bluuebunny/crossref_metadata_2025_split huggingface dataset:
College Students' Knowledge and Attitudes About Cesarean Birth
Authors: Lampman Claudia , Phelps Alissa 
Published: August 2010

Background: Numerous clinicians and researchers have expressed concern about the necessity and potential adverse consequences of many cesarean births in the United States. The purpose of this study was to explore college students' attitudes and beliefs about cesarean section. Methods: One hundred two college students (66% women) completed a 20‐item questionnaire that asked if they viewed cesarean delivery as a potentially negative experience, as a normal or acceptable method of childbirth, and as medically necessary, and asked about their beliefs concerning risk and prevention of cesarean birth. Results: The number of “undecided” responses in the study was striking (7.8% to 69.6% across the 20 items). In general, women and men responded similarly, although women were significantly more likely than men to say they would be profoundly disappointed if their babies had to be delivered by cesarean section. Despite expressing cynicism about the cesarean birth rate (40% agreed that many unnecessary cesarean births occurred) and not viewing the procedure as a normal way of giving birth (47%), most respondents (over 70%) disagreed that giving birth by cesarean would be a negative experience or would make a woman feel like a failure. Conclusion: A high level of uncertainty exists about certain aspects of cesarean birth among young women and men, highlighting the need for information for prospective parents. Most college students did not view the cesarean birth experience as either potentially negative or normal. Future research should explore coverage of cesarean birth in childbirth education classes and the roles physicians, nurses, and midwives play in preparing expectant parents for the possibility of cesarean delivery. (BIRTH 24:3, September 1997)
Who Worries That Something Might Be Wrong With the Baby? A Prospective Study of 1072 Pregnant Women
Authors: Statham Helen , Green Josephine M. , Kafetsios Kostas 
Published: August 2010

Background:Little is known about the normal range and pattern of pregnant women's worry about something being wrong with the baby, or how this relates to other factors. The objective of this study was to examine the extent to which women are worried about the possibility of something being wrong with the baby relative to other worries they may have, and to determine whether demographic, experiential, attitudinal, and personality characteristics are associated with this worry.Methods:Longitudinal data were collected from 1072 pregnant women who completed postal questionnaires at 16, 22, and 35 weeks of pregnancy. Multivariate statistical techniques were used to determine which variables were independently related to worry about the baby.Results:Worry that something might be wrong with the baby was one of the most prevalent worries at 16 weeks, although not as widespread a source of extreme worry as miscarriage or giving birth. Worry dropped in midpregnancy but rose again at 35 weeks. The most important factors related to this worry were perceived likelihood that something might be wrong with the baby and trait anxiety, although negative mood, previous pregnancy outcomes, and initial reactions to the current pregnancy all demonstrated significant, independent effects.Conclusions:Women who answered “Don't know” to “Have you any reason to think that your baby might be more likely than any other to have some sort of a problem?” had consistently high anxiety throughout pregnancy. We suggest that this question be asked routinely in early pregnancy to identify these potential worries and, it is to be hoped, reassure them at an early stage. (BIRTH 24:4, December 1997)
A Case Simulating Ophthalomoplegic Migraine: Clinicopathological Study
Authors: Morimoto Kazuyoshi , Nagatani Masaaki , Mogami Heitaro 
Published: August 2010

SYNOPSISWe describe a 61‐year‐old woman with unilateral ophthalmoplegia with migraine type headache. Pathological examination revealed severe atrophy of the third cranial nerve as the result of vascular compression by the atheromatous posterior cerebral artery. Although the exact pathogenesis of ophthalmoplegic migraine (OM) is uncertain at the present time, this unique case with clinical and pathological observations suggests that vascular compression and the resulting ischemia of the third cranial nerve can closely simulate OM.
The Low Molecular Weight Heparin, Tinzaparin, in Thrombosis and Beyond
Authors: Mousa Shaker A. 
Published: August 2010

