bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tuberculosis in patients on hemodialysis in an endemic region
Authors: KAZANCIOGLU Rumeyza , OZTURK Savas , GURSU Meltem , AVSAR Umit , AYDIN1 Zeki , UZUN Sami , KARADAG Serhat , TATLI Emel , SAR Fuat 
Published: October 2010

AbstractClinical presentation of tuberculosis is different in hemodialysis patients than in the general population. This study aimed to analyze hemodialysis patients with tuberculosis in Istanbul. Patients who were on a chronic hemodialysis program in Istanbul for more than 3 months and diagnosed to have tuberculosis at least 3 months after the start of hemodialysis were included. To discard the effect of immigration from other cities, we included only patients who had started their dialysis program in Istanbul. Their demographic and clinical data were analyzed using Statistical Package for Social Sciences for Windows ver. 13.0. Of the 925 patients screened from 7 different centers, 31 (3.35%) were found to have tuberculosis. The mean age was 52.3±13.5 years. The male/female ratio was 18/13. The mean duration of dialysis therapy and the duration of dialysis till the diagnosis of tuberculosis were 62.6±54.3 and 21.7±25.7 months, respectively. Extrapulmonary tuberculosis constituted 48.39%. Treatment ended with a cure in 18 (58.05%); was still ongoing in 12 (38.70%) patients; and 1 (3.25%) died of pulmonary tuberculosis. The lower incidence of tuberculosis compared with previous reports may be related to the differences in the diagnostic criteria and the decrease in the rate of tuberculosis during recent years. The demographic and clinical parameters of the patients were quite similar to the average dialysis population in Turkey. Hence, we cannot address a subpopulation with additional risk. It is important to prevent tuberculosis in hemodialysis patients due to difficulties in the diagnosis and treatment. Thus we recommend routine screening of hemodialysis patients and effective isolation and treatment of infected patients.
Prevention of secondary hyperparathyroidism in hemodialysis patients: The key role of native vitamin D supplementation
Authors: JEAN G. , VANEL T. , TERRAT J.‐C. , CHAZOT C. 
Published: October 2010

AbstractSecondary hyperparathyroidism (SHPT) is a frequent complication in chronic kidney disease, especially in hemodialysis (HD) patients. Treatments for SHPT include calcitriol analogues (CA), phosphate binders, cinacalcet (CC), and surgical parathyroidectomy (PTX). This study aimed to assess the incidence and prevalence of SHPT in a single center during the period when native vitamin D (N‐VitD) supplementation and CC treatment became available. All incident and prevalent HD patients were prospectively recorded and compared using 3 periods from 2004 to 2005 (period 1), 2006 to 2007 (period 2), and 2008 to 2009 (period 3). SHPT was diagnosed with serum parathyroid hormone (PTH) levels >300 pg/mL or the need for CA, CC, or PTX. Between periods 1 and 3, in incident patients (n=120 and 101), N‐VitD prescription increased from 11% to 68% (P<0.0001), CA prescription remained stable (40%), and patients with PTH>300 pg/mL decreased from 40% to 12% (P<0.0001). In prevalent HD patients (n=235), N‐VitD treatment increased from 55% to 91% (P<0.0001), whereas treatment with CA decreased from 67% to 17% (P<0.0001). Patients with serum PTH>300 pg/mL decreased from 38% to 13% (P<0.001), whereas patients with PTH<150 pg/mL remained stable (<30%). New CC prescriptions decreased from 45 to 3 (P<0.0001). Since 2004, SHPT has decreased drastically in incident and prevalent HD patients. The preventive role of N‐VitD supplementation appears to be obvious and represents one more argument for its general recommendation in CKD patients.
Renal replacement therapy in Nepal
Authors: HIRACHAN Padam , KHAREL Tirtha , SHAH Dibya S. , BALL John 
Published: October 2010

