bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Treatment of a Canine Intranasal Meningoencephalocele
Authors: MARTLÉ VALENTINE A. , CAEMAERT JACQUES , TSHAMALA MULENDA , VAN SOENS IRIS , BHATTI SOFIE F. M. , GIELEN INGRID , PIRON KOEN , CHIERS KOEN , TIEMESSEN ILSE , VAN HAM LUC M. 
Published: June 2009

Objective—To report the clinical signs, diagnosis, and surgical treatment of an intranasal meningoencephalocele in a dog.Study Design—Case report.Animal—Female Border collie, 5 months old.Methods—A right intranasal meningoencephalocele was identified by computed tomography and magnetic resonance imaging.Results—The lesion was approached by a modified transfrontal craniotomy. Surgical closure of the defect at the level of the cribriform plate and removal of extruded brain tissue resulted in regression of lacrimation and coincided with absence of seizuring. Treatment with phenobarbital was gradually reduced and stopped at 7 months after surgery. At 28 months the dog remained free of seizures.Conclusion—Meningoencephalocele, although rare, can cause seizures in dogs and can be treated surgically.Clinical Relevance—A transfrontal craniotomy with excision of the meningoencephalocele and closure of the defect can be an effective treatment for an intranasal meningoencephalocele in dogs.
Video‐Assisted Left Partial Arytenoidectomy by Diode Laser Photoablation for Treatment of Canine Laryngeal Paralysis
Authors: OLIVIERI MASSIMO , VOGHERA SIMONA G. , FOSSUM THERESA. W. 
Published: June 2009

Objectives—To evaluate the clinical outcome of left partial arytenoidectomy by video‐assisted laser diode photoablation as a surgical treatment for canine laryngeal paralysis (LP).Study Design—Case series.Animals—Dogs with bilateral LP (n=20).Methods—After endoscopic diagnosis of bilateral LP, left partial arytenoidectomy was performed by photoablation of arytenoid cartilage tissue using a diode laser (600 μm diameter, 15 W power, 980 nm wave length) to increase the width of the rima glottidis. Outcome was evaluated endoscopically (1 and 6 months) and clinically (1, 6, and 12 months).Results—No substantial complications occurred during photoablation or in the immediate postoperative period. Postoperative width of the rima glottidis ranged from 6 to 10 mm at its widest aspect. At 1 month, respiratory function after walking and short running appeared good. Clinical and endoscopic examination revealed good outcome at 1 and 6 months. At 6 months, there was no evidence of hypertrophic scar, hypertrophic granulation tissue, or stricture of the laryngeal glottis in any dog. Two dogs developed aspiration pneumonia after 12 months.Conclusions—Partial arytenoidectomy using video‐assisted diode laser photoablation appears to be an effective technique for treating LP.Clinical Relevance—Partial arytenoidectomy by diode laser photoablation should be considered as an alternative technique for treatment of canine LP.
Arytenoid Lateralization for Treatment of Laryngeal Paralysis in 10 Cats
Authors: HARDIE ROBERT J. , GUNBY JESSICA , BJORLING DALE E. 
Published: June 2009

Objective—To describe the signalment, history, clinical signs, surgical technique, and outcome for cats with laryngeal paralysis that had arytenoid lateralization.Study Design—Case series.Animals—Cats with laryngeal paralysis (n=10).Methods—Medical records (1996–2002) for cats with laryngeal paralysis that had arytenoid lateralization were reviewed for signalment, history, clinical signs, degree of paralysis, cause, concurrent medical conditions, surgical technique, and outcome. Follow‐up information was obtained from owners or referring veterinarians.Results—Of 10 cats, 9 had bilateral and 1 had unilateral laryngeal paralysis. Arytenoid lateralization were unilateral (n=7), bilateral (1), and staged bilateral procedures (2), 10 days and 3 years apart, respectively. Postoperatively, 1 cat had persistent inspiratory noise because of minimal enlargement of the rima glottidis and 2 cats required a temporary tracheostomy for management of laryngeal swelling. Three cats developed aspiration pneumonia and died 4, 7, and 150 days after surgery; all 3 had bilateral (simultaneous or staged) procedures. Of the 7 remaining cats, 4 were alive at follow‐up and 3 had died of causes unrelated to arytenoid lateralization. The calculated mean survival time for all 10 cats was 406 days (median, 150 days; range, 4–1825 days).Conclusions—Arytenoid lateralization was effective at enlarging the rima glottidis and reducing signs of airway obstruction in most cats.Clinical Relevance—Unilateral arytenoid lateralization is a feasible option for the surgical management of cats with marked clinical signs; however, bilateral procedures should be avoided or at least performed with considerable caution because of the apparent risk for aspiration pneumonia.
Synovial Hemangioma in a Dog
Authors: ARIAS J. IGNACIO , TORRES CRISTIAN , SAEZ DANIEL 
Published: June 2009

