bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: the functional abdominal pain syndrome
Authors: Sperber A. D. , Drossman D. A. 
Published: January 2011

Aliment Pharmacol Ther 2011; 33: 514–524SummaryBackground  Functional abdominal pain syndrome (FAPS) is a debilitating disorder with constant or nearly constant abdominal pain, present for at least 6 months and loss of daily functioning.Aim  To review the epidemiology, pathophysiology and treatment of FAPS.Methods  A literature review using the keywords: functional abdominal pain, chronic abdominal pain, irritable bowel syndrome and functional gastrointestinal disorders.Results  No epidemiological studies have focused specifically on FAPS. Estimates of prevalence range from 0.5% to 1.7% and tend to show a female predominance. FAPS pathophysiology appears unique in that the pain is caused primarily by amplified central perception of normal visceral input, rather than by enhanced peripheral stimulation from abdominal viscera. The diagnosis of FAPS is symptom‐based in accordance with the Rome III diagnostic criteria. These criteria are geared to identify patients with severe symptoms as they require constant or nearly constant abdominal pain with loss of daily function and are differentiated from IBS based on their non‐association with changes in bowel habit, eating or other gut‐related events. As cure is not feasible, the aims of treatment are reduced suffering and improved quality of life. Treatment is based on a biopsychosocial approach with a therapeutic patient–physician partnership at its base. Therapeutic options include central nonpharmacological and pharmacological modalities and peripheral modalities. These can be combined to produce an augmentation effect.Conclusion  Although few studies have assessed functional abdominal pain syndrome or its treatment specifically, the treatment strategies outlined in this paper appear to be effective.
Research on person‐centred clinical care
Authors: Finset Arnstein 
Published: January 2011

AbstractRationale, aims and objectives  To give a selective review of empirical studies on person‐centred clinical care, in particular concerning communication patterns between patients and providers.Methods  Descriptive and selective review of relevant literature.Results  Person‐centred clinical care may have positive effects on patient satisfaction, patient adherence, health care utilization, malpractice litigation and health outcome. Person‐centred communication skills may be promoted by way of communication skills training.Conclusion  The concept of person‐centred care is rare in the empirical literature. Future research should operationalize the concept and design studies of the impact of patient‐centred clinical care.
A bacterial dynamin‐like protein mediating nucleotide‐independent membrane fusion
Authors: Bürmann Frank , Ebert Nina , van Baarle Suey , Bramkamp Marc 
Published: January 2011

SummaryDynamins are a family of large GTPases that are involved in key cellular processes, where they mediate events of membrane fission and fusion. The dynamin superfamily is not restricted to eukaryotes but might have a bacterial origin, with many species containing an operon of two genes related to mitofusins. However, it is not clear whether bacterial dynamins promote membrane fission or fusion. The dynamin‐like protein DynA of Bacillus subtilis is remarkable in that it arose from a gene fusion of two dynamins and contains two separate dynamin‐like subunits and GTPase domains. We found that DynA exhibits strictly auto‐regulated GTP hydrolysis, and that progress through the GTPase cycle is concerted within DynA oligomers. Furthermore, we show that DynA can tether membranes and mediates nucleotide‐independent membrane fusion in vitro. This process merely requires magnesium as a cofactor. Our results provide a set of minimal requirements for membrane fusion by dynamin‐like proteins and have mechanistic implications in particular for the fusion of mitochondria.
Limited Utility of Exercise‐Stress Testing to Prevent T‐Wave Oversensing in Pediatric Internal Cardioverter Defibrillator Recipients
Authors: COHEN MITCHELL I. , SHAFFER JENNIFER , PEDERSEN SCOTT , SIMS J. JASON , PAPEZ ANDREW 
Published: January 2011

