bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negative hepatitis B envelope antigen predicts intrahepatic recurrence in hepatitis B virus‐related hepatocellular carcinoma after ablation therapy
Authors: Chung Goh Eun , Kim Won , Lee Jeong‐Hoon , Kim Yoon Jun , Yoon Jung‐Hwan , Lee Jeong Min , Lee Jae Young , Kim Se Hyung , Kim Donghee , Lee Hyo‐Suk 
Published: May 2011

AbstractBackground and Aim:  Patients with persistently active hepatitis B virus (HBV) replication are at high risk for progression to liver cirrhosis and hepatocellular carcinoma (HCC). The influence of the viral load of HBV on intrahepatic recurrence after local ablation therapy in patients with HBV‐related HCC has not been elucidated. We aimed to evaluate predictors of intrahepatic recurrence and clarify the correlation between viral load and intrahepatic recurrence after percutaneous ablation.Methods:  Patients with HBV‐related, solitary HCC undergoing radiofrequency ablation (RFA) or percutaneous ethanol injection (PEI), between October 2004 and December 2008 were prospectively enrolled. Statistical analyses were performed using the Kaplan–Meier method and Cox regression model to identify risk factors for intrahepatic recurrence.Results:  A total of 145 patients (male, 81.4%; mean age, 55.3 years) were included. Ninety patients (62.1%) had serum HBV DNA ≥ 2000 IU/mL. The median follow‐up duration was 28.9 months (range, 12.0–57.0) and 63 patients (43.4%) experienced intrahepatic tumor recurrence. Multivariate analysis indicated that seropositivity for hepatitis B envelope antigen (HBeAg) was an independent negative predictor of intrahepatic recurrence (hazard ratio, 0.473; P = 0.026) and late (≥ 1 year) recurrence (HR, 0.288; P = 0.012). The serum alpha fetoprotein (AFP) level also significantly predicted late recurrence (HR, 1.001; P = 0.005). However, neither the ablation method nor serum HBV DNA titers were correlated with intrahepatic recurrence.Conclusions:  These findings show that HBeAg‐negativity and serum AFP levels were associated with late intrahepatic recurrence of HCC, implicating HBeAg‐negativity as a risk factor for de novo recurrence after percutaneous ablation in HBV‐related HCC.
Portal venous invasion: The single most independent risk factor for immediate postoperative recurrence of hepatocellular carcinoma
Authors: Choi Kang Kook , Kim Sung Hoon , Choi Sae Byeol , Lim Jin Hong , Choi Gi Hong , Choi Jin Sub , Kim Kyung Sik 
Published: May 2011

AbstractBackground and Aim:  Despite improvements of treatment in hepatocellular carcinoma (HCC), the recurrence rate after curative hepatic resection still remains remarkably high. An immediate recurrence of HCC after surgery is frustrating. We tried to clarify risks of immediate postoperative recurrence of HCC; that is, within 4 months after curative hepatic resection.Methods:  A total of 167 patients with HCC underwent hepatic resection; 60 had immediate postoperative recurrences (IPR group), and 107 had disease‐free survival for more than 5 years (DFS group). Variables were compared between the two groups.Results:  Univariate analysis showed the following variables were significant risk factors for immediate postoperative recurrence of HCC: male sex, elevated serum aspartate aminotransferase level, greater amount of blood loss, longer operation time, worse tumor differentiation, higher tumor node metastasis stage, and presence of any of the following: intrahepatic metastasis, tumor‐rupture, portal venous invasion, or microvascular invasion. In multivariate analysis, only portal venous invasion was a significant risk factor (odds ratio = 3.2, P = 0.03, standard error = 0.5, Logistic regression analysis).Conclusions:  Portal venous invasion may be the most significant risk factor for immediate postoperative recurrence of HCC. However, accurate assessment of this risk factor may require histological examination, limiting its utility as a preoperative predictor. Further research is necessary to definitively identify preoperative predictors.
Sudden cardiac death: the perspectives of Spanish survivors
Authors: Palacios‐Ceña Domingo , Losa‐Iglesias Marta Elena , Salvadores‐Fuentes Paloma , Fernández‐de‐las‐Peñas Cesar 
Published: May 2011

