bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma guanosine3′,5′‐cyclic monophosphate and severity of peri/intraventricular haemorrhage in the preterm newborn
Authors: van Bel F , Valk L , Uiterwaal CSPM , Egberts J , Krediet TG 
Published: August 2010

A poorly controlled cerebral circulation, caused by excessive production of nitric oxide, has been suggested as predisposing to peri/intraventricular haemorrhage (PIVH) in the immature neonate. It is hypothesized that a relation exists between plasma cyclic GMP (cGMP) as an effector of endogenous vasodilatory nitric oxide production and severity of PIVH. In 83 consecutively admitted preterm neonates, nitric oxide production was assessed by measuring plasma cGMP at 0, 24, 48, 72 and 168 h of age. Simultaneously, cranial ultrasound investigations were performed and haemodynamic parameters registered. The investigations showed that 60 neonates (72%) had no PIVH; 18 neonates (22%) had mild to moderate PIVH; and 5 neonates (6%) had severe PIVH. At 48 and 72 h of age, cGMP levels of infants with severe PIVH were significantly higher than those of infants with no or only mild PIVH, whereas at 72 and at 168 h, infants with moderate PIVHs had significantly higher cyclic cGMP levels than infants without PIVH. Finally, at 168 h of age infants with mild PIVH also had higher cyclic cGMP values than those of infants without PIVH. Maximal cGMP values preceded the final extension of PIVH in moderate and severe PIVHs. Blood pressure support was necessary significantly more often in infants with moderate and severe PIVH. A logistic regression model revealed that cGMP was significantly associated with PIVH, irrespective of gestational age, mean arterial pressure or severity of infant respiratory distress syndrome. Conclusion: Increased cGMP levels are associated with the development of PIVH. It is suggested that vasodilatory nitric oxide‐induced impairment of cerebral autoregulation plays a role here.
Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin
Authors: Christmann V , Liem KD , Semmekrot BA , van de Bor M 
Published: August 2010

Vasoconstriction induced by bolus injection of indomethacin reduces organ perfusion and has been related to the well‐known side effects of indomethacin given for closure of the patent ductus arteriosus (PDA). The aim of the study was to compare the changes in cerebral, renal and mesenteric blood flow velocities after continuous infusion versus bolus injection of indomethacin for closure of the PDA. Thirty‐two preterm infants (range 26–35 wk gestational age) with PDA were randomly assigned to receive the same amount of indomethacin either as three bolus injections (n= 14) or as a continuous infusion (n= 18) over 36 h. Blood flow velocities were measured in the internal carotid, right renal and superior mesenteric arteries at baseline and serially at 10, 30, 60 and 120 min and 12, 24, 36 and 48 h after the start of indomethacin treatment. There were no differences in blood flow velocities between both groups at baseline. During continuous infusion of indomethacin there was no significant change in the cerebral, renal and mesenteric blood flow velocities, whereas the flow velocities in the infants receiving bolus injections decreased significantly during the first 2 h after indomethacin administration in all arteries measured. There was a transient, but significant reduction in urine output after bolus injection of indomethacin. Conclusion: In contrast to bolus injections, decrease of organ blood flow and impairment of urine output do not accompany continuous infusion of indomethacin over 36 h.
Late onset of right Bochdalek's hernia with strangulation of the omentum
Authors: Shimizu T , Hira S , Hirooka S , Yonekura T , Tamai H 
Published: August 2010

We report a case of bloody pleural effusion and infarction of the greater omentum caused by a non‐traumatic diaphragmatic hernia with a late presentation. A 15‐y‐old boy with Down's syndrome developed abdominal pain and vomiting, as well as an elevated serum level of C‐reactive protein. Chest roentgenograms showed a right‐sided pleural effusion and computed tomography revealed a right diaphragmatic hernia. Barium enema confirmed the diagnosis. An operation revealed a right Bochdalek's hernia with strangulation of the greater omentum in the right pleural cavity. Conclusion: Diaphragmatic hernia should be considered in patients with pleural effusion, abdominal pain and vomiting.
Preoperative cranial ultrasound findings in infants with major congenital heart disease
Authors: TE PAS ARJAN B. , VAN WEZEL‐MEIJLER GERDA , BÖKENKAMP‐GRAMANN REGINA , WALTHER FRANS J. 
Published: August 2010

