bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for delirium in intensive care patients: a prospective cohort study
Authors: Van Rompaey Bart , Elseviers Monique M , Schuurmans Marieke J , Shortridge-Baggett Lillie M , Truijen Steven , Bossaert Leo 
Published: May 2009

Abstract
Introduction
Delirium is a common complication in the intensive care unit. The attention of researchers has shifted from the treatment to the prevention of the syndrome necessitating the study of associated risk factors.

Methods
In a multicenter study at one university hospital, two community hospitals and one private hospital, all consecutive newly admitted adult patients were screened and included when reaching a Glasgow Coma Scale greater than 10. Nurse researchers assessed the patients for delirium using the NEECHAM Confusion Scale. Risk factors covered four domains: patient characteristics, chronic pathology, acute illness and environmental factors. Odds ratios were calculated using univariate binary logistic regression.

Results
A total population of 523 patients was screened for delirium. The studied factors showed some variability according to the participating hospitals. The overall delirium incidence was 30%. Age was not a significant risk factor. Intensive smoking (OR 2.04), daily use of more than three units of alcohol (OR 3.23), and living alone at home (OR 1.94), however, contributed to the development of delirium. In the domain of chronic pathology a pre-existing cognitive impairment was an important risk factor (OR 2.41). In the domain of factors related to acute illness the use of drains, tubes and catheters, acute illness scores, the use of psychoactive medication, a preceding period of sedation, coma or mechanical ventilation showed significant risk with odds ratios ranging from 1.04 to 13.66. Environmental risk factors were isolation (OR 2.89), the absence of visit (OR 3.73), the absence of visible daylight (OR 2.39), a transfer from another ward (OR 1.98), and the use of physical restraints (OR 33.84).

Conclusions
This multicenter study indicated risk factors for delirium in the intensive care unit related to patient characteristics, chronic pathology, acute illness, and the environment. Particularly among those related to the acute illness and the environment, several factors are suitable for preventive action.
Determinants of postoperative acute kidney injury
Authors: Abelha Fernando José , Botelho Miguela , Fernandes Vera , Barros Henrique 
Published: May 2009

Abstract
Introduction
Development of acute kidney injury (AKI) during the perioperative period is associated with increases in morbidity and mortality. Our aim was to evaluate the incidence and determinants of postoperative AKI after major noncardiac surgery in patients with previously normal renal function.

Methods
This retrospective cohort study was carried out in the multidisciplinary Post-Anaesthesia Care Unit (PACU) with five intensive care beds. The study population consisted of 1166 patients with no previous renal insufficiency who were admitted to these intensive care unit (ICU) beds over 2 years. After admission patients were followed for the development of AKI, defined as proposed by The Acute Kidney Injury Network (increment of serum creatinine [greater than or equal to] 0.3 mg/dL or 50% from baseline within 48 hours or urine output < 0.5 mL/kg/hr for > 6 hours despite fluid resuscitation when applicable). Patient preoperative characteristics, intraoperative management and outcome were evaluated for associations with acute kidney injury using an univariate and multiple logistic regression model.

Results
A total of 1597 patients were admitted to the PACU and of these, 1166 met the inclusion criteria. Eighty-seven patients (7.5%) met AKI criteria. Univariate analysis identified age, American Society of Anesthesiologists (ASA) physical status, emergency surgery, high risk surgery, ischemic heart disease, congestive heart disease and Revised Cardiac Risk Index (RCRI) score as independent preoperative determinants for AKI in the postoperative period. Multivariate analysis identified ASA physical status, RCRI score, high risk surgery and congestive heart disease as preoperative determinants for AKI in the postoperative period. Patients that developed AKI had higher Simplified Acute Physiology Score (SAPS) II and Acute Physiology and Chronic Health Evaluation (APACHE) II, higher PACU length of stay (LOS), higher PACU mortality, higher hospital mortality and higher mortality at 6 months follow-up. AKI was an independent risk factor for hospital mortality (OR 3.12, 95% CI 1.41 to 6.93, P = 0.005).

