bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemostatic and inflammatory responses to blood flow‐restricted exercise in patients with ischaemic heart disease: a pilot study
Authors: Madarame Haruhiko , Kurano Miwa , Fukumura Kazuya , Fukuda Taira , Nakajima Toshiaki 
Published: July 2012

SummaryLow‐intensity resistance exercise can effectively induce muscle hypertrophy and increases in strength when combined with moderate blood flow restriction (BFR). As this type of exercise does not require lifting heavy weights, it might be a feasible method of cardiac rehabilitation, in which resistance exercise has been recommended to be included. Although previous studies with healthy subjects showed relative safety of BFR exercise, we cannot exclude the possibility of unfavourable effects in patients with cardiovascular disease. We therefore aimed to investigate haemostatic and inflammatory responses to BFR exercise in patients with ischaemic heart disease (IHD). Nine stable patients with IHD who were not taking anticoagulant drugs performed four sets of knee extension exercise at an intensity of 20% one‐repetition maximum (1RM) either with or without BFR. Blood samples were taken before, immediately after and 1 h after the exercise session and analysed for noradrenaline, D‐dimer, fibrinogen/fibrin degradation products (FDP) and high‐sensitive C‐reactive protein (hsCRP). Plasma noradrenaline concentration increased after the exercise, and the increase was significantly larger after the exercise with BFR than without BFR. On the other hand, increases in concentrations of plasma D‐dimer and serum hsCRP were independent of the condition. However, increases in D‐dimer and hsCRP were no longer observed after plasma volume correction, suggesting that hemoconcentration was responsible for these increases. Plasma FDP concentration did not change after the exercise. These results suggest that applying BFR during low‐intensity resistance exercise does not affect exercise‐induced haemostatic and inflammatory responses in stable IHD patients.
Red blood cell transfusion compared with gelatin solution and no infusion after cardiac surgery: effect on microvascular perfusion, vascular density, hemoglobin, and oxygen saturation
Authors: Atasever Bektaş , van der Kuil Marjolein , Boer Christa , Vonk Alexander , Schwarte Lothar , Girbes Armand R.J. , Ince Can , Beishuizen Albertus , Groeneveld A.B. Johan 
Published: July 2012

BACKGROUND: After cardiac surgery, red blood cell (RBC) transfusion may improve systemic hemodynamics and thereby microvascular blood flow and O2 delivery (DO2).STUDY DESIGN AND METHODS: In a nonrandomized prospective observational study on post–cardiac surgery patients, systemic hemodynamics and microvascular blood flow, vascular density (sidestream dark‐field imaging), hemoglobin (Hb) content, and saturation (reflectance spectrophotometry) were measured before and 1 hour after start of transfusion of 1 to 2 units of leukoreduced RBCs (270 ± 203 mL), 500 mL of gelatin solution, or control (no infusion), when patients were considered clinically hypovolemic with (RBC group, n = 12) or without (gelatin group, n = 14) anemia (Hb < 10 g/dL) or not (n = 13), respectively.RESULTS: Systemic Hb was lower and increased in the RBC transfusion but not in gelatin and control groups. There were no differences in changes in systemic DO2, O2 uptake, and extraction between groups. RBC transfusion, compared with gelatin or control, increased medium‐sized vascular density, Hb content, and saturation in the microcirculation, while blood flow remained unchanged. Changes of microvascular Hb and saturation paralleled changes in systemic Hb.CONCLUSION: The data argue in favor of efficacy of RBC transfusion after cardiac surgery. RBC transfusion increases systemic Hb and this in turn increases medium‐sized vascular density and DO2 in the sublingual microcirculation, independently of systemic hemodynamics and volume status.
Analysis of donor deferral at three blood centers in Brazil
Authors: Gonçalez Thelma T. , Sabino Ester C. , Schlumpf Karen S. , Wright David J. , Mendrone Alfredo , Lopes Maria , Leão Silvana , Miranda Carolina , Capuani Ligia , Carneiro‐Proietti Anna Barbara F. , Basques Fernando , Ferreira João E. , Busch Michael , Custer Brian ,   NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II), International Component
Published: July 2012

