trauma and analysis of trends in management are presented. Methods: We retrospectively reviewed all patients with traumatic thoracobiliary fistula, treated from April 2008 to February 2010. There were 5 patients: 4 suffered gunshot wounds and 1 was stabbed. The mean injury severity score was 22. Results: Initial treatment was insertion of a chest tube in all cases. One patient underwent damage-control surgery and hepatic packing, and 3 were managed with laparotomy, a perihepatic closed drain, and suture of the diaphragm. Two patients developed bronchobiliary fistulas and 3 had pleurobiliary fistulas. Diagnostic procedures involved determination of bilirubin in pleural effusion, computed tomography, magnetic resonance cholangiography, hepatobiliary iminodiacetic scans, and endoscopic retrograde cholangiography. Definitive treatment included sphincterotomy and stenting in 4 cases, pulmonary decortication in 5, fistulectomy in 2, hepatic suture in 2, perihepatic closed drain placement in 4, and suture of the diaphragm in 4. Conclusions: Traumatic thoracobiliary fistulas are complex lesions. A multidisciplinary approach is required for a timely and successful outcome. Endoscopic retrograde cholangiography is very useful as the initial procedure to confirm the diagnosis and also for treatment.
Thoracoscopic surgery for non-small-cell lung cancer: elderly vs. octogenarians
Authors: Srisomboon Chaisit , Koizumi Kiyoshi , Haraguchi Shuji , Mikami Iwao , Iijima Yoshihito , Shimizu Kazuo 
Published: May 2013

Background: Octogenarians are rarely referred for surgical treatment of lung cancer owing to the morbidity and mortality of pulmonary resection, their frailty, and limited lifespan. We reviewed the results of thoracoscopic surgery, performed completely under the monitor, for treatment of primary non-small-cell lung cancer in octogenarians, and compared them with those in elderly patients. Patients and methods: Between September 25, 2002 and August 25, 2011, a retrospective database of 24 octogenarians and 70 elderly patients (age range, 75–79 years) who underwent thoracoscopic surgery for treatment of primary non-small-cell lung cancer were reviewed. Demographic, histopathologic, preoperative, perioperative, postoperative, outcome variables, and survival were assessed. Results: In the octogenarian group, 29% had postoperative respiratory complications, 4% had postoperative cardiac complications, operative mortality was 4%, the recurrence rate was 8%, and the postsurgical 5-year survival rate was 74%. In the elderly group, 25% had postoperative respiratory complications, 6% had postoperative cardiac complications, operative mortality was 3%, the recurrence rate was 6%, and the postsurgical 5-year survival rate was 80%. Conclusions: Thoracoscopic surgery for treatment of primary non-small-cell lung cancer can be performed with similar postoperative complication rates, operative mortality, and survival in octogenarians when compared to elderly patients.
Gusto Hawaii: A Community Hospital's Experience in an International Randomized Study
Authors: Ashmore Roger C , Pine Maria C , Chen J Roy , Grattan Mark T , Kai Wesley J , Scully Nial M , Shen Edward N , White Roger L 
Published: May 2013

Multiple thrombolytic agents are available for treating patients with acute myocardial infarction. The recently completed Global Utilization of Streptokinase and rt-PA for Occluded coronary arteries (GUSTO) study randomized 41,000 patients to 1 of 4 thrombolytic treatment regimens. Straub Clinic and Hospital, a small community hospital in Hawaii, participated in this international clinical trial enrolling a total of 40 patients. Our patient characteristics and use of concomitant therapy were similar to the combined GUSTO, study results. Coronary angiography was performed in 93% of patients postthrombolytic therapy, with a majority of patients having single vessel coronary disease and a patent infarct-related artery. The severity of coronary artery disease at our hospital was similar to the combined GUSTO study results. Percutaneous transluminal coronary angioplasty was performed in 53% of patients and coronary artery bypass surgery in 13% of patients postthrombolytic therapy at our hospital, compared to 15% and 9% in the combined GUSTO study, respectively. The clinical events postthrombolytic therapy at Straub Clinic and Hospital were similar to the combined GUSTO study results, except for a lower incidence of ischemia/reinfarction at our hospital (7.5% v 23.2% respectively). These data suggest that treatment of acute myocardial infarction with thrombolytic therapy can be administered in a safe and timely manner at a small community hospital.
Enhanced External Counterpulsation in the Treatment and Rehabilitation of Coronary Patients in Indonesia
Authors: Karim Sjukri , Sani Aulia , Karo-Karo Santoso , Kasim Manoefris , Basha Adnil , Gunadhi Ign , Japaries Willie , Suwita Raymond 
Published: May 2013

