bluuebunny/crossref_metadata_2025_split huggingface dataset:
Onset of Vocal Interaction Between Parents and Newborns in Skin‐to‐Skin Contact Immediately After Elective Cesarean Section
Authors: Velandia Marianne , Matthisen Ann‐Sofi , Uvnäs‐Moberg Kerstin , Nissen Eva 
Published: September 2010

Abstract:  Background:  Cesarean section is associated with delayed mother‐infant interaction because neither the mother nor the father routinely maintains skin‐to‐skin contact with the infant after birth. The aim of the study was to explore and compare parent‐newborn vocal interaction when the infant is placed in skin‐to‐skin contact either with the mother or the father immediately after a planned cesarean section.Methods:  A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin‐to‐skin contact either with fathers or mothers after an initial 5 minutes of skin‐to‐skin contact with the mothers after birth. The newborns’ and parents’ vocal interaction were recorded on a videotape and audiotape. The following variables were explored: newborns’ and parents’ soliciting, newborns’ crying and whining, and parental speech directed to the other parent and to the newborn.Results:  Newborns’ soliciting increased over time (p = 0.032). Both fathers and mothers in skin‐to‐skin contact communicated more vocally with the newborn than did fathers (p = 0.003) and mothers (p = 0.009) without skin‐to‐skin contact. Fathers in skin‐to‐skin contact also communicated more with the mother (p = 0.046) and performed more soliciting responses than the control fathers (p = 0.010). Infants in skin‐to‐skin contact with their fathers cried significantly less than those in skin‐to‐skin contact with their mothers (p = 0.002) and shifted to a relaxed state earlier than in skin‐to‐skin contact with mothers (p = 0.029).Conclusions:  Skin‐to‐skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin‐to‐skin contact and exposed to the parents’ speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin‐to‐skin contact after cesarean section, to support the early onset of the first vocal communication. (BIRTH 37:3 September 2010)
Advanced Maternal Age and the Risk of Cesarean Birth: A Systematic Review
Authors: Bayrampour Hamideh , Heaman Maureen 
Published: September 2010

Abstract:  Background:  The increasing pregnancy rate at advanced maternal age is contemporaneous with the increasing rate of cesarean birth. Several studies have found that advanced maternal age is a risk factor for cesarean birth. The objective of this systematic review was to assess the relationship between advanced maternal age and cesarean birth among nulliparous and multiparous women.Methods:  To identify relevant studies, we searched the literature for articles published from January 1, 1995 to March 1, 2008, using Medline, EMBASE, PsychINFO, and CINAHL. We also hand‐searched the bibliographies of retrieved articles to identify additional related studies. We included all cohort studies and all case‐control studies that examined this association in developed countries. The Cochrane Collaboration’s Review Manager software (5.0) was used to summarize the data.Results:  Twenty‐one studies met the inclusion criteria and were included in the review. All studies demonstrated an increased risk of cesarean birth among women at advanced maternal age compared with younger women, for both nulliparas and multiparas (relative risk varied from 1.39 to 2.76). Because we found extreme heterogeneity (both statistical and clinical) among the included studies, we did not provide a pooled estimate of the risk of cesarean birth.Conclusions:  All included studies illustrated an increased risk of cesarean birth among older women. Fifteen studies adjusted this association for potential confounders, which suggests that a valid and independent association is likely to exist between advanced maternal age and cesarean birth. However, the associated factors for this increased risk are not totally understood in the literature. (BIRTH 37:3 September 2010)
Behavioral Interventions for Lung Cancer‐Related Breathlessness
Authors: Gallo‐Silver Les , Pollack Barbara 
Published: September 2010