BACKGROUND: The safety of the blood supply is ensured through several procedures from donor selection to testing of donated units. Examination of the donor deferrals at different centers provides insights into the role that deferrals play in transfusion safety.STUDY DESIGN AND METHODS: A cross‐sectional descriptive study of prospective allogeneic blood donors at three large blood centers located in São Paulo, Belo Horizonte, and Recife, Brazil, from August 2007 to December 2009 was conducted. Deferrals were grouped into similar categories across the centers, and within each center frequencies out of all presentations were determined.RESULTS: Of 963,519 prospective blood donors at the three centers, 746,653 (77.5%) were accepted and 216,866 (22.5%) were deferred. Belo Horizonte had the highest overall deferral proportion of 27%, followed by Recife (23%) and São Paulo (19%). Females were more likely to be deferred than males (30% vs. 18%, respectively). The three most common deferral reasons were low hematocrit or hemoglobin, medical diagnoses, and higher‐risk behavior.CONCLUSION: The types and frequencies of deferral vary substantially among the three blood centers. Factors that may explain the differences include demographic characteristics, the order in which health history and vital signs are taken, the staff training, and the way deferrals are coded by the centers among other policies. The results indicate that blood donor deferral in Brazil has regional aspects that should be considered when national policies are developed.
A Mobile Phone Text Message Program to Measure Oral Antibiotic Use and Provide Feedback on Adherence to Patients Discharged From the Emergency Department
Authors: Suffoletto Brian , Calabria Jaclyn , Ross Anthony , Callaway Clifton , Yealy Donald M. 
Published: July 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:949–958 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  Nonadherence to prescribed medications impairs therapeutic benefits. The authors measured the ability of an automated text messaging (short message service [SMS]) system to improve adherence to postdischarge antibiotic prescriptions.Methods:  This was a randomized controlled trial in an urban emergency department (ED) with an annual census of 65,000. A convenience sample of adult patients being discharged with a prescription for oral antibiotics was enrolled. Participants received either a daily SMS query about prescription pickup, and then dosage taken, with educational feedback based on their responses (intervention), or the usual printed discharge instructions (control). A standardized phone follow‐up interview was used on the day after the intended completion date to determine antibiotic adherence: 1) the participant filled prescription within 24 hours of discharge and 2) no antibiotic pills were left on the day after intended completion of prescription.Results:  Of the 200 patients who agreed to participate, follow‐up was completed in 144 (72%). From the 144, 26% (95% confidence interval [CI] = 19% to 34%) failed to fill their discharge prescriptions during the first 24 hours, and 37% (95% CI = 29% to 45%) had pills left over, resulting in 49% (95% CI = 40% to 57%) nonadherent patients. There were no differences in adherence between intervention participants and controls (57% vs. 45%; p = 0.1). African American race, greater than twice‐daily dosing, and self‐identifying as expecting to have difficulty filling or taking antibiotics at baseline were associated with nonadherence.Conclusions:  Almost one‐half (49%) of our patients do not adhere to antibiotic prescriptions after ED discharge. Future work should improve the design and deployment of SMS interventions to optimize their effect on improving adherence to medication after ED discharge.
Disagreement Between Emergency Physician and Inpatient Physician Diagnosis of Infection in Older Adults Admitted From the Emergency Department
Authors: Caterino Jeffrey M. , Stevenson Kurt B. 
Published: July 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:908–915 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  Older adults with infection are at increased risk of misdiagnosis while they are patients in the emergency department (ED) due to the common presence of nonspecific signs and symptoms. The primary objective was to determine the proportion of admitted older adult patients thought by the emergency physician (EP) to be infected, as compared with the diagnostic impression of inpatient physicians. The secondary objective was to determine the agreement between EP and inpatient physician diagnosis of specific infection types.Methods:  The authors conducted a prospective, observational, convenience sampling of a cohort of ED patients ≥65 years old admitted to the hospital with diagnoses of acute infection. EPs noted at least one suspected source of infection. Inpatient diagnosis of infection was determined by chart review of the inpatient chart. Outcomes included the presence of any infection and of specific infectious sources diagnosed within 48 hours of admission. EP and inpatient diagnoses were compared using proportions, positive and negative likelihood ratios (LR+ and LR−), and the phi coefficient.Results:  The study included 103 patients diagnosed with a suspected infection by the EP. Nineteen patients (18.4%, 95% confidence interval [CI] = 11.5% to 27.3%) were not diagnosed with any infection by the inpatient physician. For specific infection sources, ED diagnosis of bloodstream infection often did not agree with the inpatient diagnosis. Sensitivity was 40.0% and specificity 78.4% with an LR+ of 1.85 and LR− of 0.76. The phi coefficient was 0.15. EPs overdiagnosed pulmonary infection, with 72.1% specificity and an LR+ of 3.24. EP diagnosis had good accuracy for skin and soft tissue infection (sensitivity = 78.6% and specificity = 96.6%), with adequate LRs (LR+ of 23.3 and LR− of 0.22). Urinary tract infection (UTI) was underdiagnosed in the ED (sensitivity = 58.3%), but it is unclear if this is due to true ED underdiagnosis or due to overdiagnosis of UTI in the inpatient setting.Conclusions:  In older patients admitted from the ED, the provisional ED diagnosis and the inpatient diagnosis of an acute infection often disagree. In this sample, 18% of older ED patients diagnosed with infection during an ED stay were not diagnosed as infected by the inpatient physician. Regarding infection types, EPs were poor at diagnosing bacteremia and overdiagnosed pulmonary infections. EP diagnosis of skin and soft tissue infection generally agreed with the inpatient physician. There was also disagreement regarding presence of UTI, but the true nature of this difference is unclear from the data obtained in this study.
Patients with organic acidaemias have an altered thiol status
Authors: Salmi Heli , Leonard James V. , Lapatto Risto 
Published: July 2012