We report our experience using the new noninvasive treatment for coronary patients called enhanced external counterpulsation (EECP). Thallium-201 stress scintigraphy and treadmill test were done before and after 36 sessions of EECP treatment on 38 coronary patients. The results showed significant (P < 0.01) improvement in perfusion as well as exercise tolerance in 86.8% and 94.2% of patients, respectively. The symptoms of angina pectoris and functional classes of the patients also showed significant (P < 0.05) improvement. All patients tolerated the treatment without serious complications. The magnitude and rate of increased exercise tolerance achieved by EECP treatment was greater than those achieved by training after coronary bypass surgery (CABG) or exercise training rehabilitation program for the matched coronary patients reported by others 7 , 8 . The mean double products (DP) from the treadmill test results of the improved Tl-201 perfusion subgroups decreased significantly (P < 0.001). On the contrary, the DP of the unimproved subgroup increased significantly (P < 0.001). This could mean improvement in efficiency of the heart in the former, that is, more work was done with lower pressure-pulse products.
The use of hormone therapy and its alternatives in women with a history of hormone dependent cancer
Authors: Sekar Hashviniya , Singhal Tasneem , Holloway Debra , Rymer Janice 
Published: May 2013

Objective Treating the effects of menopause in women with history of oestrogen-dependent cancers presents a clinical dilemma. Endocrine adjuvant agents like tamoxifen and other cancer treatments, often induce premature menopause. Vasomotor, psychological and somatic symptoms may be more severe in these women. The risk of hormone therapy (HT) and its efficacy must be balanced. Currently, there are no consensus guidelines for the management of these patients. Study Design This is a retrospective study carried out between 10/01/2011 and 27/01/2012 in a tertiary referral menopausal clinic. Main Outcome measures Data was collected about cancer type and treatment, symptoms, prior use of T, bone density analyses and menopause treatments. Results 590 patient records were scanned and 146 patients (24.7%) had a history of cancer. Of these, 45.9% were younger than 50 years old. 67.1% comprised breast cancer patients, of which 69.4% were on adjuvant endocrine agents. 24.7% consisted of gynaecological cancer patients who were predominantly treated with surgery in conjunction with adjuvant therapies. 90.4% of the women had at least one menopause-related symptom, vasomotor symptoms being most prevalent, followed by psychological and vaginal symptoms. Women used a variety of HT and non-HRT therapies for their symptoms. Of the 77 women who had a personal history of oestrogen receptor positive cancers, 19.5% chose to take HT in spite of it being contraindicated. Conclusions Prescribing HT to women with a history of hormone dependent cancer remains controversial. Patient ‘Quality of Life’ must be considered. More research is required in this area.
Older adults are mobile too!Identifying the barriers and facilitators to older adults’ use of mHealth for pain management
Authors: Parker Samantha J , Jessel Sonal , Richardson Joshua E , Reid M Cary 
Published: May 2013

Abstract

Background
Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults’ attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management.

Methods
We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes.

Results
Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%).

Conclusions
This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, mHealth devices for older persons with CP.
Localization of putative binding sites for cyclic guanosine monophosphate and the anti-cancer drug 5-fluoro-2′-deoxyuridine-5′-monophosphate on ABCC11 in silico models
Authors: Honorat Mylène , Terreux Raphaël , Falson Pierre , Di Pietro Attilio , Dumontet Charles , Payen Lea 
Published: May 2013

Abstract

Background
The Multidrug Resistance Protein ABCC11/MRP8 is expressed in physiological barriers and tumor breast tissues in which it secretes various substrates including cGMP (cyclic guanosine monophosphate) and 5FdUMP (5-fluoro-2′-deoxyuridine-5′-monophosphate), the active metabolite of the anticancer drug 5-FluoroUracil (frequently included to anticancer therapy).
Previously, we described that ABCC11 high levels are associated to the estrogen receptor (ER) expression level in breast tumors and in cell lines resistant to tamoxifen. Consequently, by lowering the intracellular concentration of anticancer drugs, ABCC11 likely promotes a multidrug resistance (MDR) phenotype and decreases efficiency of anticancer therapy of 5FdUMP. Since no experimental data about binding sites of ABCC11 substrate are available, we decided to in silico localize putative substrate interaction sites of the nucleotide derivatives. Taking advantage of molecular dynamics simulation, we also analysed their evolution under computational physiological conditions and during the time.

Results
Since ABCC11 crystal structure is not resolved yet, we used the X-ray structures of the mouse mdr3 (homologous to human ABCB1) and of the bacterial homolog Sav1866 to generate two independent ABCC11 homology models in inward- and outward-facing conformations. Based on docking analyses, two putative binding pockets, for cGMP and 5FdUMP, were localized in both inward- and outward-facing conformations. Furthermore, based on our 3D models, and available biochemical data from homologous transporters, we identified several residues, potentially critical in ABCC11 transport function. Additionally, molecular dynamics simulation on our inward-facing model revealed for the first time conformation changes assumed to occur during transport process.

