bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two types of orthostatic dysregulation assessed by diameter of inferior vena cava
Authors: Fujii Yuri , Ishizaki Yuko , Kino Minoru , Taniuchi Shoichiro , Kobayashi Yohnosuke , Kaneko Kazunari 
Published: August 2010

AbstractAims:  Orthostatic dysregulation (OD) is common in adolescents. This study was conducted to evaluate the usefulness of the measurement of the diameter of the inferior vena cava (IVC) for objective assessment of patients with OD.Methods:  Twenty children with OD (median 14 years, range 9–15 years) and 23 age‐matched healthy children (median 12 years, range 10–15 years) were enrolled. A diameter of IVC was measured by an abdominal echogram before and after a head‐up tilt table testing (HUT). Changes in IVC was assessed by an arbitrary parameter, collapse index (CI) as the following equation: [(maximal IVC diameter in the supine position − maximal IVC diameter in the standing position)/(maximal IVC diameter in the supine position)]× 100. CI was evaluated 4 weeks after treatment with an adrenergic agent.Results:  Children with OD demonstrated either higher CI or lower CI compared to that in control children: CI was more than 50 (range 50–71) in 12 patients with OD while that was equal to or less than 0 (range −225 to 0) in eight out of 20 patients. In contrast, CI was between 0 and 50 (range 1–26) in 23 healthy children. Pharmacological treatment induced the normalization in the CI in both higher and lower CI group.Conclusion:  OD can be classified into two subtypes: by HUT, one is characterized by an increase of IVC diameter while another is characterized by its decrease. Measurement of IVC diameter by HUT is useful to understand the pathophysiology and to assess the efficacy of treatment.
The impact on the emergency department of integrating psychiatric services into a general hospital
Authors: MACLEAN ANDREW , ANDREW‐STARKEY SYLVIA 
Published: August 2010

ABSTRACTObjectives: To compare Emergency Department presentations before and after the integration of a 23 bed psychiatric unit with a general hospital.Design: Retrospective analysis of Emergency Department register over a six year period.Subjects: Patients included were those who presented to the Emergency Department with either a primary psychiatric complaint or an intentional toxic ingestion.Results: Total Emergency Department presentations have remained relatively stable during the study period (27,693 ± 699). Intentional ingestion numbers have shown only a slight increase since the opening of the Psychiatric Unit from 198 in 1987 to 308 in 1992.The number of patients with primary psychiatric complaints has however increased greatly from an average of 47 annually prior to the opening of the Psychiatric Unit to an average of 550 per year after the opening with a trend of increasing numbers each year.Emergency departments of hospitals considering inpatient psychiatric services must carefully plan to meet the needs of an increased emergency psychiatric population.
Panspinal epidural abscess secondary to vertebral osteomyelitis
Authors: Tall Gary D , Rowe Dominic 
Published: August 2010

AbstractSpinal epidural abscess is an unusual but potentially devastating condition that constitutes a neurosurgical emergency. Early diagnosis is imperative as delays in therapy commonly result in irreversible neurologic impairment, or death. We present the case of a 52 year old man with a panspinal epidural abscess secondary to lumbar vertebral osteomyelitis. This is only the third case of panspinal epidural abscess reported in the literature. Urgent decompression and prolonged intravenous antibiotics resulted in full recovery.
Adenosine is safe and effective in the emergency management of tachyarrhythmias
Authors: Dilley Stuart J , Rogers Ian , Sprivulis Peter , Jelinek George A 
Published: August 2010

AbstractObjective:To describe three Australasian emergency departments' experience with the use of intravenous adenosine for the treatment of tachyarrhythmias.Design:Prospective uncontrolled study of the indications, efficacy and adverse effects encountered during the use of adenosine for the treatment of regular tachyarrhythmias presenting to the emergency departments of Fremantle, Box Hill and Maroondah Hospitals during a twelve month period.Results:One hundred and two episodes of regular tachyarrhythmia were treated in 87 patients. Of 92 cases of narrow complex tachycardia (NCT), 75 were A‐V nodal in origin. All but four patients (96%) reverted to sinus rhythm although nine subsequently relapsed. Dosages used ranged from 5 to 20mg. Of 10 cases of wide complex tachycardia (WCT), five were subsequently shown to be ventricular tachycardia (VT). No cases of decompensation requiring cardioversion were seen following adenosine. A total of 17 cases were due to atrial flutter. Flutter waves were exposed by adenosine in 14 cases. Mild transient adverse effects were common.Conclusions:Intravenous adenosine is useful in the treatment of supraventricular tachycardia and is of diagnostic value in other NCTs. The agent may be safely administered to patients with WCT where a diagnosis other than VT is considered. Adverse effects are common, though generally well tolerated and transient.
Removal of nasal foreign bodies using the Fogarty catheter
Authors: Ryan Nicholas J 
Published: August 2010