AbstractAim:  To study whether patients with organic acidaemias have altered glutathione (GSH) levels and thiol redox status. Previously, organic acidaemias have been associated with mitochondrial dysfunction and oxidative stress, suggesting an increased need for antioxidant protection. Furthermore, dietary protein restriction may impair GSH synthesis in these diseases.Methods:  In children with organic acidaemias, cysteine (CYSH) and GSH concentrations in plasma and erythrocytes as well as erythrocyte GSH peroxidase, GSH reductase, GSH S‐transferase and glucose‐6‐phosphate dehydrogenase activities were studied. In addition, GSH and CYSH concentrations were measured in human fibroblasts exposed to organic acids.Results:  Patients with organic acidaemias had lower plasma GSH concentration than their controls. A greater fraction of GSH and CYSH in the patients’ plasma was oxidized, suggesting decreased GSH synthesis and increased consumption.Conclusion:  Patients with organic acidaemias may have a relative GSH deficiency. With further research, these results could also have therapeutic implications.
Preschool children with high adherence to inhaled corticosteroids for asthma do not show behavioural problems
Authors: Quak Wouter , Klok Ted , Kaptein Adrian A , Duiverman Eric J , Brand Paul LP 
Published: July 2012

AbstractAim:  To assess prevalence of behavioural problems in preschool children with asthma with electronically verified exposure to inhaled corticosteroids (ICS).Methods:  Cross‐sectional study of 81 children 2–5 years of age using daily ICS for persistent asthma. During 3 months’ follow‐up, adherence to ICS treatment was recorded by an electronical logging device (Smartinhaler®). Parents completed the Child Behavior Checklist 1.5–5 years (CBCL 1.5–5) to assess behavioural problems; results were compared to a published reference group of healthy children.Results:  The median (interquartile range) adherence to ICS was 92 (78–97) %. There was no difference in total CBCL score between children with asthma on ICS (mean, [SD] 32.10 [1.99]) and the reference group (33.30 [1.87], 95% CI for difference −6.62 to 4.22). Children with asthma were more likely to have somatic complaints (95% CI for difference 0.64 to 1.96) and less likely to have anxious/depressive symptoms (95% CI for difference −1.57 to −0.25) than the reference group. CBCL scores were not significantly related to the electronically measured adherence rates.Conclusions:  Maintenance treatment with ICS, taken daily as prescribed, is not associated with an increased risk of behavioural problems in preschool children.
Physician perspectives on collaborative working relationships with team-based hospital pharmacists in the inpatient medicine setting
Authors: Makowsky Mark J , Madill Helen M , Schindel Theresa J , Tsuyuki Ross T 
Published: July 2012

Abstract

Objective
Collaborative care between physicians and pharmacists has the potential to improve the process of care and patient outcomes. Our objective was to determine whether team-based pharmacist care was associated with higher physician-rated collaborative working relationship scores than usual ward-based pharmacist care at the end of the COLLABORATE study, a 1 year, multicentre, controlled clinical trial, which associated pharmacist intervention with improved medication use and reduced hospital readmission rates.