Conclusions
ABCC11 would present two binding sites for cGMP and for 5FdUMP. Substrates likely first bind at the intracellular side of the transmembrane segment while ABCC11 is open forward the cytoplasm (inward-facing conformation). Then, along with conformational changes, it would pass through ABCC11 and fix the second site (close to the extracellular side), until the protein open itself to the extracellular space and allow substrate release.
Effects of Lung Support Formula on respiratory symptoms among older adults: results of a three-month follow-up study in Shanghai, China
Authors: Cai Yong , Shi Rong , Song Huijiang , Shang Meili , Shen Tian , Shariff Mina , Kami Kenneth , Gu Pingping , Nguyen Tuong , Rao Jianyu 
Published: May 2013

Abstract

Background
With the acceleration of industrialization in low or middle-income nations, the prevalence of respiratory symptoms among older adults is even more significant now in China. Contemporary treatments using Western medicine, such as anti-inflammatory regimens, may be effective in relieving the symptoms, but may have unexpected side effects. Some natural products may be effective in improving respiratory functions, yet their efficacies remain to be examined in randomized, placebo-controlled studies. To evaluate the effects of Lung Support Formula, a nutritional supplement which contains naturally derived Chinese herbal medicines, we conducted a clinical study among older adults in Shanghai, China.

Methods
A total of 100 patients over 50 years old were recruited and blindly randomized into the treatment or control group. The subjects took either 1 Lung Support Formula capsule or a placebo capsule twice a day for 12 weeks. All subjects were followed-up every 4 weeks to perform investigative and clinical examinations. Repeated measure of analysis of variance was employed to compare the trend of respiratory symptoms scores between the 2 groups during 12 weeks of follow-up.

Results
Fifty patients from the treatment group and 49 patients in the control group completed the 3-month follow-up. No adverse events were reported in the treatment duration. The percentage of patients reported to have chronic cough, chronic expectoration and chronic bronchitis were significantly decreased in the treatment group when compared with baseline after a 3-month intervention (P < 0.05). The respiratory symptoms scores declined gradually with the lapse of time (P < 0.05) in the treatment group and there were no significant changes in the control group by repeated measure of analysis of variance (P > 0.05).

Conclusions
The clinical research shows that use of Lung Support Formula shows significant improvements of respiratory symptoms and is well-tolerated in short-term use among older adults. An additional study involving more subjects and longer-term follow-up would be needed to provide convincing evidence of the improvement of respiratory symptoms in the treatment group.
One-pot synthesis of α-Fe2O3 nanospheres by solvothermal method
Authors: Wang Caihua , Cui Yumin , Tang Kaibin 
Published: May 2013

Abstract
We have successfully prepared α-Fe2O3 nanospheres by solvothermal method using 2-butanone and water mixture solvent for the first time, which were about 100 nm in diameter and composed of very small nanoparticles. The as-prepared samples were characterized using X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. The results showed that the product was α-Fe2O3 nanosphere, and the temperature was an important factor on the formation of α-Fe2O3 nanospheres.
High level of susceptibility to human TRIM5α conferred by HIV-2 capsid sequences
Authors: Takeuchi Junko S , Perche Benjamin , Migraine Julie , Mercier-Delarue Séverine , Ponscarme Diane , Simon François , Clavel François , Labrosse Béatrice 
Published: May 2013

Abstract

Background
HIV-2, which was transmitted to humans from a distant primate species (sooty mangabey), differs remarkably from HIV-1 in its infectivity, transmissibility and pathogenicity. We have tested the possibility that a greater susceptibility of HIV-2 capsid (CA) to the human restriction factor TRIM5α (hTRIM5α) could contribute to these differences.

Results
We constructed recombinant clones expressing CA from a variety of HIV-2 viruses in the context of HIV-1 NL4-3-luciferase. CA sequences were amplified from the plasma of HIV-2 infected patients, including 8 subtype A and 7 subtype B viruses. CA from 6 non-epidemic HIV-2 subtypes, 3 HIV-2 CRF01_AB recombinants and 4 SIVsmm viruses were also tested. Susceptibility to hTRIM5α was measured by comparing single-cycle infectivity in human target cells expressing hTRIM5α to that measured in cells in which hTRIM5α activity was inhibited by overexpression of hTRIM5γ.
The insertion of HIV-2 CA sequences in the context of HIV-1 did not affect expression and maturation of the HIV-2 CA protein. The level of susceptibility hTRIM5α expressed by viruses carrying HIV-2 CA sequences was up to 9-fold higher than that of HIV-1 NL4-3 and markedly higher than a panel of primary HIV-1 CA sequences. This phenotype was found both for viruses carrying CA from primary HIV-2 sequences and viruses carrying CA from laboratory-adapted HIV-2 clones. High hTRIM5α susceptibility was found in all HIV-2 subtypes. In this series of viruses, susceptibility to hTRIM5α was not significantly affected by the presence of a proline at position 119 or by the number of prolines at positions 119, 159 or 178 in HIV-2 CA. No significant correlation was found between HIV-2 viremia and sensitivity to hTRIM5α.

Conclusions
HIV-2 capsid sequences expressed high levels of susceptibility to hTRIM5α. This property, common to all HIV-2 sequences tested, may contribute in part to the lower replication and pathogenicity of this virus in humans.