AbstractSudden cardiac death is an episode of sudden death from cardiac causes in previously healthy patients. The aim of this study was to investigate the life experiences of patients who were resuscitated successfully following a sudden cardiac death. Purposeful sampling was used to recruit the nine participants through the snowball technique. Unstructured interviews were carried out until data saturation was reached. The Giorgi method of analysis, which seeks to reduce the participant's experience to minimal thematic units, common thematic groups, and essential themes in order to describe it, was used. Four essential themes were found: “facing fear”; “the search for meaning”; “feeling death up close and personal”; and “loneliness and estrangement”. Nurses must integrate the lifestyle changes of patients who survive a cardiac death in order to provide adequate care following hospital discharge. Patients should undertake follow‐up programs in order to receive counseling from health professionals. As a result, the creation of interdisciplinary support groups and the implementation of follow‐up programs after hospital discharge are fundamental. Survivors' experiences can inform the development of nursing programs and hospital follow‐up services that address the survival of cardiac death.
Factor analysis on oral health care for acute hospitalized patients in Japan
Authors: Kuramoto Chika , Watanabe Yutaka , Tonogi Morio , Hirata Soichiro , Sugihara Naoki , Ishii Takuo , Yamane Gen‐yuki 
Published: May 2011

Aim:  We conducted a survey to investigate the status regarding the implementation of oral health care for inpatients aged 65 years and older who were in the acute stages of stroke and to examine the factors related to the details of excellent model hospitals.Methods:  We sent a questionnaire on oral health care targeting all 8089 hospitals in Japan. On the basis of the responses obtained from the hospitals, we conducted a survey to analyze the factors defining what are known to be excellent model hospitals. We then conducted a logistic regression analysis using a stepwise procedure.Results:  Replies were received from 2444 of the 8089 hospitals (30.2%): 91.8% of the hospitals reported that oral health care was a part of the daily nursing routine while 91.2% of the hospitals considered that aspiration pneumonia could be prevented by appropriate oral health care. Only 30% of the nurses had undergone oral hygiene training. Among the factors involved in excellent model hospitals, we observed a strong correlation with a sense of the necessity for oral health care, oral hygiene training for nurses and a large number of hospital beds.Conclusion:  Large scale hospitals tend to be more interested in oral health care than smaller hospitals. Providing oral health care is already common in acute hospitals in Japan. There is a great demand for oral hygiene training and obtaining information from dental professionals. It is important to promote the cooperation between dental and nursing personnel within hospitals regarding oral hygiene training. Geriatr Gerontol Int 2011; 11: 460–466.
Evaluation of delirium in elderly: A hospital‐based study
Authors: Khurana Vishal , Gambhir Indrajeet Singh , Kishore Dhiraj 
Published: May 2011

Aim:  The study aimed to study the prevalence, etiologies, clinical profile and outcome of delirium in hospitalized elderly in medicine wards.Methods:  Four hundred elderly patients of more than 60 years of age admitted with delirium in the emergency and medicine wards of Sir Sunderlal Hospital Varanasi, India, were evaluated and managed. The Hindi version of the Mini‐Mental Status Examinations, a vernacular (Hindi) version of the Mini‐Mental State Examination, was used for evaluation of cognitive function status of patients and Confusion Assessment Method (CAM), a screening instrument based on the third edition of the Diagnostic and Statistical Manual of Mental Disorders was used for diagnosis of delirium.Results:  A total of 400 hospitalized elderly delirious patients were included in the study aged 61–105 years. The mean age of the subjects was 70.87 ± 9.26 years and 70.81 ± 8.4 years amongst males and females, respectively. The mortality rate was 14.75%. Out of nine CAM features, all the cases had all three essential features, 78.75% had four features, 58.5% had five features, 44.5% had six features and 9.25% had all nine features. There was a high prevalence of hypoactive delirium (65%) as compared to hyperactive (25%) or mixed (10%). Most common etiologies were sepsis followed by metabolic abnormalities. 70% had 2 or more etiologies.Conclusion:  Sepsis and metabolic abnormalities were the most common etiologies of delirium in this study. The maximum patients had more than one etiology and this emphasizes the multifactorial nature of delirium and need for thorough evaluation to unravel them. Most of the causes were treatable and have favorable outcome (83% recovered). Geriatr Gerontol Int 2011; 11: 467–473.
Modified evisceration technique in a golden eagle (Aquila chrysaetos)
Authors: Dees D. Dustin , Knollinger Amy M. , MacLaren Nicole E. 
Published: May 2011