Conclusions
This study shows that age, emergency and high risk surgery, ischemic heart disease, congestive heart disease, ASA physical status and RCRI score were considered risk factors for the development of AKI, in patients needing intensive care after surgery. AKI has serious impact on PACU length of stay and mortality. AKI was an independent risk factor for hospital mortality.
Thyroid Hormone (T3)-Induced Up-Regulation of Voltage-Activated Sodium Current in Cultured Postnatal Hippocampal Neurons Requires Secretion of Soluble Factors from Glial Cells
Authors: Niederkinkhaus Vanessa , Marx Romy , Hoffmann Gerd , Dietzel Irmgard D. 
Published: May 2009

Abstract
We have previously shown that treatment with the thyroid hormone T3 increases the voltage-gated Na+current density (Nav-D) in hippocampal neurons from postnatal rats, leading to accelerated action potential upstrokes and increased firing frequencies. Here we show that the Na+ current regulation depends on the presence of glial cells, which secrete a heat-instable soluble factor upon stimulation with T3. The effect of conditioned medium from T3-treated glial cells was mimicked by basic fibroblast growth factor (bFGF), known to be released from cerebellar glial cells after T3 treatment. Neutralization assays of astrocyte-conditioned media with anti-bFGF antibody inhibited the regulation of the Nav-D by T3. This suggests that the up-regulation of the neuronal sodium current density by T3 is not a direct effect but involves bFGF release and satellite cells. Thus glial cells can modulate neuronal excitability via secretion of paracrinely acting factors.
Development of a new measurement method for serum calcium with chlorophosphonazo-III
Authors: Hokazono Eisaku , Osawa Susumu , Nakano Tomota , Kawamoto Yukari , Oguchi Yuji , Hotta Taeko , Kayamori Yuzo , Kang Dongchon , Cho Yuichiro , Shiba Kiyoko , Sato Kenji 
Published: May 2009

Background Although serum calcium has been measured using the o-cresolphthalein complexone (oCPC) method in the clinical laboratory, this method still has some problems regarding linearity and reagent stability. We developed a new measurement procedure using chlorophosphonazo-III (CPZ-III: 2,7-bis (4-chloro-2-phosphonophenylazo) -1,8- dihydroxy-3, 6-naphthalenedisulphonic acid, disodium salt) as a chelator with an acid medium for serum calcium measurement. The present method showed better linearity and reagent stability compared with the oCPC method. Methods Characteristics were studied in optimized conditions measuring wavelength by absorption spectra analysis, and interference of protein and metals with Mg2+, Fe2+, Cu2+ and Zn2+. The method was applied to an automated analyser (7170; Hitachi High Technologies Corp). The measurement performance was evaluated for accuracy, precision, recovery rate, linearity and reagent stability with a comparison study against atomic absorption spectrophotometry (AAS). Results The within-run and between-run variations (coefficient of variation [CV]) were 0.92–1.01% and 0.75–1.43%, respectively. The linearity was 0–7.0 mmol/L. The comparison study obtained y = 1.002 x (AAS) – 0.10, S y/x = 0.18 mmol/L, n = 50. Reagent stability was at least 20 d at 4°C without daily calibration. Conclusion The new calcium measurement method in serum was demonstrated to have reliable and acceptable performances as a routine test in clinical laboratory.
A double-blind placebo-controlled study to evaluate the effect of progestelle progesterone cream on postmenopausal women
Authors: Benster Beverly , Carey Adam , Wadsworth Fred , Vashisht Arvind , Domoney Claudine , Studd John 
Published: May 2009

Objective To evaluate the effect on climacteric symptoms and quality of life, and the safety of four doses of progestelle progesterone cream administered for 24 weeks to postmenopausal women complaining of moderate to severe menopausal symptoms. Design Single-centre, double-blind, randomized, placebo-controlled study. Population Two hundred and twenty-three healthy postmenopausal women, aged between 40 and 60 years and complaining of severe menopausal symptoms were recruited through newspaper advertisements. Methods Women were randomly allocated to progestelle progesterone cream 60, 40, 20, 5 mg or placebo, to be applied daily for six months. Main outcome measures The primary efficacy variable was the psychological, somatic and vasomotor components of the Greene Climacteric Scale after six months. Secondary endpoints were incidence of hot flushes and night sweats, the nine subscales of the Medical Outcome Survey Short Form-36 (SF-36), serum progesterone, endometrial thickness and histology after six months. Adverse events were sought and recorded and followed up to resolution. Results There were no statistically significant differences between any of the treatment groups and placebo for any of the components of the Greene Score. A statistically significant difference between the 20 mg group and placebo was found for the physical functioning (95% confidence interval [CI] 1.7–12.3; P = 0.01) and social functioning (95% CI 1.9–16.7; P = 0.01) scales of SF-36 after six months. No other statistically significant differences were found between any treatment group and placebo for any of the other secondary efficacy variables. There appeared to be a higher incidence of headache in the groups treated with progesterone cream. Conclusions Progesterone cream was no more effective than placebo for relief of menopausal symptoms.
Depression and the menopause: why antidepressants are not enough?
Authors: Graziottin Alessandra , Serafini Audrey 
Published: May 2009