ABSTRACTStandard unfractionated heparin (UFH) has been in clinical use for over 50 years. The commercial use of low molecular weight heparins (LMWHs) began in the mid 1980s for hemodialysis and the prophylaxis of deep vein thrombosis (DVT). Initially, the clinical development of LMWHs was concentrated on the European continent. Subsequently, LMWHs were introduced in North America as well. In the initial stages of development of these drugs only nadroparin, dalteparin and enoxaparin were used. Subsequently, several other LMWHs such as ardeparin, tinzaparin, reviparin and parnaparin were introduced. LMWHs constitute a group of important medications with total sales reaching nearly 2.5 billion dollars with expanded indications reaching far beyond the initial indications for the prophylaxis of post‐surgical DVT. This review highlights the pharmacology of tinzaparin. Unlike other LMWHs, tinzaparin is prepared by enzymatic hydrolysis with heparinase, while various chemical depolymerization methods are used for the synthesis of other LMWHs. As compared with the standard heparin, LMWHs have different pharmacodynamic, and pharmacokinetic properties; they also differ in clinical benefits.
Clinical Use and Molecular Mechanisms of Action of Extract of Ginkgo biloba Leaves in Cardiovascular Diseases
Authors: Zhou Wei , Chai Hong , Lin Peter H. , Lumsden Alan B. , Yao Qizhi , Chen Changyi 
Published: August 2010

ABSTRACT Ginkgo biloba is one of the oldest living tree species that has been referred to as a living fossil. Extract from Ginkgo biloba leaves (GBE) is among the most commonly used herbal drugs and is popularized for its alleged tonic effect and possible curative and restorative properties. There is an increasing evidence of the potential role of GBE in treating cardiovascular diseases. We examined the history of GBE usage and reviewed the literature on its effects on the cardiovascular system. In the extensive studies involving cell cultures and animal models, GBE has been shown to exert its action through diverse mechanisms. GBE has been reported to have antioxidatant properties, to modify vasomotor function, to reduce adhesion of blood cells to endothelium, to inhibit activation of platelets and smooth muscle cells, to affect ion channels, and to alter signal transduction. In addition, relevant clinical trials with CBE are being carried out, particularly in the treatment of arterial and venous insufficiency and in the prevention of thrombosis. Finally, the controversial clinical findings and the possible adverse interactions between GBE and other drugs are discussed. This review underscores the potential benefits of Ginkgo biloba in cardiovascular diseases, highlights the gaps in our current research, and suggests the necessity for more rigorous systematic investigation of cardiovascular properties of CBE.
Colesevelam: Potential Uses for the Newest Bile Resin
Authors: Steinmetz Karen L. , Schonder Kristine S. 
Published: August 2010

ABSTRACTColesevelam is the newest bile resin with a unique chemical structure. It binds to bile acids with higher affinity than traditional bile acid sequestrants and has fewer gastrointestinal side effects and drug interactions. Colesevelam is safe and efficacious alone or in combination with HMG‐CoA reductase inhibitors (statins) in reducing low‐density lipoprotein cholesterol (LDL‐C) levels. Despite this, the role of colesevelam in the treatment of hyperlipidemia remains limited, particularly in the face of new lipid lowering agents. As guidelines for cholesterol control become more stringent, the need to maximize therapeutic benefit through combination therapy will become increasingly more important. Colesevelam has a dose‐sparing effect on statin therapy, potentially decreasing the risk of unwanted side effects or drug‐drug interactions associated with statin use. This makes colesevelam a viable option for addition to a statin regimen when goal LDL‐C levels cannot be achieved with a statin alone. Additionally, anecdotal reports indicate that colesevelam may have potential benefits in certain patient populations that cannot tolerate other lipid lowering therapies, including organ transplant recipients, cholestatic liver disesase, and end‐stage renal disease. By recognizing the potential utility of colesevelam, clinicians can better manage those patients who are not able to tolerate first‐line therapies.
Clinical Use of Sirolimus‐Eluting Stents
Authors: Kirtane Ajay J. , Leon Martin B. 
Published: August 2010

