bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Agents to Prevent and Treat Enteral Feeding Tube Clogs
Authors: Dandeles Lauren M , Lodolce Amy E 
Published: April 2011

Objective: To review the efficacy and safety of agents used to prevent and treat clog formation in enteral feeding tubes. Data Sources: A literature search was conducted through MEDLINE (1948-February 2011) and International Pharmaceutical Abstracts (1970-February 2011) using the search terms enteral feeding tube and occlusion. In addition, reference citations from publications identified were reviewed. Study Selection and Data Extraction: All English-language publications were reviewed for applicability. Data Synthesis: Occlusion is a common complication of enteral tube feeding. With Food and Drug Administration regulations, pancreatic enzymes have recently been reformulated and previously published reports can no longer be applied to currently available agents. This has led to concern over what available products have been shown to be efficacious. Three in vitro studies, 1 randomized in vivo trial, and 1 descriptive report were reviewed. In the prevention of tube clogging, it was concluded that water was comparable in efficacy, while being more readily available and cost effective, when compared to Coca-Cola, and both were superior to cranberry juice. For resolution of an existing clog, evidence of the efficacy of any individual agents is limited and has not been reproducible. New formulations of pancreatic enzymes, a new delivery system for enzymes, and products to mechanically dismantle clogs have become commercially available, but no studies have been completed to evaluate safety and efficacy. Comparative in vivo studies of currently available products are needed to evaluate possible methods for resolving an occlusion. Conclusions: Water flushes have shown to be the most effective method in preventing enteral feeding tube clogging. Well-designed trials are needed to establish the proper place in therapy of new commercially available agents marketed for resolving clogs. In addition, well-designed in vivo trials are needed to establish the role, dosage, and extemporaneous formulation of extended-release pancreatic enzymes in treating such clogs.
Role of α2-Agonists in the Treatment of Acute Alcohol Withdrawal
Authors: Muzyk Andrew J , Fowler Jill A , Norwood Daryn K , Chilipko Allison 
Published: April 2011

Objective: To evaluate literature reporting on the role of norepinephrine in alcohol withdrawal and to determine the safety and efficacy of α2-agonists in reducing symptoms of this severe condition. Data Sources: Articles evaluating the efficacy and safety of the α2-agonists clonidine and dexmedetomidine were identified from an English-language MEDLINE search (1966-December 2010). Key words included alcohol withdrawal, delirium tremens, clonidine, dexmedetomidine, α2-agonist, norepinephrine, and sympathetic overdrive. Study Selection and Data Extraction: Studies that focused on the safety and efficacy of clonidine and dexmedetomidine in both animals and humans were selected. Data Synthesis: The noradrenergic system, specifically sympathetic overdrive during alcohol withdrawal, may play an important role in withdrawal symptom development. Symptoms of sympathetic overdrive include anxiety, agitation, elevated blood pressure, tachycardia, and tremor. Therefore, α2-agonists, which decrease norepinephine release, may have a role in reducing alcohol withdrawal symptoms. The majority of controlled animal and human studies evaluated clonidine, but the most recent literature is from case reports on dexmedetomidine. The literature reviewed here demonstrate that these 2 α2-agonists safely and effectively reduce symptoms of sympathetic overdrive and concomitant medication use. Dexmedetomidine may offer an advantage over current sedative medications used in the intensive care unit, such as not requiring intubation with its use, and therefore further study is needed to fully elicit its benefit in alcohol withdrawal. Conclusion: Clonidine and dexmedetomidine may provide additional benefit in managing alcohol withdrawal by offering a different mechanism of action for targeting withdrawal symptoms. Based on literature reviewed here, the primary role for clonidine and dexmedetomidine is as adjunctive treatment to benzodiazepines, the standard of care in alcohol withdrawal.
Vancomycin-Induced Neutropenia: Is it Dose- or Duration-Related?
Authors: Black Emily , Lau Tim TY , Ensom Mary HH 
Published: April 2011

