bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of titration schedule of topiramate for the development of depression in patients with epilepsy
Authors: Mula Marco , Hesdorffer Dale C. , Trimble Michael , Sander Josemir W. 
Published: May 2009

SummaryPurpose:  To determine whether a fast titration schedule of topiramate (TPM) has different effects on the occurrence of depression, in relation to other risk factors for TPM‐induced depression, including history of depression (HxDEP), febrile seizures (FS), and hippocampal sclerosis (HS).Methods:  Using data from a large case registry of patients prescribed TPM, two models were constructed: Model 1 examined the independent effect of rapid TPM titration after separate adjustment for FS, HxDEP, and HS. Model 2 examined effect of the cooccurrence of rapid titration on the development of depression with each of these risk factors.Results:  A total of 423 patients were included (51.8% females), mean age (SD) 35.5 (11.8) years, mean duration of epilepsy of 22.2 (11.5) years. Forty‐four patients (10.4%) developed depression during TPM therapy. A rapid TPM titration was associated with 5‐fold increased risk of depression that increased to 12.7‐fold in the presence of both FS and rapid TPM titration, 23.3‐fold in the presence of both HxDEP and rapid TPM titration, and 7.6‐fold in the presence of both HS and rapid TPM titration schedule.Conclusions:  Our study suggests that a rapid titration schedule is associated with an increased risk of developing depression during TPM therapy. HxDEP and FS are major contraindications to the use of a rapid titration, with a 23.3‐fold and 12.7 fold increased risk, respectively.
The FDA alert on suicidality and antiepileptic drugs: Fire or false alarm?
Authors: Hesdorffer Dale C. , Kanner Andres M. 
Published: May 2009

SummaryIn January 2008, the U.S. Food and Drug Administration (FDA) issued an alert about an increased risk for suicidality in 199 clinical trials of 11 antiepileptic drugs (AEDs) for three different indications, including epilepsy. An advisory panel voted against a black‐box warning on AED labels, and the FDA has accepted this recommendation. We discuss three potential problems with the alert. First, adverse event data were used rather than systematically collected data. Second, the 11 drugs grouped together as a single class of AEDs have different mechanisms of action and very different relative risks, many of which were not statistically significant and some of which were smaller than one. These facts suggest that they should not be grouped as a class. Third, the risk of adverse effects from uncontrolled seizures almost certainly outweighs the small risk of suicidality. We place our comments in the context of a review of the literature on suicidality and depression in epilepsy and the sparse literature on AEDs and suicidality. We recommend that all patients with epilepsy be routinely evaluated for depression, anxiety, and suicidality, and that future clinical trials include validated instruments to systematically assess these conditions to determine whether the possible signal observed by the FDA is real.
Periprocedural Management and In‐Hospital Outcome of Patients with Indication for Oral Anticoagulation Undergoing Coronary Artery Stenting
Authors: RUBBOLI ANDREA , COLLETTA MAURO , VALENCIA JOSÈ , CAPECCHI ALESSANDRO , FRANCO NICOLETTA , ZANOLLA LUISA , VECCHIA LUIGI LA , PIOVACCARI GIANCARLO , DI PASQUALE GIUSEPPE ,   for the WARfarin and Coronary STENTing (WAR‐STENT) Study Group
Published: May 2009

Purpose: In patients on oral anticoagulation (OAC) undergoing coronary stenting (PCI‐S), procedural management and in‐hospital outcome have never been specifically and prospectively investigated. Also, the contribution of early bleeding to the relevant hemorrhagic rate reported at follow‐up with triple therapy of OAC, aspirin, and clopidogrel is largely unknown.
Methods: Consecutive patients with indication for OAC undergoing PCI‐S at 5 centers were enrolled and prospectively evaluated.
Results: Out of 3410 patients undergoing PCI‐S in the study period, indication for OAC was present in 4.8%. Femoral approach and bare metal stents were the most frequently used. During PCI‐S, OAC was continued in about 30% of patients, whereas in about 20% heparin bridging was carried out. Glycoprotein IIb/IIIa inhibitors were rarely used (11%), whereas a standard bolus of unfractionated heparin was given in 93% of cases. Major adverse cardiovascular events (MACE) occurred in 4.8% of patients and major bleeding in 4.3%. No predictors of MACE or bleeding were identified, although the femoral approach was of borderline significance for major bleeding (OR 4.6, 95% CI 1.0–20.8; P = 0.05). A history of previous hemorrhage (OR 5.3, 95% CI 1.6–18.1; P = 0.007) predicted Carbofilm™‐coated stent implantation.
Conclusions: A limited, albeit clinically relevant, proportion of patients undergoing PCI‐S has indication for OAC. Procedural management appears not substantially different from that of common patients. In‐hospital major bleeding is relevant and should be taken into account when evaluating the overall hemorrhagic rate at a medium‐ to long‐term follow‐up.
A history of childhood attention‐deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD
Authors: Rydén E. , Thase M. E. , Stråht D. , Åberg‐Wistedt A. , Bejerot S. , Landén M. 
Published: May 2009