ABSTRACTDrug‐eluting stents, or intracoronary stents that combine the local delivery of antirestenotic pharmacologic therapies while maintaining the mechanical advantage of bare metal stents over balloon angioplasty alone, are a highly complex technology that have profoundly affected the practice of percutaneous coronary intervention over the last 5 years. These devices were designed specifically to treat the neointimal hyperplasia occurring after conventional bare metal stent placement, and have been remarkably successful in this regard. However, recent concerns have been raised regarding the long‐term safety of these devices, particularly when used outside of the specific patient and lesion subsets studied in the pivotal randomized trials that led to device approval by regulatory bodies within the United States and abroad. This review aims to present a brief description of the sirolimus‐eluting stent device platform and its mechanism of action, followed by an overview of current data regarding efficacy and safety regarding the clinical use of sirolimus‐eluting stent technology.
The underlying etiology of infantile spasms (West syndrome): Information from the United Kingdom Infantile Spasms Study (UKISS) on contemporary causes and their classification2
Authors: Osborne John P. , Lux Andrew L. , Edwards Stuart W. , Hancock Eleanor , Johnson Anthony L. , Kennedy Colin R. , Newton Richard W. , Verity Christopher M. , O’Callaghan Finbar J. K. 
Published: August 2010

SummaryPurpose:  To examine the underlying etiology of infantile spasms from the United Kingdom Infantile Spasms Study (UKISS), using the pediatric adaptation of ICD 10.Methods:  Infants were enrolled in a randomized controlled trial or a parallel epidemiologic study. Etiological information included history, examination, and investigations. The infants were classified as proven etiology, if a neurologic disease was identified; as no identified etiology, if no neurologic disease was identified; and as not fully investigated, if a major piece of information was missing. Proven etiology was subclassified using the pediatric adaptation of ICD 10. The results were then examined to identify further methods of classification.Results:  Of 207 infants, 127 (61%) had proven etiology, 68 (33%) had no identified etiology, and 12 (6%) were not fully investigated. Etiologies were prenatal in 63, perinatal in 38, postnatal in 8, and 18 other. The most common etiologies were: hypoxic–ischemic encephalopathy (HIE) 21 (10%), chromosomal 16 (8%), malformations 16 (8%), stroke 16 (8%), tuberous sclerosis complex (TSC) 15 (7%), and periventricular leukomalacia or hemorrhage 11 (5%). The remaining 32 etiologies were all individually uncommon. Response to treatment is given for individual etiologies.Discussion:  Our method of classification allows the reporting of results by individual diseases, disease groups, or categories and is structured and clear. It avoids the use of poorly defined terms such as symptomatic and cryptogenic. It can adapt to new neurologic diseases, such as gene defects, and can be used for comparison of different groups of infants, thereby aiding meta‐analysis.
Absence seizures: Individual patterns revealed by EEG‐fMRI
Authors: Moeller Friederike , LeVan Pierre , Muhle Hiltrud , Stephani Ulrich , Dubeau Francois , Siniatchkin Michael , Gotman Jean 
Published: August 2010

SummaryPurpose:  Absences are characterized by an abrupt onset and end of generalized 3–4 Hz spike and wave discharges (GSWs), accompanied by unresponsiveness. Although previous electroencephalography–functional magnetic resonance imaging (EEG–fMRI) studies showed that thalamus, default mode areas, and caudate nuclei are involved in absence seizures, the contribution of these regions throughout the ictal evolution of absences remains unclear. Furthermore, animal models provide evidence that absences are initiated by a cortical focus with a secondary involvement of the thalamus. The aim of this study was to investigate dynamic changes during absences.Methods:  Seventeen absences from nine patients with absence epilepsy and classical pattern of 3–4 Hz GSWs during EEG‐fMRI recording were included in the study. The absences were studied in a sliding window analysis, providing a temporal sequence of blood oxygen–level dependent (BOLD) response maps.Results:  Thalamic activation was found in 16 absences (94%), deactivation in default mode areas in 15 (88%), deactivation of the caudate nuclei in 10 (59%), and cortical activation in patient‐specific areas in 10 (59%) of the absences. Cortical activations and deactivations in default mode areas and caudate nucleus occurred significantly earlier than thalamic responses.Discussion:  Like a fingerprint, patient‐specific BOLD signal changes were remarkably consistent in space and time across different absences of one patient but were quite different from patient to patient, despite having similar EEG pattern and clinical semiology. Early frontal activations could support the cortical focus theory, but with an addition: This early activation is patient specific.
Novel test for microparticles in platelet‐rich plasma and platelet concentrates using dynamic light scattering
Authors: Xu Yan , Nakane Nobu , Maurer‐Spurej Elisabeth 
Published: August 2010