AbstractRenal replacement therapy in Nepal fulfills only a small part of the current needs, with 97 hemodialysis machines available for the general population of 29 million. Transportation difficulties to dialysis centers preclude many of the patients from end‐stage renal disease care, due to the rural nature of the population. Peritoneal dialysis (PD) organized into rural sub segments, considering the Mexican model of PD and government funding appear to offer some solution to provision of care for this mountainous rural country. We review the current statistics of dialysis patients, hemodialysis numbers, and renal transplantations within Nepal and offer suggestions regarding possibilities for increasing renal care within the country.
Is there an association between intradialytic hypotension and serum magnesium changes?
Authors: PAKFETRAT Maryam , ROOZBEH SHAHROODI Jamshid , MALEKMAKAN Leila , ZARE Najaf , NASAB Mahshid HASHEMI , HOSSEIN NIKOO Mohamad 
Published: October 2010

AbstractIntradialytic hypotension (IDH) is the most common complication of hemodialysis (HD). The aim of this study was to investigate the significance of intradialytic changes of serum magnesium (sMg) and its relation to IDH. We considered 58 patients undergoing HD. Serum magnesium was measured at start, after 2 hours, and at the end of the HD sessions. Total sMg concentration corrected for albumin was according to Krolles proposed formula. Blood pressure was measured every 30 min. Data were analyzed by SPSS.15. A P value of less than 0.05 was considered as significant. Occurrence of IDH among HD patients was 27.6% (16/58). Serum magnesium decreased significantly during HD session (P<0.05). Comparing corrected sMg in IDH group with non‐IDH group showed that: corrected sMg was 0.66 ± 0.14 mmol/L vs. 0.84 ± 0.26 mmol/L at the start of dialysis (P=0.43), 0.62 ± 0.17 mmol/L vs. 0.74 ± 0.23 mmol/L (P=0.04) at 2 hours, and 0.61 ± 0.12 mmol/L vs. 0.72 ± 0.22 mmol/L (P=0.03) at the end of dialysis. Intradialytic hypotension episodes were significantly related to a decrease in sMg during dialysis (P=0.02). There was a significant decrease in sMg levels during dialysis. Intradialytic hypotension was significantly related to lowered sMg levels during dialysis.
Effect of a single hemodialysis session on inflammatory markers
Authors: BITLA Aparna R. , REDDY Prabhakar E. , MANOHAR Suchitra M. , VISHNUBHOTLA Sivakumar V. , PEMMARAJU VENKATA LAKSHMI NARASIMHA Srinivasa Rao 
Published: October 2010

AbstractInflammation is a common feature of end‐stage renal disease. Although there is evidence for hemodialysis (HD)‐induced inflammatory process, the effect of a dialysis session on changes in inflammatory markers is still unclear. Seventeen patients of end‐stage renal disease on maintenance HD along with 20 age‐matched and sex‐matched healthy controls were recruited after informed consent. C‐reactive protein (CRP) and lipoprotein‐associated phospholipase A2 (LpPLA2) activity were measured in the study and control groups. Intradialytic in CRP and LpPLA2 were studied. Comparison of pre‐HD vs. the control group and predialytic and postdialytic values was performed using the Mann‐Whitney U test and Wilcoxon's test, respectively. Statistical evaluation of intradialytic changes in inflammatory markers was performed using Friedman's test. Hemodialysis patients had higher CRP levels compared with controls (P=0.001). Post‐HD LpPLA2 activity (n=17) was higher (P=0.039) compared with the pre‐HD activity. Intradialytic changes in inflammatory markers showed a significant increase (P=0.012) in LpPLA2 activity (n=7), while no change (P=0.133) was observed in CRP levels (n=17). Evidence on the pro‐inflammatory state being initiated by dialysis is provided by increased LpPLA2 activity. This may add to the atherogenic mileu and cause endothelial dysfunction in this high‐risk group. Drugs that inhibit the LpPLA2 pathway have been developed and may be effective in these patients.
Sudden unexpected death in patients with epilepsy receiving renal replacement therapy with dialysis: A 17‐year experience at a single institution
Authors: SCORZA Fulvio A. , SCATTOLINI Marcello , CYSNEIROS Roberta M. , ARIDA Ricardo M. , DE ALBUQUERQUE Marly , TERRA Vera C. , MACHADO Hélio R. , GOMES Rui A. , KESROUANI Silvana , CRUZ Jenner , PELARIGO Fátima C. M. , SILVA Alexandre L. , HENRIQUES Tânia M. G. , CAVALHEIRO Esper A. 
Published: October 2010