Purpose:The purpose of this report is to present behavioral interventions to assist persons with lung cancer in the management of feelings of breathlessness and, thus, also to enhance their quality of life.Overview:Breathlessness is a serious symptom that adversely affects the quality of life of persons with lung cancer. A review of the literature points to the value of exercises in assisting patients to breathe more effectively and to manage related anxiety. However, the professional literature frequently does not describe these basic interventions in enough detail to enable oncology professionals to learn them. Instructional materials, found in the popular wellness and self‐help literature, are included in this article to more easily facilitate acquisition of these skills. Interventions described include exercises that enhance the use of the diaphragm when breathing and those that help to alter the breathing rhythm and to exhale more effectively.clinical Implications:All oncology professionals should be aware of the importance of breathlessness as a problem that diminishes the quality of life for patients with lung cancer. Addressing breathlessness through the use of psychosocially oriented behavioral interventions can act as an adjunct to the medical management of this debilitating symptom.
Factors Influencing Oral Mucositis in Patients Receiving Chemotherapy
Authors: Dodd Marylin J. , Miaskowski Christine , Dibble Suzanne L. , Paul Steven M. , MacPhail Laurie , Greenspan Deborah , Shiba Gayle 
Published: September 2010

Purpose: Oral mucositis is a painful complication of chemotherapy and can greatly affect patients' morbidity and mortality. Findings from two previous studies suggested a decrease in the prevalence of chemotherapy‐induced mucositis in patients with solid tumors. The purposes of this study were to follow a large cohort of outpatients to determine the prevalence of mucositis and to identify whether certain clinical factors were significant in the development of mucositis.description of Study: In this prospective study, a convenience sample of 199 outpatients was followed for three cycles or until mucositis developed. The clinical factors monitored included the following: pretreatment dental examination/repair; initial standard chemotherapy dosage; prophylactic use of colony‐stimulating factors; and use of preventive mouthwashes or other prophylactic measures.Results: Oral mucositis developed in 50 patients (25.1%). Prechemotherapy dental examination/repair and initial standard chemotherapy dosage were equivalent among both groups. Of the 48 patients in whom mucositis developed, 10 (20.8%) received prophylactic colony‐stimulating factors. Of 134 patients in whom mucositis did not develop, 46 (34.3%) received prophylactic colony‐stimulating factors. This difference was statistically nonsignificant.clinical Implications: Differences in the clinical factors investigated could not explain the lower prevalence of oral mucositis among the current patient cohort. The reason for the diminishing prevalence of this side effect remains unclear, and additional parameters, particularly detailed oral hygiene practices, should be evaluated. In the meantime, oncology clinicians should consider the teaching of patients and urging them to use good oral hygiene practices as necessary and potentially preventive measures against chemotherapy‐induced mucositis.
Lake Superior Rural Cancer Care Project
Authors: Elliott Thomas E. , Elliott Barbara A. , Regal Ronald R. , Renier Colleen M. , Crouse Byron J. , Gangeness David E. , Witrak Martha T. , Jensen Patricia B. 
Published: September 2010

Purpose: The purpose of this article is to report the main learning outcomes of the Lake Superior Rural Cancer Care Project.Description of Study: The authors designed and tested a multimodal intervention directed at rural providers and their healthcare systems in a large rural area in the north central United States. An experimental design was used to randomize rural providers at the group level. The intervention consisted of providing increased education for rural providers with a number of approaches, including the use of clinical opinion leaders. The main outcome of the intervention was knowledge scoring on discipline‐specific cancer management tests.Results: Knowledge scores for providers in the experimental group significantly increased from pretest to post‐test: 66 to 79 for physicians (and physician assistants) (P = .02); 58 to 71 for nurses (P = .01); and 54 to 64 for pharmacists (P = .01). At post‐test, participating providers in the experimental group performed significantly better on the knowledge tests (P < .01) than those in the control groups.Clinical Implications: This study may be the first to test educational interventions to improve rural providers' knowledge about cancer practice using an experimental design. The intervention may possibly change provider practice behaviors and, thus, patient outcomes, data that will be reported in a future issue. Finally, this educational intervention may prove useful for providers in other rural areas.
Cancer and Folie à Deux.
Authors: SanjurjoHartman Teresita , Weitzner Michael A. , Santana Carlos , Devine Charles , Grendys Edward 
Published: September 2010