Background Gender differences, related to varying sexual hormone levels and hormone secretion patterns across the lifespan, contribute to women's vulnerability to mood disorders and major depression. Women are more prone than men to depression, from puberty onwards, with a specific exposure across the menopausal transition. However, controversy still exists in considering fluctuation/loss of estrogen as a specific aetiologic factor contributing to depression in perimenopause and beyond. Aims To briefly review the interaction between changes in menopausal hormone levels, mood disorders, associated neuropsychological co-morbidities and ageing, and to evaluate the currently available therapeutic options for perimenopausal mood disorders: (a) treatment of light to moderate mood disorders with hormonal therapy (HT); (b) treatment of major depression with antidepressants; (c) the synergistic effect between HT and antidepressants in treating menopausal depression. Results Depression across the menopause has a multifactorial aetiology. Predictive factors include: previous depressive episodes such as premenstrual syndrome and/or postpartum depression; co-morbidity with major menopausal symptoms, especially hot flashes, nocturnal sweating, insomnia; menopause not treated with HT; major existential stress; elevated body mass index; low socioeconomic level and ethnicity. Postmenopausal depression is more severe, has a more insidious course, is more resistant to conventional antidepressants in comparison with premenopausal women and has better outcomes when antidepressants are combined with HT. Conclusion The current evidence contributes to a re-reading of the relationship between menopause and depression. The combination of the antidepressant with HT seems to offer the best therapeutic potential in terms of efficacy, rapidity of improvement and consistency of remission in the follow-up.
Anticoagulation: Low-Molecular-Weight Heparins in Renal Impairment and Obesity: Available Evidence and Clinical Practice Recommendations Across Medical and Surgical Settings
Authors: Nutescu Edith A , Spinier Sarah A , Wittkowsky Ann , Dager William E 
Published: May 2009

Objective To develop practical recommendations for the use of low-molecular-weight heparins (LMWHs) as prophylaxis and treatment of venous thromboembolism and acute coronary syndromes in patients with impaired renal function or obesity. Data Sources Multiple MEDLINE searches were performed (November 2008) to identify studies for inclusion, using a comprehensive list of search terms including, but not limited to, LMWH, enoxaparin, dalteparin, tinzaparin, obesity, weight, renal, kidney, elderly, monitoring, and anti-Xa. Study Selection And Data Extraction Only articles published in English that were relevant for this review were included. Data Synthesis In the majority of patients, standardized prophylaxis or treatment doses of LMWHs can be used without the need for monitoring and adjusting regimens. For patients with severe renal impairment (estimated creatinine clearance [CrCl] <30 mL/min), doses of some LMWHs should be adjusted or unfractionated heparin should be used instead. CrCl should be estimated using the Cockcroft-Gault method. Differences are noted in the degree of accumulation of various LMWHs in patients with moderate-to-severe renal impairment, and thus, the degree of dose adjustment may differ among the various LMWHs. Increasing the prophylactic doses of LMWH may be appropriate in morbidly obese patients (body mass index ≥40 kg/m2). The use of total body weight is appropriate for therapeutic doses of LMWH in obese patients. Laboratory monitoring of the anticoagulation effect of LMWHs is generally not necessary, but should be considered in patients with morbid obesity (weight >190 kg), those with severe renal impairment, and those with moderate renal impairment with prolonged (>10 days) LMWH use. When anti-Xa activity is monitored, it should be determined using a chromogenic method and a calibration curve based on the LMWH used. Conclusions Additional data are needed for specific dose guiding in obese and renally impaired patients, who are often excluded from larger clinical trials. Practice recommendations are made based on available evidence and authors' clinical opinions.
The transformation of synthetic hectorite in the presence of Cu(II)
Authors: Fischer Håkon , Weidler Peter G. , Grobéty Bernard , Luster Jörg , Gehring Andreas U. 
Published: May 2009