AbstractEpilepsy is the most common acquired chronic neurological disorder; each year about 1 in a 1000 patients with chronic epilepsy die suddenly, unexpectedly, and without explanation, even with postmortem examination (SUDEP). Seizure incidence is approximately 10% in patients with chronic renal failure and hemodialysis‐associated seizure has been considered to be a common complication of people on hemodialysis treatment. Considering this, we evaluated the incidence of seizures in 189 patients under dialytic treatment.
Biocompatibility of heparin‐grafted hemodialysis membranes: Impact on monocyte chemoattractant protein‐1 circulating level and oxidative status
Authors: MORENA Marion , JAUSSENT Isabelle , CHALABI Lotfi , BARGNOUX Anne‐Sophie , DUPUY Anne‐Marie , BADIOU Stéphanie , RAKIC Claire , THOMAS Michel , CANAUD Bernard , CRISTOL Jean‐Paul 
Published: October 2010

AbstractThis prospective observational study aimed at evaluating efficacy and biocompatibility performances of the new heparin‐coated Evodial dialyzers with/without systemic heparin reduction. After a 4‐week wash‐out period with reference polysulfone F70S dialyzers, 6 hemodialysis patients were sequentially dialyzed with Evodial, F70S, and Evodial dialyzers using 30% heparin reduction, each period of treatment was 4 weeks. Removal rates (RR) (urea, creatinine, and β2‐microglobulin), dialysis dose, and instantaneous clearances (urea and creatinine) were measured as well as inflammatory (C‐reactive protein, fibrinogen, interleukin 6, tumor necrosis factor α, and monocyte chemoattractant protein‐1) and oxidative stress (OS) (superoxide anion, homocysteine, and isoprostanes) parameters at the end of each study period. Patients treated with Evodial or F70S dialyzers for 4 weeks presented comparable dialysis efficacy parameters including urea and creatinine RR, dialysis dose and instantaneous clearances. By contrast, a significantly lower but reasonably good β2‐microglobulin RR was achieved with Evodial dialyzers. Regarding biocompatibility, no significant difference was observed with inflammation and OS except for postdialysis monocyte chemoattractant protein‐1 which significantly decreased with Evodial dialyzers. Thirty percent heparinization reduction with Evodial dialyzers did not induce any change in inflammation but led to an improvement in OS as demonstrated by a decrease in postdialysis superoxide production and predialysis homocysteine and isoprostane. This bioactive dialyzer together with heparin dose reduction represents a good trade‐off between efficacy and biocompatibility performance (improvement in OS with a weak decrease in efficacy) and its use is encouraging for hemodialysis patients not only in reducing OS but also in improving patient comorbid conditions due to lesser heparin side effects.
Myocardial stunning in hemodialysis: What is the overall message?
Authors: DORAIRAJAN Smrita , CHOCKALINGAM Anand , MISRA Madhukar 
Published: October 2010

AbstractHeart failure and cardiovascular events are common in chronic renal failure. Hemodialysis (HD) causes significant hemodynamic changes and hypotension. New evidence based on intradialytic echocardiography demonstrates transient cardiac dysfunction or stunning in majority of chronic HD patients. Over time, this group may progress to chronic heart failure and appears to predict higher cardiovascular events and mortality. Although the exact etiology is unclear, alterations in HD technique and cardiac medications may reduce this complication. We review the current understanding of acute cardiac stunning during HD and present a systematic management algorithm to optimizing overall outcomes in this high‐risk population.
Whole‐blood viscosity increases significantly in small arteries and capillaries in hemodiafiltration. Does acute hemorheological change trigger cardiovascular risk events in hemodialysis patient?
Authors: CANAUD Bernard , RODRIGUEZ Annie , CHENINE Leila , MORENA Marion , JAUSSENT Isabelle , LERAY‐MORAGUES Hélène , PICARD Annie , CRISTOL Jean‐Paul 
Published: October 2010