Objective:  The occurrence of comorbid attention‐deficit hyperactivity disorder (ADHD) might have an impact of the course of the bipolar disorder.Method:  Patients with bipolar disorder (n = 159) underwent a comprehensive evaluation with respect to affective symptoms. Independent psychiatrists assessed childhood and current ADHD, and an interview with a parent was undertaken.Results:  The prevalence of adult ADHD was 16%. An additional 12% met the criteria for childhood ADHD without meeting criteria for adult ADHD. Both these groups had significantly earlier onset of their first affective episode, more frequent affective episodes (except manic episodes), and more interpersonal violence than the bipolar patients without a history of ADHD.Conclusion:  The fact that bipolar patients with a history of childhood ADHD have a different clinical outcome than the pure bipolar group, regardless of whether the ADHD symptoms remained in adulthood or not, suggests that it represent a distinct early‐onset phenotype of bipolar disorder.
Glossopharyngeal pistoning for lung insufflation in children with spinal muscular atrophy type II
Authors: Nygren‐Bonnier Malin , Markström Agneta , Lindholm Peter , Mattsson Eva , Klefbeck Brita 
Published: May 2009

AbstractAim:  To evaluate whether children with spinal muscular atrophy (SMA) type II were able to learn glossopharyngeal pistoning for lung insufflation (GI), and to evaluate the effects of GI on pulmonary function and chest expansion.Methods:  Eleven children with SMA type II were recruited. They performed 10 cycles of GI, four times per week, for 8 weeks. Lung function and chest expansion were measured before and after the 8‐week period.Results:  Five of the 11 children learned the technique. The median GI volume was 0.28 (range 0.15–0.98) L. Four of the children who completed the study showed a mean increase in inspiratory vital capacity (IVC) of 0.13 L (95% confidence interval (CI) 0.03–0.23) and peak expiratory flow (PEF) of 116 L/min (95% CI 60–173). They also had an increased chest expansion with GI at the level of the xiphoid process of 1.50 cm (95% CI 0.16–2.84) and at the level of the fourth costa of 1.79 cm (95% CI 0.85–2.73). The children reported temporary symptoms of dizziness and tension in the chest.Conclusion:  Five of the 11 children were able to learn the technique of GI and for the four who fulfilled the training, it had positive effects on IVC, PEF and chest expansion. GI did not cause major discomfort.
A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review
Authors: Assunção Wirley Gonçalves , Barão Valentim Adelino Ricardo , Delben Juliana Aparecida , Gomes Érica Alves , Tabata Lucas Fernando 
Published: May 2009

doi:10.1111/j.1741‐2358.2009.00299.x

A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review Background:  It has been stated that mandibular overdentures are more satisfactory than conventional dentures, but problems relating to the use of retrospective ratings, lack of control group and sequential provision of treatment may compromise the findings.Objective:  To establish a comparison between treatment with conventional complete dentures and implant‐retained overdentures in elderly patients by conducting a literature review.Materials and methods:  A search of English language peer‐review literature was completed using Medline up to 2008 focusing on evidence‐based research. Randomised clinical trials (RCTs) and longitudinal prospective studies were favoured in the review, using a general hierarchical classification. Articles that did not focus exclusively on the comparison of patient satisfaction between complete dentures and overdentures were excluded from further evaluation. The last search was conducted in February 2008. Key terms included quality of life, patient satisfaction, edentulism, complete denture and overdenture.Results:  Among the 90 articles found in the initial search, 27 met the inclusion criteria. This included 18 RCTs and eight prospective and one cohort study. Most of the articles stated superiority of the mandibular implant‐retained overdenture therapy over the conventional complete denture regarding patient satisfaction and quality of life.Conclusion:  Even with implant treatment presenting higher patient satisfaction and improvement of quality of life, it was not possible to establish a direct comparison between the studies due to differences in adopted methodologies.
A Survey on Prevention of Surgical Infections in Operating Theaters
Authors: Demir Fatma 
Published: May 2009