Objective: To systematically evaluate the literature to determine whether vancomycin-induced neutropenia is dose- or duration-related and provide clinicians with feasible treatment alternatives. Data Sources: A literature search of PubMed (1949-November 2010), MEDLINE (1950-November 2010), EMBASE (1980-November 2010), and International Pharmaceutical Abstracts (1970-November 2010) was performed using the terms vancomycin, neutropenia, and leukopenia. Citations from publications were reviewed for additional references. Study Selection and Data Extraction: Studies and case reports were included if they reported neutropenia with vancomycin administration and excluded if they did not describe vancomycin dosages and/or concentrations, or if neutropenia resolved white the patient was still receiving vancomycin. Cases with significant confounders and those in which authors provided minimal information about patients were also excluded. Data Synthesis: Seven retrospective chart reviews (ie, case series) and 33 case reports were identified. Of these, 3 retrospective reviews and 26 case reports met inclusion criteria. To our knowledge, no prospective studies have assessed this clinical complication. Data suggest that vancomycin-induced neutropenia may not be completely related to daily dosages, total cumulative dosage, or supratherapeutic vancomycin concentrations. Furthermore, evidence suggests that neutropenia is more likely associated with therapy longer than 7 days, with the majority of episodes occurring beyond 20 days of therapy. Given these findings, a practical approach is to monitor white blood cell (WBC) count with a differential (including absolute neutrophil count) once a week in patients who are receiving vancomycin for more than 7 days. Conclusions: Vancomycin-induced neutropenia is most likely associated with prolonged vancomycin exposure. Patients receiving vancomycin for longer than 7 days should have WBC count, differential, monitored weekly. Vancomycin should be discontinued if there is a high clinical suspicion of it causing neutropenia, and an alternative agent should be initiated. Prospective case-controlled studies are needed to better characterize this adverse event.
Assessment of Vancomycin Dosing and Subsequent Serum Concentrations in Pediatric Patients
Authors: Eiland Lea S , English Thomas M , Eiland Edward H 
Published: April 2011

Background Because of concerns regarding increasing microbial resistance to vancomycin, adult treatment guidelines recommend higher trough concentrations based on the type of infectious process. Although these recommendations are not specific to pediatrics, the principles can be extrapolated. Desired higher trough serum concentrations will require escalated dosages of vancomycin in children. Objective: To evaluate current dosing regimens and subsequent trough serum concentrations of vancomycin in children, compare these to reference recommended dosages and guidelines, and predict a dosing equation to achieve desired serum concentrations. Methods: Pharmacokinetic parameters of children in a community teaching hospital who were prescribed vancomycin from January 2005 to May 2010 were evaluated in this retrospective chart review. Vancomycin dosing and subsequent serum concentrations were analyzed. Therapeutic serum concentrations were evaluated and compared to vancomycin prescribing and monitoring guidelines by year. Results: Four hundred thirty-five trough serum concentrations determined in 295 patients were analyzed. The average dosages, when evaluated by year, were 48 mg/kg/day (2005-2008) and 59 mg/kg/day (2009-2010). Using trough concentration recommendations of 5-15 mg/L, vancomycin regimens provided therapeutic trough concentrations 78% of the time from 2005 to 2008. Using 10-20 mg/L as the trough recommendations in 2009-2010, only 49% of serum concentrations reached a therapeutic level. Based on our predictive equation for children aged 1 month-18 years with normal renal function, a vancomycin dosage of 70 mg/kg/day is required to provide trough serum concentrations of 10 mg/L; a dosage of 85 mg/kg/day is required to provide trough serum concentrations of 15 mg/L. Conclusions: Our institution was primarily using vancomycin dosing regimens that were recommended in pediatric references (40-60 mg/kg/day), which resulted in subtherapeutic serum concentrations in our population based on new monitoring recommendations. Considering that the currently desired therapeutic trough concentrations of vancomycin are 10-20 mg/L, the total daily dosage should be increased.
Estimates of Statin Discontinuation Rates are Influenced by Exposure and Outcome Definitions
Authors: Geers Harm CJ , Bouvy Marcel L , Heerdink Eibert R 
Published: April 2011