AbstractWhole‐blood viscosity is increasingly being recognized as a factor implicated in the vascular disease progression in high‐risk chronic kidney disease patients. Intermittent hemodialysis and hemodiafiltration sessions, characterized by rapid volume changes and anemia correction by erythropoietin stimulating agents, are favorable conditions for enhancing whole‐blood viscosity changes and consequently triggering cardiovascular events. To evaluate whole‐blood viscosity changes induced by hemodiafiltration, a cross‐sectional study has been performed in a group of 28 stable patients. In order to assess the impact of vessel size on whole‐blood viscosity changes, we performed a dynamic whole viscosity analysis on a wide spectrum of shear rates reproducing vasculature hemorheologic conditions. Blood viscosity changes are dependent on patient characteristics, hemoglobin, and total plasma protein concentrations. Whole blood viscosity increases significantly during hemodiafiltration over the complete spectrum of shear rates. Dynamic whole‐blood viscosity (WBV) increases up to 60%, predominantly at low shear rates in small arterioles and capillary beds. This observation underlines the potential pathogenic contribution of WBV increase in capillaries triggering cardiovascular events in the postdialysis period. Eight patients died from cardiovascular events. Higher WBV increase was noted in this group but did not reach statistical significance due to the insufficient power of the study. Hemorheological changes associated with WBV increase in capillary beds may contribute to aggravate silent tissue hypoxemia and precipitate cardiovascular events in chronic kidney disease patients. Prospective studies specifically designed and powered to evaluate the impact of WBV changes on cardiovascular events in dialysis patients are required.
Retaining Nurses and Other Hospital Workers: An Intergenerational Perspective of the Work Climate
Authors: Lavoie‐Tremblay Melanie , Paquet Maxime , Duchesne Marie‐Anick , Santo Anelise , Gavrancic Ana , Courcy François , Gagnon Serge 
Published: October 2010

Abstract Purpose: This article describes and compares work climate perceptions and intentions to quit among three generations of hospital workers and nurses. Background: Never before in history has the workplace comprised such a span of generations. The current workforce includes three main generations: Baby Boomers (born between 1946 and 1963), Generation X (born between 1964 and 1980), and Generation Y (born between 1981 and 2000). However, very little research has linked turnover among nurses and other healthcare workers to their generational profile. Method: A quantitative study with a correlational descriptive design was used. 1,376 hospital workers of the three generations (with 42.1% nurses, 15.6% support staff, 20.1% office employees, and 22.1% health professionals or technicians), employed in a university‐affiliated hospital, completed a self‐administered questionnaire. They answered the Psychological Climate Questionnaire and a measure of turnover intention. Results: Generation Y hospital workers obtained a significantly lower score on the “Challenge” scale than did Baby Boomers. On the “Absence of Conflict” and “Warmth” scales, the opposite occurred, with Baby Boomers obtaining a significantly lower score than Generation Y respondents. If the nurse job category is taken separately, Generation Y nurses expressed a negative perception of the “Goal Emphasis” scale, compared with Baby Boomers. The proportion of Generation Y nurses who intend to quit is almost three times higher than that of other hospital workers from Generation Y. The main reason given by workers from Generations Y and X who intend to quit the organization is their own career advancement. The main reason given by Baby Boomers who intend to quit is retirement. Conclusions: Retention strategies that focus on improving the work climate are beneficial to all generations of hospital workers and nurses. If generation‐specific retention strategies are developed, these should focus on the three areas identified to have intergenerational differences: challenges, absence of conflict, and warmth. Clinical Relevance: New nurses will benefit from strategies aimed at supporting their career advancement in the workplace.
Cervical insulin‐like growth factor binding protein‐1 (IGFBP‐1) to predict spontaneous onset of labor and induction to delivery interval in post‐term pregnancy
Authors: DÖGL MALIN , SKOGVOLL EIRIK , HEIMSTAD RUNA 
Published: October 2010