AbstractBackground: Advances in diagnostic testing and surgical techniques have resulted in reduced mortality in neonates with congenital heart disease (CHD) and a major concern for neurological morbidity in the presence of preoperative neurological injury. Objectives: To determine the incidence and nature of preoperative cerebral ultrasound abnormalities in neonates with major CHD and to examine the relationship between cerebral abnormalities and the type of CHD.Methods: Retrospective study; inclusion criteria: (1) neonates with major CHD admitted to the NICU over a 3‐y period, (2) gestational age > 35 wk, (3) documented preoperative cranial ultrasound available; exclusion criteria: (1) small for gestational age, (2) other congenital anomalies and/or chromosomal abnormalities, (3) a 5‐min Apgar score < 7, (4) congenital infection. Cranial ultrasounds (CUS) were reviewed without knowledge of the cardiac defect. CHDs were categorized.Results: Fifty of 108 neonates with CHD met the inclusion criteria. Twenty‐one patients (42%) had abnormalities on CUS. Thirteen of these (26%) had widened ventricular and/or subarachnoid spaces, three (6%) lenticulostriate vasculopathy, one (2%) calcification in the basal nuclei, and four (8%) had acute ischaemic changes. Cerebral abnormalities occurred more frequendy in patients with coarctation or hypoplastic left heart syndrome (HLHS) than transposition of the great arteries (TGA) (63% vs 14%; n.s.).Conclusion: There is a high incidence of preoperative cerebral ultrasound abnormalities in this group of neonates with major CHD.
Developmental delay at 12 months in children born extremely preterm
Authors: LANDO ANE , KLAMER ANJA , JONSBO FINN , WEISS JANNE , GREISEN GORM 
Published: August 2010

AbstractAim: To evaluate the feasibility and validity of a structured telephone interview to assess the development of children born extremely preterm.Methods: The parents of 88 children born with a gestational age below 28 wk admitted to the neonatal intensive care unit (NICU) at Rigshospitalet, Copenhagen, were interviewed by telephone when their child was 1 y of age, corrected for preterm birth. A fully structured questionnaire on psychomotor function was used (Revised Prescreening Developmental Questionnaire (R‐PDQ)). The parents of 30 children born at term without complications were interviewed for comparison. The interview was conducted by NICU staff. To validate the R‐PDQ, parents of 22 children in the preterm group and parents of 19 children in the reference group conducted an Ages and Stages Questionnaire (ASQ) when their children had reached the age of 3–3 y.Results: The R‐PDQ was easy to use by staff and well accepted by parents. The mean score in the preterm group was 14.9 ± 3.9 vs 17.7 ± 2.7 in the term group (p < 0.001). Three children had developmental scores below ‐2 SD. The R‐PDQ score was associated with the ASQ score 2 y later.Conclusion: A structured questionnaire administrated by telephone is an alternative and usable tool for assessing neuro‐developmental deficit in children born extremely preterm. The mean developmental delay in the preterm group compared to the term group (about‐1 SD) was close to expectations.
Tourette syndrome and other tic disorders in a total population of children: Clinical assessment and background
Authors: KHALIFA NAJAH , VON KNORRING ANNE‐LIIS 
Published: August 2010

AbstractAim: To describe the symptoms, onset, heredity, pre‐/perinatal events and socio‐economic status in Tourette syndrome (TS) and other tic disorders.Methods: From a total population of 4479 children, 25 (0.6%) with TS, 58 (1.3%) with chronic motor/vocal tics (CMVT) and 214 (4.8%) with transient tics (TT) in the last year were found. A three‐stage procedure was used: tic screening, telephone interview and clinical assessment. The TS group was compared with 25 children with TT and 25 controls without tics.Results: The mean age of the first symptoms of TS was significantly lower than the onset of CMVT. All except one with TS had contact with medical services. The tics of children with TS were significantly more severe than the tics of others. Younger age of onset of TS indicated more severe tics. Parents and siblings of children with TS had an increased prevalence of tic disorders, obsessive‐compulsive behaviour (OCD), attention‐deficit/hyperactivity disorder (ADHD) and depression. Eighty per cent had a first‐degree relative with a psychiatric disorder. A non‐significant increase with regards to reduced optimality score in the pre‐, peri‐ or neonatal periods was found in children with TS compared to controls. No differences were found concerning socio‐economic status.Conclusion: Almost all children from a total population with TS have sought help from medical services. An increased prevalence of tics, OCD, depression or ADHD was found in the parents/siblings of children with TS, which draws attention to the importance of thorough investigation of family members.
Sphingosine 1‐phosphate in neural signalling and function
Authors: Milstien Sheldon , Gude David , Spiegel Sarah 
Published: August 2010

