bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endotoxin Adsorption using Polymyxin B Immobilized Fiber Cartridges in Severe Sepsis Patients following Cardiac Surgery
Authors: Yaroustovsky Michail , Abramyan Marina , Krotenko Nickolay , Popov Dmitry , Plyushch Marina , Popok Zakhar 
Published: May 2014

Introduction Sepsis still represents an obstacle in modern medicine. The purpose of this study was to evaluate the safety and effectiveness of selective lipopolysaccharide (LPS)-adsorption therapy using polymyxin B immobilized fiber cartridges in adult patients complicated with severe sepsis after cardiac surgery. Methods 65 patients received extracorporeal LPS-adsorption procedures using Toraymyxin columns (PMX; Toray, Tokyo, Japan) in addition to the standard treatment according to the Surviving Sepsis Campaign guidelines. The inclusion criteria were clinical signs of severe sepsis, endotoxin activity assay (EAA) ≥0.6, and blood plasma procalcitonin (PCT) >2 ng/ml. For the control group, we selected 40 patients who were comparable with the study group but who received only the standard therapy. Results Each patient received 2 standard LPS-adsorption procedures (lasting for 120 min each). After the LPS-adsorption course, we noted any indices of hemodynamic improvements, including an increase in mean arterial pressure from 73 to 89 mmHg (p<0.001), mean oxygenation index (213-265, p<0.001. We observed a decrease in LPS concentrations by the EAA (0.71-0.55, p<0.001) and by the LAL test (1.44-0.36 EU/ml, p<0.001). In the control group, there were no significant changes in any of the studied parameters. Moreover, the 28-day mortality was 42% in the study group and 65% in the control group (p = 0.032). The endotoxin adsorption procedures were not associated with any adverse reactions, and specifically, no extracorporeal circuit thrombosis cases were noted. Conclusions Selective LPS-adsorption is a safe and possibly effective adjunctive treatment method for severe sepsis patients.
Type of Vascular access and Location in Online Hemodiafiltration and its Association with Patient's Perception of Health-Related Quality of Life
Authors: Moura Alexandra , Madureira José , Alija Pablo , Fernandes João Carlos , Oliveira José Gerardo , Lopez Martin , Filgueiras Madalena , Amado Leonilde , Sameiro-Faria Maria , Miranda Vasco , Vieira Margarida , Santos-Silva Alice , Costa Elísio 
Published: May 2014

Purpose The aim of this work is to evaluate the patient-reported health-related quality of life (HRQOL), according to the type and location of vascular access used for dialysis procedure. Methods In this transversal study, 322 end-stage renal disease (ESRD) patients under online hemodiafiltration (OL-HDF, 59.63% males; 64.9±14.3 years) were enrolled. Arteriovenous fistula (AVF) was used by 252 patients (78.3%), whereas 70 patients (21.7%) had a central venous catheter (CVC). Besides AVF location, data on comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected. Moreover, the patients’ reported HRQOL score, using the Kidney Disease Quality of Life-Short Form, was evaluated. Results ESRD patients using CVC as vascular access presented a decrease in four SF-36 domain scores, namely physical functioning, emotional well-being, role-emotional and energy/fatigue when compared with those using AVF as vascular access. Additionally, these patients also showed significant differences in ESRD target areas, namely decline in cognitive function and quality of social interaction domains. When comparing the variables according to the localization of the AVF, significant differences were found in three SF-36 domain scores, namely physical functioning, pain and general health. Moreover, we also found significant differences in ESRD target areas, namely symptoms/problem list, effects of kidney disease and quality of social interaction domains. Conclusions Our results showed that ESRD patients under OL-HDF using AVF as vascular access had higher HRQOL scores in several domains when compared with those using CVC. Additionally, we also found that dialysis patients using AVF in the left forearm presented with higher HRQOL scores.
Percutaneous Translumbar Catheterization of the Inferior Vena Cava as an Emergency access for Hemodialysis – 5 Years of Experience
Authors: Kade Grzegorz , Leś Jarosław , Buczkowska Magdalena , łabuś Małgorzata , Niemczyk Stanisław , Wańkowicz Zofia 
Published: May 2014