Background: Inappropriate internal cardioverter defibrillator (ICD) therapies may result from T‐wave oversensing (TWOS) during exertion in children. The aim of this study was to evaluate the utility of an exercise treadmill test to predict inappropriate ICD therapies secondary to TWOS.
Methods: Eligible pediatric ICD recipients underwent exercise‐stress testing with concomitant evaluation of all intracardiac electrograms. Double counting at a programmed sensitivity of 0.3 mV was considered indicative of TWOS. Patients were prospectively followed for 2 years and censored at either the development of an inappropriate ICD therapy secondary to TWOS or at the time of ICD revision.
Results: Nineteen patients (age: 13.8 ± 3.2 years) underwent exercise testing (median time from ICD implant: 1.5 years, range 2–4.3 years). Two patients were identified with TWOS during the stress test and had a clinically inappropriate ICD discharge within 2 weeks despite a sensitivity adjustment to 0.6 mV. One individual had an inappropriate ICD discharge from TWOS 11 months following an initial uneventful exercise‐stress test.
Conclusions: Inappropriate ICD therapies from TWOS relate to a reduction in the intrinsic R wave or augmentation of the T wave during exertion. While intracardiac electrogram assessment during stress testing may aid in the early recognition of TWOS, it did not absolutely translate to a reduction in the incidence of inappropriate ICD shocks. (PACE 2011; 34:436–442)
Different Image Integration Modalities to Guide AF Ablation: Impact on Procedural and Fluoroscopy Times
Authors: PRATOLA CLAUDIO , BALDO ELISA , ARTALE PAOLO , MARCANTONI LINA , TOSELLI TIZIANO , PERCOCO GIANFRANCO , SASSONE BIAGIO , FERRARI ROBERTO 
Published: January 2011

Background: Different image integration modalities are available for atrial fibrillation (AF) ablation, but their impact on procedural and fluoroscopy times has not been evaluated yet.
Methods: Sixty patients (mean age 52.2 ± 12.0 years, 48.3% men, 75% paroxysmal AF) undergoing pulmonary vein (PV) encircling with PV disconnection for symptomatic drug‐refractory AF were randomized to ablation with CARTO electroanatomical mapping (Biosense Webster, Diamond Bar, CA, USA) integrated with: (1) preprocedural magnetic resonance imaging (MRI; Group 1); (2) intracardiac echocardiography (ICE; Group 2); (3) preprocedural MRI and ICE (Group 3).
Results: PV disconnection was achieved in all patients. Total procedural time (Group 1: 124.7 ± 47.0; Group 2: 112.5 ± 30.4; Group 3: 108.6 ± 34.7 minutes) and total ablation time were similar between groups (P = ns). MRI integration alone required a higher fluoroscopy time (23.8 ± 6.9 in Group 1 vs 11.0 ± 2.3 and 13.9 ± 4.2 minutes in Groups 2 and 3, respectively; P < 0.005) and a longer time spent in the left atrium (109.0 ± 43.5 in Group 1 vs 78.2 ± 29.7 and 74.8 ± 34.3 minutes in Groups 2 and 3, respectively; P = 0.03) in comparison to ICE integration. Addition of MRI to ICE integration showed a tendency for a higher fluoroscopy time in comparison to ICE integration alone (P = 0.06). At a mean follow‐up of 9.1 ± 2.2 months, there were no significant differences in AF recurrences among the groups (P = ns).
Conclusion: ICE image integration significantly reduces the fluoroscopy time and the time spent in the left atrium in comparison to MRI integration alone. Addition of MRI to ICE integration does not reduce total procedural time and seems to lead to higher fluoroscopy time in comparison to ICE integration alone. (PACE 2011; 34:422–430)
Delayed ICD Lead Cardiac Perforation: Comparison of Small versus Standard‐Diameter Leads Implanted in a Single Center
Authors: RORDORF ROBERTO , CANEVESE FABIO , VICENTINI ALESSANDRO , PETRACCI BARBARA , SAVASTANO SIMONE , SANZO ANTONIO , GANDOLFI EDOARDO , DORE ROBERTO , LANDOLINA MAURIZIO 
Published: January 2011

