bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug‐Eluting Balloon in the Treatment of In‐Stent Restenosis and Diffuse Coronary Artery Disease: Real‐World Experience from Our Registry
Authors: BASAVARAJAIAH SANDEEP , LATIB AZEEM , SHANNON JOANNE , NAGANUMA TORU , STICCHI ALESSANDRO , BERTOLDI LETIZIA , COSTOPOULOS CHARIS , FIGINI FILIPPO , CARLINO MAURO , CHIEFFO ALAIDE , MONTORFANO MATTEO , COLOMBO ANTONIO 
Published: May 2014

ObjectivesTo report a single‐center experience of drug‐eluting balloons (DEB) in the treatment of in‐stent restenosis (ISR) and de novo coronary artery disease.BackgroundDEB are emerging as an alternative treatment for coronary stenosis especially when metal scaffolding is undesirable (in‐stent restenosis and small‐vessel de novo disease). Although there are various randomized trials and registry studies, the data from real‐world cohorts are lacking.MethodsConsecutive patients treated with the In.Pact Falcon™ (Medtronic Inc., Minneapolis, MN, USA) paclitaxel‐eluting balloon between January 2009 and December 2011 were retrospectively studied. The measured end‐points were cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and major adverse cardiac events (MACE) defined as combination of cardiac death, MI, and TVR.ResultsA total of 275 lesions were successfully treated in 184 patients. The mean age was 66.2 ± 9.6 years, and 87% were males. The predominant indication for DEB use was ISR (62%), with de novo lesions accounting for the remainder (38%). A mean of 1.48 ± 0.9 DEB were used per patient. Bailout stenting was required in 24% of lesions. The median clinical follow‐up was 14.6 months (IQR 12–23). The overall rates of cardiac death, MI, TLR, TVR, and MACE were 3.8%, 1.6%, 16.8%, 17.9%, and 21.7%, respectively. The overall rate of stent thrombosis was 0.5% (n = 1).ConclusionOur results suggests that DEB can be considered in lesions where the use of stents is not desirable, especially restenotic lesions. Further long‐term follow‐up of these patients will provide us more insights on the long‐term outcomes. (J Interven Cardiol 2014;27:348–355)
LIVING KIDNEY DONATION: CONSIDERATIONS AND DECISION‐MAKING
Authors: Agerskov Hanne , Bistrup Claus , Ludvigsen Mette Spliid , Pedersen Birthe D. 
Published: May 2014

SUMMARYBackgroundWhen possible, renal transplantation is the treatment of choice for patients with end‐stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non‐genetic living donors before first consultation at the transplant centre.ObjectiveThe aim was to investigate early experiences in the process of becoming a living kidney donor (LKD).Materials and MethodsThe study was conducted within a phenomenological‐hermeneutic theoretical framework. Data were generated through semi‐structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation theory on the three levels of naïve reading, structural analysis and critical interpretation and discussion.ResultsTwo themes emerged: the decision‐making process and dilemmas in decision‐making. The study identifies that the decision about donation was made in relation to one's own life, family situation and in relation to the recipient—considerations that demonstrate that a range of dilemmas can occur during the decision‐making process. The desire to help was prominent and was of significance in decision‐making.ConclusionThe study provides insight and knowledge for the health care professionals to meet and involve donors' narratives in reflections about and modifications to clinical nursing practice. It is essential that health care professionals have an understanding and appreciation of the experiences and concerns among LKDs, and this can help in planning and providing individual nursing care and support to donors.
Salutary effects of melatonin combined with treadmill exercise on cartilage damage
Authors: Hong Yunkyung , Kim Hyunsoo , Lee Youngjeon , Lee Seunghoon , Kim Koo , Jin Yunho , Lee Sang‐Rae , Chang Kyu‐Tae , Hong Yonggeun 
Published: May 2014

