bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASDIN: Autogenous Side‐to‐Side Brachial‐Basilic Fistulas Without Vein Transposition: A Valuable Option?
Authors: Lomonte Carlo , Casucci Francesco , Antonelli Maurizio , Losurdo Nicola , Marchio Giovanni , Teutonico Annalisa , Libutti Pasquale , Basile Carlo 
Published: April 2009

AbstractAn autogenous brachial‐basilic arteriovenous fistula (BBAVF) in the upper arm must be considered before placing prosthetic grafts in hemodialysis patients with multiple failures of forearm AVFs. The aim of this observational study was to compare technical and clinical outcomes of a new construction technique for BBAVF (n‐BBAVF) with that of the standard one‐stage side‐artery to end‐vein transposed BBAVF (t‐BBAVF). A n‐BBAVF is constructed in the following way: basilic vein and brachial artery are isolated. Patency of the proximal and distal vein is verified by injecting warmed (37°C) saline solution. A venotomy and an arterotomy of 4–5 mm are performed. The two vessels are prepared for a side‐to‐side anastomosis without transposition of the vein. The latter allows both an antegrade and retrograde flow along the basilic vein, both proximally and distally to the anastomosis with more sites available for the venipunctures of the dialysis. Thirty BBAVFs were constructed as the secondary or tertiary vascular access in 30 patients over a 4‐year period: 17 patients with adequate forearm basilic vein underwent the construction of a n‐BBAVF; 13 underwent the construction of a t‐BBAVF. The construction of a n‐BBAVF requires a significantly lesser surgical time (55.0 ± 9.0 minutes vs. 115.0 ± 18.0, p < 0.0001), has fewer surgical complications (5.9% vs. 46.2%, p < 0.0001), and a reduced time to first use (24.5 ± 6.3 vs. 37.7 ± 9.1 days, p < 0.0001) than that of a t‐BBAVF. n‐BBAVFs showed a relatively low rate of thrombosis per patient‐year at risk (0.067 at 1 year and 0.099 at 2 years). The latter was significantly lower at 1 year when compared with t‐BBAVFs (0.067 vs. 0.285; p < 0.004). Our policy of “all AVFs should be autogenous” led us to the construction of a vascular access which is based on a side‐to‐side anastomosis between the brachial artery and the basilic vein without transposition of the vein allowing both antegrade and retrograde flow into the basilic vein. The results of this surgical technique appear satisfactory.
THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Continuous Renal Replacement Therapies in Patients with Liver Disease
Authors: Davenport Andrew 
Published: April 2009

AbstractPatients with acute and chronic liver disease are prone to hypotension, and mortality increases when acute kidney injury supervenes. Hypotension during renal replacement therapy compromises cerebral perfusion, which can exacerbate cerebral edema in cases of fulminant hepatic failure and those with encephalopathy due to chronic liver failure. As such, any renal replacement therapy utilized should have minimal adverse effects on cardiovascular and cerebrovascular stability. Continuous modes of renal replacement therapy have been shown to cause less cardiovascular and cerebrovascular instability compared to other modalities, and as such are the treatments of choice for this group of critically ill patients.
THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: The Use of Renal Replacement Therapy in Acute Decompensated Heart Failure
Authors: Udani Suneel M. , Murray Patrick T. 
Published: April 2009

AbstractThe worsening of renal function in the context of decompensated heart failure is an increasingly common clinical scenario, dubbed the cardiorenal syndrome. Its development is not completely understood; however, it results from the hemodynamic and neurohumoral alterations that occur in the setting of left ventricular pressure and volume overload with poor cardiac output. Diuretics have been the mainstay of treatment; however, they are often unsuccessful in reversing the vicious cycle of volume overload, worsening cardiac function, and azotemia. Renal replacement therapy (RRT) in the form of isolated or continuous ultrafiltration (UF) with or without a component of solute clearance (hemofiltration or hemodialysis) has been increasingly utilized as a therapeutic tool in this setting. Initial clinical trial data on the use of UF have demonstrated promising cardiac outcomes with regard to fluid removal and symptom relief without worsening renal function. The addition of a component of solute clearance may provide additional benefits in these patients with varying degrees of renal impairment. The exact clinical setting in which the various forms of RRT should be applied as initial or early therapy for acute decompensated heart failure (ADHF) remains unknown. More research examining the use of RRT in ADHF is necessary; however, it appears that the patients with the most severe clinical presentations have the best chance of benefiting from the early application of RRT.
THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Clinical Nursing for the Application of Continuous Renal Replacement Therapy in the Intensive Care Unit
Authors: Baldwin Ian , Fealy Nigel 
Published: April 2009