Background Estimates of statin discontinuation rates are generally high but show large variations. Discontinuation rates are possibly influenced by unrecognized supplies from previous prescriptions and the operational definitions of statin discontinuation. Objective: To investigate whether the outcome (discontinuation) was affected by (1) the operational definition used to calculate statin exposure and (2) the operational definition and different cutoff values used to calculate discontinuation. Methods: Data for this study were obtained from the PHARMO medical record linkage system in the Netherlands. Participants were patients with a new statin and no statin prescription in the preceding year. The outcome, discontinuation, was defined based on a variable number of days without medication after exposure (gaps) or based on the availability of supplies 12 months after the inclusion date (at 1 year). Exposure to statins was assessed by 2 methods. The method termed No Overlap accounted for only the supplies of the last prescription to calculate exposure, and the method termed Overlap accounted for all supplies from previous prescriptions. We investigated the effect of 4 exposure outcome combinations on statin discontinuation estimates. Results: The exposure outcome combinations, including overlap, resulted in a 7% unit lower discontinuation rate. At gap lengths of 90 days and longer, no significant differences between No Overlap and Overlap were observed. Shorter minimum gap lengths gave higher discontinuation rates compared to longer minimum gap lengths and ranged from as high as 86% to 21%. Conclusions: If previous supplies are accounted for in the calculation of exposure to statins, lower discontinuation rates are observed, The influence of previous supplies on discontinuation rates is less pronounced than the influence of gap lengths. The calculation of exposure does not influence discontinuation if gaps longer than 90 days are used to assess discontinuation.
Defining the Minimal Detectable Change in Scores on the Eight-Item Morisky Medication Adherence Scale
Authors: Muntner Paul , Joyce Cara , Holt Elizabeth , He Jiang , Morisky Donald , Webber Larry S , Krousel-Wood Marie 
Published: April 2011

Background Self-report scales are used to assess medication adherence. Data on how to discriminate change in self-reported adherence over time from random variability are limited. Objective: To determine the minimal detectable change for scores on the 8-item Morisky Medication Adherence Scale (MMAS-8). Methods: The MMAS-8 was administered twice, using a standard telephone script, with administration separated by 14-22 days, to 210 participants taking antihypertensive medication in the CoSMO (Cohort Study of Medication Adherence among Older Adults). MMAS-8 scores were calculated and participants were grouped into previously defined categories (<6, 6 to <8, and 8 for low, medium, and high adherence). Results: The mean (SD) age of participants was 78.1 (5.8) years, 43.8% were black, and 68.1% were women. Overall, 8.1% (17/210), 16.2% (34/210), and 51.0% (107/210) of participants had low, medium, and high MMAS-8 scores, respectively, at both survey administrations (overall agreement 75.2%; 158/210). The weighted κ statistic was 0.63 (95% CI 0.53 to 0.72). The intraclass correlation coefficient was 0.78. The within-person standard error of the mean for change in MMAS-8 scores was 0.81, which equated to a minimal detectable change of 1.98 points. Only 4.3% (9/210) of the participants had a change in MMAS-8 of 2 or more points between survey administrations. Conclusions: Within-person changes in MMAS-8 scores of 2 or more points over time may represent a real change in antihypertensive medication adherence.
Cloning and functional analysis of the dpm2 and dpm3 genes from Trichoderma reesei expressed in a Saccharomyces cerevisiae dpm1Δ mutant strain
Authors: Zembek Patrycja , Perlińska-Lenart Urszula , Rawa Katarzyna , Górka-Nieć Wioletta , Palamarczyk Grażyna , Kruszewska Joanna S. 
Published: April 2011

AbstractInTrichoderma reesei, dolichyl phosphate mannose (dpm) synthase, a key enzyme in the O-glycosylation process, requires three proteins for full activity. In this study, thedpm2anddpm3genes coding for the DPMII and DPMIII subunits ofT. reeseiDPM synthase were cloned and functionally analyzed after expression in theSaccharomyces cerevisiae dpm1Δ[genotype (BY4743;his3Δ1; /leu2Δ0; lys2Δ0; /ura3Δ0; YPR183w::kanMX4] mutant. It was found that apart from the catalytic subunit DPMI, the DPMIII subunit is also essential to form an active DPM synthase in yeast. Additional expression of the DPMII protein, considered to be a regulatory subunit of DPM synthase, decreased the enzymatic activity. We also characterizedS. cerevisiaestrains expressing thedpm1,2,3ordpm1, 3genes and analyzed the consequences ofdpmexpression on protein O-glycosylationin vivoand on the cell wall composition.
Extended Play: Reflections of Heinrich Isaac's Music in Early Tudor England
Authors: Bryan John 
Published: April 2011