ABSTRACT Background: It is well known that surgical site infections (SSIs) contribute significantly to the cost of nosocomial infections. Although many guidelines and recommendations exist, research has demonstrated that practices for preventing SSIs in operating theaters (OT) vary. Aim: The purpose of this study was to describe the current infection control practices for SSIs, formerly called surgical wound infections, in OTs, and compare these findings with evidence‐based practice guidelines. Methods: In order to accomplish the purpose, a prospective, cross‐sectional descriptive survey was conducted. Data were collected by interviewing the charge nurses in 24 OTs of 11 hospitals in the city of Izmir, Turkey. The results were tabulated and compared with an evidence‐based guideline. Results: Data showed that there is a lack of adherence to the guideline. The most compliant areas to the guideline were hand/forearm antisepsis and the use of surgical gowns and drapes. Implications: It is suggested that increased compliance to infection control guidelines for surgical infections in OTs would facilitate providing best practice and evidence‐based care. There is a need for further research to determine why there is a difference between what is practiced and what guidelines indicate should be practiced.
Penile Prosthesis Implantation Compares Favorably in Malpractice Outcomes to Other Common Urological Procedures: Findings from a Malpractice Insurance Database
Authors: Chason Juddson , Sausville Justin , Kramer Andrew C. 
Published: May 2009

ABSTRACT

Introduction
Some urologists choose not to offer penile prostheses because of concern over malpractice liability.

Aim
The aim of this study was to assess whether urologists performing penile prosthesis surgery are placed at a greater malpractice risk.

Main Outcome Measures
Percentage of malpractice suits from prosthesis surgery and other urological procedures that result in payment, average resulting payout from these cases, and category of legal issue that ultimately resulted in payout.

Methods
A database from the Physician Insurers Association of America, an association of malpractice insurance companies covering physicians in North America, was analyzed to quantitatively compare penile implant surgery to other urological procedures in medicolegal terms.

Results
Compared to other common urological procedures, penile implant is comparable and on the lower end of the spectrum in terms of both the percentage of malpractice suits that result in payment and the amount ultimately paid in indemnity from those cases. Additionally, issues of informed consent play the largest role in indemnities for all urological procedures, whereas surgical technique is the most important issue for prosthesis surgery.

Conclusions
Urologists who are adequately trained in prosthetic surgery should not avoid penile implant procedures for fear of malpractice suits. A focus on communication and informed consent can greatly reduce malpractice risk for urological procedures.
Prevalence and Characteristics of Vibrator Use by Women in the United States: Results from a Nationally Representative Study
Authors: Herbenick Debra , Reece Michael , Sanders Stephanie , Dodge Brian , Ghassemi Annahita , Fortenberry J. Dennis 
Published: May 2009

ABSTRACT

Introduction
Although vibrators are commonly recommended by clinicians as adjunct to treatment for female sexual dysfunction, and for sexual enhancement, little is known about their prevalence or correlates of use.

Aim
The aim of this study was to determine the lifetime and recent prevalence of women’s vibrator use during masturbation and partnered sex, and the correlates of use related to sociodemographic variables, health behaviors, and sexual function.

Methods
A nationally representative sample of 3,800 women aged 18–60 years were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated.

Main Outcome Measures
The prevalence of vibrator use, the relationship between vibrator use and physical and psychological well-being (as assessed by the Centers for Disease Control and Prevention [CDC] Healthy Days measure) and health-promoting behaviors, the relationship between vibrator use and women’s scores on the Female Sexual Function Index, and an assessment of the frequency and severity of side effects potentially associated with vibrator use.