AbstractThe influence of Cu(II) on the hydrothermal and thermal transformations of a synthetic hectorite was investigated by a combined approach using mainly X-ray diffraction, thermal analyses, and electron paramagnetic resonance spectroscopy. The presence of Cu(II) during hydrothermal treatment increased the crystallite size. Copper (II) was both structure-bound and associated with the inner surfaces of the particles. Upon heating, structural destabilization of the hectorite began at ∼400°C as indicated by the formation of free radicals. Between 600 and 700°C, the hectorite converted to enstatite, and in the presence of Cu(II), to enstatite and richterite. The formation of richterite as an additional conversion product is explained by the creation of structural weakness due to structure-bound Cu(II) in F-containing hectorite. Our results suggest that traces of Cu(II), typical of natural environments, may influence the conversion products in high-temperature geochemical systems.
Mineralogical and physicochemical investigation of Mg-smectite from Jbel Ghassoul, Morocco
Authors: Benhammou Abdelaziz , Tanouti Boumediene , Nibou Lahbib , Yaacoubi Abdelrani , Bonnet Jean-Pierre 
Published: May 2009

Abstract‘Ghassoul’ clay is a Mg-rich clay from Morocco which is of great industrial use and interest, but its characterization is still incomplete. The purpose of this study was to provide further details regarding the structure and characteristics of this important commercial clay mineral. Mineralogical and physicochemical characterizations of the raw form of ‘Ghassoul’ clay from Jbel Ghassoul in Morocco, and of its <2 µm size fraction, purified and Na+-saturated, were carried out using X-ray diffraction (XRD), X-ray fluorescence (XRF), infrared spectroscopy (IR), and differential and thermogravimetric analysis (DTA/TG). The XRD data revealed that the raw Ghassoul clay consists mainly of a Mg-rich trioctahedral smectite, stevensite, together with quartz and dolomite. The IR spectra consisted of vibrations typical of trioctahedral smectites. The DTA/TG curves were also similar to those of trioctahedral smectites. Chemical analysis confirms that this Mg-rich trioctahedral smectite is a stevensite characterized by a limited isomorphic substitution of Si4+ by Al3+. The thermal transformations examined by in situ XRD as a function of the firing temperature from 100 to 1200°C indicated that stevensite was transformed to enstatite (MgSiO3) at temperatures >800°C and that quartz was transformed to cristobalite when the temperature exceeded 1100°C. These transformations were irreversible. The specific surface area and cation exchange capacity (CEC) of the ‘Ghassoul’ clay are 133 m2/g and 75 meq/100 g, respectively. The main exchangeable cation is Mg2+ (53 meq/100 g).
Associations between psychopathic traits and mental disorders among adolescents with substance use problems
Authors: Hemphälä Malin , Tengström Anders 
Published: May 2009

Objectives. The aim of this study was to examine the association between psychopathic traits and mental disorders and to study associations between psychopathic traits and familial problems across gender.Design. This is a cross‐sectional study.Methods. One hundred and Eighty adolescents seeking help at a substance abuse treatment clinic (99 girls, 81 boys) and their parents (165 mothers, 90 fathers) were studied. The assessment included Psychopathy checklist: Youth version (PCL‐YV) and SCID I/II or Kiddie‐Sads‐Present and Lifetime Version (K‐SADS‐PL).Results. Across gender, there was a positive correlation between externalizing symptoms and PCL‐YV score. Among boys, there was a positive correlation between internalizing symptoms and PCL‐YV score. Further, the behavioural dimension of psychopathy was predictive of externalizing symptoms across gender. The interpersonal and affective dimension of psychopathy predicted oppositional defiant disorder (ODD)‐symptoms among girls. Parent problem behaviour predicted PCL‐YV score amongst girls only.Conclusions. Psychopathic traits do not only exist among adolescents who are identified because of their criminal behaviour. There were gender differences in the association between symptoms and psychopathic traits. It is suggested that different dimensions of psychopathy predisposed substance use for girls and for boys, and that ODD is particularly important in the expression of psychopathic traits among girls. This study showed transmission of antisocial behaviour between two generations among girls.
Early Research on Human Genetics Using the Twin Method: Who Really Invented the Method?
Authors: Mayo Oliver 
Published: May 2009