AbstractTreatment of critically ill patients with continuous renal replacement therapy (CRRT) requires a set of new skills and knowledge base for the intensive care unit (ICU) nurse. After a decision to treat is made, nurses effectively manage the technique by following a series of steps in sequence. These sequential steps include patient and machine circuit preparation, connection of the extracorporeal circuit (EC) to the patient’s vascular access, and nursing management of a treatment in progress. During treatment, nurses prepare fluids, adjust fluid settings to provide fluid balance, prepare electrolyte additives, monitor acid base and electrolyte levels, monitor patient and machine “vital signs,” and, when necessary, diagnose circuit clotting and perform a disconnection of the EC from the patient. All of these aspects of CRRT nursing are essential for a successful CRRT nursing policy or protocol. This chapter provides a clinical review for this every day sequence when using CRRT in the ICU setting.
THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Overview of Pediatric Renal Replacement Therapy in Acute Kidney Injury
Authors: Goldstein Stuart L. 
Published: April 2009

AbstractThe disease spectrum leading to pediatric renal replacement therapy (RRT) provision has broadened over the last decade. In the 1980’s, intrinsic renal disease and burns comprised the most common pediatric acute kidney injury (AKI) etiologies. More recent data demonstrate that pediatric AKI most often results from complications of other systemic diseases resulting from the advancements in congenital heart surgery, neonatal care, and bone marrow and solid organ transplantation. In addition, RRT modality preferences to treat critically ill children have shifted from peritoneal dialysis to continuous renal replacement therapy (CRRT) as a result of improvements in CRRT technologies. Currently, multicenter prospective outcome studies for critically ill children with AKI are sorely lacking. The aims of this paper are to review the pediatric specific causes necessitating RRT provision with an emphasis on emerging practice patterns with respect to modality and the timing of treatment, and focus upon the application of the different RRT modalities and assessment of the outcome of children with AKI who receive RRT.
THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Continuous Renal Replacement Therapy in Sepsis and Multisystem Organ Failure
Authors: Joannidis Michael 
Published: April 2009

AbstractThis study reviews the role of continuous renal replacement therapy (CRRT) in sepsis with acute kidney injury (AKI) and septic shock with multiple organ failure. In addition to the conventional aim of replacing renal function in AKI, CRRT is often used with the concept of modulating immune response in sepsis. With the intention of influencing circulating levels of inflammatory mediators like cytokines and chemokines, the complement system, as well as factors of the coagulation system, several modifications of CRRT have been developed over the last years. These include high volume hemofiltration, high adsorption hemofiltration, use of high cut‐off membranes, and hybrid systems like coupled plasma filtration absorbance. One of the most promising concepts may be the development of renal assist devices using renal tubular cells for implementing renal tubular function into CRRT.
THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Vascular Access for Continuous Renal Replacement Therapy
Authors: Vijayan Anitha 
Published: April 2009

AbstractA working vascular access is essential for performing continuous renal replacement therapy (CRRT) efficiently and without interruption. Dual‐lumen temporary hemodialysis catheters are the catheters of choice, although tunneled catheters can also be utilized if therapy is expected to be prolonged. Hemodialysis catheters have to be inserted under ultrasound guidance by trained personnel, using aseptic conditions. The right internal jugular vein is the preferred site. Catheter malfunction and catheter‐related infections can be reduced by adhering to preventive guidelines such as ultrasound guidance for placement, strict hand hygiene, gauze dressings, and sterile techniques during catheter handling. Antibiotic or antiseptic‐coated catheters and lock solutions may be beneficial in certain patients, but these are not widely used due to the concern for resistant organisms and allergic reactions.
Aging Adversely Impacts Biological Properties of Human Bone Marrow‐derived Mesenchymal Stem Cells: Implications for Tissue Engineering Heart Valve Construction
Authors: Xin Yuan , Wang Yu‐mei , Zhang Hao , Li Jun , Wang Wei , Wei Ying‐jie , Hu Sheng‐shou 
Published: April 2009

