bluuebunny/crossref_metadata_2025_split huggingface dataset:
S100/Calgranulin-Mediated Inflammation Accelerates Left Ventricular Hypertrophy and Aortic Valve Sclerosis in Chronic Kidney Disease in a Receptor for Advanced Glycation End Products–Dependent Manner
Authors: Yan Ling , Mathew Liby , Chellan Bijoy , Gardner Brandon , Earley Judy , Puri Tipu S. , Hofmann Bowman Marion A. 
Published: May 2014

Objective—
S100A12 and fibroblast growth factor 23 are biomarkers of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD). We tested the hypothesis that human S100/calgranulin would accelerate cardiovascular disease in mice subjected to CKD.

Approach and Results—
A bacterial artificial chromosome of the human S100/calgranulin gene cluster containing the genes and regulatory elements for S100A8, S100A9, and S100A12 was expressed in C57BL/6J mouse (hBAC-S100) to generate a novel humanized mouse model. CKD was induced by ureteral ligation, and hBAC-S100 mice and wild-type mice were studied after 10 weeks of chronic uremia. hBAC-S100 mice with CKD showed increased fibroblast growth factor 23 in the hearts, left ventricular hypertrophy, diastolic dysfunction, focal cartilaginous metaplasia, and calcification of the mitral and aortic valve annulus together with aortic valve sclerosis. This phenotype was not observed in wild-type mice with CKD or in hBAC-S100 mice lacking the receptor for advanced glycation end products with CKD, suggesting that the inflammatory milieu mediated by S100/receptor for advanced glycation end products promotes pathological cardiac hypertrophy in CKD. In vitro, inflammatory stimuli including interleukin-6, tumor necrosis factor-α, lipopolysaccarides, or serum from hBAC-S100 mice upregulated fibroblast growth factor 23 mRNA and protein in primary murine neonatal and adult cardiac fibroblasts.

Conclusions—
Myeloid-derived human S100/calgranulin is associated with the development of cardiac hypertrophy and ectopic cardiac calcification in a receptor for advanced glycation end products–dependent manner in a mouse model of CKD. We speculate that fibroblast growth factor 23 produced by cardiac fibroblasts in response to cytokines may act in a paracrine manner to accelerate left ventricular hypertrophy and diastolic dysfunction in hBAC-S100 mice with CKD.
Rh vs pH: the role of Rhesus glycoproteins in renal ammonia excretion during metabolic acidosis in a freshwater teleost fish
Authors: Wright Patricia A. , Wood Chris M. , Wilson Jonathan M. 
Published: May 2014

AbstractIncreased renal ammonia excretion in response to metabolic acidosis is thought to be a conserved response in vertebrates. We tested the hypothesis that Rhesus (Rh) glycoproteins in the kidney of the freshwater common carp Cyprinus carpio play a critical role in regulating renal ammonia excretion during chronic metabolic acidosis. Exposure to water pH 4.0 (72 h) resulted in a classic metabolic acidosis with reduced plasma pHa, [HCO3-], no change in PCO2, and large changes in renal function. Urine [NH4+] as well as [titratable acidity–HCO3-] rose significantly over the acid exposure, but the profound reduction (5-fold) in urine flow rates eliminated the expected elevations in renal ammonia excretion. Low urine flow rates may be a primary strategy to conserve ions, as urinary excretion of Na+, Cl- and Ca2+ were significantly lower during the acid exposure relative to the control period. Interestingly, renal Rhcg1 mRNA and protein levels were elevated in acid relative to control groups, along with mRNA levels of several ion transporters, including the Na+/H+ exchanger (NHE3), H+ATPase and Na+/K+ATPase (NKA). Immunofluorescence microscopy showed a strong apical Rhcg1 signal in distal tubules. Taken together, these data show that renal Rh glycoproteins and associated ion transporters are responsive to metabolic acidosis, but conservation of ions through reduced urine flow rates takes primacy over renal acid-base regulation in the freshwater C. carpio. We propose that an “acid/base-ion balance” compromise explains the variable renal responses to metabolic acidosis in freshwater teleosts.
Transition from wing to leg forces during landing in birds
Authors: Provini Pauline , Tobalske Bret W. , Crandell Kristen E. , Abourachid Anick 
Published: May 2014