AbstractPatients with nasal foreign bodies frequently present to emergency departments. Nasal foreign bodies are often difficult to remove and may require referral to an ENT surgeon or admission to hospital for removal under general anaesthetic. This study reviews patients with nasal foreign bodies who presented to the Gosford District Hospital Emergency Department over a three and a half year period. The results indicate that a technique for the removal of nasal foreign bodies in the emergency department using a Fogarty catheter may be successful.
Effects of bariatric surgery on urinary and sexual function
Authors: Ranasinghe Weranja K.B. , Wright Timothy , Attia John , McElduff Patrick , Doyle Terrence , Bartholomew Meegan , Hurley Katrina , Persad Rajendra A. 
Published: August 2010

Study Type – Symptom prevalence (non‐consecutive cohort) Level of Evidence 4 What’s known on the subject? and What does the study add? Obesity is a known risk factor for Urinary Incontinence. Non surgical weight loss has been shown to reduce Urinary Incontinence, but there is only limited evidence for surgically induced weight loss. This study aims to clarify the effects of surgically induced weight loss on urinary and erectile function.OBJECTIVETo investigate the effects of weight loss and time post laparoscopic gastric banding surgery (LGB) on urinary and sexual function.MATERIALS AND METHODS653 females and 145 males who underwent LGB over the last 10 years at a single centre in Australia were contacted by post and asked to complete validated questionnaires.RESULTSThe pre‐surgery body‐mass index (BMI) was higher in males than females (47.3 vs 43.5); 65% of the females and 24% of males previously had some degree of urinary incontinence (UI). There were significant weight and BMI losses in males and females (23.2 kg and 7.51 vs 22.7 kg and 8.28; P < 0.0001). In females there were significant improvements in the ICIQ‐SF (P= 0.0008) and Quality of Life (P < 0.0001) scores. For each kilogram lost there was a 0.05 improvement in the ICIQ score (P= 0.03) in females. There were also postoperative improvements in all symptoms of UI and stress incontinence in females but urge incontinence worsened, when adjusted for weight loss. In males there was no improvement in UI with weight loss after LGB. There was no relationship with time and UI in either gender; 83.3% of males reported a degree of ED before LGB. There was improvement in the IIEF score in males post LGB but there was worsening of erectile index (P= 0.005) and orgasmic function (P= 0.002) when adjusted for time. More males had started using phosphodiesterase type 5 inhibitors, post‐LGB.CONCLUSIONSSurgically induced weight loss by LGB improved overall UI, quality of life and stress incontinence in females but urge incontinence worsened. There was no improvement in UI with weight‐loss or overall sexual function after LGB in males. However, erectile index and orgasmic function worsened when adjusted for time. Further evaluation is required by means of larger prospective studies involving urodynamic testing.
Predictors of prolonged operative time during robot‐assisted laparoscopic radical prostatectomy
Authors: Yong Daniel Z. , Tsivian Matvey , Zilberman Dorit E. , Ferrandino Michael N. , Mouraviev Vladimir , Albala David M. 
Published: August 2010