Methods
We conducted a cross-sectional survey of all team-based and usual care physicians (attending physicians and medical residents) who worked on the participating clinical teaching unit or primary healthcare teams during the study period. They were invited to complete an online version of the validated Physician-Pharmacist Collaboration Index (PPCI) survey at the end of the study. The main endpoint of interest was the mean total PPCI score.

Key findings
Only three (response rate 2%) of the usual care physicians responded and this prevented us from conducting pre-specified comparisons. A total of 23 team-based physicians completed the survey (36%) and reported a mean total PPCI score of 81.6 ± 8.6 out of a total of 92. Mean domain scores were highest for relationship initiation (14.0 ± 1.4 out of 15), and trustworthiness (38.9 ± 3.7 out of 42), followed by role specification (28.7 ± 4.3 out of 35).

Conclusion
Pharmacists who are pursuing collaborative practice in inpatient settings may find the PPCI to be a meaningful tool to gauge the extent of collaborative working relationships with physician team members.
Cascaded systems analysis of noise and detectability in dual‐energy cone‐beam CT
Authors: Gang Grace J. , Zbijewski Wojciech , Webster Stayman J. , Siewerdsen Jeffrey H. 
Published: July 2012

Purpose:Dual‐energy computed tomography and dual‐energy cone‐beam computed tomography (DE‐CBCT) are promising modalities for applications ranging from vascular to breast, renal, hepatic, and musculoskeletal imaging. Accordingly, the optimization of imaging techniques for such applications would benefit significantly from a general theoretical description of image quality that properly incorporates factors of acquisition, reconstruction, and tissue decomposition in DE tomography. This work reports a cascaded systems analysis model that includes the Poisson statistics of x rays (quantum noise), detector model (flat‐panel detectors), anatomical background, image reconstruction (filtered backprojection), DE decomposition (weighted subtraction), and simple observer models to yield a task‐based framework for DE technique optimization.Methods:The theoretical framework extends previous modeling of DE projection radiography and CBCT. Signal and noise transfer characteristics are propagated through physical and mathematical stages of image formation and reconstruction. Dual‐energy decomposition was modeled according to weighted subtraction of low‐ and high‐energy images to yield the 3D DE noise‐power spectrum (NPS) and noise‐equivalent quanta (NEQ), which, in combination with observer models and the imaging task, yields the dual‐energy detectability index (d′). Model calculations were validated with NPS and NEQ measurements from an experimental imaging bench simulating the geometry of a dedicated musculoskeletal extremities scanner. Imaging techniques, including kVp pair and dose allocation, were optimized using d′ as an objective function for three example imaging tasks: (1) kidney stone discrimination; (2) iodine vs bone in a uniform, soft‐tissue background; and (3) soft tissue tumor detection on power‐law anatomical background.Results:Theoretical calculations of DE NPS and NEQ demonstrated good agreement with experimental measurements over a broad range of imaging conditions. Optimization results suggest a lower fraction of total dose imparted by the low‐energy acquisition, a finding consistent with previous literature. The selection of optimal kVp pair reveals the combined effect of both quantum noise and contrast in the kidney stone discrimination and soft‐tissue tumor detection tasks, whereas the K‐edge effect of iodine was the dominant factor in determining kVp pairs in the iodine vs bone task. The soft‐tissue tumor task illustrated the benefit of dual‐energy imaging in eliminating anatomical background noise and improving detectability beyond that achievable by single‐energy scans.Conclusions:This work established a task‐based theoretical framework that is predictive of DE image quality. The model can be utilized in optimizing a broad range of parameters in image acquisition, reconstruction, and decomposition, providing a useful tool for maximizing DE‐CBCT image quality and reducing dose.
Indotecan (LMP400) and AM13-55: Two Novel Indenoisoquinolines Show Potential for Treating Visceral Leishmaniasis
Authors: Balaña-Fouce Rafael , Prada Christopher F. , Requena José María , Cushman Mark , Pommier Yves , Álvarez-Velilla Raquel , Escudero-Martínez José Miguel , Calvo-Álvarez Estefania , Pérez-Pertejo Yolanda , Reguera Rosa M. 
Published: July 2012