AbstractTransitions to and from the air are critical for aerial locomotion and likely shaped the evolution of flying animals. Research on take-off demonstrates that legs generate greater body accelerations compared to wings, and thereby contribute more to initial flight velocity. Here, we explore coordination between wings and legs in two species with different wingbeat styles, and quantified force production of these modules during the final phase of landing. The same birds we studied during take-off were used: zebra finch (Taeniopygia guttata, n=4) and diamond dove (Geopelia cuneata, n=3). We measured kinematics using high-speed video, aerodynamics using particle image velocimetry, and ground-reaction forces using a perch mounted on a force-plate. In contrast with the first three wingbeats of take-off, the final four wingbeats during landing featured ~2 times greater force production. Thus, wings contribute proportionally more to changes in velocity during the last phase of landing compared with the initial phase of take-off. Both species touched down at the same velocity (~1 m/s), but they exhibited significant differences in timing of their final wingbeat relative to touchdown. The ratio of average wing force to peak leg force was greater in doves than finches. Peak ground reaction forces during landing were ~50% of those during take-off, consistent with the birds being motivated to control landing. Likewise, estimations of mechanical energy flux for both species indicate wings produce 3-10 times more mechanical work within the final wingbeats of flight compared with the kinetic energy of the body absorbed by legs during ground contact.
Adherence to intermittent preventive treatment for malaria in pregnancy
Authors: Nankwanga Hasahya Alice Agnes , Gorette Nalwadda 
Published: May 2014

Malaria during pregnancy is a serious health risk for pregnant women; it is associated with maternal and infant morbidity and mortality. In Uganda, Intermittent Preventive Treatment (IPT) for prevention of Malaria in pregnancy, coverage one and two are still low standing at 61%, 38% respectively. To identify client-related, health worker-related and health-related factors affecting adherence to IPT. A descriptive cross-sectional study involving 222 pregnant women and 15 health workers was undertaken in Kampala City Council (KCC) health centre IV (Kawempe, Naguru and Kiruddu), Data was collected using interview guided and self-administered questionnaires and checklist. Only 21% of pregnant women were told about the use of drugs to prevent malaria; 31.5% knew the recommended drug used in prevention of malaria in pregnancy; while 4.5% knew the fansidar recommended doses taken. Over 95% of pregnant women reported no health education was given to them concerning IPT. Surprisingly only 34.4% took fansidar under observation by a health worker. Guidelines on malaria in pregnancy were not referred to and only 1.6% of health workers were trained in the last six months. Generally all the three heath units lacked cups, kettles, posters on prevention of malaria in pregnancy and IPT. Awareness and use of IPT among pregnant women in KCC health units was very low. Health workers knew the importance of IPT but practice as directly observed therapy was poor. KCC should strengthen campaigns for IPT, support training and supervise health workers.
Managing postnatal depression in young mothers
Authors: Danda Grace , Mudokwenyu-Rawdon Christine , Mapanga KG 
Published: May 2014

The purpose of this study was to determine knowledge of stress management techniques and their affect on postnatal depression in young mothers. A descriptive design was used; 75 young mothers (17–25 years) were sampled at two and six weeks postnatally using systematic random sampling. The instruments used for postnatal depression were the Mills depression scale and the Edinburgh postnatal depression scale and for assessing stress management a knowledge questionnaire was used. Most common responses given were appetite change (54.7%), feeling depressed (48%), feeling irritable (49.3%), loss of libido (52%), self-blame (54.7%), worried and anxious (50.7%) and sadness or miserable (42.7%). Both instruments combined defined 32% (n=24) subjects with postnatal depression. The Mills scale indicated 48% with depressed feelings, which suggests the need for early diagnosis as well as educating mothers on stress management as evidenced by the stress management knowledge questionnaire with 35.9% showing below average knowledge.
Adopting a fast-track approach to cardiac surgery
Authors: Aps Chris 
Published: May 2014