Results
The prevalence of women’s vibrator use was found to be 52.5% (95% CI 50.3–54.7%). Vibrator users were significantly more likely to have had a gynecologic exam during the past year (P &lt; 0.001) and to have performed genital self-examination during the previous month (P &lt; 0.001). Vibrator use was significantly related to several aspects of sexual function (i.e., desire, arousal, lubrication, orgasm, pain, overall function) with recent vibrator users scoring higher on most sexual function domains, indicating more positive sexual function. Most women (71.5%) reported having never experienced genital symptoms associated with vibrator use. There were no significant associations between vibrator use and participants’ scores on the CDC Healthy Days Measures.

Conclusions
Vibrator use among women is common, associated with health-promoting behaviors and positive sexual function, and rarely associated with side effects. Clinicians may find these data useful in responding to patients’ sexual issues and recommending vibrator use to improve sexual function. Further research on the relationships between vibrator use and sexual health is warranted.
The Prevalence of Hypoactive Sexual Desire Disorder in Surgically Menopausal Women: An Epidemiological Study of Women in Four European Countries
Authors: Graziottin Alessandra , Koochaki Patricia E. , Rodenberg Cynthia A. , Dennerstein Lorraine 
Published: May 2009

ABSTRACT

Introduction
Insufficient documentation exists regarding the prevalence of hypoactive sexual desire disorder (HSDD) in surgically menopausal (SM) women in European countries. Women who have undergone hysterectomy and bilateral oophorectomy experience a loss of ovarian hormones. Inclusion of these women in an epidemiological study provided the opportunity to study biological and cultural impacts on sexual function.

Aim
The aim of this study was to compare the prevalence of HSDD among SM women in France, Germany, Italy, and the United Kingdom, as well as the relationship between low sexual desire and sexual activity or behavior, and sexual or partner relationship satisfaction.

Methods
Cross-sectional survey of a convenience sample of 427 SM women aged 20–70 years.

Main Outcome Measures
The desire domain of the Profile of Female Sexual Function (PFSF) to identify women with low sexual desire, Personal Distress Scale (PDS) to measure distress caused by low sexual desire, and a sexual activities measure. Women with low sexual desire who were distressed were classified as having HSDD.

Results
SM women having low sexual desire ranged from 35% (United Kingdom) to 44% (Italy); of these women, 16% (Germany) to 56% (France) were distressed because of their low sexual desire. Overall, SM women classified with HSDD ranged from 7% (Germany) to 22% (France). A strong positive correlation was observed between sexual desire and arousal, orgasm, and sexual pleasure in all countries (P &lt; 0.001). Low sexual desire leads to less sexual activity, more dissatisfaction with sex life and partner relationship, and more negative emotional or psychological states, than normal desire in each country.

Conclusions
A similar percentage of SM women with low sexual desire were found across countries suggesting the role of biological factors (i.e., losing ovarian hormones) in determining sexual desire. Differences in the percentage of SM women with HSDD suggest a role for cultural factors in determining how low sexual desire is perceived.
A Conceptual Framework for the Evolution of Sexual Medicine and a Model for the Development of Alternative Sexual Health Services: 10-Year Experience of the Center for Sexual and Reproductive Health
Authors: Kirana Paraskevi-Sofia , Papaharitou Stamatis , Athanasiadis Loukas , Nakopoulou Evangelia , Salpiggidis George , Moysidis Kyriakos , Pipilaki Chryssa , Hatzimouratidis Konstantinos , Tzotstzis Vassilios , Portseli Aleka , Iraklidou Maria , Apostolidis Apostolos , Bekos Athanasios , Hatzichristou Dimitrios 
Published: May 2009

ABSTRACT

Introduction
Sexual health services are limited and inadequate to reduce factors that hinder treatment and adequate care, despite the growing interest for public awareness and prevention strategies.

Aim
The aim of this study was to present an integrative conceptual framework, which led to the development of a model of alternative sexual health services and the 10-year experience of the practice of the service.

Main Outcome Measures
Multiple-level needs assessments.

Methods
The conceptual framework is composed of four distinct elements: (i) it adopts a social/ecological perspective; (ii) it assumes that results are optimal when multiple interventions are used; (iii) interventions are influenced by behavioral theories; and (iv) sexual health is conceptualized through the biopsychosocial model. Based on this model, a Sexual and Reproductive Health Center was developed, dedicated to research, education, and public awareness.