The so-called Henry VIII's Book (London, British Library Add. MS 31922) contains two textless pieces by Isaac—his three-part Benedictus and the four-part La my—together with a number of other Franco-Flemish “songs without words” typical of the contents of manuscripts copied for the North Italian courts where the earliest viol consorts were being developed in the 1490s and early 1500s. Alongside these pieces are works by native English composers, including William Cornyshe, whose extended three-part Fa la sol has a number of stylistic traits in common with some works by Isaac (for example, his three-part Der Hundt) and Alexander Agricola (his three-part Cecus non judicat de coloribus) that were also transmitted in textless format. The fact that these latter two pieces were published in Hieronymus Formschneider's Trium vocum carmina (Nuremberg, 1538) while Cornyshe's Fa la sol was published in XX Songes (London, 1530) shows that this type of repertoire was still prized several years after the composers' deaths.
Analysis of musical connections between the work of Isaac and Cornyshe, as evident in pieces such as those from Henry VIII's Book—in particular, techniques employed by the composers to extend the structures of their “songs without words”—sheds fresh light on the reception in England of Isaac's music and that of his continental contemporary Agricola. Relevant considerations include the context in which these pieces were anthologized together and the introduction into England of viols similar to those Isaac may have known in Ferrara in 1502, when La my was composed. Such pieces are representative of a typical courtly repertoire that developed into the riches of the later Tudor instrumental consort music.
Isaac's Signature
Authors: Wegman Rob C. 
Published: April 2011

ABSTRACT
The notion of the signature could serve as an appropriate metaphor by which to explore Heinrich Isaac as a man of his time and world. It may be mere coincidence that he has left more documents signed in his own hand than contemporary composers, but some of the documents he authenticated in this way really do attest to a new idea of professional musicianship that Isaac was the earliest and most successful in implementing: that of the professional composer who undertakes to produce new works under contractual obligation. Isaac is the first-known musician who signed a document specifically in this capacity. Yet his signature, or at least the assurance that he personally composed and signed a musical work, is also found in the context of practical musical sources, where they would appear to have no legal significance. Martin Just has shown, however, that the particular folios containing these compositions, in the manuscript Berlin 40021, were originally sent as letters. The implication is that Isaac's signature, in this case, is not an attribution so much as a mark of authentication—something that would have been required only if the musical works in question were sent, and changed hands, as part of a commercial transaction.
Taking the metaphor of the signature in a broader figurative sense, one could suggest that Isaac's work also bears his musical signature—namely in the personal style that his contemporaries tried to recognize and in some cases to characterize in words. Two authors who tried to capture the peculiar quality of Isaac's music are Paolo Cortesi and Heinrich Glarean. The latter's attempt is especially significant, since Glarean seems to attest to a new way of hearing and conceptualizing polyphony. Although it is hard to identify specifically which passages in Isaac's music he would have had in mind, the key to his appraisal seems to lie in a different way of conceptualizing the interplay of contrapuntal voices in contemporary music. To the extent that we can associate this with Isaac's musical signature, it would appear, once again, that this composer, more than any other, was at the forefront of some of the most significant developments in the music history of his time.
Implantable Prosthesis of Osseous Conduction (BAHA): Case Report
Authors: Buschle Maurico , Mendes Rita de Cássia , Ataíde André Luiz , Pereira Rodrigo , Vassoler Trissia Maria Farah , Polanski José Fernando , Ribas Angela , Stumpf Claudia Mittelmann , Nobre Raquel Alves , Daroit Roberta , Pedriali Izabella Vince Garcia 
Published: April 2011