AbstractOur aim was to study the aging effects on the in vitro biological properties of bone marrow‐derived mesenchymal stem cells (BMSCs) for construction of tissue‐engineered heart valves. BMSCs were taken from teenagers with congenital heart diseases, and middle‐aged and elderly patients with valvular diseases. Proliferative abilities were compared among the three groups by using colony‐forming unit counting and growth curves (5‐bromo‐2′‐deoxyuridine assay). Cell differentiation, vascular endothelial growth factor (VEGF) release under hypoxic condition, and migratory abilities were compared as well. Colony‐forming units in the teenage group were significantly greater than those in the other two groups (P < 0.05), and significantly higher counts were observed in the middle age group than in the aged group (P < 0.05). Growth curves presented similar trends in which cells' proliferative abilities in the aged group decreased significantly (P < 0.05), while no differences were noted between the two nonaged groups. The differentiation potential to endothelial cells, osteoblasts and adipocytes, VEGF releases, and migratory abilities differed significantly between the aged group and nonaged groups (P < 0.05). However, no differences were noted between the two nonaged groups. BMSCs from older patients with heart valve diseases could be harvested and expanded successfully, and the phenotype and morphology were uniform as nonaged groups. However, the proliferative and differentiation properties of aged cells, as well as cytokine release and migratory abilities, are significantly impaired.
Ethanol Teratogenesis in Five Inbred Strains of Mice
Authors: Downing Chris , Balderrama‐Durbin Christina , Broncucia Hali , Gilliam David , Johnson Thomas E. 
Published: April 2009

Background: Previous studies have demonstrated individual differences in susceptibility to the detrimental effects of prenatal ethanol exposure. Many factors, including genetic differences, have been shown to play a role in susceptibility and resistance, but few studies have investigated the range of genetic variation in rodent models.Methods: We examined ethanol teratogenesis in 5 inbred strains of mice: C57BL/6J (B6), Inbred Short‐Sleep, C3H/Ibg, A/Ibg, and 129S6/SvEvTac (129). Pregnant dams were intubated with either 5.8 g/kg ethanol (E) or an isocaloric amount of maltose–dextrin (MD) on day 9 of pregnancy. Dams were sacrificed on day 18 and fetuses were weighed, sexed, and examined for gross morphological malformations. Every other fetus within a litter was then either placed in Bouin’s fixative for subsequent soft‐tissue analyses or eviscerated and placed in ethanol for subsequent skeletal analyses.Results: B6 mice exposed to ethanol in utero had fetal weight deficits and digit, kidney, brain ventricle, and vertebral malformations. In contrast, 129 mice showed no teratogenesis. The remaining strains showed varying degrees of teratogenesis.Conclusions: Differences among inbred strains demonstrate genetic variation in the teratogenic effects of ethanol. Identifying susceptible and resistant strains allows future studies to elucidate the genetic architecture underlying prenatal alcohol phenotypes.
Altered White Matter Integrity in Adolescent Binge Drinkers
Authors: McQueeny Tim , Schweinsburg Brian C. , Schweinsburg Alecia D. , Jacobus Joanna , Bava Sunita , Frank Lawrence R. , Tapert Susan F. 
Published: April 2009