AbstractThe twin method consists of a formal comparison between the resemblance between identical (monozygotic, MZ) twins and the resemblance between fraternal (dizygotic, DZ) twins for some trait of interest. It was developed between 1900 and about 1940, as more accurate tools for diagnosis of zygosity and for statistically analyzing the resemblance between relatives were built. Its early use was in the demonstration that a trait was inherited or that part of the causation of a trait was genetical, but it has now evolved to the point that twin registries constitute an important resource for the identification of specific genes and their interactions both with other genes and with the internal and external environment. Who really invented the method is still an unsettled question, which this article explores.
Genetic Dominance Influences Blood Biomarker Levels in a Sample of 12,000 Swedish Elderly Twins
Authors: Rahman Iffat , Bennet Anna M. , Pedersen Nancy L. , de Faire Ulf , Svensson Per , Magnusson Patrik K. E. 
Published: May 2009

AbstractIn twin studies of cardiovascular disease biomarkers the dizygotic correlations are often estimated to be less than half of monozygotic correlations indicating a potential influence of nonadditive genetic factors. Using a large and homogenous sample, we estimated the additive and dominance genetic influences on levels of high density lipoprotein, low density lipoprotein, apolipoprotein A-I, apolipoprotein B, total cholesterol, triglycerides, glucose, hemoglobin Alc and c-reactive protein, all of which are biomarkers associated with cardiovascular disease. The blood biomarkers were measured on 12,000 Swedish twins born between 1911 and 1958. The large sample allowed us to obtain heritability estimates with considerable precision and provided adequate statistical power for estimation of dominance genetic components. Our study showed complete absence of the shared environment component for the investigated traits. Dominant genetic component was shown to be significant for low density lipoprotein (0.18), glucose (0.31), Hemoglobin Alc (0.55), and c-reactive protein (0.27). To our knowledge, this is the first statistically significant evidence for dominance genetic variance found for low density lipoprotein, glucose, hemoglobin Alc, and c-reactive protein in a population based twin sample. The study highlights the importance of acknowledging nonadditive genes underlying the risk of developing cardiovascular diseases.
ZMPSTE24, an integral membrane zinc metalloprotease with a connection to progeroid disorders
Authors: Barrowman Jemima , Michaelis Susan 
Published: May 2009

Abstract
ZMPSTE24 is an integral membrane zinc metalloprotease originally discovered in yeast as an enzyme (called Ste24p) required for maturation of the mating pheromone a-factor. Surprisingly, ZMPSTE24 has recently emerged as a key protease involved in human progeroid disorders. ZMPSTE24 has only one identified mammalian substrate, the precursor of the nuclear scaffold protein lamin A. ZMPSTE24 performs a critical endoproteolytic cleavage step that removes the hydrophobic farnesyl-modified tail of prelamin A. Failure to do so has drastic consequences for human health and longevity. Here, we discuss the discovery of the yeast and mammalian ZMPSTE24 orthologs and review the unexpected connection between ZMPSTE24 and premature aging.
Cross talk between kinin and angiotensin II receptors in mouse abdominal aorta
Authors: Rodrigues Eliete S. , Martin Renan P. , Felipe Sandra A. , Bader Michael , Oliveira Suzana M. , Shimuta Suma I. 
Published: May 2009

AbstractBradykinin (BK) is a vasorelaxant, algesic and inflammatory agent. Angiotensin II (AngII) is known to control vascular tone and promote growth, inflammation and artherogenesis. There is evidence for cross talking between BK and AngII receptors. Therefore, the effect of lack of kinin receptors was assessed in mice with genetic disruption of B1or B2and both receptors. Responsiveness of abdominal aortic rings to BK and AngII as well as the receptor gene expression of both peptides were analysed. Although no specific phenotype was displayed in the normotensive and healthy mice lacking the kinin receptors, a decreased expression level of the remaining kinin receptor mRNA was observed. AT1receptor mRNA level was also reduced, indicating that kinin receptors regulate AngII receptors. Downregulation of the receptors was well correlated with reduction in the reactivity of both agonists to induce contraction of aortic rings, but other signal regulations must be sought in these transgenic mice. We conclude that cross talk between kinin and AngII receptors occurs in mouse abdominal aorta and that both peptides may regulate the initiation and progression of important pathophysiological processes, such as hypertension and inflammation.