Patients and Methods In this study, 13 patients (11 men and 2 women) undergoing hemodialysis (HD) with the use of a catheter placed into the inferior vena cava with percutaneous translumbar access were retrospectively evaluated. In the studied group, 16 procedures of percutaneous translumbar catheterization were performed. Complications connected with the presence of catheter, such as hematoma, thrombosis, infection, catheter movement or unsuccessful catheterization, were analyzed. Moreover, another aspect of our report was to evaluate the adequacy of HD treatment performed by lumbar catheter. Results The total time of translumbar catheter observation was 4,169 days. Average time of their functioning was 261 days. The most frequent reason for termination of the use of translumbar HD catheters was spontaneous/idiopathic removal – 2 cases. Episodes of infection and thrombosis per 1,000 days of catheter observation were 2.2 and 1.2, respectively. Conclusions Based on our study, we can conclude that correctly performed percutaneous translumbar catheterization of the inferior vena cava, in order to produce a long-term vascular access for HD, is a valuable and safe method in patients after depletion of standard vascular accesses.
A Refinement of Hong's Technique for the Removal of Stuck Dialysis Catheters: An Easy Solution to a Complex Problem
Authors: Quaretti Pietro , Galli Franco , Fiorina Ilaria , Moramarco Lorenzo Paolo , Spina Monica , Forneris Giacomo , Torresi Mario , Bellazzi Roberto 
Published: May 2014

Aim A long-term tunneled hemodialysis catheter can be difficult or impossible to pull out if a fibrin sleeve has attached it to the venous wall. We report the outcome of a refinement of Hong's technique for removing incarcerated catheters aimed at improving its feasibility and safety. Methods We applied a modification of Hong's technique in four patients (two males, age ranging from 51 to 68 years) with jugular twin hemodialysis catheters (five of eight lines incarcerated). Hong pioneered the technique of endoballooning to expand a stuck central venous catheter, thus freeing it from adhesions. In our technical refinement, we cut the catheter close to its venous entry point in order to facilitate pullout and inserted a valved introducer as access for guide wires as well as for inflations of the catheter balloon. A stiff guide wire was placed in the inferior vena cava to avoid potential damage to heart cavities. Dilation was monitored under fluoroscopy with constrictions showing points where the catheter was incarcerated. If adhesions persisted through the same introducer, endoluminal dilations were repeated with a larger diameter balloon until the catheter was released. New catheters can be positioned using the stiff guide wire already in place. All removals were carried out under local anesthesia in an angiographic room by interventional radiologists. Results All catheters were successfully removed without complications. Average fluoroscopy time for removal was 12 minutes. In the case of a Tesio catheter removed after 12 years because of infection, a computed tomography scan 2 months later revealed persistence of a calcified fibrin sleeve in the vessel. Conclusions Hong's technique was confirmed to be a simple, safe and highly effective way to remove incarcerated long-term central venous catheters. The refinements we adopted made the procedure more flexible and possibly less prone to complications. By properly using ordinary tools available anywhere, Hong's technique could be considered Columbus’ egg in this previously risky field.
Is Ultrasound-guided Central Venous Port Placement Effective to Avoid Pinch-off Syndrome?
Authors: Tamura Akio , Sone Miyuki , Ehara Shigeru , Kato Kenichi , Tanaka Ryoichi , Nakasato Tatsuhiko , Itabashi Tetsuya 
Published: May 2014