AbstractOsteoarthritis (OA) is a major cause of disability in the adult population. The purpose of this study was to evaluate the effects of melatonin with graded dosage on extracellular matrix synthesis and cellular death in response to cartilage damage in vitro and in vivo. TNF‐α reduced the viability of primary cultured chondrocytes and extracellular matrix protein, but melatonin at concentrations of 1 μm and 1 nm restored them. Rats with knee instability induced by intra‐articular collagenase were used for the in vivo study. Joint parameters were significantly augmented in the collagenase injection‐only group but not in the melatonin‐alone or melatonin+exercise groups, as cartilage degeneration progressed. Serum TNF‐α and IL‐6 were upregulated by collagenase injection, which was attenuated by melatonin with and without exercise in the early phase. TGF‐β1 mRNA was either conserved or enhanced by melatonin with and without exercise at the early phase. In particular, melatonin combined with exercise dramatically decreased the expression of not only catabolic mediators but also cellular death markers with lower mineralization. At the advanced phase, prolonged melatonin treatment promoted mineralization through caspase‐3‐mediated chondrocyte apoptosis. However, co‐intervention induced extracellular matrix remodeling through increases in IL‐6, EPAS‐1, and MMP‐13. Reconstructed micro‐CT images showed that collagenase injection induced subchondral bone erosion, formation of parameniscal osteophytes, and reduction of trabecular bone thickness regardless of the intervention, which was minimized by combined intervention. In conclusion, we suggest that melatonin with treadmill exercise may have both preventive and synergistic effects on rescue from cartilage degeneration and is more effective in the initial phase.
Synergistic cytotoxicity of the poly (ADP‐ribose) polymerase inhibitor ABT‐888 and temozolomide in dual‐drug targeted magnetic nanoparticles
Authors: Muñoz‐Gámez José A , López Viota Julián , Barrientos Andrés , Carazo Ángel , Sanjuán‐Nuñez Laura , Quiles‐Perez Rosa , Muñoz‐de‐Rueda Paloma , Delgado Ángel , Ruiz‐Extremera Ángeles , Salmerón Javier 
Published: May 2014

AbstractBackground & AimsHepatocellular carcinoma (HCC) is associated with a poor prognosis because of a lack of effective treatment options. The objective of this study was to examine a new strategy for HCC treatment, namely the use of poly (ADP‐ribose) polymerase 1 (PARP‐1) inhibitor (ABT‐888) together with Temozolomide (TMZ) incorporated onto magnetic nanoparticles.MethodsMagnetic Fe3O4/Fe cores were encapsulated within a silica shell to facilitate the simultaneous incorporation of ABT‐888 and TMZ. In vitro tests were performed with HepG2, Hep3B and PLC‐PRF‐5 liver tumoural cell lines and with WRL‐68 liver non‐tumoural cells.ResultsThe magnetic nanocarriers were loaded simultaneously with ABT‐888 and TMZ. High stability and extended release were achieved in culture medium. Confocal microscopy images showed that drug‐loaded particles were uptaken and accumulated into the cytoplasm of liver tumoural cells, inducing the following effects: G2/M cell cycle arrest (P < 0.05), accumulation of DNA damage (P < 0.05), mitochondrial depolarization (P < 0.01), reduction in BCL‐xL, FOS, JUND gene expression (P < 0.05), PARP‐1 fragmentation, Caspase‐3 activation and apoptotic cell death (P < 0.05). Interestingly, drugs loaded onto nanoparticles exhibited better efficiency than free drugs (cell death triggered by drug delivery nanosystem: 53.5% vs. 34.5% by free drugs, P = 0.01).ConclusionsThese magnetic nanocompounds are able to incorporate both drugs simultaneously, enter the tumour cells and release them. ABT‐888/TMZ/NPs decrease the transcription of key genes involved in tumour survival and induce apoptotic cell death in a more effective manner than is achieved by free drugs.
Alteration of Urothelial Inflammation, Apoptosis, and Junction Protein in Patients with Various Bladder Conditions and Storage Bladder Symptoms Suggest Common Pathway Involved in Underlying Pathophysiology
Authors: LIU Hsin‐Tzu , JIANG Yuan‐Hong , KUO Hann‐Chorng 
Published: May 2014

