bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long term outcome after delirium in the intensive care unit
Authors: Van Rompaey Bart , Schuurmans Marieke J , Shortridge‐Baggett Lillie M , Truijen Steven , Elseviers Monique , Bossaert Leo 
Published: September 2009

Aims and objectives.  This research studied the long term outcome of intensive care delirium defined as mortality and quality of life at three and six months after discharge of the intensive care unit.Background.  Delirium in the intensive care unit is known to result in worse outcomes. Cognitive impairment, a longer stay in the hospital or in the intensive care unit and a raised mortality have been reported.Design.  A prospective cohort study.Methods.  A population of 105 consecutive patients was included during the stay at the intensive care unit in July–August 2006. The population was assessed once a day for delirium using the NEECHAM Confusion Scale and the CAM‐ICU. Patients were visited at home by a nurse researcher to assess the quality of life using the Medical Outcomes Study Short‐Form General Health Survey at three and six months after discharge of the intensive care unit. Delirious and non delirious patients were compared for mortality and quality of life.Results.  Compared to the non delirious patients, more delirious patients died. The total study population discharged from the intensive care unit, scored lower for quality of life in all domains compared to the reference population. The domains showed lower results for the delirious patients compared to the non delirious patients.Conclusions.  Mortality was higher in delirious patients. All patients showed lower values for the quality of life at three months. The delirious patients showed lower results than the non delirious patients.Relevance to clinical practice.  Nurses are the first caregivers to observe patients. The fluctuating delirious process is often not noticed. Long term effects are not visible to the interdisciplinary team in the hospital. This paper would like to raise the awareness of professionals for long term outcomes for patients having experienced delirium in the intensive care unit.
Exophiala xenobiotica infection in cultured striped jack, Pseudocaranx dentex (Bloch & Schneider), in Japan
Authors: Munchan C , Kurata O , Wada S , Hatai K , Sano A , Kamei K , Nakaoka N 
Published: September 2009

AbstractThis report describes Exophiala infection in cultured striped jack, Pseudocaranx dentex, in Japan in 2005. One hundred out of 35 000 fish died per day and mortalities continued for 1 month. Diseased fish showed swelling of the abdomen and kidney distension. Numerous septate hyphae, pale brown in colour, were seen in kidney in squash preparations. Histology revealed abundant fungal hyphae and conidia in gill, heart and kidney. Fungal hyphae were accompanied by cell necrosis and influx of inflammatory, mainly mononuclear cells. The fungus isolated from the diseased fish had septate hyphae, pale brown in colour and 1.8–3.0 μm in diameter. Conidiogenous cells were conspicuous annellides, short or cylindrical or fusiform in shape. Conidia were one‐celled, ellipsoidal with smooth walls, accumulated in balls at the apices of annellides that tended to slide down, 1.5–2.0 μm in width and 3.0–5.0 μm in length. The fungus was classified into the genus Exophiala based on its morphology and as Exophiala xenobiotica based on the sequences of the ITS 1–5.8S–ITS 2 regions of rDNA. This is the first record of this fungus in a marine fish.
The nutritional intake supplied by enteral formulae used in older children (aged 7–12 years) on home tube feeds
Authors: Evans S. , Daly A. , Davies P. , MacDonald A. 
Published: September 2009

AbstractBackground:  In the UK, patients aged 6–12 years contribute more than one‐third of children on home enteral tube feeds (HETF). Many enteral feeds are given to this age group. The present study aimed to investigate the formula with the best nutritional composition for children aged 7–12 years on HETF by comparing the nutrient intake of three feed types; a paediatric feed (PF) for 1–6 year olds, an adult feed (AF), and a feed for children (OCF) aged 7–12 years.Methods:  Twenty‐five HETF children aged 7–14 years (median 10 years) were given a 6.3 kJ mL−1 enteral feed designed for 7–12 year olds (or weighing 21–45 kg) for 9 months. Nutrient intakes on the 7–12‐year‐old feed were compared with baseline feed (paediatric n = 10; or adult n = 15).Results:  At baseline, the PF failed to meet 100% of the reference nutrient intake (RNI) for three of 19 (16%) of the nutrients studied, whereas AF provided in excess of 250% of the RNI for six of 19 (32%) of the nutrients. During the trial, the nutrients on the OCF were two of 19 (11%) <100% and four of 19 (21%) >250% of the RNI. Only seven of 10 (70%) children on a PF met at least 100% of the UK RNI for calcium, compared to 17 of 19 (89%) on the OCF.Conclusions:  It is important to offer older children an enteral feed that provides an optimal level of nutrients to meet their nutritional requirements. Feeds designed for 7–12‐year‐old children more closely meet nutrient requirements than paediatric or adult formulae, but require further modification to fully meet the nutritional needs of this group.
The impact of enteral feeding protocols on nutritional support in critically ill children
Authors: Meyer R. , Harrison S. , Sargent S. , Ramnarayan P. , Habibi P. , Labadarios D. 
Published: September 2009