Purpose Ultrasound (US)-guided internal jugular vein access has been the standard practice of central venous port (CVP) placement. The subclavian vein (SCV) access has also been preferred, but has potential risk of pinch-off syndrome (POS). The purpose of this study was to examine the effect of US-guided SCV access to avoid POS in patients with CVP. Methods Included in this study were patients who had undergone CVP placement via the SCV. We mainly assessed the computed tomography (CT) findings from two different placement techniques of a CVP via the SCV: (i) venipuncture point described by the ratio between the distance from the venipuncture point to the sternoclavicular joint and the clavicular length; and (ii) presence of direct attachment of the catheter to the clavicle. Secondary outcome was POS rate associated with two different placement techniques of CVP via the SCV. Results A total of 237 patients were included in this study between August 2007 and January 2011. A total of 100 patients (42.2%) underwent CVP placement using the landmark technique while 137 patients (57.8%) underwent CVP placement by US guidance. CT revealed that the US-guided technique tended to be lateral SCV approach compared with the landmark technique (p<0.001). A total of four patients (1.7%) experienced POS, all of them in the landmark group. Conclusion Our results showed that the US-guided technique determines a more lateral SCV approach, with a reduced POS risk than the landmark venipuncture technique.
Hybrid Simultaneous Treatment of Thrombosed Prosthetic Grafts for Hemodialysis
Authors: Troisi Nicola , Chisci Emiliano , Frosini Pierfrancesco , Romano Eugenio , Setti Marco , Mingardi Giulio , Michelagnoli Stefano 
Published: May 2014

Purpose The aim of the study was to evaluate our experience in the hybrid simultaneous treatment (open and endovascular) of acute thrombosis of prosthetic grafts for hemodialysis. Methods Between January 2011 and June 2013, 23 patients with acute thrombosis of a prosthetic graft for hemodialysis were urgently treated with a hybrid simultaneous treatment in order to obtain a prompt restoration of the flow. A new puncture of the graft was scheduled after 24 hours. Results Intraoperative technical success was 100% with a completion angiography showing the restored patency of the graft. As adjunctive procedures, in 6 patients (26.1%) locoregional thrombolysis was necessary and in all cases further endovascular manoeuvres (angioplasty/stenting) were immediately performed to solve a significant stenosis of the venous anastomosis/first tract of the vein. At 24 hours when the first puncture was done, three grafts were occluded resulting in a primary patency of 87%. During the follow-up (mean duration 5.6 months) four reocclusions occurred. In-stent restenosis occurred in all patients undergone stenting. At 1 year the rates of primary patency, primary assisted patency and secondary patency were 58.7%, 78.3% and 87%, respectively. Conclusions In our series the combined simultaneous hybrid approach in urgency maximizes the use of different available techniques, which appeared to improve overall success rate to save a thrombosed graft for hemodialysis. The great difference showed between primary and primary assisted patency demonstrates the necessity of a close follow-up.
Flushing the Central Venous Catheter: Is Heparin Necessary?
Authors: Dal Molin Alberto , Allara Elias , Montani Doriana , Milani Simona , Frassati Cristina , Cossu Simonetta , Tonella Simone , Brioschi Dania , Rasero Laura 
Published: May 2014

Purpose The aim of this systematic review was to assess the efficacy of heparin flushing in the lock of central venous catheters. Methods We searched MEDLINE and CINAHL databases. Eligible studies were randomized controlled trials evaluating the use of heparin versus normal saline or other solution in the flushing of central catheter among adult patients. No language restrictions were applied. Two reviewers independently screened titles and abstracts in order to identify relevant publications. The same two reviewers retrieved and evaluated full texts. Parameter estimates regarding catheter occlusion were pooled using network meta-analysis with Bayesian hierarchical modeling. Results We identified 462 references. Eight studies were included. There was no evidence that heparin was more effective than normal saline in reducing occlusions. It was unclear whether urokinase and lepirudin were more effective than heparin in reducing occlusions. Vitamin C solution does not appear to prolong catheter patency. Conclusions There is no evidence of a different effectiveness between heparin flushing and normal saline or other solutions in reducing catheter occlusions. Due to the little and inconclusive evidence available in this field, further studies might be necessary.
Application of Human Type I Pancreatic Elastase (PRT-201) to the venous Anastomosis of Arteriovenous Grafts in Patients with Chronic Kidney Disease
Authors: Dwivedi Amit J. , Roy-Chaudhury Prabir , Peden Eric K. , Browne Barry J. , Ladenheim Eric D. , Scavo Vincent A. , Gustafson Pamela N. , Wong Marco D. , Magill Marianne , Lindow Francesca , Blair Andrew T. , Jaff Michael R. , Franano F. Nicholas , Burke Steven K. 
Published: May 2014