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Robotic prostatectomy has now become the most common surgical approach in the United States for patients with prostate cancer. There is a significant learning curve for this procedure and this paper attempts to help understand what factors will make the operative times longer. Very little to date has been written on this topic.OBJECTIVETo determine risk factors for prolonged operative time (OT) during robot‐assisted laparoscopic radical prostatectomy (RALP). Being able to predict prolonged OT is of pivotal importance both to the physician for patient counseling and to the hospital management.PATIENTS AND METHODSRetrospective review of patient records undergoing RALP between 2003 and 2009 at a tertiary academic center with a structured teaching program. The following variables were recorded: age, race, body‐mass index (BMI), previous abdominal surgery (yes/no), nerve‐sparing technique (yes/no), lymph nodes dissection (yes/no), pathological stage (organ‐confined versus non), cumulative surgical experience with RALP (expressed as number of years since introduction of RALP at our center), prostate weight and OT calculated skin‐to‐skin by the anesthesiologists. Prolonged OT was defined as the upper quintile (20%) according to the distribution. Multivariate regression model was generated to assess potential predictors of prolonged OT.RESULTSA total of 523 records were retrieved. Caucasians accounted for 77.8% of the cohort. Median age was 60.3 years (interquartile range, IQR, 55.0–64.6 years), median BMI 28.1 (25.8–30.7 kg/m2), prostate weight 46.0 g (37.0–57.8 g). Eighty‐six (16.4%) patients had previous abdominal surgery, lymph nodes dissection was performed in 341 (65.2%) and nerve‐sparing technique was done in 310 (59.3%) cases. Median OT was 175 min (IQR 146–220 min). Prolonged OT was set at >230 min, thereby 105 (20.1%) records were classified as such. On multivariate analysis, cumulative surgical experience with RALP (P < 0.001), nerve sparing (P= 0.023) and prostate weight (P < 0.001) were independent predictors of prolonged OT.CONCLUSIONSLarger prostates are associated with longer OT and this effect is maintained independently of cumulative robotic experience that represents another independent factor in determining OT.
Trospium chloride once‐daily extended release is efficacious and tolerated in elderly subjects (aged ≥75 years) with overactive bladder syndrome
Authors: Sand Peter K. , Johnson II Theodore M. , Rovner Eric S. , Ellsworth Pamela I. , Oefelein Michael G. , Staskin David R. 
Published: August 2010

Study Type – Therapy (data synthesis from RCTs) Level of Evidence 1c What’s known on the subject? and What does the study add? Treatment of overactive bladder syndrome (OAB) in elderly individuals presents several potential clinical challenges, which include alterations in sleep and cognition, multiple co‐morbidities, polypharmacy, and frailty syndrome. A broad consensus of clinical opinion exists that the addition of an overactive bladder medication may amplify these clinical challenges via the antimuscarinic effects on cognition and the potential for drug‐drug interactions.The quaternary amine structure of trospium chloride provides protection against penetration of the blood‐brain barrier, and minimizes the potential for metabolic drug‐drug interactions. This study globally supports the efficacy and safety of Sanctura XR (extended release trospium chloride) in a population of elderly patients (75 years or older) with overactive bladder syndrome and multiple co‐morbidities at risk for drug‐drug interactions, impaired cognition and frailty syndrome.OBJECTIVE

To evaluate the safety and efficacy of once‐daily trospium chloride extended release (ER) in overactive bladder syndrome (OAB) in subjects aged ≥75 years.

SUBJECTS AND METHODS

The analysis included subjects ≥75 years of age with OAB.
A subgroup analysis of pooled data was performed for subjects aged ≥75 years from two randomized, double‐blind, multicenter studies of subjects with OAB receiving once‐daily trospium 60 mg extended release (ER) or placebo for 12 weeks, followed by 9‐month open‐label extension periods during which all subjects received trospium ER. A total of 143 of the 1165 subjects from two phase III registration trials who were aged ≥75 years (85 trospium ER, 58 placebo; mean age 79 years and ranging up to 90 years; 73% female) were evaluated.
Dual primary efficacy variables were the changes from baseline in the average number of toilet voids per day and urge urinary incontinence episodes per day.

RESULTS

At week 12 of the double‐blind period, trospium ER produced greater improvements from baseline than placebo in voiding diary parameters, OAB Patient Global Assessment, and quality of life.
Efficacy and tolerability persisted among subjects receiving open‐label trospium ER for up to 1 year.