AbstractBackground:  Studies have shown that feeding protocols may assist in achieving optimal nutritional care in critically ill children. The present study aimed to assess the impact of enteral feeding protocols on nutritional support practices through a continuous auditing process over a defined period.Materials and methods:  A prospective audit on nutritional practice was initiated in 1994–1995 on all ventilated patients who were admitted for more than a complete 24‐h period in the paediatric intensive care unit. The audit was repeated 1997–1998, 2001 and 2005. The collection of data on outcomes included the time taken to initiate nutritional support, the proportion of patients fed via the enteral versus parenteral route, and the proportion of children reaching 50% and 70% of the estimated average requirement (EAR) by day 3. Feeding algorithms and protocols were introduced after each audit with a view to improving practices.Results:  Over the study period, time taken to initiate nutrition support was reduced from 15 h (1994–1995), 8 h (1997–1998), 5.5 h (2001) to 4.5 h (2005). The proportion of patients on parenteral feeds was reduced from 11% (1994–1995) to 4% (2005). An increase was also documented in the percentage of patients receiving a daily energy provision of 50% and 70% of the EAR by day 3 after the initiation of nutritional support (6% in 1994–1995 to 21% in 2005 for 70% of EAR).Conclusion:  The present study demonstrates that feeding protocols improve nutritional practices in a paediatric intensive care unit. However, protocol introduction needs to be monitored regularly through audit.
Long‐term efficacy of ‘ready‐to‐drink’ protein substitute in phenylketonuria
Authors: Gokmen‐Ozel H. , MacDonald A. , Daly A. , Hall K. , Ryder L. , Chakrapani A. 
Published: September 2009

AbstractBackground:  In phenylketonuria (PKU), protein substitute is an essential part of dietary treatment. Short‐term studies have demonstrated that liquid protein substitutes (LPS) are efficacious, and improve compliance in teenagers and adults with PKU, although there are no data available to demonstrate that their effectiveness is sustained over time. The present retrospective study aimed to evaluate the long‐term efficacy of ready‐to‐drink protein substitute in a group of people with PKU.Methods:  Thirty‐four patients (17 females and 17 males, median age 14.9 years, range 7.2–53.8 years) with PKU on dietary management were recruited from Birmingham Children’s Hospital. All patients who were taking a LPS for a median of 2.4 years (range 6 months to 4.1 years), had their plasma phenylalanine concentrations, anthropometric and nutritional biochemical markers reviewed, both before and when taking the LPS.Results:  There was a significant improvement in median plasma phenylalanine (P < 0.05), vitamin B12 (P < 0.01), calcium (P < 0.05) and albumin (P < 0.05) concentrations in subjects (n = 13) aged >18 years when taking the LPS. In the children aged 7–18 years (n = 21), median plasma phenylalanine concentrations were maintained on LPS. Their plasma selenium concentrations (P < 0.05) deteriorated, but calcium (P < 0.05), albumin (P < 0.01), haemoglobin (P < 0.01) and haematocrit (P < 0.01) significantly improved.Conclusions:  This retrospective review suggested that, in adult patients, the long‐term use of LPS is associated with better compliance by lowering blood phenylalanine and improving nutritional biochemical markers.
Phase imaging atomic force microscopy in the characterization of biomaterials
Authors: YE Z. , ZHAO X. 
Published: September 2009