Purpose To explore the safety and efficacy of PRT-201 applied to the outflow vein of a newly created arteriovenous graft (AVG). Methods Randomized, double-blind, placebo-controlled, single-dose escalation study of PRT-201 (0.01 to 9 mg) applied to the graft-vein anastomosis and adjacent outflow vein immediately after AVG placement. The primary outcome measure was safety. The efficacy measures were intraoperative increases in outflow vein diameter and blood flow rate, primary unassisted patency, and secondary patency by dose groups (placebo, low, medium, high and All PRT-201). Results A total of 89 patients were treated (28 placebo and 61 PRT-201). There were no significant differences in the proportion of placebo and PRT-201 patients reporting adverse events. Intraoperative outflow vein diameter increased 5% (p=0.14) in the placebo group compared with 13% (p=0.01), 15% (p=0.07) and 12% (p<0.001), in the low, medium and high groups, respectively. The comparison between the high and placebo groups was marginally statistically significant (p=0.06). The intraoperative blood flow did not change in the placebo group, and increased in the low, medium and high groups by 19% (p=0.34), 36% (p=0.09) and 46% (p=0.02), respectively. The low group had the longest primary unassisted and secondary patency and the fewest procedures to restore or maintain patency; however, the differences between groups were not statistically significant. Conclusions PRT-201 was well tolerated and increased AVG intraoperative outflow vein diameter and blood flow. Low dose tended to increase secondary patency and decrease the rate of procedures to restore or maintain patency. Larger studies with these doses will be necessary to confirm these results.
The Prevalence of Overactive Bladder Syndrome and Urinary Incontinence in a Turkish Women Population; Associated Risk Factors and Effect on Quality of Life
Authors: Sarici Hasmet , Ozgur Berat Cem , Telli Onur , Doluoglu Omer Gokhan , Eroglu Muzaffer , Bozkurt Selen 
Published: May 2014

Aims To investigate the prevalence and risk factors of overactive bladder syndrome and urinary incontinence in Turkish women; furthermore, to assess the impact on the quality of life. Materials and Methods A cross-sectional, epidemiological study was carried out in women of reproductive age to define overactive bladder syndrome, urinary incontinence, ICIQ-SF score and medical care seeking. Results The women's average age was 34.4 ± 5.26 years. The prevalence of UI was 26.9%. Stress UI was the predominant form. The prevalence of UI increased with age, BMI, number of pregnancies and children delivered. The prevalence of OAB was 20.7%. Women with OAB were older and had greater number of pregnancies than women without OAB. History of nocturnal enuresis was a significant risk factor for OAB and UUI. Women with MUI had more frequent and more abundant leakage of urine. 10.7% of women sought medical care for their condition. Conclusions Although prevalence estimates differ across studies, the available evidence indicates that UI and OAB are highly prevalent conditions among women. UI had negative effect on QoL, but only severely-affected women sought medical care. Public health and clinical management programs are needed to determine diagnosis and management of these social problems.
5ARIs and PSA: Evidences
Authors: Morgia Giuseppe , Urzì Daniele , Russo Giorgio Ivan 
Published: May 2014

Objective The 5α-reductase inhibitors (5ARIs) represent a valid therapeutic option in the long-term treatment of benign prostatic hyperplasia (BPH). One of the most debated topics is the interpretation of the variation of the serum PSA during treatment with 5ARIs. The objective of this review was to analyze the change in serum PSA levels over time and to evaluate its sensitivity and specificity in the screening for prostate cancer (CaP) during treatment. Methods An extensive search using PubMed and Scopus was performed including the following key words: “5ARI”, “finasteride”, “dutasteride”, “prostate cancer”, “benign prostatic hyperplasia”, “PSA”, “kinetics”, “PSA derivatives”. Results The reduction of serum PSA during treatment with 5ARIs can be observed up to 48 months after the beginning of the therapy. This category of drugs seems to improve the diagnostic performance of PSA in screening CaP. On the other hand, there is a reduction of the diagnosis of indolent cancers. Any increase in PSA from nadir should be considered suspicious for malignancy. However, if the choice of a biopsy depended only on an increase of the values of serum PSA, a variable percentage of potentially aggressive tumors could not be diagnosed. Therefore, it is important to consider in the clinical and diagnostic follow-up other factors such as digital rectal examination, age, family history of CaP and imaging techniques. Conclusions 5-ARIs have a positive impact on the specificity of PSA but they must not be the only tool that can identify CaPs with poor prognosis.
Exile in Postwar Polish Women’s Prose
Authors: Karwowska Bożena 
Published: May 2014