Purpose: This report describes the uncommon psychopathological state best known as folie à deux, or shared psychotic disorder, in a unique case in which the grandiose, religious delusions of a woman with uterine cancer are shared with her husband.Overview: More than 50% of patients with cancer meet the criteria for diagnosis of major psychiatric disorders. Certainly, these disorders may occur as a result of the stress of the cancer diagnosis and treatment, but also because of a predisposition to psychiatric illness or a pre‐existing psychiatric illness. In the medical setting, the phenomenon of folie à deux poses significant problems not only for the patient, but also for the involved family member, psychiatric consultant, and healthcare team.Clinical implications: In this case, the patient's delusional system had a grave impact on her ability to make rational healthcare decisions, for which she was deemed incompetent. The first choice for her healthcare surrogate, her husband, was so affected by his sharing of her psychotic condition that he could not fulfill this role. In assessing a suspected case of folie à deux, awareness of several issues—the point at which religious overideation becomes delusional, the spectrum of competency, informed consent, and treatment refusal—is important.
The Treatment of Prostate Cancer.
Authors: Pirtskhalaishvili Georgi , Hrebinko Ronald L. , Nelson Joel B. 
Published: September 2010

Purpose: The purpose of this report is to discuss the current treatment options available to the patient with prostate cancer in all stages of the disease.Overview: With the exception of skin cancer, prostate cancer is the most common cancer in men in the United States. Most patients in the current era will present with organ‐confined disease, amenable to curative treatment. Treatment for organ‐confined disease includes watchful waiting, radical prostatectomy, radiation therapy, and cryosurgery in selective cases. Hormone therapy is the cornerstone of treatment of patients with advanced prostate cancer. There is no curative treatment for hormone‐refractory prostate cancer.Clinical implications: The availability of several therapeutic options for localized prostate cancer warrants careful consideration when planning treatment with curative intent. Patients need to be active participants in decision making, and they must be aware of the benefits and possible complications of the different types of treatment. Patients with advanced prostate cancer need to be aware that hormone treatment will provide temporization and palliation in the majority of cases. Hormone‐resistant prostate cancer is refractory to most forms of conventional and experimental therapy.
Hemicrania Continua: A Second Case in Which the Remitting Form Evolved From the Chronic Form
Authors: Yablon Lisa A. , Newman Lawrence C. 
Published: September 2010

We report the case of a woman with a 15‐year history of chronic hemicrania continua, which over time evolved to remitting hemicrania continua. This is the second reported case in the literature documenting this transition.(Headache 2010;50:1381‐1389)
Maintenance of Sinus Rhythm after Cardioversion of Atrial Fibrillation in Patients with Lone Atrial Fibrillation and Patients with Hypertension
Authors: Carlsson Joerg , Appel Karl‐Friedrich , von Essen Rainer , Jansen Wolfgang , Miketic Sinisa , Stammwitz Ekkehard , Kettner Wolfgang , Tebbe Ulrich ,   for the ALKK‐Study Group
Published: September 2010

Background: The success rate and prognosis of cardioversion of atrial fibrillation (AF) in patients with organic heart disease is well known. In contrast, little data exist about cardioversion success and maintenance of sinus rhythm (SR) in patients with lone AF and in patients with hypertension as the only underlying cardiovascular disease.Methods: In a prospective cardioversion registry 148 of 181 patients (81.8%) with lone AF (age 58 ± 13 years, duration of AF 7.6 ± 19 weeks) and 120 of 148 patients (81.1%) with hypertension (age 62 ± 10 years, duration of AF 6.6 ± 21 weeks) had successful cardioversion and were followed for 7.7 ± 1.9 months.Results: At follow‐up, 120 patients (81.1%) with lone AF were in SR, and 18 of these patients had had repeated cardioversion during follow‐up (AF total recurrence rate 31.1%). In stepwise regression analysis, the number of previous cardioversions was predictive of rhythm at follow‐up (P = 0.0453). Rhythm at follow‐up did not differ between patients who were or were not on antiarrhythmic drugs. At follow‐up 96 patients (80%) with hypertension were in SR, and 9 of these had had repeated cardioversion during follow‐up (AF total recurrence rate 27.5%). As in lone AF, the recurrence rate of AF did not differ between patients with or without antiarrhythmic drug treatment, and in multivariate regression analysis, the number of previous cardioversions was the only clinical predictor of rhythm at follow‐up (P = 0.0284).Conclusions: Even in patients with such benign conditions as lone AF or hypertension as the only underlying disease, the prognosis of cardioversion in terms of maintenance of SR is poor. Future studies of rhythm control versus rate control need to include not only patients with organic heart disease but also patients with lone AF and patients with hypertension, since the long‐term benefits of these two strategies remain unclear even in these subsets of patients.
Atrial Ectopics Prior to Atrial Fibrillation Onset
Authors: Waktare Johan E.P. , Hnatkova Katerina , Murgatroyd Francis D. , Guo Xiaohua , Camm A. John , Malik Marek 
Published: September 2010