Results
Over 10 years of experience show that the present approach constitutes a process which: (i) facilitates our understanding of the needs at individual, community, and system level; and (ii) increases the individuals’, community and systems’ capacity to control sexual health.

Conclusion.
Alternative models for sexual and reproductive health services should be encouraged, in order for best practices to be explored and identified. In addition, future research in the effectiveness of such interventions shall be beneficial in order for evidence-based interventions to be designed.
Role of shear stress on nitrite and NOS protein content in different size conduit arteries of swine
Authors: Guo X. , Kassab G. S. 
Published: May 2009

AbstractAim:  Inherent fundamental difference exists among arteries of different sizes. The purpose of this study was to evaluate the relation between regional difference of wall shear stress (WSS) in various sizes arteries and contents of nitrite and NO synthase (NOS) isoforms.Methods:  Five different conduit arteries in a wide range of diameter (1–8 mm) were examined in the hind limbs of 13 pigs. Blood flow rate and outer diameter were measured in vivo to determine WSS. Arterial tissues were harvested for the measurement of nitrite and NOS protein contents. The concentration of nitrite, a product of NO synthesis, was determined by high‐performance liquid chromatography method. Western blot analysis was used to assess the protein contents of endothelial NOS (eNOS), inducible NOS (iNOS) and neuronal NOS (nNOS).Results:  Our data show that WSS increases with a decrease in artery diameter. Nitrite level increases with increasing WSS and hence decreases with artery diameter. The eNOS protein contents decrease with an increase in diameter. No significant difference for iNOS and nNOS protein contents was found with different artery diameter. A significant positive correlation between tissue nitrite and eNOS protein contents was also observed. Finally, the WSS‐normalized eNOS is not significantly different in various size vessels.Conclusion:  Regional difference in blood flow has no effect on iNOS and nNOS protein contents in these conduit arteries. Regional difference in eNOS expression and nitrite contents may be related to the WSS‐induced NO by the endothelium under normal physiological conditions.
Post‐ischaemic activation of kinases in the pre‐conditioning‐like cardioprotective effect of the platelet‐activating factor
Authors: Penna C. , Mognetti B. , Tullio F. , Gattullo D. , Mancardi D. , Moro F. , Pagliaro P. , Alloatti G. 
Published: May 2009

AbstractAim:  Platelet‐activating factor (PAF) triggers cardiac pre‐conditioning against ischemia/reperfusion injury. The actual protection of ischaemic pre‐conditioning occurs in the reperfusion phase. Therefore, we studied in this phase the kinases involved in PAF‐induced pre‐conditioning.Methods:  Langendorff‐perfused rat hearts underwent 30 min of ischaemia and 2 h of reperfusion (group 1, control). Before ischaemia, group 2 hearts were perfused for 19 min with PAF (2 × 10−11 m); groups 3–5 hearts were co‐infused during the initial 20 min of reperfusion, with the protein kinase C (PKC) inhibitor chelerythrine (5 × 10−6 m) or the phosphoinositide 3‐kinase (PI3K) inhibitor LY294002 (5 × 10−5 m) and atractyloside (2 × 10−5 m), a mitochondrial permeability transition pore (mPTP) opener respectively. Phosphorylation of PKCε, PKB/Aκt, GSK‐3β and ERK1/2 at the beginning of reperfusion was also checked. Left ventricular pressure and infarct size were determined.Results:  PAF pre‐treatment reduced infarct size (33 ± 4% vs. 64 ± 5% of the area at risk of control hearts) and improved pressure recovery. PAF pre‐treatment enhanced the phosphorylation/activation of PKCε, PKB/Aκt and the phosphorylation/inactivation of GSK‐3β at reperfusion. Effects on ERK1/2 phosphorylation were not consistent. Infarct‐sparing effect and post‐ischaemic functional improvement induced by PAF pre‐treatment were abolished by post‐ischaemic infusion of either chelerythrine, LY294002 or atractyloside.Conclusions:  The cardioprotective effect exerted by PAF pre‐treatment involves activation of PKC and PI3K in post‐ischaemic phases and might be mediated by the prevention of mPTP opening in reperfusion via GSK‐3β inactivation.