BACKGROUND: The level and clinical importance of platelet (PLT)‐derived microparticles (PMPs) in PLT‐rich plasma (PRP) and PLT transfusions is largely unknown due to the lack of technology to routinely determine the number and size of PMP in PLT samples. Dynamic light scattering (DLS) is ideally suited to measure particles of submicron size but has previously been limited to the analysis of PLT‐free samples.STUDY DESIGN AND METHODS: PMPs were enumerated in 81 PRP and 79 apheresis PLT concentrate (APC) samples from the same donors using ThromboLUX (LightIntegra Technology, Inc.), a new DLS PLT quality test. The ThromboLUX results were compared with flow cytometry. Phase contrast and differential interference contrast (DIC) microscopy were used to qualitatively determine PMP levels.RESULTS: The relative counts of PMPs measured by flow cytometry strongly correlated with the relative light scattering intensities of the PMP determined by ThromboLUX in both PRP (R = 0.7596, p < 0.0001) and APC (R = 0.6572, p < 0.0001) samples. High or low PMP levels in PLT samples were confirmed by phase contrast and DIC microscopy. The mean PMP radius measured with ThromboLUX, an absolute sizing technology, was 117.1 ± 77.6 nm as determined from the distribution of PMP content in all PLT samples investigated in this study.CONCLUSIONS: Correlation with flow cytometry and microscopy showed that ThromboLUX is well suited to measure PMP concentration and size distribution in PLT concentrate samples. In combination with noninvasive sampling, ThromboLUX could provide routine microparticle enumeration of PLT‐containing samples.
Weak D and DEL alleles detected by routine SNaPshot genotyping: identification of four novel RHD alleles
Authors: Silvy Monique , Simon Sophie , Gouvitsos Julia , Di Cristofaro Julie , Ferrera Virginie , Chiaroni Jacques , Bailly Pascal 
Published: August 2010

BACKGROUND: Molecular RHD blood group typing is very efficient for managing donors and patients carrying any of the various molecular types of weak D and DEL. The purpose of the work was to develop a multiplex polymerase chain reaction (PCR) SNaPshot assay for simultaneous detection of weak D and DEL alleles that are prevalent in Europeans, Africans, and Asians.STUDY DESIGN AND METHODS: Preliminary profiling was carried out on single‐nucleotide polymorphisms (SNPs) associated with 13 prevalent RHD alleles, that is, weak D Types 1, 2, 3, 4.0, 4.0.1, 4.1, 4.2, 5, 11, 15, and 17; RHD(IVS3+1g>a); and RHD(K409K). Multiplex PCR was used to amplify six RHD regions encompassing 14 SNPs. Identification was obtained by incorporation of the complementary dye single base at the 3′‐end of each probe‐primer. A prospective analysis was then carried out on 152 blood samples from patients (n = 53) and donors (n = 88) with equivocal RhD serology and pregnant women (n = 11).RESULTS: After validation, our SNaPshot assay allowed direct genotyping of 82.9% of samples overall and 100% of samples harboring weak D Types 1, 2, 3, and 4.1 alleles. In the remaining 17.1% of samples overall, sequence investigation allowed accurate genotyping. In addition, four novel RHD alleles were identified, that is, RHD(S256P), RHD(L390L), RHD(F410V), and RHD(IVS4‐2a>g).CONCLUSION: The SNaPshot assay described herein is a helpful supplementary tool for resolving doubtful RhD serology. By allowing accurate identification of weak D and DEL alleles this assay should allow better management of the donors and the patients genotyped weak D Types 1, 2, 3, and 4.1 who can receive D+ blood units.
Atrial Threshold Variability: Implications for Automatic Atrial Stimulation Algorithms
Authors: BIFFI MAURO , SPITALI GIROLAMO , SILVETTI MASSIMO STEFANO , ARGNANI SELINA , RUBINO IDA , FONTANA PIERLUIGI , BARBATO GAETANO , MAZZINI ELENA , DE SANTO TIZIANA , DRAGO FABRIZIO , BORIANI GIUSEPPE 
Published: August 2010