Objective— To report arthroscopic diagnosis and treatment of synovial hemangioma in a dog.Study Design— Case report.Animal— Standard Poodle (8‐year‐old neutered male).Methods— A soft tissue density mass observed radiographically in the left stifle joint of a dog with a 2‐month history of recurrent lameness, hemarthrosis, and a slight cranial drawer sign, was located by diagnostic arthroscopy and surgically excised via arthrotomy.Results— Histologic evaluation revealed tissue composed of variably sized cavernous vascular spaces filled with erythrocytes that were considered compatible with synovial hemangioma.Conclusions— In this dog, synovial hemangioma evident as a soft tissue mass on radiographs was associated with chronic lameness and hemarthrosis, and resolved with surgical excision.Clinical Relevance— Synovial hemangioma, although seemingly rare in dogs, should be considered in the differential diagnosis for nontraumatic, recurrent lameness, and unresponsive to anti‐inflammatory therapy when there is a circumscribed intracapsular soft tissue mass evident radiographically together with hemarthrosis.
Safe and Rapid Isolation of Pulmonary Veins Using a Novel Circular Ablation Catheter and Duty‐Cycled RF Generator
Authors: FREDERSDORF SABINE , WEBER STEFAN , JILEK CLEMENS , HEINICKE NORBERT , VON BARY CHRISTIAN , JUNGBAUER CARSTEN , RIEGGER GÜNTER A. , HAMER OKKA W. , JERON ANDREAS 
Published: June 2009

Background: Ablation of atrial fibrillation (AF) has been one of the most difficult and time‐consuming electrophysiological procedures. Due to the rapidly increasing demand for ablation procedures, technical advances would be helpful to reduce complexity and procedure time in AF ablation. Therefore, we investigated the feasibility of a single‐catheter technique for pulmonary vein (PV) isolation utilizing a decapolar catheter combined with a duty‐cycled, unipolar–bipolar radiofrequency (RF) generator.
Methods: AF mapping and ablation was performed in 21 consecutive patients (mean age 59 ± 12 years, 9 males) with paroxysmal AF (n = 17) and persistent AF (n = 4). The ablation catheter was forwarded to the LA via single‐transseptal puncture. All electrodes were energized in 2 to 5 applications per vein, followed by segmental RF applications, as needed, to achieve electrical isolation. To assess left atrial anatomy for purposes of catheter manipulation, and later evaluate the possibility of asymptomatic PV‐stenosis, CT or MR imaging was performed both prior to ablation and at 6‐month follow‐up.
Results: Isolation could be achieved in 85/86 veins (99%). Procedure time for ablation was 81 ± 13 minutes, and fluoroscopy time was 30 ± 11 minutes. There were no procedural complications. Success rate at 6 months was 86% (18/21). MR or CT imaging excluded asymptomatic PV‐stenosis.
Conclusion: Mapping and ablation of PVs can be performed in a safe and efficient manner using a single‐catheter technique, with short procedure times and minimal learning curve. Thus, this system may be of high interest not only for high volume but all centers performing AF ablation.
Characterization of In Vitro and In Vivo Lesions Made by a Novel Multichannel Ablation Generator and a Circumlinear Decapolar Ablation Catheter
Authors: WIJFFELS MAURITS C.E.F. , VAN OOSTERHOUT MATTHIJS , BOERSMA LUCAS V.A. , WERNETH RANDY , KUNIS CHRIS , HU BETTY , BEEKMAN JET D.M. , VOS MARC A. 
Published: June 2009