Background: An increased risk of delayed cardiac perforation (DCP) with active‐fixation small‐diameter ICD leads has recently been reported, especially with regard to the St. Jude Riata lead (St. Jude Medical, Sylmar, CA, USA). Few data on the risk of DCP in small versus standard‐diameter leads implanted in a single high‐volume center are available. Moreover, no data on the performances of St. Jude's new small‐diameter Durata lead are as yet available. The aim of this study was to assess the incidence of DCP in small versus standard‐diameter leads implanted in our center.
Methods: Between January 2003 and October 2009, 437 small‐diameter leads (190 Medtronic Sprint Fidelis [Medtronic Inc., Minneapolis, MN, USA], 196 Riata, 51 Durata) and 421 standard‐diameter (>8 Fr) leads were implanted.
Results: After a median follow‐up of 421 days seven of 858 (0.8%) patients experienced DCP. The incidence of DCP was higher in patients with small‐diameter leads than in those with standard‐diameter leads (1.6% vs 0%, P = 0.01). No cases of DCP occurred among 371 passive‐fixation leads versus 1.4% of events among active‐fixation leads (P = 0.02). The incidence of DCP was 2.5% in Riata, 1% in Sprint Fidelis, 0% in Durata, and 0% in standard‐diameter leads (P < 0.01 for Riata vs standard‐diameter leads).
Conclusions: Small‐diameter active‐fixation ICD leads are at increased risk of DCP, a finding mostly due to the higher incidence of events in the Riata family. By contrast, passive‐fixation small‐diameter leads and standard‐diameter leads appear to be safe enough regarding the risk of DCP. Our preliminary data suggest that the new Durata lead is not associated with an increased risk of DCP. (PACE 2011; 34:475–483)
Long‐term Outcome Following Ablation of Atrial Flutter Occurring Late after Atrial Septal Defect Repair
Authors: TEH ANDREW W. , MEDI CAROLINE , LEE GEOFFREY , ROSSO RAPHAEL , SPARKS PAUL B. , MORTON JOSEPH B. , KISTLER PETER M. , HALLORAN KAREN , VOHRA JITENDRA K. , KALMAN JONATHAN M. 
Published: January 2011

Aims: In patients with surgical atrial septal defect (ASD) repair, late atrial flutters (AFLs), including cavotricuspid isthmus (CTI)‐dependent and non‐CTI‐dependent scar‐related flutter (AFL), are common. Radiofrequency ablation (RFA) of these arrhythmias has a high acute success rate. We aimed to characterize the long‐term freedom from atrial arrhythmias in this population.
Methods: Twenty consecutive patients undergoing RFA for AFL late after ASD repair were included. Electrophysiological assessment included multipolar activation, entrainment, and electroanatomic mapping. Clinical, electrocardiograph, and Holter monitoring follow‐up was conducted every 6 months.
Results: Mean age was 53 ± 13 years. Time from surgical repair to RFA was 29 ± 15 years. All patients had CTI‐dependent AFL (20/20). There were 1.6 ± 0.7 arrhythmias per patient; other arrhythmias included non‐CTI‐dependent AFL (14), focal atrial tachycardia (two), and atrioventricular nodal reentry tachycardia (two)
. Acute success was obtained in 100%. Five patients with recurrent AFL (three CTI dependent, two non‐CTI dependent) at 13 ± 8 months had successful repeat RFA. At 3.2 ± 1.6 years follow‐up since the last procedure, 90% of patients with successful RFA for AFL remained free of their clinical arrhythmia. However, 30% of the original 20 patients had documented atrial fibrillation (AF) 2.1 ± 1.6 years after the last procedure; five (25%) required AF intervention. One stroke (5%) occurred in the context of late AF.
Conclusion: RFA of AFL occurring late after surgical ASD repair has a low long‐term risk of recurrence, although 25% of patients required two procedures. However, there is a high late incidence of AF (30%), with an additional 25% of patients requiring intervention for AF. (PACE 2011; 34:431–435)
‘Better Wear Out Sheets than Shoes’: A Survey of 202 Stroke Professionals' Early Mobilisation Practices and Concerns
Authors: Skarin Monica , Bernhardt Julie , Sjöholm Anna , Nilsson Michael , Linden Thomas 
Published: January 2011