ObjectiveLower urinary tract symptoms (LUTS) are common in various bladder disorders. This study investigated urothelial dysfunction and chronic inflammation in the urothelium in different types of lower urinary tract dysfunction (LUTD), which causes bladder storage symptoms.MethodsBladder tissues were obtained from patients with LUTD including 17 with interstitial cystitis/bladder pain syndrome (IC/BPS), 15 with bladder outlet obstruction (BOO), 12 with spinal cord injury (SCI), 12 with recurrent urinary tract infection (UTI), 13 with ketamine related cystitis (KC) and 10 controls. The bladder specimens were investigated using immunofluorescence (IF) staining of the urothelial junction protein E‐cadherin and the TUNEL assay for urothelial apoptosis. Mast cell activation was also measured by IF using tryptase for mucosal inflammation. Statistical analysis was performed using the Kruskal–Wallis and Wilcoxon rank‐sum test and P‐values less than 0.05 were considered significant.ResultsHighly significant increases of mast cell infiltration were observed in patients with KC (7.8 ± 3.7), IC/BPS (4.6 ± 3.0), recurrent UTI (2.4 ± 1.2), SCI (3.7 ± 2.7), and BOO (5.1 ± 2.0) compared with controls (1.3 ± 1.2) (all p < 0.05). Statistically significant increases of apoptotic cells were observed in patients with KC (4.2 ± 1.5), IC/BPS (2.4 ± 1.7), SCI (2.4 ± 1.4), recurrent UTI (1.9 ± 2.4), and BOO (1.2 ± 1.1) compared with controls (0.08 ± 0.3) (all p < 0.05). Significantly decreased expression of E‐cadherin in patients with IC/BPS (25.1 ± 16.3), KC (11.0 ± 11.3), and recurrent UTI (26.2 ± 5.0) was found compared to controls (42.4 ± 16.7) and patients with SCI (44.4 ± 18.8) or BOO (42.8 ± 14.3) (all P < 0.05).ConclusionIncreased urothelial inflammation and urothelial cell apoptosis seem to share common pathophysiologies of various LUTDs that cause similar bladder symptoms.
Modelling, substrate docking and mutational analysis identify residues essential for function and specificity of the major fungal purine transporter AzgA
Authors: Krypotou Emilia , Lambrinidis George , Evangelidis Thomas , Mikros Emmanuel , Diallinas George 
Published: May 2014

SummaryThe AzgA purine/H+ symporter of Aspergillus nidulans is the founding member of a functionally and phylogenetically distinct transporter family present in fungi, bacteria and plants. Here a valid AzgA topological model is built based on the crystal structure of the Escherichia coli uracil transporter UraA, a member of the nucleobase‐ascorbate transporter (NAT/NCS2) family. The model consists of 14 transmembrane, mostly α‐helical, segments (TMSs) and cytoplasmic N‐ and C‐tails. A distinct compact core of 8 TMSs, made of two intertwined inverted repeats (TMSs 1–4 and 8–11), is topologically distinct from a flexible domain (TMSs 5–7 and 12–14). A putative substrate binding cavity is visible between the core and the gate domains. Substrate docking, molecular dynamics and mutational analysis identified several residues critical for purine binding and/or transport in TMS3, TMS8 and TMS10. Among these, Asn131 (TMS3), Asp339 (TMS8) and Glu394 (TMS10) are proposed to directly interact with substrates, while Asp342 (TMS8) might be involved in subsequent substrate translocation, through H+ binding and symport. Thus, AzgA and other NAT transporters use topologically similar TMSs and amino acid residues for substrate binding and transport, which in turn implies that AzgA‐like proteins constitute a distant subgroup of the ubiquitous NAT family.
Translational potential of a mouse in vitro bioassay in predicting gastrointestinal adverse drug reactions in Phase I clinical trials
Authors: Keating C. , Ewart L. , Grundy L. , Valentin J.P. , Grundy D. 
Published: May 2014

AbstractBackgroundMotility‐related gastrointestinal (GI) adverse drug reactions (GADRs) such as diarrhea and constipation are a common and deleterious feature associated with drug development. Novel biomarkers of GI function are therefore required to aid decision making on the GI liability of compounds in development.MethodsFifteen compounds associated with or without clinical GADRs were used to assess the ability of an in vitro colonic motility bioassay to predict motility‐related GADRs. Compounds were examined in a blinded fashion for their effects on mouse colonic peristaltic motor complexes in vitro. For each compound concentration‐response relationships were determined and the results compared to clinical data. Compounds were also assessed using GI transit measurements obtained using an in vivo rat charcoal meal model.Key ResultsWithin a clinically relevant dosing range, the in vitro assay identified five true and three false positives, four true and three false negatives, which gave a predictive capacity of 60%. The in vivo assay detected four true and four false positives, four false and three true negatives, giving rise to a predictive capacity for this model of 47%.Conclusions & InferencesOverall these results imply that both assays are poor predictors of GADRs. Further analysis would benefit from a larger compound set, but the data show a clear need for improved models for use in safety pharmacology assessment of GI motility.
A case–control study of childhood trauma in the development of irritable bowel syndrome
Authors: Halland M. , Almazar A. , Lee R. , Atkinson E. , Larson J. , Talley N. J. , Saito Y. A. 
Published: May 2014