Abstract
The article deals with the lives of postwar Polish emigration as portrayed in literary works by Polish émigré women writers. It begins with the “domestic” theme whose prominence in the works in question can be at least partly explained by the fact that in Poland, for historical and political reasons, the public and private spheres had acquired a different character than in the West. The blurring of the line separating the two spaces and the image of Matka Polka (a patriotic mother) are then used as points of departure for the description and analysis of the role of women of the first generation of postwar émigrés as wives and mothers. This is followed by a discussion of women authors as observers of their new countries (Great Britain, France, Argentina, and the United States) and their inhabitants (including other émigré diasporas and visible minorities). Their view of social change and the beginnings of the feminist movement is largely shaped by the “domestic” patriotic perspective typical of Polish women of their generation. Finally, the article discusses the problems that the mothers encounter in raising the next generation (and generation one-and-a-half) in the context of the cultures and mores of their new countries.
Effect of plasma torus density variations on the morphology and brightness of the Io footprint
Authors: Payan A. P. , Rajendar A. , Paty C. S. , Crary F. 
Published: May 2014

AbstractWe develop a 2‐D‐layered model of the Io plasma torus to study the apparent “shutoff” of the Io footprint in 2007, when it disappeared beneath a region of diffuse emissions, roughly coincident with a massive eruption of Tvashtar Paterae. First, we investigate the effects of Io's location in the plasma torus and validate our model results against Hubble UV observations of the Io footprint. We are able to qualitatively reproduce variations in the morphology of the footprint due to Io's changing latitudinal location with respect to the center of the plasma torus, capturing the bright leading spot and the dimmer tail. Then, we consider the effects of an increase in the local plasma density on the brightness and morphology of the Io footprint. Our results show a correlation between a local density increase in the plasma torus and the dimming of the Io footprint as observed in 2007. In particular, we find that a local density enhancement at Io of fivefold compared to the nominal value is sufficient to produce the observed shutoff of the footprint.
Response of the Jovian thermosphere to variations in solar EUV flux
Authors: Tao Chihiro , Miyoshi Yoshizumi , Achilleos Nick , Kita Hajime 
Published: May 2014

AbstractExamining the response to solar extreme ultraviolet (EUV) radiation is an established diagnostic method used to understand the physics of planetary environments. In this study, we focus on the response of the Jovian thermosphere to variations in the solar EUV flux and discuss the consequences for the coupled thermosphere‐ionosphere‐magnetosphere system. We use a model that simulates both the thermospheric dynamics and the magnetospheric plasma velocity distribution under conditions of angular momentum transport between these regions. The simulations show that when the EUV flux increases by ~100% and 200%, the thermospheric neutral wind velocity at ~45° latitude increases by 16% and 22%, respectively. The short‐term variation over a few Earth days causes an increased velocity at middle latitudes which are magnetically conjugate to the Jovian radiation belt. Increased heating due to solar EUV contributes to this velocity change. The other contribution arises ~30 planetary rotations after the initial solar EUV flux increase. This second (“delayed”) effect is due to propagation of momentum from high latitudes (the auroral region), where Joule heating is dominant, and is related to the behavior of the ionospheric conductance and magnetosphere‐ionosphere coupling currents. The modeled velocity enhancement is smaller than that required to explain the observed enhancement of the synchrotron emission by radial diffusion of the trapped energetic electrons. In this context, we discuss the sensitivity of the underlying thermosphere‐ionosphere response to short‐wavelength solar radiation and the ensuing three‐dimensional wind fields.