AbstractTwo different modified techniques have been described for enucleation in raptors, including the transaural approach and the globe‐collapsing procedure. This case report describes an alternative, modified evisceration procedure in a mature female Golden Eagle (Aquila chrysaetos). The advantages of this procedure are decreased anesthetic time, ease of procedure, decreased risk of excessive traction of the optic nerve, decreased intraoperative orbital trauma, and preservation of the natural symmetry of the head. The major disadvantage of this procedure is that it does not allow complete histologic examination of the globe. Patients with intraocular infection or neoplasia, or significant orbital disease may be poor candidates for this technique.
Infective complications after transrectal ultrasound‐guided prostate biopsy following a new protocol for antibiotic prophylaxis aimed at reducing hospital‐acquired infections
Authors: Madden Thomas , Doble Andrew , Aliyu Sani H. , Neal David E. 
Published: May 2011

Study Type – Therapy (case series)Level of Evidence 4What’s known on the subject? and What does the study add?
Clostridium Difficile infections have been a serious problem throughout the NHS and have forced clinicians to change the types of antibiotics they routinely prescribe.
Ciprofloxacin is a good choice of prophylactic agent for TRUSP Bx.
Co‐amoxiclav and gentamicin have never been studied in combinations as prophylaxis for TRUSP Bx.

Co‐amoxiclav and gentamicin in combination are an inferior choice of prophylactic agent compared to Ciprofloxacin.
Development of Clostridium Difficile infection does not appear to be a concern when using Ciprofloxacin as prophylaxis for TRUSP Bx.
Any change in antibiotic usage should take into account local knowledge of antiobiotic resitance as well as published evidence.
OBJECTIVE• To compare the infective complications between two different antibiotic regimens used as prophylaxis for transrectal ultrasound‐guided prostate biopsy (TRUSP Bx).PATIENTS AND METHODS• The records of 709 consecutive patients undergoing TRUSP Bx over a period of 20 months at a UK teaching hospital were examined retrospectively.• All clinic letters, microbiology reports and admission records were examined for each patient.RESULTS• Within the study period a total of 454 patients received prophylaxis with ciprofloxacin; 11 of these patients (2.4%) developed an infective complication within 4 weeks of the TRUSP Bx.• A total of 255 patients received prophylaxis with co‐amoxiclav and gentamicin; 33 patients (12.9%) in this group had an infective complication.• No cases of Clostridium difficile infection were recorded for any of these patients within 1 month of receiving antibiotics.• Re‐introduction of the original regimen led to a fall in infective complications.CONCLUSION• Understandable concerns about the development of hospital‐acquired infection led to a new protocol for antibiotic prophylaxis which in turn led to a number of patients being put at increased risk of potentially serious infective complications. Antibiotic prophylaxis must reflect tissue penetration, the organisms encountered and their susceptibilities, as well as being based on objective evidence.
Non‐inferiority of silodosin to tamsulosin in treating patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH)
Authors: Yu Hong‐Jeng , Lin Alex Tong‐Long , Yang Stephen Shei‐Dei , Tsui Ke‐Hung , Wu Hsi‐Chin , Cheng Chen‐Li , Cheng Hong‐Lin , Wu Tony T. , Chiang Po‐Hui 
Published: May 2011

