bluuebunny/crossref_metadata_2025_split huggingface dataset:
α2‐Adrenoceptor‐mediated potassium currents in acutely dissociated rat locus coeruleus neurones
Authors: Arima Junichi , Kubo Chiharu , Ishibashi Hitoshi , Akaike Norio 
Published: September 2010

The noradrenaline (NA)‐activated response was investigated in neurones acutely dissociated from the rat locus coeruleus (LC) using nystatin‐perforated, conventional whole‐cell and inside‐out patch recording modes under current‐ and voltage‐clamp conditions.Under current‐clamp conditions, NA hyperpolarized the LC neurones, abolishing the spontaneous action potentials. In voltage‐clamp studies, NA induced an inwardly rectifying K+current (INA) in a concentration‐dependent manner with a half‐maximum effective concentration of 2.2 × 10−7M.INAwas mimicked by the α2‐agonist UK14304 but was inhibited by either the α2B/α2Cantagonist ARC239 or the α1‐ and α2B/α2Cantagonist prazosin, suggesting the contribution of α2B/α2Cadrenoceptors.INAwas inhibited by the intracellular application of GDPβS but fully activated by intracellular perfusion of GTPγS.In the inside‐out recording mode, the application of GTP to the cytoplasmic side of the patch membrane markedly enhanced the open probability of the NA‐activated single channels which represented the inwardly rectifying properties.These results indicate that the activation of α2B/α2Cadrenoceptors coupled with GTP‐binding protein directly activates the inwardly rectifying K+currents in rat LC neurones, thus resulting in a decrease in the spontaneous firing activities.
PERSONALITY AND AROUSAL CORRELATES OF SPECIFIC GALVANIC SKIN RESPONSES
Authors: Roessler Robert , Burch Neil R. , Childers Harold E. 
Published: September 2010

ABSTRACTBasal skin resistance (BSR) and galvanic skin responses (GSR) to five intensities of sound and light were recorded on four occasions in 32 student subjects (Ss). These occasions were assumed to include unfamiliarity and basal and real life stress conditions. All Ss completed the MMPI, California Personality Inventory, Wechsler Adult Intelligence Scale, Clyde Mood Scale and Examination Anxiety Scale. GSR amplitude was greater under conditions of unfamiliarity, alertness (by electroencephalographic criteria), and higher intensities of stimulation in both stimulus modalities. It was not greater during the presumed stress period. High ego strength‐high Barrier score Ss showed a greater GSR amplitude than low ego strength‐low Barrier Ss. Test indices of anxiety generally were not related to GSR amplitude, nor were other personality and mood variables.
Consumer choice for hearing aids and listening devices: newspaper advertisements for UK private sector provision
Authors: Ross Liz , Cathcart Craig , Lyon Phil 
Published: September 2010

AbstractIn the UK there can be several ways to access health care and this is true of hearing aid provision. Although there may appear to be a well‐defined distinction between the National Health Service (NHS) and independent dispenser hearing aid provision, there have been many examples of overlap between the two and recent government policy initiatives mean that distinctions have become less clear. This article outlines the changing relationship between the two sectors and the problems that potential consumers face accessing information on private sector options for amplification devices. A 1‐year sample of newspaper advertisements was content‐analysed for clarity of information provided. The analysis highlighted a range of provision, from well‐known hearing aid dispensers to the greyer areas of listening device retailers and intermediary services. Some advertisements were found to have been reported to the Advertising Standards Authority. Sufficiently misleading adverts may also infringe consumer protection legislation. The article concludes there is the possibility of consumer confusion about products and their potential for amelioration.
Consumers' perceptions of food packaging: an exploratory investigation in Potchefstroom, South Africa
Authors: Venter Karin , van der Merwe Daleen , de Beer Hanli , Kempen Elizabeth , Bosman Magdalena 
Published: September 2010