Background:

Automatic management of atrial stimulation by verification of atrial threshold (ACM) has recently been made feasible. We investigated circadian atrial threshold variability over the long term and the predictors of successful automatic atrial threshold measurement, in order to provide practical clues for programming ACM features, in such a way as to achieve daily threshold verification and > 99% effective atrial stimulation.
Methods:

Six daily attempts to measure atrial threshold were programmed in patients receiving an EnPulse™ pacemaker (Medtronic Inc., Minneapolis, MN, USA). Atrioventricular (AV) conduction was maximized by programming Search AV+ (SAV+) to a resting Paced AV delay = 400 ms in the first month, and 600 ms thereafter.
Results:

Seventy‐six patients had a median follow‐up of 12 months. Median ACM success was 77%. Concordance between automatically and manually measured thresholds was observed during the entire follow‐up (Rho = 0.82, P < 0.001). Daily variability in atrial threshold was < 0.5 V in > 94% of measurements in the first trimester after implantation, and < 0.5 V in > 99% of measurements thereafter, as well as any time after pacemaker replacement. Atrial threshold was measured on 86% of days: the predictors of ACM failure were AV block (AVB), high%Atrial pacing, and atrial fibrillation. Programming SAV+ to achieve 600 ms resting Paced AV decreased%Vpacing in patients with normal AV conduction and first‐degree AVB, improving the ability to detect atrial threshold.
Conclusions:

The reliability of ACM is high over a long follow‐up. On the basis of atrial threshold variability, a practical approach to ACM programming should be two daily atrial threshold measurements in patients with normal AV conduction and%Ap ≤ 40%, or with normal sinus activity and AVB, whereas 3–4 measurements should be recommended in patients with first‐degree AVB and%Ap > 40% or with recurrent atrial fibrillation and AVB. The lowest adapted stimulation output should achieve at least threshold +1 V in the first trimester after implantation, then threshold +0.5 V thereafter, in order to achieve > 99.5% effective atrial stimulation.
Left Ventricular Endocardial Pacing: A Transarterial Approach
Authors: REINIG MICHAEL , WHITE MELVIN , LEVINE MARC , CHA RIDO , CINEL ISMAIL , PURNACHANDRA JASTI , GOLDFARB ROY , YANG ZHONGPING , MULLIGAN LARRY , PARRILLO JOSEPH , GESSMAN LAWRENCE 
Published: August 2010

Introduction:

We tested the feasibility of a new technique of direct left ventricular endocardial lead placement across the aortic valve in a chronic (six month) pig model. The potential for aortic valve damage, systemic embolization, and pacing lead maturation and function within the left ventricle are unknown.
Methods:

Ten minipigs were successfully implanted with a transaortic left ventricular lead (Medtronic CapSureFix®, Minneapolis, MN, USA) placed in the left ventricular apex via the carotid artery. Each pig received either a polyurethane (n = 5) or silicone (n = 5) lead. Post implant each pig received clopidogrel and aspirin for seven days. After six months all surviving pigs underwent thorough necropsy.
Results:

Each pig had adequate sensing (12.1 ± 4 mV) and pacing thresholds (0.79 ± 0.2 @ 0.5 V) at implant. Postoperatively two pigs died of a respiratory illness. One pig died postoperatively due to sepsis. At the six‐month follow‐up, all surviving pigs (n = 7) were in a healthy state. Of the pigs without dislodgement (n = 5) there was adequate sensing, but a rise in pacing thresholds. Echocardiography revealed a normal ejection fraction and only trace to mild aortic insufficiency in all pigs. Of the seven surviving pigs there were no thromboembolic events noted. One silicone lead was noted to have thrombosis along the lead screw and shaft.
Conclusion:

Direct transaortic placement of a left ventricular lead is feasible. After six months, there was no significant aortic regurgitation and no evidence of thromboembolism despite no anticoagulation. Lead function was acceptable and only one silicone lead (and no polyurethane lead) was noted to have significant thrombosis.