Background: This study examined the possible role of atrial ectopics and short runs of atrial tachycardia in the initiation of episodes of paroxysmal atrial fibrillation (PAF).Methods: Holter recordings from patients participating in pharmacotherapy trials for the prevention of PAF were examined. Treatment comprised placebo, digoxin, disopyramide, or atenolol. The frequency of atrial ectopic beats during each 30 seconds over the 5 minutes prior to PAF and whether this was also associated with atrial tachycardia (3 or more ectopics in succession) was calculated.Results: The mean number of ectopics was 4.1 in the final minute, but patients receiving disopyramide or atenolol had significantly more ectopics than those on placebo (P > 0.05 for both). Those on digoxin had a similar number of ectopics to placebo patients. There was no relationship between heart rate at PAF onset and ectopic frequency, nor any association between the presence of one or more episodes of atrial tachycardia and ectopic frequency.Conclusion: Atrial ectopics increase in frequency prior to PAF onset, and this study suggests that antiarrhythmic therapy may increase the number of ectopics required to initiate PAF.
Nonlinear Analysis of ECG in Normal Subjects and Acute Myocardial Infarction Patients
Authors: Goranitou Georgia S. , Chrissos Dimitrios N. , Harissis Haralampos V. , Kontoyianni Dimitra D. , Antonatos Panagiotis G. 
Published: September 2010

Background:In the last two decades, methods from nonlinear analysis and chaos theory have been used for the characterization of cardiac dynamics. Previous studies, mainly in the analysis of RR time series, indicated the diagnostic and prognostic value of such techniques in several pathological conditions, but also generated disputes regarding the presence of true nonlinearities in the data. The application of such methods to ECG time series analysis, in normal subjects as well as in patients with heart disease, is less investigated. The present study was undertaken to test whether nonlinear analysis of ECG can define possible changes in the complexity of cardiac dynamics in patients with acute myocardial infarction (AMI).Methods:We examined 10 normal subjects and 20 AMI patients in sinus rhythm for 3 consecutive days. Correlation dimension (D2) measurements were obtained with a combination of the SingularValue Decomposition and the Grassberger‐Procaccia methods and compared with the results from corresponding surrogate data series, in order to detect the presence of nonlinearities. The reproducibility of ECG D2 measurements was tested with the coefficient of variation.Results:No difference was found in ECG D2 between normals and patients. The surrogate data score was above two in all measurements, which indicates the presence of nonlinearities in the ECG signal. The intraindividual reproducibility of D2 measurements was moderate to good in normals and AMI patients.Conclusion:The results of this study support the hypothesis that the ECG signal is produced by a low‐dimensional dynamic system. D2 analysis of ECG is a nonlinear quantitative method with moderate to good reproducibility, but with no evident discriminating capabilities between normals and AMI patients.
Impact of Left Ventricular Remodeling on Ventricular Repolarization and Heart Rate Variability in Patients after Myocardial Infarction Treated with Primary PCI: Prospective 6 Months Follow‐up
Authors: Szydlo Krzysztof , Wita Krystian , Trusz‐Gluza Maria , Urbanczyk Dagmara , Filipecki Artur , Orszulak Witold , Tabor Zbigniew , Krauze Jolanta , Kwasniewski Wojciech , Myszor Jaroslaw , Turski Maciej , Kolasa Jaroslaw , Szczogiel Jan 
Published: September 2010