Study Type – Therapy (RCT)Level of Evidence 1bWhat’s known on the subject? and What does the study add?Silodosin administered by 4 mg twice daily is as effective as tamsulosin 0.2 mg daily in treating patients with LUTS associated with BPH.Relative to tamsulosin, silodosin has less cardiovascular side effects as judged by the minimal changes of blood pressure and pulse rats after treatment.OBJECTIVE• To test the hypothesis that the efficacy of silodosin would not be inferior to tamsulosin in treating patients with lower urinary tract symptoms associated with benign prostate hyperplasia (BPH).PATIENTS AND METHODS• At nine medical centres, 209 patients with an International Prostate Symptom Score (IPSS) of ≥13 were randomized to silodosin (4 mg twice daily) or tamsulosin (0.2 mg once daily) for 12 weeks.• The primary efficacy measure was the mean change from baseline to endpoint in IPSS.• The non‐inferiority margin of the IPSS change was set at 1.0.• Secondary efficacy measures included change in maximal urinary flow rate (Qmax) and health‐related quality of life (HRQL) score.RESULTS• Of the 170 (81.3%) patients who completed the study, 86.2% in the silodosin group vs 81.9% in the tamsulosin group achieved a ≥25% decrease in IPSS (P= 0.53).• The mean difference (silodosin minus tamsulosin) in IPSS change from baseline was −0.60 (95% confidence interval −2.15, 0.95), inferring the non‐inferiority of silodosin to tamsulosin.• The mean changes in the Qmax and HRQL score from baseline were comparable between the groups (both, P > 0.05). Although patients receiving silodosin had a significantly higher incidence of abnormal ejaculation (9.7% vs tamsulosin 1.0%, P= 0.009), only 1.9% discontinued treatment.• Tamsulosin treatment resulted in a significant reduction in mean systolic blood pressure (−4.2 mmHg, within‐group P= 0.004) relative to the negligible change of silodosin (−0.1 mmHg, within‐group P= 0.96)CONCLUSION• The trial shows the non‐inferiority of silodosin 4 mg twice daily to tamsulosin 0.2 mg once daily in patients with symptoms of BPH.
Effect of varicocele on sperm function and semen oxidative stress
Authors: Blumer Camile Garcia , Restelli Adriana Ester , Giudice Paula Toni Del , Soler Thiesa Butterby , Fraietta Renato , Nichi Marcilio , Bertolla Ricardo Pimenta , Cedenho Agnaldo Pereira 
Published: May 2011

Study Type – Aetiology (case control)Level of Evidence 3bWhat’s known on the subject? and What does the study add?Varicocele leads to alterations in sperm DNA integrity even when alterations in semen quality are not yet observed in adolescents. In adults, alterations to sperm DNA are associated to altered sperm morphology, indicating that altered spermatogenesis may be an important cause for the increased sperm DNA fragmentation observed in these men. One other important cause of increased DNA fragmentation is oxidative stress, and we wished to verify if this was the case.The study adds the information that, in the adult varicocele, it is most likely that an altered testicular environment is leading to increased DNA fragmentation and decreased mitochondrial activity and acrosome integrity, because no increase in oxidative stress was observed.OBJECTIVE• To assess the effect of varicocele on sperm DNA integrity, mitochondrial activity, lipid peroxidation and acrosome integrity.PATIENTS AND METHODS• In all, 30 patients with a clinically diagnosed varicocele of grade II or III and 32 men without a varicocele were evaluated for sperm DNA fragmentation (comet assay), mitochondrial activity (3,3′‐diaminobenzidine assay), lipid peroxidation (malondialdehyde) and acrosome integrity (fluorescent probe labelled peanut agglutinin).RESULTS• The varicocele group showed fewer spermatozoa with intact DNA (grade II,P= 0.040), more cells with inactive mitochondria (class III,P= 0.001), fewer cells with active mitochondria (class I,P= 0.005) and fewer spermatozoa with intact acrosomes (P< 0.001). Finally, no significant differences were observed in lipid peroxidation levels.CONCLUSION• Men with varicocele showed an increase in sperm DNA fragmentation and a reduction in mitochondrial activity and acrosome integrity. However, lipid peroxidation levels remained unchanged.
Near‐infrared tissue oximetry and digital image analysis: quantification of renal ischaemia in real time during partial nephrectomy
Authors: Caire Arthur A. , Alvarez Xavier , Conley Sarah , Sartor Alton , Lee Benjamin R. 
Published: May 2011

What’s known on the subject? and What does the study add?There is little known on how to objectively measure renal ischemia during partial nephrectomy. This study clemonstrates two potentially useful methods to measure renal ischemia during partial nephrectomy.OBJECTIVE• To determine the feasibility of using near‐infrared tissue oximetry (TO) and digital image analysis for assessing renal function and to quantify local renal ischaemia in a porcine model.MATERIALS AND METHODS• Tissue oximetry was performed and red/blue (R/B) colour ratios were determined on renal units of Yorkshire swine.• Interval measurements were taken before clamping the renal hilum, during warm ischaemia, and after unclamping using a ViOptix T.OxTM Tissue Oximeter and Matlab® digital image analysis.• Matlab software analysed images from the laparoscopic camera and determined an R/B ratio to track renal ischaemia.• The tissue oximeter used direct infrared light and was placed adjacent to the kidney parenchymal surface.• The data were divided into preclamp, clamp and post‐clamp, and compared between methodologies.RESULTS• The R/B ratio showed a higher rate of change compared with TO during clamp time in both the 15‐min experiment (R/B = 96.0 vs. TO = 52.1 unit/reference) and the 30‐min experiment (R/B = 97.6 vs. TO = 45.9).• The R/B ratio showed a higher rate of change compared with TO at 1 min after clamping in the 15‐min experiment (R/B = 80.1 vs. TO = 12.4).• Both detection devices showed similar changes in pre‐ and post‐clamp measurements in the 15‐ min experiment (R/B = 1.6 vs. TO = 3.8) and the 30‐min experiment (R/B = 4.7 vs. TO =−4.5).• In the 30‐min experiment the R/B ratio showed a significant difference between preclamp, clamp, and post‐clamp states (P= 0.026).CONCLUSIONS• Both TO and digital image analysis were able to calculate an ischaemic drop in tissue oxygen saturation during periods of acute renal ischaemia.• The findings suggest that the R/B ratio observed during histogram analysis shows a greater sensitivity compared with TO in quantifying renal ischaemia.
Occupational exposure to HIV: a conflict situation for health workers
Authors: Kumakech E. , Achora S. , Berggren V. , Bajunirwe F. 
Published: May 2011