AbstractBackgroundThe etiology of irritable bowel syndrome (IBS) is not been fully elucidated, but childhood trauma may disturb the brain–gut axis and therefore be important. Thus, we conducted a family based case–control study of IBS cases and their relatives with the aims to (i) determine the frequency of childhood trauma among IBS cases and controls as well as their relatives, and (ii) assess childhood trauma among IBS cases with affected relatives (familial IBS).MethodsOutpatients with IBS, matched controls, and their first‐degree relatives completed a self‐report version of Bremner' Early Trauma Inventory. Percent of cases and controls with a family history were compared and odds ratios were computed using chi‐squared test; recurrence risks to relatives were computed using logistic regression and generalized estimating equations.Key ResultsData were collected from 409 cases, 415 controls, 825 case relatives, and 921 control relatives. IBS cases had a median age of 50 and 83% were women. Of IBS cases, 74% had experienced any general trauma compared to 59% among controls, yielding an odds ratio of 1.56 (95% CI: 1.13–2.15, p < 0.008). There were no statistical differences between IBS relatives and control relatives with regards to lifetime trauma.Conclusions & InferencesIBS is associated with childhood trauma, and these traumas often occur prior to onset of IBS symptoms. This provides further insight into how traumatic childhood events are associated with development of adult IBS.
Is there a relationship between red or processed meat intake and obesity? A systematic review and meta‐analysis of observational studies
Authors: Rouhani M. H. , Salehi‐Abargouei A. , Surkan P. J. , Azadbakht L. 
Published: May 2014

SummaryA body of literature exists regarding the association of red and processed meats with obesity; however, the nature and extent of this relation has not been clearly established. The aim of this study is to conduct a systematic review and meta‐analysis of the relationship between red and processed meat intake and obesity. We searched multiple electronic databases for observational studies on the relationship between red and processed meat intake and obesity published until July 2013. Odds ratios (ORs) and means for obesity‐related indices and for variables that may contribute to heterogeneity were calculated. A systematic review and a meta‐analysis were conducted with 21 and 18 studies, respectively (n = 1,135,661). The meta‐analysis (n = 113,477) showed that consumption of higher quantities of red and processed meats was a risk factor for obesity (OR: 1.37; 95% CI: 1.14–1.64). Pooled mean body mass index (BMI) and waist circumference (WC) trends showed that in comparison to those in the lowest ntile, subjects in the highest ntile of red and processed meat consumption had higher BMI (mean difference: 1.37; 95% CI: 0.90–1.84 for red meat; mean difference: 1.32; 95% CI: 0.64–2.00 for processed meat) and WC (mean difference: 2.79; 95% CI: 1.86–3.70 for red meat; mean difference: 2.77; 95% CI: 1.87–2.66 for processed meat). The current analysis revealed that red and processed meat intake is directly associated with risk of obesity, and higher BMI and WC. However, the heterogeneity among studies is significant. These findings suggest a decrease in red and processed meat intake.
Comparison of propofol and dexmedetomedine techniques in children undergoing magnetic resonance imaging
Authors: Wu Junzheng , Mahmoud Mohamed , Schmitt Megan , Hossain Md , Kurth Dean 
Published: May 2014