Abstract Objective. To evaluate whether insulin‐like growth factor binding protein‐1 (IGFBP‐1) assessed in cervical secretion can predict successful induction and spontaneous onset of labor in post‐term pregnancy, compared to ultrasound measurement of cervical length and Bishop score. Design. Cohort study, originating from a randomized controlled trial. Setting. Obstetric department of a university and tertiary referral hospital, Norway. Population. Five hundred and eight post‐term women who had been randomized to induction of labor or expectant management 1 week beyond estimated day of delivery (289 [±2] days of gestation). Methods. Time to delivery was related to presence of IGFBP‐1 in cervical secretion, Bishop score and ultrasound measurement of cervical length recorded at inclusion. Main outcome measures. Spontaneous onset of labor and delivery within 3 days in the expectant management, and delivery within 24 hours of induction in the induction group. Test characteristics (sensitivity, specificity and negative and positive values and likelihood ratios) for IGFBP‐1, Bishop score and cervical length were calculated. Logistic regression and Cox regression were used to account for parity and body mass index. Results. With expectant management, IGFBP‐1 predicted spontaneous labor onset and delivery within 72 hours with low sensitivity and high specificity (0.45 and 0.80, respectively), as did Bishop score (0.24, 0.92). Cervical length was more sensitive (0.67, 0.58). IGFBP‐1 predicted successful induction within 24 hours with low sensitivity and high specificity (0.30, 0.85), such as Bishop score (0.06, 1.00) and cervical length (0.45, 0.76). Parity enhanced successful induction. Conclusion. IGFBP‐1 predicts both spontaneous labor onset and successful induction in post‐term pregnancy. Bishop score and cervical length performed equally well.
Postural control in women with premenstrual symptoms during oral contraceptive treatment
Authors: EKENROS LINDA , HIRSCHBERG ANGELICA LINDÉN , BÄCKSTRÖM TORBJÖRN , FRIDÉN CECILIA 
Published: October 2010

Abstract Objective. This study investigates postural control among women with and without premenstrual symptoms (PMS) on oral contraceptive (OC) treatment. Design. Prospective repeated measures design. Setting. Women's health clinical research unit at a university hospital. Population. Fifteen women using low‐dose monophasic oral contraceptives participated in the study. Depending on premenstrual symptoms, the women were divided into one PMS group and one non‐PMS group. Methods. Postural control (displacement area) was measured using an AMTI® force platform during the active hormone phase (OC phase) and the hormone‐free phase (non‐OC phase) of the pill chart. Premenstrual symptoms were evaluated prospectively using the Cyclicity Diagnoser. Main Outcome Measures. Displacement area as a measure of postural control. Results. Six of 15 women showed premenstrual symptoms (primarily negative mood symptoms) between the phases and were considered having premenstrual symptoms. When analyzing postural control, the PMS group displayed a significantly greater displacement area in the OC‐phase compared to the non‐OC phase. In contrast, the non‐PMS group did not show any significant difference between the phases. Furthermore, the PMS group had significantly greater displacement area during the OC phase compared to the non‐PMS group. Conclusions. The present study shows that women with premenstrual symptoms have greater displacement area than those without premenstrual symptoms during the active phase of oral contraceptive treatment. Negative mood symptoms may affect the maintenance of postural control by central interactions. Further studies are needed to clarify the precise mechanism for altered postural control in women with premenstrual symptoms.
Induction of labor and cerebral palsy: a population‐based study in Norway
Authors: ELKAMIL AREEJ I. , ANDERSEN GURO L. , SALVESEN KJELL Å. , SKRANES JON , IRGENS LORENTZ M. , VIK TORSTEIN 
Published: October 2010

Abstract Objective. To investigate the association between labor induction and later development of cerebral palsy (CP). Design. Registry‐based cohort study. Setting. Perinatal data on all children born in Norway 1996–1998 were obtained from the Medical Birth Registry of Norway (MBRN). Neurodevelopmental data were collected from the Norwegian Cerebral Palsy Registry (CPRN). Population. A total of 176,591 children surviving the neonatal period. Of 373 children with CP, detailed data were available on 241. Methods. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated as estimates of the relative risk that a child with CP was born after labor induction. Main outcome measures. Total CP and spastic CP subtypes. Results. Bilateral cerebral palsy was more frequently observed after induced labor (OR: 3.1; 95% CI 2.1–4.5). For children born at term the association between bilateral CP and labor induction was stronger (OR: 4.4; 95% CI 2.3–8.6). The association persisted after adjustment for maternal disease, gestational age, standard deviation score for birthweight (z‐score) and prelabor rupture of membranes (PROM) (adjusted OR: 3.7; 95%CI 1.8–7.5). Among children with CP born at term, four‐limb involvement (quadriplegia) was significantly more frequent after induced (45.5%) compared with non‐induced labor (8.0%). There was no significant association between labor induction and unilateral CP subtype or CP in preterm born children. Conclusions. In this study population, we found that labor induction at term was associated with excess risk of bilateral spastic CP and in particular CP with four‐limb involvement.