In the UK fast-tracking is a clinical practice that reduces the need For or duration of, postoperative critical care support, thus allowing Patients to be admitted to clinical areas other than the intensive care Unit (ICU) after surgery. In some other countries, notably the USA, this Practice is used to reduce ICU length of stay and hence costs. Implicit in successful fast-tracking is the improved clinical condition Of patients (a quality issue), which reduces time to extubation and Facilitates same-day discharge to lower dependency beds. This Relieves the pressure on over-stretched critical care resources, Impacts beneficially on operative cancellation rates and frees up ICU Beds for emergency admissions.
Nurse-led versus physician-led post-myocardial infarction review clinics: A retrospective study
Authors: Leslie Stephen J , Katikreddi Vittal , Geddes Jane , Perkins Sarah , Hargreaves Allister D 
Published: May 2014

Objectives: The study aimed to investigate differences between physician and nurse-led post myocardial infarction (MI) clinics in relation to quality of documentation and initiation of changes in treatment. In the hospital there was concern that patients were not seen in clinic quickly enough after their MI. Therefore the decision was made to undertake a study to help determine whether nurse-led clinics were an effective service development. Methods: Clinic letters from 78 patients who attended both a physician-led and nurse-led clinic after a myocardial infarction were reviewed. The role of the clinic was to assess patients in relation to symptoms and drug treatment and to address any secondary prevention issues. Results: Nurses letters contained more details of symptoms and clinical findings than those of doctors, and nurses invited more patients to attend rehabilitation, but they suggested fewer changes in drug treatment. Conclusions: Nurses were better at the documenting symptoms and addressing secondary prevention but they were less confident about initiating treatment changes. Nurse-led clinics should continue to develop, but specialist physician support is needed to arrange invasive investigations or initiate complex therapy changes for more complex cases
Obesity and cardiovascular disease: A population perspective
Authors: Lindfield Robert , Lemic Nada 
Published: May 2014

Obesity is increasing rapidly throughout the world. As more people become obese there will be a significant rise in the prevalence of diseases associated with obesity. This has major implications for public health and health service provision. Numerous studies have revealed the links between obesity and cardiovascular disease. In certain diseases such as hypertension, coronary heart disease, heart failure and stroke, there is clear evidence for an increased risk in adults with a body mass index greater than 30kg/m2. Childhood obesity probably increases the risk of cardiovascular disease in later life and intentional weight loss probably decreases the risk at any age but the evidence is less clear. Prevention is key to avoiding the potential for epidemics in diseases associated with obesity. Prevention of obesity must include sustainable changes in lifestyle, including diet and exercise in an environment that supports healthy choices.
Addressing the taboos: Resuming sexual activity after myocardial infarction
Authors: O’Donovan Kate 
Published: May 2014

Resuming sexual activity after a myocardial infarction (MI) is a common worry shared between patients and their partners. Common concerns that are expressed often involve the perceived risk of causing another acute coronary event and the impact that cardiovascular medication may have on sexual function. Patients and their partners need practical information that they can process and deal with. Such information comprises when to resume sexual activity and what to avoid. For example, avoiding sexual activity after a heavy meal or the consumption of alcohol. Patients also need to be informed that sexual dysfunction may develop as a result of the atherosclerotic process or the cardiovascular medications and other treatment options. Providing information on resuming sexual activity after an MI is an essential aspect of patient education and the discharge process, but many nurses in the critical care setting are reluctant to initiate discussion on this sensitive subject. This reluctance may develop as a result of embarrassment or the nurse may be uncomfortable with his or her own sexuality. The nurse may also feel that bringing up this subject is an invasion of the patient’s privacy. Other influences include environmental factors. For example, the unit may be very busy or there is not a suitable place to conduct the conversation. In addition, the patient may be considered too ill. The literature has illustrated many strategies to overcome this reluctance to initiate a discussion about sexuality. These may include workshops or the use of open questions that may encourage discussion.
Acute coronary syndromes and hospital care: Patients’ experiences
Authors: Dunckley Maria , Quinn Tom , McDonald Ruth , Dickson Rumona , Jayram Rav , Wright Christine 
Published: May 2014