KUMAKECH E., ACHORA S., BERGGREN V. & BAJUNIRWE F. (2011) Occupational exposure to HIV: a conflict situation for health workers. International Nursing Review58, 454–462Aim:  To determine the frequency of occupational exposure to human immunodeficiency virus (HIV), the circumstances and predisposing factors, the high‐risk groups, the extent to which exposures are reported and the post‐exposure prophylaxis (PEP) utilized by health‐care workers (HCWs) and students in a Ugandan hospital.Background:  Occupational exposure to HIV is a low but potential risk of HIV infection to health workers.Method:  Self‐administered questionnaire was given to 224 participants (including 98 HCWs and 126 students) in Mbarara Hospital, Uganda. Data were analysed with descriptive statistics using the Statistical Package for the Social Sciences version 15.0 (SPSS Inc, Chicago, IL, USA).Findings:  Of the 224 participants surveyed, 19.2% reported having sustained injection needle stick injuries in the previous year, of which 4.46% occurred with HIV‐infected blood. Other reported injuries were cannula needle stick injury (0.89%), suture needle stick injuries (3.13%), scalpel cut injuries (0.45%) and muco‐cutaneous contamination (10.27%). The most affected groups were nurses–midwives for scalpel injuries and students for stick injuries. The predisposing factors reported included lack of protective devices and recapping of needles. Exposures were under‐reported. Uptake of PEP was also low.Conclusion:  Occupational exposure to HIV presents a conflict situation for HCWs. It remains a frequent occurrence particularly among student nurses–midwives, despite being avoidable. Its prophylactic treatment is hampered by poor reporting and investigation of exposures, and poor access to PEP. Strict adherence to universal precaution and proper handling of occupational exposure to HIV should be encouraged.
The nursing profession in Saudi Arabia: an overview
Authors: Almalki M. , FitzGerald G. , Clark M. 
Published: May 2011

ALMALKI M., FITZGERALD G. & CLARK M. (2011) The nursing profession in Saudi Arabia: an overview. International Nursing Review58, 304–311Aim:  The study aims to provide an overview of the nursing profession in Saudi Arabia, including its history, educational development, workforce and professional practice.Background:  Saudi Arabia is faced with a chronic shortage of Saudi nurses, accompanied by high rates of turnover. Expatriate nurses form a large proportion of the nursing workforce in Saudi healthcare facilities, with Saudis comprising only 29.1% of the total nursing workforce. Despite the fact that the proportion of Saudi nurses is very low in general, this rate is lower in the private health sector where local nurses comprise only 4.1% of the total.Methods:  Data relating to the nursing profession in Saudi Arabia were extracted from published literature identified through search of a range of publically available databases such as Medline, CINAHL, Google Scholar, Saudi health databases, Saudi health journals, government reports and relevant texts. Obtained information was evaluated for relevance and grouped on a thematic basis.Conclusion:  The status of nursing in Saudi Arabia should be enhanced in order to make it a worthwhile career. The media should engage in helping to promote a positive image of the nursing profession. The education sector should reconsider the length of nursing training (5 years compared with 3 years in many developed countries) while maintaining competent and safe practice. Reducing the financial burden on the nursing student through provision of additional financial support would encourage more students. In particular, nurses should be paid a full salary during the intern year as currently occurs with medical students.