AbstractComplex sphingolipids are particularly enriched in the central nervous system. Although they were long considered to be structural components of membranes, in the last decades it has become apparent that they have other important functions. More recently, attention has been given to the sphingolipid metabolites ceramide, sphingosine and sphingosine 1‐phosphate (S1P), which have been implicated in the regulation of many aspects of neuronal proliferation, differentiation, survival and apoptosis. Dysregulation of the relative levels of these bioactive sphingolipid metabolites may have implications for a wide array of neurodegenerative disorders and neural malformations. In this paper, we will focus on studies from our laboratory over the past few years using cultured neurons to examine the roles of the sphingolipid metabolite S1P in neuronal survival and differentiation.Conclusion: Identification of potential intracellular targets of S1P remains a crucial objective for attaining a better understanding of the potent role this molecule plays in regulating cell fate.
Vascular effects of sphingolipids
Authors: Michel Martin C , Mulders Arthur CM , Jongsma Maikel , Alewijnse Astrid E , Peters Stephan LM 
Published: August 2010

AbstractThe sphingomyelin metabolites ceramide, sphingosine 1‐phosphate (S1P) and sphingosylphosphorylcholine (SPC) are emerging modulators of vascular tone. While ceramide appears to act primarily intracellularly, S1P and SPC appear to mainly work via specific receptors, although those for SPC have not yet been defined unequivocally. Each of the sphingomyelin metabolites can induce both vasoconstriction and vasodilatation and, in some cases – ceramide on the one hand, and S1P and SPC on the other hand – have opposite effects on vascular tone. The differences in effects between vessels may relate to the relative roles of endothelial and smooth muscle cells in mediating them, as well as to the distinct expression patterns of S1P receptors among vascular beds and among endothelial and smooth muscle cells. Recent evidence suggests that vascular tone is not only modulated by sphingomyelin metabolites which are exogenously added or reach the vessel wall via the bloodstream but also by those formed locally by cells in the vessel wall. Such local formation can be induced by known vasoactive agents such as angiotensin II and may serve a signalling function.Conclusion: We conclude that sphingomyelin metabolites are important endogenous modulators of vascular function, which may contribute to the pathophysiology of some diseases and be targets for therapeutic interventions.
Optimization of concomitant medication in Fabry cardiomyopathy
Authors: Close Lydia , Elliott Perry 
Published: August 2010

AbstractWe describe a male patient with Fabry disease and use this case study to illustrate the importance of a detailed cardiovascular evaluation and the role of supportive therapy in routine management of the disease. The major areas of discussion include the management of exertional chest pain, progressive heart failure and the diagnosis and treatment of atrial and ventricular arrhythmia.Conclusion: In the era of enzyme replacement therapy, conventional pharmacological and device‐based therapies remain central to the management of cardiovascular symptoms and the prevention of complications, such as arrhythmia and stroke.
Reduced basal salivary cortisol in children with asthma and allergic rhinitis
Authors: Bakkeheim E , Mowinckel P , Carlsen KH , Burney P , Lødrup Carlsen KC 
Published: August 2010

AbstractAim:  Reduced basal cortisol is reported in allergic disease. We investigated if basal salivary cortisol levels were reduced in children with asthma or allergic rhinitis, controlling for inhaled corticosteroids (ICS) use.Methods:  Morning and evening saliva of asthmatic children aged 7–12 years (n = 50) and that of controls (n = 52) were sampled. A total of 19 asthmatics and four controls had allergic rhinitis. Healthy children were controls without rhinitis. Of all, 14 asthmatic children used low, and 12 used moderate or high doses of ICS. Cortisol was analysed by radioimmunoassay.Results:  Morning salivary cortisol median (95% CI) was lower in asthmatics (8.7 (7.1, 9.7)) compared with that in controls (10.4 (9.6, 11.8); p = 0.006), which was similar for evening cortisol levels. Regression analyses demonstrated that asthmatics using moderate or high doses of ICS had reduced morning salivary cortisol adjusted (for age and gender) odds ratio (aOR) (95% CI) (0.54 (0.37, 0.80); p = 0.002) and reduced evening cortisol aOR (0.09 (0.01, 0.6); p = 0.02) compared with that in healthy children. Asthmatics with rhinitis on no or low doses of ICS had reduced morning cortisol aOR (0.73 (0.56, 0.96); p = 0.02) compared with that in healthy children.Conclusion:  Asthmatic children on moderate or high doses of inhaled corticosteroids had reduced salivary cortisol, but co‐morbidity of asthma and rhinitis was also associated with reduced cortisol levels.
Are we getting the best from breastfeeding?
Authors: Walshaw C Anne 
Published: August 2010