SummaryThe phase imaging atomic force microscopy is a powerful tool in surface characterization of the biomaterials, and the resulting phase image is able to detect chemical variation and reveal more detailed surface properties than the morphological image. However, the chemical‐ and morphological‐dependent phase images were still not distinguished well. In order to better understand actual occurring phase images, we examined non‐carious human maxillary incisor, microphase separated polyurethane and self‐assembling peptide nanofibres. We herein reported that phase image mainly plotted the morphological change: the phase peak corresponding to the morphological valley, and the morphological peak to the phase valley, and exhibited fine surface structures of materials. The chemical‐dependent phase contrast was generally masked by their inherent roughness. For the sample being very rough and having great phase separation, its chemical‐dependent phase contrast could be detected at the hard tapping mode (‘Amp. Ref. “set point ratio”’: −0.4 to −0.8), for the sample with medium roughness only at the light tapping mode (‘Amp. Ref.’: −0.1 to −0.4). These results will help us understand and determine actual occurring phase images of natural or fabricated biomaterials, even, other materials.
Intermittent slow sand filtration for preventing diarrhoea among children in Kenyan households using unimproved water sources: randomized controlled trial
Authors: Tiwari Sangya‐Sangam K. , Schmidt Wolf‐Peter , Darby Jeannie , Kariuki Z. G. , Jenkins Marion W. 
Published: September 2009

SummaryObjective  Measure effectiveness of intermittent slow sand filtration for reducing child diarrhoea among households using unimproved water sources in rural Kenya.Methods  A randomized controlled trail was conducted among populations meeting a high‐risk profile for child diarrhoea from drinking river water in the River Njoro watershed. Intervention households (30) were provided the concrete BioSand Filter and instructed on filter use and maintenance. Control households (29) continued normal practices. Longitudinal monthly monitoring of diarrhoea (seven‐day daily prevalence recall) and of influent, effluent, and drinking water quality for fecal coliform was conducted for 6 months.Results  Intervention households had better drinking water quality than control households (fecal coliform geometric mean, 30.0 CFU vs. 89.0 CFU/100 ml, P < 0.001) and reported significantly fewer diarrhoea days (86 days over 626 child‐weeks) compared to controls (203 days over 558 child‐weeks) among children up to 15 (age‐adjusted RR 0.46; 95 % CI = 0.22, 0.96). Greater child diarrhoea reduction due to the intervention (age‐adjusted RR 0.23, 95 % CI = 0.10, 0.51) was observed among the sub‐group using unimproved water sources all of the time.Conclusion  Intermittent slow sand filtration, a non‐commercial technology, produces similar observed effects on child diarrhoea as commercial POU products, adding to the range of effective options for poor populations (chlorination, ceramic filtration, solar disinfection, flocculation/disinfection).
Health care waste management: a neglected and growing public health problem worldwide
Authors: Harhay Michael O. , Halpern Scott D. , Harhay Jason S. , Olliaro Piero L. 
Published: September 2009

SummaryThe objective of this Short Communication is to promulgate an inventory of 87 papers pertaining to health care waste management practices and challenges in 40 low and middle income countries worldwide amassed through a multi‐language systematic review. Herein, we discuss the major gaps, failures, and frequently reported themes by geographic region. Following this we outline a proposed research agenda moving forward, and conclude that greater research and attention towards these unintended consequences of technologic progress in medical care delivery is needed to address and understand this growing public health threat around the world.
Plasma concentrations of growth arrest‐specific protein 6 and protein S in patients with acute pancreatitis
Authors: Uehara Soichiro , Handa Hiroshi , Gotoh Katuhiro , Tomita Hiroshi , Sennshuu Mitiko 
Published: September 2009