AbstractConsumers form perceptions of various food products through their comprehension of the visual stimuli on food packaging that attract their attention. These perceptions directly affect their purchasing decision at the point of purchase, which emphasizes the importance of attention‐capturing packaging attributes. However, little research is available regarding consumers' perceptions of food packaging, especially in the South African context. This study aimed to explore a sample of South African consumers' perceptions of food packaging and how these perceptions were formed through the perceptual process. A qualitative, exploratory study was conducted by means of 25 semi‐structured interviews and through the use of ambiguous mock packaging as a projective technique. Participants were questioned regarding their general perceptions of food packaging. The attention‐capturing ability of packaging as well as consumers' interpretation of this packaging after exposure to the mock packaging was also discussed. Findings from the study indicated that participants mainly based their perception of food packaging on its functional (being purposive, recyclable and informative) and physical attributes (being attractive, of high quality and hygienic). This study also indicated that information and visual attributes of packaging are important to gain consumers' attention in‐store. Participants' comprehension of packaging included general associations of specific food products with certain types of packaging, such as associations with quality and shelf life. Negative associations with packaging mostly entailed difficulty to handle the product, poor quality of the product and environmental problems. This study identifies those product attributes that participants regarded as the most important stimuli for forming positive perceptions regarding food packaging. It is important for manufacturers to pay attention to the information on perceptions that was gained in this study, as it might help them to create packaging that better fulfil consumer needs. These findings could also be applied in a larger study of a quantitative nature, which will ultimately result in more positive consumer shopping experiences and consumer satisfaction regarding food packaging.
R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer
Authors: Matull Wolf‐Rudiger , Dhar Dipok K. , Ayaru Lakshmana , Sandanayake Neomal S. , Chapman Michael H. , Dias Aruna , Bridgewater John , Webster George J. M. , Bong Jin J. , Davidson Brian R. , Pereira Stephen P. 
Published: September 2010

AbstractBackground: There is a need for better management strategies to improve the survival and quality of life in patients with biliary tract cancer (BTC).Aim: To assess prognostic factors for survival in a large, non‐selective cohort of patients with BTC.Method: We compared outcomes in 321 patients with a final diagnosis of BTC (cholangiocarcinoma n=237, gallbladder cancer n=84) seen in a tertiary referral cancer centre between 1998 and 2007. Survival according to disease stage and treatment category was compared using log‐rank testing. Cox's regression analysis was used to determine independent prognostic factors.Results: Eighty‐nine (28%) patients underwent a surgical intervention with curative intent, of whom 38% had R0 resections. Among the 321 patients, 34% were given chemo‐ and/or radiotherapy, 14% were palliated with photodynamic therapy (PDT) and 37% with biliary drainage procedures alone. The overall median survival was 9 months (3‐year survival, 14%). R0‐resective surgery conferred the most favourable outcome (3‐year survival, 57%). Although patients palliated with PDT had more advanced clinical T‐stages, their survival was similar to those treated with attempted curative surgery but who had positive resection margins. On multivariable analysis, treatment modality, serum carbohydrate‐associated antigen 19‐9, distant metastases and vascular involvement were independent prognostic indicators of survival.Conclusion: In this large UK series of BTC, palliative PDT resulted in survival similar to those with curatively intended R1/R2 resections. Surgery conferred a survival advantage only in patients with R0 resection margins, emphasising the need for accurate pre‐operative staging.
Results of TOT operations alone and combined with other vaginal surgical procedures
Authors: ARK Cemal , GÜNGÖRDÜK Kemal , CELEBı Ibrahım 
Published: September 2010

Objective:  To evaluate the safety and efficacy of transobturator vaginal tape (TOT) procedure in women with stress urinary incontinence (SUI).Methods:  The study population consisted of 210 patients who were diagnosed as having stress urinary incontinence, and they underwent a TOT operation alone (99) or concomitant vaginal surgery (101) between January 2005 and February 2009 and were followed up for at least one year. Patients with detrusor overactivity and intrinsic sphincter deficiency were excluded. The cure and complication rates were investigated.Results:  The mean follow‐up was 46.4 ± 8.7 months (range 13–48). No vascular, nervous system, or digestive perioperative complications were observed; however, 3.9% of the patients had voiding difficulty. The overall 12‐month objective cure and subjective cure rates were 89.0% and 89.0% respectively. The overall four‐year objective and subjective cure rates were 83.3% and 86.2% respectively. There was no difference between the four‐year objective and subjective cure rates when TOT alone was performed (83.8 and 86.9%) or when performed as part of another surgical procedure (82.9 and 85.6%).Conclusion:  The TOT procedure is a safe, effective and minimally invasive procedure for treating SUI with a low rate of complications. Moreover, it can be carried out safely and effectively in association with vaginal surgery.
Treating Intractable Venous Stenosis: Present and Future Therapy
Authors: Clark Timothy W. I. , Rajan Dheeraj K. 
Published: September 2010