Background:  White matter integrity has been found to be compromised in adult alcoholics, but it is unclear when in the course of alcohol exposure white matter abnormalities become apparent. This study assessed microstructural white matter integrity among adolescent binge drinkers with no history of an alcohol use disorder.Methods:  We used diffusion tensor imaging to examine fractional anisotropy (FA), a measure of directional coherence of white matter tracts, among teens with (n = 14) and without (n = 14) histories of binge drinking but no history of alcohol use disorder, matched on age, gender, and education.Results:  Binge drinkers had lower FA than controls in 18 white matter areas (clusters ≥27 contiguous voxels, each with p < 0.01) throughout the brain, including the corpus callosum, superior longitudinal fasciculus, corona radiata, internal and external capsules, and commissural, limbic, brainstem, and cortical projection fibers, while exhibiting no areas of higher FA. Among binge drinkers, lower FA in 6 of these regions was linked to significantly greater lifetime hangover symptoms and/or higher estimated peak blood alcohol concentrations.Conclusions:  Binge drinking adolescents demonstrated widespread reductions of FA in major white matter pathways. Although preliminary, these results could indicate that infrequent exposure to large doses of alcohol during youth may compromise white matter fiber coherence.
Clinical Interview Assessment of Financial Capacity in Older Adults with Mild Cognitive Impairment and Alzheimer's Disease
Authors: Marson Daniel C. , Martin Roy C. , Wadley Virginia , Griffith H. Randall , Snyder Scott , Goode Patricia S. , Kinney F. Cleveland , Nicholas Anthony P. , Steele Terri , Anderson Britt , Zamrini Edward , Raman Rema , Bartolucci Alfred , Harrell Lindy E. 
Published: April 2009

OBJECTIVES: To investigate financial capacity in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) using a clinician interview approach.DESIGN: Cross‐sectional.SETTING: Tertiary care medical center.PARTICIPANTS: Healthy older adults (n=75) and patients with amnestic MCI (n=58), mild AD (n=97), and moderate AD (n=31).MEASUREMENTS: The investigators and five study physicians developed a conceptually based, semistructured clinical interview for evaluating seven core financial domains and overall financial capacity (Semi‐Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made capacity judgments (capable, marginally capable, or incapable) for each financial domain and for overall capacity.RESULTS: Study physicians made more than 11,000 capacity judgments across the study sample (N=261). Very good interrater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall financial capacity, 95% of physician judgments for older controls were rated as capable, compared with 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD.CONCLUSION: Physicians and other clinicians can reliably evaluate financial capacity in cognitively impaired older adults using a relatively brief, semistructured clinical interview. Patients with MCI have mild impairment in financial capacity, those with mild AD have emerging global impairment, and those with moderate AD have advanced global impairment. Patients with MCI and their families should proactively engage in financial and legal planning, given these patients' risk of developing AD and accelerated loss of financial abilities.
Pain and Disability in Older Mexican‐American Adults
Authors: Weaver Gayle D. , Kuo Yong‐Fang , Raji Mukaila A. , Al Snih Soham , Ray Laura , Torres Elizabeth , Ottenbacher Kenneth J. 
Published: April 2009

OBJECTIVES: To examine an association between pain severity and functional disability in older Mexican Americans.DESIGN: Cross‐sectional study (2005/06), a subsample of the Hispanic Established Population for Epidemiologic Study of the Elderly.SETTING: Community.PARTICIPANTS: One thousand thirteen Mexican American aged 74 to 100.MEASUREMENTS: Bilingual interviewers administered structured questionnaires and assessed physical measures of mobility and frailty (exhaustion, weight loss, walking speed, grip strength, and self‐reported physical activity). Two items from the SF‐36 questionnaire assessed pain experiences in the previous 4 weeks.RESULTS: Chi‐square one‐way analysis of variance and least square and negative binomial regressions were computed for 744 participants with complete data to investigate experience of pain and other dimensions of health and functioning. Close to two‐thirds (64.7%) reported pain within 4 weeks of the interview, and 49.7% reported that pain interfered with performance of daily activities. Female sex; low education; frailty; reduced mobility; disability; and high comorbidity, body mass index, and depressive symptomatology were significantly associated with pain severity and interference. Regression coefficients revealed that pain severity was significantly related to disability in activities of daily living (0.22, P<.001) and instrumental activities of daily living (0.23, P<.01) after controlling for sociodemographic and health status characteristics.CONCLUSION: The findings expand the pain literature on older Mexican Americans. High pain rates were most prevalent in women and subjects with high comorbidity, high depressive symptomatology, poor mobility, and frailty. Pain also plays a significant role in disability status. In‐depth research is needed to understand the pain experiences of older Mexican Americans and their effect on health and well‐being.
Comparison of the Load at Fracture of Turkom‐Cera to Procera AllCeram and In‐Ceram All‐Ceramic Restorations
Authors: AL‐Makramani Bandar M. A. , Razak Abdul A. A. , Abu‐Hassan Mohamed I. 
Published: April 2009