Introduction: The aim of this study is to characterize ablation lesions using varying ratios of bipolar:unipolar energy and to show the feasibility of a circular decapolar pulmonary vein ablation catheter (PVAC™) to create transmural lesions in an in vivo porcine superior vena cava (SVC) model.
Methods and Results: Ablations were performed on (1) isolated blocks of bovine myocardium, (2) thigh muscle preparations (4 pigs), and (3) the junction between SVC and right atrium (6 pigs). Radiofrequency (RF) energy was delivered simultaneously to all electrodes (target temperature 60°C, maximum power 10 W/electrode) with various ratios of bipolar:unipolar energy. (1) In vitro PVAC™ resulted in circumscript lesions. Changing RF energy mode from unipolar only to bipolar:unipolar 1:1, 2:1 and 4:1 and bipolar only decreased lesion depth significantly (6.7 ± 0.2 vs. 5.0 ± 0.2, 4.1 ± 0.3, 3.6 ± 0.1 and 3.1 ± 0.1 mm, P < 0.001). (2) Similar results were obtained in vivo (thigh muscle) showing less deep lesions with more bipolar energy modes (e.g., 5.4 ± 1.3 for unipolar only vs. 4.1 ± 0.8 mm for bipolar only, P < 0.05). (3) Ablation at the SVC did not result in device‐related complications. All animals survived and were sacrificed after 7 ± 1 days except for one pig, which died immediately postoperatively from an unknown cause. Macroscopy and microscopy showed circumferential transmural SVC lesions.
Conclusions: Temperature‐controlled, power‐limited RF energy with the PVAC™ is feasible for creating circumferential transmural lesions (SVC) that sometimes extended to neighboring structures. Lesion depth can be titrated by varying the bipolar:unipolar energy ratio. This novel ablation system paves the way for single‐catheter ablation of AF.
Rationale and Design for the Defibrillators to Reduce Risk by Magnetic Resonance Imaging Evaluation (DETERMINE) Trial
Authors: KADISH ALAN H. , BELLO DAVID , FINN J. PAUL , BONOW ROBERT O. , SCHAECHTER ANDI , SUBACIUS HARIS , ALBERT CHRISTINE , DAUBERT JAMES P. , FONSECA CARISSA G. , GOLDBERGER JEFFREY J. 
Published: June 2009

Background: Cardiac magnetic resonance imaging (CMR) can accurately determine infarct size. Prior studies using indirect methods and CMR to assess infarct size have shown that patients with larger myocardial infarctions have worse prognoses. Implantable cardioverter defibrillators (ICD) have been shown to improve survival among patients with severe left ventricular (LV) dysfunction. However, the majority of cardiac arrests occur in patients with higher ejection fractions.
Methods: The Defibrillators To Reduce Risk By Magnetic Resonance Imaging Evaluation study (DETERMINE) is a prospective, multicenter, randomized, clinical trial in patients with coronary artery disease (CAD) and mild‐to‐moderate LV dysfunction. The purpose of this trial is to test the hypothesis that patients with an infarct size ≥10% of LV mass, randomized to ICD plus appropriate medical therapy will have improved survival compared with patients randomized to medical therapy alone. Cine and myocardial delayed contrast CMR will be performed in patients with CAD. The primary endpoint will be death from any cause. At least 10,000 patients with CAD will undergo CMR. The target enrollment is 1,550 patients with an estimated 36‐month enrollment period. The patients will be followed up for 24 months after the last patient randomization. During the follow‐up period, 330 deaths are estimated to occur. This study is powered to detect a 28% reduction in mortality by ICD therapy.
Conclusion: The DETERMINE trial will assess the efficacy of ICD therapy to improve survival among patients with CAD, mild‐to‐moderate LV dysfunction, and infarct size ≥10% of LV mass as measured by CMR.
Does Left Atrial Volume and Pulmonary Venous Anatomy Predict the Outcome of Catheter Ablation of Atrial Fibrillation?
Authors: HOF IRENE , CHILUKURI KARUNA , ARBAB‐ZADEH ARMIN , SCHERR DANIEL , DALAL DARSHAN , NAZARIAN SAMAN , HENRIKSON CHARLES , SPRAGG DAVID , BERGER RONALD , MARINE JOSEPH , CALKINS HUGH 
Published: June 2009