ABSTRACTThe widespread use of percutaneous angioplasty for venous stenoses has lengthened the functional life span of hemodialysis access, while preserving precious venous capital. A subset of dialysis patients with dysfunctional access sites will harbor stenoses which are intractable, in that they fail to respond to conventional balloon angioplasty or recur in the weeks following angioplasty. This editorial discusses various endovascular approaches to the management of intractable venous stenosis as well as promising future therapies.
Dose of Dialysis in Acute Renal Failure
Authors: Luyckx Valerie A. , Bonventre Joseph V. 
Published: September 2010

ABSTRACTAcute renal failure (ARF) is a cause of significant morbidity and mortality. Despite advances in supportive care, outcomes in ARF have improved little over the past decades. The primary goals in management of patients with ARF are to optimize hemodynamic and volume status, minimize further renal injury, correct metabolic abnormalities, and permit adequate nutrition. Renal replacement therapy (RRT) is often required to achieve these goals while awaiting renal recovery, but the optimal dose of dialysis in patients with ARF is not known. Extrapolation of required dialysis dose from recommendations in chronic dialysis is unlikely to be appropriate because of the lack of a steady state and differences in distribution volume of urea that are intrinsic to ARF. The prescribed dialysis dose in ARF is often low, and actual delivered dose is often even less than prescribed. Delivery of dialysis in ARF is often hampered by the patient's hypercatabolic state, hemodynamic instability, and volume status, as well as suboptimal vascular access with temporary venous catheters. The impact of intermittent hemodialysis (IHD) versus continuous renal replacement therapy (CRRT) on outcomes in ARF is also not clear. Patient disease severity impacts more than dialysis modality in patient outcome, but when patients are stratified for equal disease severity, CRRT may have potential benefits over IHD in terms of patient survival, fluid and metabolic control, and renal recovery. Strategies associated with improved outcomes that have emerged thus far in ARF are to aim for a time‐averaged blood urea nitrogen (BUN) of less than 60 mg/dl with IHD, varying IHD frequency as necessary, or to achieve a minimum ultrafiltration rate of 35 ml/kg/hr with CRRT.
Methods of Assessment of Volume Status and Intercompartmental Fluid Shifts in Hemodialysis Patients: Implications in Clinical Practice
Authors: Ishibe Shuta , Peixoto Aldo J. 
Published: September 2010

ABSTRACTDetermining dry weight and assessing extracellular fluid volume in hemodialysis (HD) patients is one of the greatest challenges to practicing nephrologists. The clinical examination has limited accuracy, so different strategies have been investigated to aid in this evaluation. Biochemical markers of volume overload (ANP, BNP, cGMP) are fraught with excessive variability and poor correlation with volume status. Inferior vena cava ultrasound is effective, but cumbersome and costly. Bioimpedance measurements of intra‐ and extracellular water have significant shortcomings when used as isolated measurements, but can be useful in following trends over time and have been shown to improve intradialytic symptoms and blood pressure control. Continuous blood volume monitoring is helpful in preventing intradialytic hypotension and may help identify patients who are volume overloaded and need increased ultrafiltration. In this review we discuss these different techniques and other developments in the evaluation of dry weight and volume status, which may enhance our ability to improve patient stability and well‐being during HD sessions.
Radioactive 131I Use in End‐Stage Renal Disease: Nightmare or Nuisance?
Authors: Rodby Roger A. , Sinsakul Marvin , Ali Amjad 
Published: September 2010