Background Stroke unit care improves the outcome for patients. One component responsible for this may be that patients are mobilised earlier and more intensively. An ongoing randomised controlled trial is investigating the potential benefits of early mobilisation, but currently there is limited evidence for the practice. Therefore, current practices may be driven by historical precedent and/or clinical opinion, and varying approaches to mobilisation are likely. This study aims to examine different health professionals' concerns regarding early mobilisation in acute stroke. In this study, early mobilisation was defined as frequent out of bed activities within the first 24 h after stroke onset. Methods A nine-item anonymous questionnaire exploring benefits and harms with early mobilisation after stroke was used during interviews of stroke care professionals attending the annual Australasian stroke conference in 2008. Results The survey was completed by 202 professionals, representing 38% of all conference attendees. Sixty-five per cent were females, 50% under 40-years old, 46% worked in acute stroke and 31% in rehabilitation. Thirty-five per cent were nurses, 26% medical doctors, 19% physiotherapists and 12% occupational therapists. Two-thirds had <10-years experience with stroke. Sixty per cent of the surveyed professionals had concerns about early mobilisation and there were significantly more professionals concerned about early mobilisation for haemorrhagic (59%) than ischaemic (23%) stroke patients. Conclusion Our study shows that most clinicians had concerns in relation to early mobilisation of stroke patients and more clinicians had concerns for haemorrhagic than for ischaemic stroke. The evidence underlying these concerns is shallow.
Effect of Clopidogrel plus ASA vs. ASA Early after TIA and Ischaemic Stroke: A Substudy of the CHARISMA Trial
Authors: Hankey Graeme J. , Johnston S. Claiborne , Easton J. Donald , Hacke Werner , Mas Jean-Louis , Brennan Danielle , Mak Koon Hou , Bhatt Deepak L. , Fox Keith A. A. , Topol Eric J. ,   on behalf of the CHARISMA trial investigators
Published: January 2011

Background The Clopidogrel for High Atherothrombotic Risk and Ischaemic Stabilisation, Management and Avoidance (CHARISMA) trial reported no statistically significant benefit of adding clopidogrel to acetylsalicylic acid in the long-term management of a broad population of patients with stable vascular disease. However, a subanalysis raised the hypothesis that dual antiplatelet therapy with clopidogrel plus acetylsalicylic acid may be more effective than aspirin in patients with prior ischaemic stroke, myocardial infarction of symptomatic peripheral arterial disease. We aimed to determine whether the possible benefits of clopidogrel plus acetylsalicylic acid in patients with transient ischaemic attack and ischaemic stroke may be ‘front-loaded’, and maximal within the first 30-days of randomisation, without being unduly hazardous. Methods This was a subanalysis of a randomised, double-blind, placebo-controlled trial of clopidogrel vs. placebo, in addition to background therapy with low-dose acetylsalicylic acid (CHARISMA trial), restricted to all patients with transient ischaemic attack or ischaemic stroke. The primary efficacy outcome was stroke, and safety outcome severe bleeding, during the follow-up period. Results Among all transient ischaemic attack and ischaemic stroke patients randomised to placebo ( n=2163), 131 (6·1%) experienced a stroke during follow-up compared with 105 (4·9%) of 2157 patients assigned clopidogrel (hazard ratio: 0·80, 95% confidence intervals: 0·62–1·03). There was no significant difference in severe bleeding (1·7% placebo vs. 1·9% clopidogrel, hazard ratio: 1·11, 95% confidence intervals: 0·71–1·73). Among all patients randomised within 30-days of their qualifying transient ischaemic attack or ischaemic stroke to placebo ( n=667), 46 (6·9%) experienced a stroke compared with 34 (5·1%) of 664 patients assigned clopidogrel (hazard ratio: 0·74, 0·46–1·16). There was no significant difference in severe bleeding (1·6% placebo vs. 1·4% clopidogrel, hazard ratio: 0·83, 95% confidence intervals: 0·34–2·01). Conclusion The data are consistent with, but do not prove the hypothesis that early addition of clopidogrel to acetylsalicylic acid in patients with transient ischaemic attack and ischaemic stroke of arterial origin may be more effective and acceptably safe compared with acetylsalicylic acid alone. Adequately powered clinical trials that are dedicated to exploring this hypothesis are needed.
Intravenous Recombinant Tissue Plasminogen Activator Administered after 3 H following Onset of Ischaemic Stroke: A Metaanalysis
Authors: Maiser Samuel J. , Georgiadis Alexandros L. , Suri M. Fareed K. , Vazquez Gabriela , Lakshminarayan Kamakshi , Qureshi Adnan I. 
Published: January 2011