Background: The relation between postinfarction left ventricle remodeling (LVR), autonomic nervous system and repolarization process is unclear. Purpose of the study was to assess the influence of LVR on the early (QTpeak) and late (TpeakTend) repolarization periods in patients after myocardial infarction (MI) treated with primary PCI. The day‐to‐night differences of repolarization parameters and the relation between QT and heart rate variability (HRV) indices, as well left ventricle function were also assessed. Methods: The study cohort of 104 pts was examined 6 months after acute MI. HRV and QT indices (corrected to the heart rate) were obtained from the entire 24‐hour Holter recording, daytime and nighttime periods. Results: LVR was found in 33 patients (31.7%). The study groups (LVR+ vs LVR−) did not differ in age, the extent of coronary artery lesions and treatment. Left ventricle ejection fraction (LVEF) was lower (38%± 11% vs 55%± 11%, P < 0.001), both QTc (443 ± 26 ms vs 420 ± 20 ms, P < 0.001) and TpeakTendc (98 ± 11 ms vs 84 ± 12 ms, P < 0.005) were longer in LVR + patients, with no differences for QTpeakc. Trends toward lower values of time‐domain (SDRR, rMSSD) HRV parameters were found in LVR+ pts. Day‐to‐night difference was observed only for SDRR, more marked in LVR‐group. Remarkable relations between delta LVEF (6 months minus baseline), delta LVEDV and TpeakTendc were found, with no such relationships for QTpeakc. Conclusions: The patients with LVR have longer repolarization time, especially the late phase‐ TpeakTend, which represents transmural dispersion of repolarization. Its prolongation seems to be related to local attributes of myocardium and global function of the left ventricle but unrelated to the autonomic nervous influences. Remodeling with moderate LV systolic dysfunction is associated with insignificant decrease in HRV indices and preserved circadian variability.
QT Intervals and QT Dispersion Determined from a 12‐Lead 24‐Hour Holter Recording in Patients with Coronary Artery Disease and Patients with Heart Failure
Authors: Hansen Stig , Rasmussen Verner , Torp‐Pedersen Christian , Jensen Gorm Boje 
Published: September 2010

Background: QT dispersion is considered an index of spatial inhomogeneity of repolarization duration and increased dispersion of ventricular repolarization is supposed to increase the risk of ventricular arrhythmia. Circadian variation in QT dispersion was investigated. Methods: Three different modes of lead selection was used: all 12‐leads (QTdisp 12), only precordial leads (QTdisp 6), and one pair of preselected leads (QTdisp 2) in a 24‐hour Holter recording every fourth hour each comprising 10 consecutive measurements in 54 healthy subjects, 29 patients with coronary artery disease (CAD), and 29 patients with heart failure (HF). Results: A significant circadian variation was observed in healthy subjects when modes QTdisp 12 and QTdisp 6 were used (Mean ± SD 35.58 ± 16.48 ms; P < 0.0001; and 28.82 ± 16.02 ms; P < 0.0001, respectively), and in patients with CAD (Mean ± SD 37.86 ± 17.87 ms; P < 0.01; and 28.72 ± 17.06 ms; P < 0.0001, respectively), whereas no circadian variation was observed in QTdisp 2. No circadian variation was observed in patients with HF irrespectively of lead selection. Patients with CAD without myocardial infarction (MI) had a circadian variation in QTdisp 12 (Mean ± SD 33.13 ± 14.86 ms; P < 0.05), whereas no circadian variation was observed in patients with MI (Mean ± SD 40.35 ± 18.80 ms; P = NS). Conclusions: Circadian variation of QT dispersion was detected in healthy subjects and in patients with uncomplicated CAD, but not in those who had suffered a previous MI and in patients with HF. The number of leads among which selection of the longest and shortest QT intervals took place was critical for the disclosure of circadian variation of QT dispersion.