ABSTRACTPatients with end‐stage renal disease (ESRD) are at risk of prolonged radiation exposure during therapy with radioactive iodine (131I) because it is normally renally excreted. However, 131I is dialyzable and exposure can be monitored with a standard Geiger counter during dialysis. We present two cases of thyroid carcinoma in patients with ESRD who were treated successfully with 131I while continuing chronic hemodialysis (HD). In each case, single HD treatments of 3 and 4 hours performed approximately 20 hours after the administration of 131I resulted in an 80% and 70% reduction in total body radiation levels, respectively. In both cases, Geiger counter measurements after HD following 131I administration revealed levels less than 3 mR/hr, allowing safe discharge from the hospital in a timely manner. All contaminated waste was disposed of by the hospital's Department of Radiation Safety. Postdialysis monitoring revealed no residual radiation contamination of the HD machine or radiation exposure to the dialysis staff. Hemodialyzer reuse was suspended until monitoring demonstrated no appreciable evidence of radioactivity in these spent supplies. HD is a critical aspect in the treatment of patients with ESRD receiving 131I and can safely be administered with close planning between the HD staff and the staff of radiation safety.
American Society of Diagnostic and Interventional Nephrology Section Editor: Stephen Ash: Preliminary Evaluation of a Valved Introducer Sheath for the Insertion of Tunneled Hemodialysis Catheters
Authors: Vesely Thomas M. , Fazzaro Alicia G. , Gherardini Danielle 
Published: September 2010

ABSTRACTThis brief technical report describes our initial experience using the FlowGuard valved introducer sheath during the insertion of tunneled hemodialysis catheters in 15 patients. The incorporation of a silicone valve into the introducer sheath is intended to minimize blood loss and decrease the risk of air embolism during the catheter insertion procedure. Our preliminary experience demonstrated that the FlowGuard sheath is a substantial improvement when compared to standard introducer sheaths. However, an asymptomatic air embolus did occur in one patient. This article describes several caveats for the use of this new product.
Improving Access to Renal Transplantation
Authors: Gaston Robert S. 
Published: September 2010

ABSTRACTKidney transplantation is the treatment of choice for most patients with end‐stage renal disease (ESRD), with success rates greater than were envisioned as recently as a decade ago. Unfortunately this trend has created unprecedented demand for transplantable organs and new challenges for those desiring transplantation. This report is an overview of this changing landscape, with a focus on the clinical implications of the current process that culminates in renal transplantation. It also highlights potential solutions to overcome these newly recognized obstacles.
Kidney Transplantation in HIV‐Infected Patients
Authors: Wyatt Christina M. , Murphy Barbara 
Published: September 2010

ABSTRACTHuman immunodeficiency virus (HIV) infection has traditionally been considered an absolute contraindication to solid organ transplantation. With improvements in survival and increases in the prevalence of end‐stage liver and kidney disease in HIV‐positive patients treated with highly active antiretroviral therapy, many transplant centers have begun to reconsider the role of transplantation in patients with well‐controlled HIV infection. This article reviews the literature on transplantation in HIV‐infected patients, with a focus on kidney transplantation in the era of highly active antiretroviral therapy.
HEMATOLOGY: ISSUES IN THE DIALYSIS PATIENT: Nonhematologic Complications of Erythropoietin Therapy
Authors: Zhu Xiaolei , Perazella Mark A. 
Published: September 2010

ABSTRACTExogenous recombinant human erythropoietin (rHuEPO) is a beneficial therapeutic agent for correction of anemia in both chronic kidney disease (CKD) and end‐stage renal disease (ESRD) patients. Transfusion requirements in ESRD patients are reduced significantly and anemia management is much improved. Despite widespread use and near‐universal exposure of ESRD patients to the drug, rHuEPO remains an effective and safe product. However, a number of nonhematologic complications are described with rHuEPO therapy. Most notable is hypertension, whereas the connection between seizure and enhanced thrombosis is less clear. A possible complication recently described is exacerbation of proliferative diabetic retinopathy. Finally, other less common adverse effects, although rare in most patients, should be recognized as such by physicians who prescribe rHuEPO.
HEMATOLOGY: ISSUES IN THE DIALYSIS PATIENT: Neutrophil Dysfunction and Infection Risk in End‐Stage Renal Disease
Authors: Chonchol Michel 
Published: September 2010