Summary
Introduction: The implantable prosthesis of osseous conduction (BAHA) is deemed to be an excellent option in the auditory rehabilitation of patients with conductive and mixed hearing loss, unilaterally or bilaterally, and unilateral sensorineural hearing loss. It has been a good advantage over the conservative bone conduction apparatus and those of individual sound-amplifier apparatus (ISAA), when their usage becomes unfeasible because of chronic otitis externa, which has a hard clinic control.
Objective: To introduce the first BAHA case performed in Brazil, as duly authorized by ANVISA (National Agency for Sanitary Surveillance), to rehabilitate the mixed hearing loss with occurrences of chronic otitis externa.
Method: 50-year-old female patient with right-ear moderate and left-ear severe hearing loss, bilateral tinnitus derived from otosclerosis, was submitted to 04 surgeries of stapedotomy and unable to use ISAA as a result of otorrhea and bilateral otalgia. The medical and audiological evaluation indicated the benefit of using BAHA. Having surgery been performed and BAHA implemented, the patient showed a significant improvement in audiometric thresholds, speech perception and distinction, as well as she declared to be extremely satisfied with the esthetic factor.
Final commentaries: BAHA surgical process is safe, simple and swift, thus providing excellent audiological results and a higher degree of satisfaction to patients.
Effects of Exercise on Cardiovascular Risk Factors in Type 2 Diabetes
Authors: Chudyk Anna , Petrella Robert J. 
Published: April 2011

OBJECTIVE
Exercise is a cornerstone of diabetes management and the prevention of incident diabetes. However, the impact of the mode of exercise on cardiovascular (CV) risk factors in type 2 diabetes is unclear.

RESEARCH DESIGN AND METHODS
We conducted a systematic review of the literature between 1970 and October 2009 in representative databases for the effect of aerobic or resistance exercise training on clinical markers of CV risk, including glycemic control, dyslipidemia, blood pressure, and body composition in patients with type 2 diabetes.

RESULTS
Of 645 articles retrieved, 34 met our inclusion criteria; most investigated aerobic exercise alone, and 10 reported combined exercise training. Aerobic alone or combined with resistance training (RT) significantly improved HbA1c −0.6 and −0.67%, respectively (95% CI −0.98 to −0.27 and −0.93 to −0.40, respectively), systolic blood pressure (SBP) −6.08 and −3.59 mmHg, respectively (95% CI −10.79 to −1.36 and −6.93 to −0.24, respectively), and triglycerides −0.3 mmol/L (95% CI −0.48 to −0.11 and −0.57 to −0.02, respectively). Waist circumference was significantly improved −3.1 cm (95% CI −10.3 to −1.2) with combined aerobic and resistance exercise, although fewer studies and more heterogeneity of the responses were observed in the latter two markers. Resistance exercise alone or combined with any other form of exercise was not found to have any significant effect on CV markers.

CONCLUSIONS
Aerobic exercise alone or combined with RT improves glycemic control, SBP, triglycerides, and waist circumference. The impact of resistance exercise alone on CV risk markers in type 2 diabetes remains unclear.
Early Christian Tradition in Theology of Apostle Paul
Authors: Kardis Mária 
Published: April 2011

Early Christian Tradition in Theology of Apostle Paul
One of the most important questions in disciple Paul's theology is knowledge of source without is not possible to comprehend the Paul's theology. Among the sources belong not just his letters and The Acts of disciples but ideas, literature and philosophic-religious lines that time period, the early Christian tradition, cultural backround - judaizm and helenizm. Paul is confronted with existing elements in Christian churches which is knotting, interpretating and showing them in his letters. The aim of this contribution is to show spesifics of the first Christian tradition which Paul met. And how deep he is taken what he met in form of the first disciple's kerygma.
Pastoral Meaning and Application of Selected Messages of His Holiness Benedict XVI. to Catechesis and Media
Authors: Tirpák Peter 
Published: April 2011

Pastoral Meaning and Application of Selected Messages of His Holiness Benedict XVI. to Catechesis and Media
One of the exhortations of John Paul II begins with a very interesting and inspirational statement with respect to the catechesis and its purpose. In particular, it argues that the Church always treated catechesis as one of its primary duties in pastoral service, since the risen Christ, before he ascended to his Father, gave to his apostles one specific order - to teach all nations the gospel he preached to them. Thus, catechesis does not affect only those who are open to hear the gospel, but also to those who may have been initiated into Christianity, but Christianity became for them only a lose bundle of traditions and customers, with little relationship to daily life, daily matters related to family, moral, politics, and so on. Further inspirational thoughts about catechesis focusing on this latter group of people come from the current Bishop of Rome - Benedict XVII, who by means of his messages about media addresses both the clergy and the people, and spreads the hope that a human being will be able to make a good use of modern technological achievements, especially for his or her personal development and the development of the entire society.