Background: Acute coronary syndromes (ACS) are a major health problem. However, there is little research into the determinants of patients’ experiences of their care when they are admitted to hospital with an ACS. Nurses across the NHS are being empowered to undertake a growing range of responsibilities but the literature on patients’ perceptions of these role changes is sparse. In this article we report findings from a patient focus group that was designed to inform the development of a patient survey. The aim of this survey was to evaluate the process of introducing ACS nurses into six hospitals in England and Scotland. Method: Patients with a diagnosis of ACS were invited to take part in one focus group. Data were analysed using the method of constant comparison. Results: Five men and five women (age range 51–85 years) participated. The following themes emerged from the analysis: expectations and satisfaction, competence of staff, nursing roles, communication and coordination, and discharge and transition. Discussion: This study provides an insight into a number of potentially modifiable factors that may affect the experiences of patients who are being treated for an ACS in the NHS.
Stored ICD electrograms: How do they aid diagnosis of arrhythmia episodes?
Authors: Elliott-Rotgans Donna 
Published: May 2014

The development of specialist arrhythmia nurse roles caring for patients who have an implantable cardiac defibrillator (ICD) means nurses are increasingly expected to know more about the technical aspects of ICD therapy. This article explains how the intracardiac electrogram (IEGM) data stored in an ICD is used by the device to adjust patient therapy. It also explains how the information is used in follow-up, including how it can guide device reprogramming by the specialized cardiac physiologist.
Electrical cardioversion to terminate cardiac arrhythmia
Authors: Sargent Andrew 
Published: May 2014

Electrical cardioversion involves the passage of direct current (DC) electricity across the heart, synchronized to the ECG rhythm, to convert cardiac arrhythmias causing haemodynamic symptoms (where a cardiac output is still present). This article describes the theory behind electrical cardioversion, indications and the procedure for elective cardioversion (for example, for atrial fibrillation). Nurse-led initiatives relating to this aspect of arrhythmia management are also considered.
A multidisciplinary service for inherited cardiac disease in a regional clinical genetics service
Authors: Watts Sally , Bueser Tootie , Robert M L P 
Published: May 2014

During the past decade there has been a rapid rise in genetic knowledge and huge technological advances. It is now possible to identify families at increased risk of inherited cardiac disorders such as cardiomyopathy and long QT syndrome. Such conditions can be associated with early onset sudden death and the National Service Framework (Chapter 8) recommends that families are offered appropriate support and treatment in specialized centres. In addition, delivery of efficient, effective and increasingly patient-focused services has become vital. This article describes the development of a multidisciplinary cardiac genetics service in a regional genetics centre. It highlights the current challenges for health screening and genetic testing. The importance of the role of the health professionals caring for patients with inherited cardiac disease in establishing the accurate diagnosis and management of these families is also highlighted. A case study demonstrates the variability in presentation of cardiac disease that can occur in families and the necessity of providing a multidisciplinary service.
Evolution of a nurse-facilitated suspected arrhythmia clinic
Authors: Lapper Andrew , Smallwood Andrew 
Published: May 2014

Objective: The purpose of this audit was to describe and compare the referred population to a nurse-facilitated suspected arrhythmia clinic for the period July 2007 to July 2008 with the previous year’s audit data as reported by Lapper and Smallwood (2008); assessing the impact on service provision and use of resources. Method: Retrospective data were collected from all new referrals to a nurse-facilitated suspected arrhythmia clinic from July 2007 to July 2008. Results: 302 patients were referred to the nurse-facilitated suspected arrhythmia clinic. Referrals were predominantly female, aged between 17–92 years and mostly Caucasian. The most common symptom prompting referral was palpitations (60%), with ‘stress’ being the most common self-reported precipitating factor (20%). Cardiac monitoring was instituted in 73% of patients. Following investigation atrial fibrillation was identified in 31% of referred patients, paroxysmal supra-ventricular tachycardia 9%, atrial ectopy 7%, ventricular ectopy 13%, sinus rhythm with pauses (1%), with no arrhythmias identified in 38% of the cohort. Findings were not recorded in 1% of patients. Conclusions: The most striking feature of this review is the 57% increase in new patients referred suggesting that this clinic has become embedded in the cardiology appointments system and shows a willingness of referrers to use this avenue of referral. An impact on resources and practitioner role was noted. Despite the increase in referrals the number of arrhythmias detected was noted to be similar to the previous audit period. The need to evaluate clinic effectiveness is highlighted.
Heart attacks and circadian rhythms
Authors: Pierce-Hayes Ian 
Published: May 2014