AbstractBackground:  The aim of the present study was to clarify the changes in plasma concentrations of growth arrest‐specific protein 6 (Gas6) and protein S (PS) in patients with mild or severe acute pancreatitis (AP).Methods:  The study group comprised 29 consecutive patients with AP (24 males, five females; mean age, 54.8 ± 15.0 years) and 20 healthy controls (10 males, 10 females; mean age, 53.0 ± 15.3 years). Plasma concentrations of Gas6 and PS were measured by enzyme‐linked immunosorbent assay.Results:  The concentration of Gas6 was significantly higher in both severe and mild AP than in healthy controls, and was significantly correlated with two of the multiple organ failure assessment scores. Furthermore, when compared with survivors, the concentrations of Gas6 in non‐survivors of severe AP were significantly increased. The concentrations of free PS and total PS were significantly decreased compared with normal controls, but there was no difference between cases and controls in the concentrations of C4 binding protein–PS.Conclusion:  Plasma concentrations of Gas6 and PS correlate with disease severity. High concentrations of Gas6 reflect microcirculatory abnormalities, and phagocytosis of dying cells in sepsis associated with severe AP.
Patient satisfaction after endoscopic retrograde cholangiopancreatography for biliary stones: A prospective multicenter study in Lombardy
Authors: Masci Enzo , Rossi Marzia , Minoli Giorgio , Mangiavillano Benedetto , Bianchi Guglielmo , Colombo Enrico , Comin Umberto , Fesce Edoardo , Perego Maurizio , Ravelli Paolo , Lella Fausto , Buffoli Federico , Zambelli Alessandro , Lomazzi Aldo , Fasoli Renato , Prada Alberto , Testoni Pier Alberto 
Published: September 2009

AbstractAims:  To measure patients' satisfaction after endoscopic retrograde cholangiopancreatography (ERCP) for biliary stones in a large number of unselected endoscopy units.Methods:  A prospective study using a questionnaire (Group Health Association of America—9 [GHAA‐9], modified) was administered 24 h and 30 days after the procedure. Patients undergoing endoscopy for biliary stones for the first time were enrolled in a large number of endoscopy units, regardless of their size and workload.Results:  In all, 700 patients were enrolled in 15 units. A high proportion of patients expressed satisfaction (80%). Satisfaction was less extensive for pain control and the quality of information provided before the procedure. There were no differences in the replies to questionnaires at 24 h and 30 days.Conclusion:  It is feasible to record patients' satisfaction and in this series most patients were very satisfied. Criticisms concerned pain control and explanations provided before the procedure.
Transrectal ultrasound navigation during minilaparotomy retropubic radical prostatectomy: Impact on positive margin rates and prediction of earlier return to urinary continence
Authors: Okihara Koji , Kamoi Kazumi , Kanazawa Motohiro , Yamada Takeshi , Ukimura Osamu , Kawauchi Akihiro , Miki Tsuneharu 
Published: September 2009

Objectives:  To assess the impact of transrectal ultrasound (TRUS) navigation on positive margin rates and membranous urethral length (MUL) after minilaparotomy radical retropubic prostatectomy (MRP).Methods:  Rates of positive distal margins prior to and after the application for TRUS navigation during MRP were assessed. Of the 189 men undergoing MRP at our institution, 70 were evaluated for the clinical usefulness of preoperative and postoperative MUL. Patients filled out self‐administrated questionnaires concerning continence status at 1, 3, 6, 9, and 12 months after the MRP. Surgery‐related factors including MUL were analyzed for the prediction of urinary continence after MRP.Results:  With the application of TRUS, the rate of positive distal margins decreased by 14%. Postoperative MUL was an independent variable predictive of urinary continence 1 month after surgery. Patients with a MUL longer than 12 mm showed a significantly more favorable recovery from urinary incontinence after surgery.Conclusion:  Application of TRUS results in a lower rate of positive margins, and a longer postoperative MUL is associated with an earlier return to urinary continence after MRP.
Radiofrequency ablation for renal tumors: Our experience
Authors: Hiraoka Kenji , Kawauchi Akihiro , Nakamura Terukazu , Soh Jintetsu , Mikami Kazuya , Miki Tsuneharu 
Published: September 2009