ABSTRACTInfections are still a major cause of morbidity and mortality in end‐stage renal disease (ESRD) patients. The susceptibility of ESRD patients to infections is typically ascribed to the immunodeficient state associated with uremia. A central role in the host defense against bacterial infections is played by phagocytic polymorphonuclear white blood cells, which are characterized by the capacity to ingest and subsequently destroy bacteria. Disorders in polymorphonuclear cell function are exacerbated by the dialysis procedure and numerous factors including uremic toxins, iron overload, anemia of renal disease, and dialyzer bioincompatibility. It is concluded that the phagocytic defect observed in ESRD is multifactorial, and each factor should be managed individually with specific therapeutic approaches.
HEMATOLOGY: ISSUES IN THE DIALYSIS PATIENT: When Heparin Causes Thrombosis: Significance, Recognition, and Management of Heparin‐Induced Thrombocytopenia in Dialysis Patients
Authors: Chang John Jae Young , Parikh Chirag R. 
Published: September 2010

ABSTRACTHeparin‐induced thrombocytopenia (HIT) is characterized by thrombocytopenia and paradoxical hypercoagulability. HIT occurs when an antibody (“HIT antibody”) produced against the complex of heparin and platelet factor 4 (PF4) causes systemic platelet consumption and activation. Nephrologists encounter HIT in the care of end‐stage renal disease (ESRD) patients because heparin is a routine anticoagulant in hemodialysis. The incidence of HIT in ESRD appears to be lower than in other clinical settings. However, HIT is equally life threatening in ESRD patients and therefore demands the same prompt recognition and aggressive treatment. Diagnosing HIT requires the detection of HIT antibodies. A functional assay (e.g., [14C] serotonin release assay) relies on the patient's HIT antibodies to activate donor platelets at pharmacologic heparin concentrations. The more common antigen assay (e.g., enzyme‐linked immunosorbent assay [ELISA]) detects the binding of the patient's HIT antibodies to antigens (e.g., heparin‐PF4 complex) in a microtiter well and does not involve platelets. The moment HIT is suspected, heparin should be stopped and an alternative anticoagulant initiated immediately, even before the result of a serologic test becomes available. The advent of several new anticoagulants in the last decade, especially argatroban and bivalirudin, has expanded treatment options for HIT in dialysis patients. This review discusses the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of HIT, with special emphasis on concepts relevant to the care of dialysis patients.
The cost‐effectiveness of introducing nucleic acid testing to test for hepatitis B, hepatitis C, and human immunodeficiency virus among blood donors in Sweden
Authors: Davidson Thomas , Ekermo Bengt , Gaines Hans , Lesko Birgitta , Åkerlind Britt 
Published: September 2010

BACKGROUND: The purpose of this study was to estimate the cost‐effectiveness of using individual‐donor nucleic acid testing (ID‐NAT) in addition to serologic tests compared with the sole use of serologic tests for the identification of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in Sweden.STUDY DESIGN AND METHODS: The two strategies analyzed were serologic tests and ID‐NAT plus serologic tests. A health‐economic model was used to estimate the lifetime costs and effects. The effects were measured as infections avoided and quality‐adjusted life‐years (QALYs) gained. A societal perspective was used.RESULTS: The largest number of viral transmissions occurred with serologic testing only. However, the risks for viral transmissions were very low with both strategies. The total cost was mainly influenced by the cost of the test carried out. The cost of using ID‐NAT plus serologic tests compared to serologic tests alone was estimated at Swedish Krona (SEK) 101 million (USD 12.7 million) per avoided viral transmission. The cost per QALY gained was SEK 22 million (USD 2.7 million).CONCLUSION: Using ID‐NAT for testing against HBV, HCV, and HIV among blood donors leads to cost‐effectiveness ratios that are far beyond what is usually considered cost‐effective. The main reason for this is that with current methods, the risks for virus transmission are very low in Sweden.
The Risk‐Adjusted Cost of Financial Distress
Authors: ALMEIDA HEITOR , PHILIPPON THOMAS 
Published: September 2010

ABSTRACTFinancial distress is more likely to happen in bad times. The present value of distress costs therefore depends on risk premia. We estimate this value using risk‐adjusted default probabilities derived from corporate bond spreads. For a BBB‐rated firm, our benchmark calculations show that the NPV of distress is 4.5% of predistress value. In contrast, a valuation that ignores risk premia generates an NPV of 1.4%. We show that marginal distress costs can be as large as the marginal tax benefits of debt derived by Graham (2000). Thus, distress risk premia can help explain why firms appear to use debt conservatively.