Aims: This study has two main aims. First, to confirm a peak incidence of heart attacks (acute myocardial infarction or AMI) occurring in the early hours of the morning and second, to explore the links between acute myocardial infarction and circadian rhythms. Circadian rhythms control a host of biochemical, biological and behavioural patterns in humans. There is an internal mechanism for circadian rhythms known as the biological clock and external factors such as the light/dark cycle that ensures that our internal clock is synchronized with the environment. Methods: This is a quantitative study collating data from patients attending a district general hospital with a diagnosis of ST-segment elevation MI as part of the Myocardial Ischaemia (formerly Infarction) National Audit Database (MINAP). Results: The results of the study show that there is a significant peak in incidence of AMI in the morning hours between 6 am and 12 noon. This peak accounts for 34% of all patients presenting with AMI which is statistically significant (P<0.001). The review of the literature suggests a link between the peak in incidence of AMI and circadian rhythms. Conclusions: An understanding of circadian rhythms is important to understand how patients with AMI and other acute coronary syndromes can be treated but also how to prevent their occurrence.
Emotional impact on patients and families on the heart transplant waiting list
Authors: McDermott Anne , Hardy Jo , McCurry Mandy 
Published: May 2014

Acceptance onto the heart transplant waiting list can lead to a period of uncertainty, as there are no guarantees as to when or if a suitable donor organ will be found. During this time, patients are seen to exhibit a wide variety of emotions, including fear, anxiety and depression and guilt, at the same time as experiencing a gradual decline in their physical health. This is also a time of intense emotional stress for the family of the patient, who while fearing the death of their loved one, have to manage extended roles and responsibilities with limited time and resources. All health professionals involved in the care of patients who are on the transplant waiting list should be aware of the physical and emotional demands placed upon the individual. This awareness must extend to the patients’ support network of family and friends.
Exploring the impact of DNA testing for familial hypercholesterolaemia
Authors: Watson Melanie 
Published: May 2014

Familial hypercholesterolaemia (FH) is a genetic disorder with a prevalence of 1 in 500, approximately 110 0000 people are estimated to be affected in the UK. The majority remain undiagnosed. Effective preventive treatment is available to reduce cholesterol. Untreated FH leads to premature CHD and death. The main aims of the study were to explore how patients and their families receive, make sense of and transmit genetic information and the impact that this dynamic process has on their perception of risk. Semi-structured interviews were conducted with 7 patients with a clinical diagnosis of FH and a mutation positive result. A further 7 interviews were conducted with members of their families who had also undergone genetic testing. The interview transcripts were thematically analysed. The findings suggest that genetic risk information help patients to make sense of their condition and acts as a stimulus to cascade testing. The process of family communication and the emotional responses to genetic risk information were complex.
Physical and psycho-social issues in treatment of elderly patients with valve disease
Authors: Parker Jessica , Saheecha Saad 
Published: May 2014

The number of elderly patients with valvular heart disease is steadily rising. Modern medicine with advancing surgical research and intervention mean that there are multiple options for treating elderly ‘high-risk’ patients. Many of these patients are frail, have complex comorbidities and added difficulties such as visual or hearing loss. Identifying the many physical and psychosocial issues that hinder interventional treatment and recovery of elderly patients with valve disease will help ensure they receive holistic unbiased treatment and maintain a good quality of life. This article will explore the complex symptoms and diagnosis of valve disease in the elderly, treatments available to ‘high-risk’ patients and the difficulties that arise in care, treatment planning and recovery. Some key nursing roles are identified.