Objectives:  To report our results of percutaneous radiofrequency ablation (RFA) for renal tumors and to assess predictors of therapeutic efficacy.Methods:  Forty patients (median age 73 years) with renal tumors were treated with RFA under local or epidural anesthesia. All of them had high surgical risk or refused radical surgery. Tumors were punctured percutaneously using the Radionics Cool‐tip RF System under computed tomography or ultrasonographic guidance. Median tumor diameter was 24 mm. After RFA, contrast‐enhanced computed tomography or magnetic resonance imaging was performed within 1 month. Complete response (CR) was defined as no enhancement inside the tumor. Factors related to the outcome and to renal function were assessed.Results:  Median follow up was 16 months. CR was observed in 34 cases (85.0%). A significant difference in CR rate was observed between tumors ≤30 mm and those >30 mm. Outcomes tended to be better for tumors in the mid to lower kidney, and those away from the renal hilum. Recurrence was observed in one case (2.9%), but a CR was obtained again by additional RFA. Out of a total of 77 RFA procedures, complications occurred in only three cases (3.9%), and conservative treatment was possible in all cases. Serum creatinine levels 3 months after RFA did not differ from those before RFA.Conclusions:  Percutaneous RFA is a safe and effective treatment for small renal tumors in patients with high surgical risk or who refuse radical surgery.
Climatic signals in tree‐rings of Araucaria angustifolia in the southern Brazilian highlands
Authors: OLIVEIRA JULIANO MORALES , ROIG FIDEL ALEJANDRO , PILLAR VALÉRIO DEPATTA 
Published: September 2009

Abstract Araucaria angustifolia (Bertol.) O. Kuntze (Araucariaceae) is a Neotropical tree, widely distributed in subtropical mountain rain forests and nearby natural grasslands of Southern Brazil. This species produces annual growth rings, but its dendroclimatic potential is barely known. In the present paper, the long‐term growth patterns of A. angustifolia were investigated using annual growth ring time series and association to climate over the last century. Wood cores of A. angustifolia trees growing in forest and grassland habitats were obtained with an increment borer. The cores were surfaced, measured and cross‐dated. The dated ring‐width time series were standardized and submitted to correlation and principal component analysis to verify growth trends among sites and trees. Growth‐climate relationships were investigated using correlation and regression analyses, comparing the ordination axes scores to regional time series of precipitation and temperature. Due to anatomical irregularities, mainly partial rings, only 35 out of 60 trees were cross‐dated. The correlation and ordination analyses showed common tree‐growth trends within and between sites, indicative of a regional environmental force determining inter‐annual cambial activity variation. Despite growing in distinct habitats and disturbance regimes, A. angustifolia trees share a common long‐term growth pattern, which is significantly related to thermal conditions during the current and previous growing seasons. Moreover, site‐specific characteristics may have influenced opposite growth responses and association to climate conditions between forest and grassland trees.
Early ontogenetic trajectories vary among defence chemicals in seedlings of a fast‐growing eucalypt
Authors: MCARTHUR CLARE , LONEY PRUE E. , DAVIES NOEL W. , JORDAN GREGORY J. 
Published: September 2009

AbstractOntogenetic changes in leaf chemistry can affect plant–herbivore interactions profoundly. Various theoretical models predict different ontogenetic trajectories of defence chemicals. Empirical tests do not consistently support one model. In Eucalyptus nitens, a fast‐growing tree, we assessed early developmental changes to seedlings, in foliage concentrations of nitrogen and the full suite of known secondary (defence) chemicals. This included the terpene, α‐pinene, whose impact on marsupial herbivory is unknown. To test for the influence of abiotic conditions on the ontogenetic trajectories we overlaid a nutrient treatment. Ontogenetic trajectories varied among compounds. Sideroxylonals and cineole were barely detected in very young seedlings, but increased substantially over the first 200 days. Total phenolic concentration increased fourfold over this time. In contrast, α‐pinene concentration peaked within the first 60 days and again between 150 and 200 days. Nutrients altered the degree but not the direction of change of most chemicals. A shorter trial run at a different season showed qualitatively similar patterns, although α‐pinene concentration started very high. We investigated the effect of detected levels of α‐pinene and cineole on food intake by two mammalian herbivores, common brushtail possums (Trichosurus vulpecula) and red‐bellied pademelons (Thylogale billardierii). Under no‐choice conditions neither terpene reduced intake; but with a choice, possums preferred α‐pinene to cineole. The ontogenetic trajectories of most compounds were therefore consistent with models that predict an increase as plants develop. Published data from later developmental stages in E. nitens also confirm this pattern. α‐Pinene, however, was the only secondary compound found at significant levels in very young seedlings; but it did not constrain feeding by marsupial herbivores. Models must allow for different roles of defensive secondary chemicals, presumably associated with different selective pressures as plants age, which result in different ontogenetic trajectories.