SummaryBackgroundPropofol (PRO) and dexmedetomidine (DEX) are commonly used to produce anesthesia and sedation for routine MRI procedures. Children with complex conditions often require much lengthy MRI for multi‐body‐part scans with frequent scanner coil changes and patient body reposition. This study compared PRO and DEX techniques on outcomes for the particular MRI setting with longer than 1 h duration.Methods95 children, aged from 1 to 7 years, scheduled for MRI >75 min were randomly assigned to PRO or DEX group. After induced with sevoflurane, a loading dose of PRO (2 mg·kg−1) was administrated and followed by continuous infusion (200 μg·kg−1·min−1); a loading dose of DEX (2 μg·kg−1) was administrated and followed by continuous infusion (2 μg·kg−1·h−1). Patients received O2 by nasal cannula. The observed outcomes were times for induction, MRI, emergence, and recovery, and total time (induction to discharge); MRI pauses from patient movement; incidence of technique failure and critical events; emergence and behavior in postanesthesia care unit (PACU); parental satisfaction; and arterial pressure (BP) and heart rate (HR) during anesthesia.ResultsPRO compared with DEX showed significantly less time for anesthesia induction (16.3 versus 24.2 min), emergence (21.2 versus 39.9 min), PACU (35.7 versus 62.5 min), and total time (135 versus 173 min) (all P < 0.001). There were significantly fewer pauses during MRI and lower failure rate to complete MRI in PRO versus DEX (0.22 versus 0.81, P = 0.01 and 1 versus 15, P < 0.001), less behavioral disturbances in PACU, and higher parental satisfaction in PRO versus DEX (P < 0.01). There were no critical events in either group: In PRO, mean BP during MRI (from 52 ± 8 to 58 ± mmHg) was significantly less than before anesthesia (80 ± 12 mmHg), while HR remained relatively constant (range of 97–103) at its baseline of 108 ± 21, but in DEX, mean BP remained unchanged (from 76 ± 12 to 78 ± 15) during anesthesia compared with before anesthesia (79 ± 14 mmHg), while HR decreased (74 ± 16 to 78 ± 15) during anesthesia from its baseline (102 ± 17) .ConclusionFor children undergoing lengthy multicomponent MRI, the propofol technique yielded overall better outcomes than the dexmedetomedine technique in terms of timeliness, PACU emergence characteristics, and parental satisfaction.
Update on the 2012 guidelines for the management of pediatric traumatic brain injury – information for the anesthesiologist
Authors: Hardcastle Nina , Benzon Hubert A. , Vavilala Monica S. 
Published: May 2014

SummaryTraumatic brain injury (TBI) is a significant contributor to death and disability in children. Considering the prevalence of pediatric TBI, it is important for the clinician to be aware of evidence‐based recommendations for the care of these patients. The first edition of the Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents was published in 2003. The Guidelines were updated in 2012, with significant changes in the recommendations for hyperosmolar therapy, temperature control, hyperventilation, corticosteroids, glucose therapy, and seizure prophylaxis. Many of these interventions have implications in the perioperative period, and it is the responsibility of the anesthesiologist to be familiar with these guidelines.
Bleeding management for pediatric craniotomies and craniofacial surgery
Authors: Goobie Susan M. , Haas Thorsten 
Published: May 2014

SummaryPediatric patients when undergoing craniotomies and craniofacial surgery may potentially have significant blood loss. The amount and extent will be dictated by the nature of the surgical procedure, the proximity to major blood vessels, and the age, and weight of the patient. The goals should be to maintain hemodynamic stability and oxygen carrying capacity and to prevent and treat hyperfibrinolysis and dilutional coagulopathy. Over transfusion and transfusion‐related side effects should be minimized. This article will highlight the pertinent considerations for managing massive blood loss in pediatric patients undergoing craniotomies and craniofacial surgery. North American and European guidelines for intraoperative administration of fluid and blood products will be discussed.
Outpatient analgesia via paravertebral peripheral nerve block catheter and On‐Q pump—a case series
Authors: Visoiu Mihaela 
Published: May 2014

SummaryOutpatient pain management after iliac crest bone harvesting can be challenging. We report the use of home L2 paravertebral nerve block catheter (L2PVBC) in a series of five children. The pain scores were low, and analgesic medication consumption was minimal. No complications were reported related with these catheters, and the patients reported very high pain control satisfaction scores. Outpatient L2PVBC can be beneficial as part of a multimodal analgesia strategy in selected pediatric patients.
Transition from hospital to home following pediatric solid organ transplant: Qualitative findings of parent experience
Authors: Lerret Stacee M. , Weiss Marianne E. , Stendahl Gail , Chapman Shelley , Neighbors Katie , Amsden Katie , Lokar Joan , Voit Ashley , Menendez Jerome , Alonso Estella M. 
Published: May 2014

AbstractTransplant providers are challenged to determine appropriate interventions for patients and families due to limited published research regarding the context of the post‐discharge experience from the perspective of parents of transplanted children. The purpose of this study is to describe the parent perspective of the transition from hospital to home following their child's solid organ transplant. Within a mixed‐methods design, 37 parents of pediatric heart, kidney, and liver transplant recipients from three pediatric hospitals responded to qualitative interview questions on the day of hospital discharge and three wk following hospital discharge. Insight to the discharge preparation process revealed necessary education components. Post‐discharge themes were identified for coping, knowledge, and adherence. The parents' responses provide awareness as to specific stressors and concerns parents are faced with when their child is discharged from the hospital after solid organ transplant and opportunities for ways the transplant team can provide support.