CONCLUSIONS

Once‐daily trospium chloride 60 mg ER demonstrated efficacy vs placebo and was tolerated in subjects aged ≥75 years with OAB.
For subjects who continued into the open‐label treatment period, efficacy and tolerability were observed for up to 1 year.
Reduced bladder tumour recurrence rate associated with narrow‐band imaging surveillance cystoscopy
Authors: Herr Harry W. , Donat Sherri M. 
Published: August 2010

Study Type – Diagnostic (exploratory cohort)  Level of Evidence 2b What’s known on the subject? and What does the study add? Narrow‐band imaging cystoscopy is a new imaging modality developed to enhance conventional standard white‐light cystoscopy to evaluate bladder tumors. The current paper suggests that fulguration of low‐risk papillary bladder tumours using NBI cystoscopy results in fewer subsequent tumour recurrences than fulguration using standard cystoscopy. How, or if, NBI cystoscopy will become integrated into routine management of non‐invasive bladder tumours remains for further study.OBJECTIVETo evaluate frequency of recurrences among patients with papillary bladder tumours followed sequentially with conventional white‐light (WLI) cystoscopy and narrow‐band imaging (NBI) cystoscopy.PATIENTS AND METHODSA cohort of 126 patients with recurrent low‐grade papillary bladder tumours were followed every 6 months for 3 years by conventional WLI cystoscopy, and then over the next 3 consecutive years by NBI cystoscopy.Recurrent tumours detected were treated by outpatient fulguration or transurethral resection.We compared the tumour recurrence rate during follow‐up with WLI and NBI cystoscopy, using patients as their own controls.RESULTSOf the 126 patients, 94% had tumour recurrences during WLI cystoscopy vs 62% during NBI cystoscopy.The mean number of recurrent tumours was 5.2 with WLI cystoscopy vs 2.8 with NBI cystoscopy, and the median recurrence‐free survival time was 13 vs 29 months (P= 0.001).CONCLUSIONCompared with follow‐up with WLI cystoscopy, NBI cystoscopy was associated with fewer patients having tumour recurrences, fewer numbers of recurrent tumours, and a longer recurrence‐free survival time.
Regression to normoglycaemia by fenofibrate in pre‐diabetic subjects complicated with hypertriglyceridaemia: a prospective randomized controlled trial
Authors: Wan Q. , Wang F. , Wang F. , Guan Q. , Liu Y. , Wang C. , Feng L. , Gao G. , Gao L. , Zhao J. 
Published: August 2010

Diabet. Med. 27, 1312–1317 (2010)AbstractAims  Lipotoxicity has recently been shown to be an important risk factor underlying the pathogenesis of pre‐diabetes. However, clinical evidence supporting the treatment of pre‐diabetes by improving lipotoxicity is lacking. Here, we conducted an open‐label, randomized, controlled trial to investigate whether fenofibrate, the widely used hypolipidaemic agent, might benefit pre‐diabetes, with metfomin and diet control, the recommended intervention methods, as positive controls.Methods  Newly diagnosed pre‐diabetes patients (n = 120) with hypertriglyceridaemia (plasma triglyceride levels between 1.8 and 4.5 mmol/l) were randomly assigned by computer‐generated randomization sequence to either control group (no intervention), fenofibrate group (200 mg once a day), metformin group (500 mg three times a day) or diet‐controlled group (diet recommendation). Plasma biochemistry examination was performed every 2 months. The primary endpoint was the outcome of the natural course of pre‐diabetes, evaluated by oral glucose tolerance test after 6‐month follow‐up.Results  Twenty subjects in the fenofibrate group, 24 subjects in the metformin group and 25 subjects in both the diet‐controlled group and the control group finished the trial. Fenofibrate, metformin and diet control had protective effects on hypertriglyceridaemic pre‐diabetes, evidenced by 53.3, 70 and 30% participants regressed to normoglycaemia, respectively. The effects of fenofibrate and metformin were comparable (P > 0.05), while diet control was less effective (P < 0.05). Liver damage occurred in six subjects in the fenofibrate group and gastrointestinal symptoms occurred in four subjects in the metformin group. No serious adverse events occurred.Conclusion  Controlling lipotoxicity by fenofibrate could effectively ameliorate the natural course of hypertriglyceridaemic pre‐diabetes.
Improvement in pregnancy‐related outcomes in the offspring of diabetic mothers in Bavaria, Germany, during 1987–2007
Authors: Beyerlein A. , Von Kries R. , Hummel M. , Lack N. , Schiessl B. , Giani G. , Icks A. 
Published: August 2010