Objective To assess the efficacy of intravenous recombinant tissue plasminogen activator administered after 3 h following onset of ischaemic stroke. Background Some recent data indicate that treatment with intravenous recombinant tissue plasminogen activator may be beneficial even when administered to ischaemic stroke patients beyond 3 h from symptom onset. Methods We searched the medical literature using the MEDLINE, BIOSIS, and Cochrane databases for pertinent publications from 1966 to 2008 using the keywords ‘alteplase’, ‘tissue plasminogen activator’, and ‘stroke’. Among the retrieved publications, we selected randomised controlled trials that administered recombinant tissue plasminogen activator during 3–6 h after symptom onset in patients with acute ischaemic stroke. We evaluated the effect of intravenous recombinant tissue plasminogen activator (compared with placebo) on the rate of good functional outcome (determined by modified Rankin Scale of 0–1) and mortality at three-months. A subset analysis was performed according to time of administration of intravenous recombinant tissue plasminogen activator (3–4·5 and 4·5–6 h). Odds ratios of individual trials were pooled using a random effects model. Results We analysed four randomised trials totaling 2104 patients (1053 control and 1051 recombinant tissue plasminogen activator-treated patients). Patients that received intravenous recombinant tissue plasminogen activator at 3–6 h following onset of symptoms had a significantly higher rate of favourable neurological outcome over the patients that received placebo (odds ratio 1·24, 95% confidence intervals 1·04–1·47, P=0·02). Treatment within the 3–4·5 time window was significantly associated with higher rate of favourable neurological outcome (OR 1·27, 95% confidence interval 1·01–1·60), but not for the 4·5–6 time window (OR 1·10, 95% confidence interval 0·75–1·51). There was no difference in mortality between patients that received intravenous recombinant tissue plasminogen activator than the patients that received pharmacologic placebo (OR 1·14, 95% confidence interval 0·76–1·70). Conclusions Treatment with intravenous recombinant tissue plasminogen activator from 3–4·5 h following symptom onset is associated with an increased rate of favourable outcome at 90-days in this analysis. Treatment with intravenous recombinant tissue plasminogen activator beyond 4·5 h did not show a benefit; however, improved patient selection is needed for future studies.
The psychometric properties of the Tinnitus Handicap Questionnaire in a Dutch‐speaking population
Authors: Vanneste S. , To W. T. , De Ridder D. 
Published: January 2011