Abstract Purpose: This study investigated the occlusal fracture resistance of Turkom‐Cera‐fused alumina compared to Procera AllCeram and In‐Ceram all‐ceramic restorations. Materials and Methods: Six master dies were duplicated from the prepared maxillary first premolar tooth using nonprecious metal alloy (Wiron 99). Ten copings of 0.6 mm thickness were fabricated from each type of ceramic, for a total of thirty copings. Two master dies were used for each group, and each of them was used to lute five copings. All groups were cemented with resin luting cement Panavia F according to manufacturer's instructions and received a static load of 5 kg during cementation. After 24 hours of distilled water storage at 37°C, the copings were vertically compressed using a universal testing machine at a crosshead speed of 1 mm/min. Results: The results of the present study showed the following mean loads at fracture: Turkom‐Cera (2184 ± 164 N), In‐Ceram (2042 ± 200 N), and Procera AllCeram (1954 ± 211 N). ANOVA and Scheffe's post hoc test showed that the mean load at fracture of Turkom‐Cera was significantly different from Procera AllCeram (p < 0.05). Scheffe's post hoc test showed no significant difference between the mean load at fracture of Turkom‐Cera and In‐Ceram or between the mean load at fracture of In‐Ceram and Procera AllCeram. Conclusion: Because Turkom‐Cera demonstrated equal to or higher loads at fracture than currently accepted all‐ceramic materials, it would seem to be acceptable for fabrication of anterior and posterior ceramic crowns.
Strength of Denture Base Resins Repaired with Auto‐ and Visible Light‐Polymerized Materials
Authors: Faot Fernanda , Da Silva Wander Jose , Da Rosa Rosena Santos , Del Bel Cury Altair A. , Garcia Renata Cunha Matheus Rodrigues 
Published: April 2009

Abstract Purpose: Clinicians are still confused about the choice of repair method, which depends on factors such as the length of time required for processing, the mechanical strength of the repaired material, and the effect of stress concentration in the acrylic resins before the repair. The aim was to determine the impact and flexural strength characteristics, such as stress at yield, Young's modulus, and displacement at yield of denture base resins fractured and repaired by three methods using heat‐, auto‐, and visible light‐polymerized acrylic resins. Material and Methods: For impact and flexural strength tests, 18 rectangular specimens measuring 50 × 6 × 4 mm3 and 64 × 10 × 3.3 mm3, respectively, were processed using Impact 2000, Lucitone 550, Impact 1500, and QC‐20 acrylic resins. Fracture tests were performed according to ISO1567:1999. Afterward, all fractured specimens were stored in distilled water at 37°C for 7 days, and then repaired with (1) the same acrylic resin used for specimen fabrication (n = 6), (2) an autopolymerized acrylic resin (TruRepair, n = 6), and (3) a visible light acrylic resin (Versyo.com, n = 6). The repaired specimens were again submitted to the same fracture tests, and the failures were classified as adhesive or cohesive. Data from all mechanical tests after repair by the different methods were submitted to two‐way ANOVA, and mean values were compared by the Tukey test. Results: All acrylic resins showed adhesive fractures after impact and flexural strength tests. Differences (p < 0.05) were found among repair methods for all acrylic resins studied, with the exception of displacement at yield, which showed similar values for repairs with auto‐ and visible light‐polymerized acrylic resins. The highest values for impact strength, stress, and displacement at yield were obtained when the repair was made with the same resin the specimen was made of. Conclusion: Denture base acrylic resins repaired with the same resin they were made of showed greater fracture strength.