ABSTRACT

Visceral leishmaniasis is an emerging neglected tropical disease (NTD) caused by the protozoan
Leishmania infantum
in the countries bordering the Mediterranean Basin. Currently there is no effective vaccine against this disease, and the therapeutic approach is based on toxic derivatives of Sb
V
. Therefore, the discovery of new therapeutic targets and the development of drugs designed to inhibit them comprise an extremely important approach to fighting this disease. DNA topoisomerases (Top) have been identified as promising targets for therapy against leishmaniasis. These enzymes are involved in solving topological problems generated during replication, transcription, and recombination of DNA. Being unlike that of the mammalian host, type IB DNA topoisomerase (TopIB) from
Leishmania
spp. is a unique bisubunit protein, which makes it very interesting as a selective drug target. In the present investigation, we studied the effect of two TopIB poisons with indenoisoquinoline structure, indotecan and AM13-55, on a murine BALB/c model of infected splenocytes with
L. infantum
, comparing their effectiveness with that of the clinically tested leishmanicidal drug paromomycin. Both compounds have high selectivity indexes compared with uninfected splenocytes. SDS-KCl-precipitable DNA-protein complexes in
Leishmania
promastigotes and
in vitro
cleaving assays confirmed that these drugs are Top poisons. The inhibitory potency of both indenoisoquinolines on
L. infantum
recombinant TopIB was assessed
in vitro
, with results showing that indotecan was the most active compound, preventing the relaxation of supercoiled DNA. Experimental infections in susceptible BALB/c mice treated with 2.5 mg/kg body weight/day once every other day for a total of 15 days showed that indotecan cleared more than 80% of the parasite burden of the spleen and liver, indicating promising activity against visceral leishmaniasis.
Intracellular Toxicity of Proline-Rich Antimicrobial Peptides Shuttled into Mammalian Cells by the Cell-Penetrating Peptide Penetratin
Authors: Hansen Anne , Schäfer Ingo , Knappe Daniel , Seibel Peter , Hoffmann Ralf 
Published: July 2012

ABSTRACT

The health threat caused by multiresistant bacteria has continuously increased and recently peaked with pathogens resistant to all current drugs. This has triggered intense research efforts to develop novel compounds to overcome the resistance mechanisms. Thus, antimicrobial peptides (AMPs) have been intensively studied, especially the family of proline-rich AMPs (PrAMPs) that was successfully tested very recently in murine infection models. PrAMPs enter bacteria and inhibit chaperone DnaK. Here, we studied the toxicity of intracellular PrAMPs in HeLa and SH-SY5Y cells. As PrAMPs cannot enter most mammalian cells, we coupled the PrAMPs with penetratin (residues 43 to 58 in the antennapedia homeodomain) via a C-terminally added cysteine utilizing a thioether bridge. The resulting construct could transport the covalently linked PrAMP into mammalian cells. Penetratin ligation reduced the MIC for Gram-negative
Escherichia coli
only slightly (1 to 8 μmol/liter) but increased the activity against the Gram-positive
Micrococcus luteus
up to 32-fold (MIC ≈ 1 μmol/liter), most likely due to more effective penetration through the bacterial membrane. In contrast to native PrAMPs, the penetratin-PrAMP constructs entered the mammalian cells, aligned around the nucleus, and associated with the Golgi apparatus. At higher concentrations, the constructs reduced the cell viability (50% inhibitory concentration [IC
50
] ≈ 40 μmol/liter) and changed the morphology of the cells. No toxic effects or morphological changes were observed at concentrations of 10 μmol/liter or below. Thus, the IC
50
values were around 5 to 40 times higher than the MIC values. In conclusion, PrAMPs are in general not toxic to mammalian cells, as they do not pass through the membrane. When shuttled into mammalian cells, however, PrAMPs are only slightly cross-reactive to mammalian chaperones or other intracellular mammalian proteins, providing a second layer of safety for
in vivo
applications, even if they can enter some human cells.
Consequences of Delayed Ciprofloxacin and Doxycycline Treatment Regimens against Francisella tularensis Airway Infection
Authors: Rotem Shahar , Bar-Haim Erez , Cohen Hila , Elia Uri , Ber Raphael , Shafferman Avigdor , Cohen Ofer 
Published: July 2012

ABSTRACT

This study examines the efficacy, bacterial load, and humoral response of extensively delayed ciprofloxacin or doxycycline treatments following airway exposure of mice to
Francisella tularensis
subsp.
holarctica
(strain LVS) or to the highly virulent
F. tularensis
subsp.
tularensis
(strain SchuS4). A delay in onset of both antibiotic treatments allowed the rescue of all LVS-infected animals. However, for animals infected with SchuS4, only ciprofloxacin was efficacious and prolongation of treatment rescued all animals.