Introduction: Preprocedural factors may be helpful in selecting patients with atrial fibrillation (AF) for treatment with catheter ablation and in making an assumption regarding their prognosis. The aims of this study were to investigate whether left atrial (LA) volume and pulmonary venous (PV) anatomy, evaluated by computed tomography (CT) prior to ablation, will predict AF recurrence following catheter ablation.
Methods and Results: We included 146 patients (mean age 57 ± 11 years, 83% male) with symptomatic AF (55% paroxysmal, 18% persistent, 27% long‐standing persistent). All patients underwent CT scanning prior to catheter ablation to evaluate LA volume and PV anatomy. Circumferential PV isolation was performed guided by Cartomerge electroanatomical mapping. The outcome was defined as complete success, improvement, or failure. After a mean follow‐up of 19 ±7 months, complete success was achieved in 59 patients (40%), and 38 patients (26%) demonstrated improvement. LA volume was found to be an independent predictor of AF recurrence with an adjusted OR of 1.14 for every 10‐mL increase in volume (95% CI 1.00–1.29, P = 0.047). PV variations were equally distributed among the different outcomes of the ablation procedure, and therefore univariate analysis did not identify PV anatomy as a predictor of outcome.
Conclusion: LA volume is an independent predictor of AF recurrence after catheter ablation. Additionally, PV anatomy did not have any effect on the outcome. These findings suggest that an assessment of LA volume may be incorporated into the preprocedural evaluation of patients being considered for AF ablation.
Pacing Threshold Testing Induced Ventricular Fibrillation Following Acute Rate Control of Atrial Fibrillation
Authors: DAY GEOFFREY A. , PADANILAM BENZY J. , FOGEL RICHARD I. , PRYSTOWSKY ERIC N. 
Published: June 2009

Background: A properly placed stimulus on the T‐wave during ventricular repolarization can result in ventricular fibrillation (VF). Initiation of VF with pacing on T‐wave is a rare event with a few reported cases in the literature. We present a unique case of induced VF attributed to a pacing stimulus on T‐wave during ventricular pacing threshold testing of a permanent pacemaker.
Case Report: A 64‐year‐old woman with persistent atrial fibrillation (AF) and a permanent pacemaker for tachycardia–bradycardia syndrome presented with symptomatic AF with rapid ventricular response. Acute rate control was achieved with intravenous diltiazem. During ventricular pacing threshold testing, noncapture occurred followed by a pacing spike on T‐wave initiating VF. Cardiopulmonary resuscitation and defibrillation converted the rhythm to rate‐controlled AF. An acute prolongation of the QT was noted and normalized within 12 hours. No antiarrhythmic medications were used. Postevent laboratory values were within normal limits. She was free of ischemia and an echocardiogram revealed normal left ventricular function. She recovered from the event and was discharged with rate‐controlled AF. No further pacing‐induced arrhythmias have occurred during follow‐up pacemaker interrogation and 12‐lead electrocardiograms continued to show normal QT intervals.
Conclusion: Pacemaker‐induced VF is an extraordinarily rare complication of cardiac pacing. Alterations in ventricular repolarization with rapid slowing of the heart rate demonstrated by acute prolongation of QT intervals may play a role. This report should alert physicians to the possibility of QT prolongation and an increased risk of ventricular arrhythmias following acute rate control of AF.
Sleep, Hunger, Satiety, Food Cravings, and Caloric Intake in Adolescents
Authors: Landis Andrea M. , Parker Kathy P. , Dunbar Sandra B. 
Published: June 2009