Clin. Otolaryngol. 2011, 36, 9–16Objective:  The aim of the study is to translate and validate the tinnitus handicap questionnaire (THQ) for a Dutch‐speaking population. The factor structure of the questionnaire, the reliability and the validity is determined. Furthermore, a statistical comparison with the original English version of the tinnitus handicap questionnaire is performed.Methodology:  We assessed 101 patients at the Tinnitus Research Initiative clinic of Antwerp University Hospital. Twenty‐seven Dutch items from the tinnitus handicap questionnaire by Kuk et al. [(1990), Ear Hear11:434‐45.] were obtained by the process of translation and back translation. The factor structure, internal consistency, was evaluated using Cronbach’s alpha coefficient and item correlations were used to confirm reliability. The construct validity was confirmed with a visual analogue scale for loudness and distress, awareness, annoyance, the Tinnitus Questionnaire (TQ), the mini‐Tinnitus Questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI) and the Profile of Mood State (POMS), ensuring that this new instrument measures the tinnitus handicap.Results:  This study demonstrates that the Dutch version of the tinnitus handicap questionnaire is a reliable (Cronbach’s alpha coefficient α = 0.93) and valid measure of self‐perceived tinnitus‐related distress [with visual analogue scale for loudness (r = 0.39) and distress (r = 0.45), awareness (r = 0.39), annoyance (r = 0.57), the Tinnitus Questionnaire (r = 0.82), the mini‐Tinnitus Questionnaire (r = 0.79), the Hospital Anxiety and Depression Scale (r = 0.62) and the Beck Depression Inventory (r = 0.32)]. The psychometric properties are in line with previous findings on the English version with regard to reliability and validity. However, the items in the subscales differ from the English version. While the English version has three subscales, our version has only two subscales. Yet, the English version reports that for the three factors, there is a low internal consistency and low correlation among the different items. For the Dutch‐speaking version, both factors show a very high reliability and validity.Conclusions:  The tinnitus handicap questionnaire is suitable for assessing the handicapping effects of tinnitus among a Dutch‐speaking population in both clinical and research settings.
Poly(para-phenylene ethynylene)s functionalized with Gd(III) chelates as potential MRI contrast agents
Authors: Atkins Katelyn M. , Martínez Francisco M. , Nazemi Ali , Scholl Timothy J. , Gillies Elizabeth R. 
Published: January 2011

A poly(para-phenylene ethynylene) with water-solubilizing groups and Gd(III) chelates conjugated to the polymer backbone was designed and synthesized. Pre- and post-polymerization functionalization approaches were explored and the pre-polymerization approach for the introduction of the Gd(III) chelate was found to be more successful. The UV–vis absorption and fluorescence emission properties of the protected polymers were characterized and were found to be consistent with the results expected for this class of polymers. Removal of the protecting groups followed by chelation of Gd(III) led to a water-dispersible polymer. Relaxivity measurements were performed on this polymer with the aim of evaluating its potential as a new MRI contrast agent, and an r1 of 1.37 L mmol–1 s–1 at 310 K and 20 MHz was determined. These results, along with dynamic light scattering analyses, suggested that the polymers formed micrometre-sized assemblies in aqueous solution. Although the relaxivity was relatively modest, these results provide important insights into the assembly properties of this new class of polymers and into the design criteria for future agents.
(–)-6α-Hydroxy polyanthellin A — A novel antifouling diterpenoid from the Indian soft coral Cladiella krempfi (Hickson)
Authors: Mol V. P. Limna , Raveendran T. V. , Parameswaran P. S. , Kunnath R. J. , Rajamohanan P. R. 
Published: January 2011

Bioassay-guided purification of methanol extract of the soft coral Cladiella krempfi (Octocorallia: Alcynocea) yielded a novel eunicellin-type diterpenoid, (–)-6α-hydroxy polyanthellin A (1), active against the cyprids of the fouling barnacle, Balanus amphitrite (EC50 9.02 µg/mL; LC50 36 µg/mL; and therapeutic ratio = 4). The structure of compound 1 was determined from its spectral data, including IR, NMR (1D and 2D NMR), and mass spectra.