Diabet. Med. 27, 1379–1384 (2010)AbstractAims  Reducing the risk of adverse outcomes in diabetic pregnancies to the level of risk in non‐diabetic pregnancies is a major goal in diabetes care. So far there have not been any data to show whether progress is being made towards this goal.Methods  We used population‐based data on 2 292 053 deliveries between 1987 and 2007 in Bavaria, Germany, to assess temporal trends for stillbirths, early neonatal mortality, preterm delivery, macrosomia and malformations in consecutive 7 year intervals. We estimated prevalences and prevalence odds ratios for these outcomes. For stillbirth, as the most severe adverse outcome, we assessed the contributions of several predictors using multiple regression models.Results  With the exception of early neonatal deaths, the risks for all outcomes were significantly increased in the offspring of mothers with pregestational diabetes in all three time periods (e.g. odds ratio for stillbirths in diabetic compared with non‐diabetic mothers in 2001–2007, 1.89; 95% confidence interval 1.24, 2.87). However, the prevalence of stillbirths, premature delivery and macrosomia decreased over time in diabetic mothers (e.g. 1.71% for stillbirths in 1987–1993 and 0.66% in 2001–2007), as did the respective odds ratios. Maternal smoking, hypertension and substandard utilization of antenatal care were significantly associated with stillbirths in diabetic women.Conclusions  Although the risk of adverse pregnancy outcomes is still increased in diabetic mothers, considerable improvement has been achieved. We hypothesize that this improvement is possibly due to improved diabetes care.
Long‐term effects of a home‐visiting intervention for depressed mothers and their infants
Authors: Kersten‐Alvarez Laura E. , Hosman Clemens M.H. , Riksen‐Walraven J. Marianne , Van Doesum Karin T.M. , Hoefnagels Cees 
Published: August 2010

Background:  Whereas preventive interventions for depressed mothers and their infants have yielded positive short‐term outcomes, few studies have examined their long‐term effectiveness. The present follow‐up of a randomised controlled trial (RCT) is one of the first to examine the longer‐term effects of an intervention for mothers with postpartum depression and their infants at school‐age. In early infancy, the intervention was found effective in improving mother–infant interaction and the child’s attachment to its mother.Methods:  Twenty‐nine mother–child pairs who completed the intervention are compared with 29 untreated mother–child dyads as to the quality of maternal interactive behaviour and the child outcomes of attachment security to the mother, self‐esteem, ego‐resiliency, verbal intelligence, prosocial behaviour, school adjustment, and behaviour problems at age 5 (M = 68 months).Results:  In the total sample no lasting treatment benefits were found, but in families reporting a higher number of stressful life events, children in the intervention group had fewer externalising behaviour problems as rated by their mothers than children in the control group.Conclusions:  In the context of multiple stressful life events the intervention served as a buffer by preventing the development of externalising problems in the child. The results warrant cautious interpretation because of the relatively small sample size and differential attrition revealing the mothers that completed the follow‐up assessment to have improved less on maternal sensitivity following the intervention than the mothers who did not participate in the follow‐up.
Report on accreditation learning sets in the West Midlands Region of the NHS
Authors: Giles Gwen 
Published: August 2010

AbstractThis article reports on the evaluation of the first year of a project, which utilized learning sets to support librarians undergoing the accreditation process, in the health libraries in the West Midlands region of the NHS.The West Midlands Health region is divided up into education consortia patches. Each group of patch librarians was allocated a local accreditation facilitator. The groups met regularly to discuss problems and progress relating to their library’s accreditation.The results of the evaluation suggest that this is a valuable approach to use. The recommendations state that regular, frequent meetings are needed. Extra training and guidance would help the facilitators to be more effective in their role.
Improving the provision of traditional health knowledge for rural communities in Ghana*
Authors: Yeboah Theophilus 
Published: August 2010

AbstractIn Ghana many rural illiterate people practise traditional medicine and spread their knowledge through oral communication among themselves. This paper observes that traditional health information which freely circulates, and is actively disseminated by healers in rural communities greatly contributes to the knowledge for preparing home remedies and other traditional interventions. Oral communication can give rise to inaccurate and even dangerous information where charlatans can penetrate and operate within the health system. The Danfa project, which involved verbal teaching of modern health techniques to illiterate herbalists, and educating villagers about improved traditional medical practices, is described as a success story of information provision for illiterates. The experience is applied to propose the modification of some training programmes under the Ministry of Health to produce traditional health care information providers. Repackaged information and the public media are recommended as the most effective method of transferring knowledge to those unable to read.