AbstractBackground and Purpose:Prevalence of adolescent obesity has increased worldwide. Although diet and exercise patterns are major determinants of weight, recent studies with adults and children have shown that total amount of sleep is inversely associated with body mass index (BMI). The purpose of this study was to examine associations among total sleep time (TST), hunger, satiety, food cravings, and caloric intake in a sample of healthy adolescents.Design‐Methods:Participants were recruited from the community and a local high school. Demographic data such as sleeping habits, pubertal status, food cravings, caloric intake, physical activity, height, and weight were collected between October 2006 and April 2007. Participants also completed a 7‐day sleep‐hunger‐satiety diary. Descriptive and parametric procedures were used for data analyses (α=.05).Findings:The sample (N=85) included 56% females (n=48), 76% African American (n=65) adolescents. Mean age was 15.6±1.4 years and mean BMI was 24.3±5.4 kg/m2. Mean reported 7‐day cumulative nocturnal sleep was 52.9 (±6.0) hours; mean reported cumulative daytime sleep (or napping) was 3.7 (±3.4) hours. Multiple regression analyses showed age, gender, and race were associated with feelings of hunger, satiety, total food cravings and caloric intake. A greater total food‐cravings score was associated with increased daytime sleep.Conclusions:These findings indicate an unexpected association between increased daytime sleep and eating behaviors that potentially lead to obesity. Longitudinal studies using objective measures of sleep, appetite regulation, and caloric intake are needed to better understand relationships between appetite and sleep in adolescents from varying racial and gender groups.Clinical Relevance:By carefully considering adolescent sleep (especially daytime sleep), race, and gender, clinicians and school health nurses in the US and other countries are in a unique position to develop novel approaches to prevent and reduce obesity.
ICU Nurses’ Oral‐Care Practices and the Current Best Evidence
Authors: Ganz Freda DeKeyser , Fink Naomi Farkash , Raanan Ofra , Asher Miriam , Bruttin Madeline , Nun Maureen Ben , Benbinishty Julie 
Published: June 2009

Abstract Purpose: The purpose of this study was to describe the oral‐care practices of ICU nurses, to compare those practices with current evidence‐based practice, and to determine if the use of evidence‐based practice was associated with personal demographic or professional characteristics. Design: A national survey of oral‐care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004–05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral‐care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. Findings: The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients’ teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67±27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence‐based protocol and demographic and professional characteristics or with the priority given to oral care. Conclusions: While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all ICU nurses to introduce and use evidence‐based, oral‐care protocols. Clinical Relevance: Practicing ICU nurses in this survey were often not adhering to the latest evidence‐based practice and therefore need to be educated and encouraged to do so in order to improve patient care.
Hmong American Women Living With Diabetes
Authors: Yang Avonne , Xiong Dal , Vang Eslee , Pharris Margaret Dexheimer 
Published: June 2009

Abstract Purpose: To understand how to better care for Hmong women with diabetes using nursing theory praxis. Design: Qualitative phenomenologic design, specifically community‐based collaborative action research based on Margaret Newman's theory of health as expanding consciousness (HEC). Methods: Five Hmong women with Type 2 diabetes and HgbA1c levels over 7.0 were recruited from a community‐health clinic. Audiotaped in‐home interviews were conducted and data were analyzed to identify common patterns and then developed into a play by the research team with the help of a female Hmong playwright. Community dialogue about the findings generated meaningful actions for health. Conclusions: This study indicates the value of nursing praxis rooted in the theory of health as expanding consciousness and the importance of engaging communities to identify meaningful patterns of health and needed actions. Clinical Relevance: Evidence‐based practice is lacking in the care of Hmong women with diabetes. Community‐based collaborative action research rooted in the HEC perspective is a new way to envision models of care.
Patients’ Adherence to Anti‐Retroviral Therapy in Botswana
Authors: Kip Esther , Ehlers Valerie J. , Van Der Wal Dirk M. 
Published: June 2009

Abstract Purpose: To identify factors influencing patients’ anti‐retroviral therapy (ART) adherence at four clinics in Botswana. Design: Quantitative descriptive. Structured interviews were conducted with a random sample of 400 patients out of the population of all patients attending the four randomly selected ART clinics in Botswana during April and May 2007. Methods: Data were analysed using SPSS version 13. Chi‐square and p‐value calculations were done to test significance of the relationships between categories or variables. Findings: Patient‐centred barriers to ART adherence included inadequate knowledge about ART, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), CD4 cell and viral‐load results, stigma, travelling costs, waiting times at clinics, side effects of ART, use of traditional (indigenous or folk) medicines, and abuse of alcohol. Service‐centred barriers included nurses’ attitudes and knowledge, health workers’ inability to conduct home visits and to contact defaulters, limited clinic hours, delays in getting CD4 and viral‐load results. Conclusions: ART adherence requires more than free ART. Adherence levels will improve if both patient‐centred and service‐centred barriers are addressed. Clinical Relevance: Nurses play key roles in educating patients about ART adherence and side effects, but they should also educate patients about CD4 and viral‐load test results and about the dangers of using traditional medicines and alcohol with ART. Shorter waiting times at clinics could make ART patients’ lives more manageable.