AbstractDifferent breastfeeding methods (traditional/scheduled, demand or baby‐led) influence lactation physiology by either supporting or interfering with the let‐down reflex, by an autocrine effect in the breast, and indirectly via infant appetite. Postnatal breast morphological changes and neonatal osmoregulation are also susceptible to breastfeeding method. Feed length is important: short feeds from both breasts (employed in traditional methods) optimize breast morphological changes and neonatal osmoregulation, condition the let‐down reflex, limit autocrine inhibition, stimulate the infant’s appetite and are associated with a plentiful supply of milk. However, the limited evidence available on prolonged feeds and those from only one breast (both often seen with the baby‐led method), suggests interference with lactation because of a compromised let‐down reflex and autocrine inhibition, resulting in a reduced milk supply.Conclusion: Regular short feeds from both breasts encourage a plentiful milk supply and successful breastfeeding: these are best reflected by a modified traditional breastfeeding method.
Nurse Practitioners: A Comparison of Rural‐Urban Practice Patterns and Willingness to Serve in Underserved Areas
Authors: Martin Kenneth E. 
Published: August 2010

PURPOSETo determine nurse practitioners' (NPs) practice patterns and willingness to practice in underserved areas in both rural and urban settings in a largely rural state.DATA SOURCESA census of all NPs holding a Pennsylvania license and providing addresses in Pennsylvania or one of the contiguous states was conducted in 1996. The ZIP codes of practice sites were matched with 1990 census data.CONCLUSIONSNurse practitioners in rural areas are more likely than their urban counterparts to provide primary care in primary care practice settings, they see more patients per week, and they are more likely to be the principal provider of care for a higher percentage of their patients. Experience with managed care contracts is greater for urban NP's as is their willingness to practice in urban underserved areas. Rural NP's were more willing to practice in rural underserved areas than their urban counterparts.IMPLICATIONS FOR PRACTICEAccess to primary care continues to be a concern in rural areas. The increasing market penetration of managed care and the deficit of primary care providers in rural environments may lead to increased opportunities for NPs in the rural health care delivery system.
Ohio APNs: Lead Poisoning Knowledge and Practices
Authors: Choate Devan W. , Polivka Barbara J. 
Published: August 2010

PURPOSETo determine lead poisoning knowledge and practices of Ohio's advanced practice nurses (APNs).DATA SOURCESOriginal research conducted by mailed survey sent to all APNs registered in Ohio (N= 1448). The response rate was 72%. APNs from nine specialties and 70% of counties responded.CONCLUSIONSRespondents correctly answered approximately 80% of the questions. Knowledge gaps in primary prevention strategies were noted. Of APNs serving pregnant women and/or children <6 years, 57% screen for lead poisoning and 16% report no one provides lead education.IMPLICATIONS FOR PRACTICELead poisoning is a preventable health problem. Education of APN students and preceptors needed in the areas of primary lead poisoning prevention issues and practice protocols. Results from this study can help focus educational efforts and outreach programs.
Training of Nurse Practitioners and Physician Assistants to Perform Screening Flexible Sigmoidoscopy
Authors: Horton Kimberlee , Reffel Angela , Rosen Karen , Farraye Francis A. 
Published: August 2010

PurposeTo describe the colorectal cancer‐screening program at Harvard Vanguard Medical Associates, a large multispecialty medical group, in which nurse practitioners (NPs) and physician assistants (PAs) perform screening flexible sigmoidoscopies.Data SourcesScientific literature, consensus statements and guidelines, and the protocol utilized to train NPs and PAs to perform flexible sigmoi‐doscopy. Data from 9,500 screening proce‐dures are presented.ConclusionsIn comparison with gastroenterologists, trained NP and PA endoscopists perform screening flexible sigmoidoscopy with similar accuracy and safety but at lower cost.Implications for PracticeScreening flexible sigmoidoscopy performed by NPs and PAs may increase the availability and lower the cost of flexible sigmoidoscopy for colorectal cancer screening.
Men And Family Planning: What Is Their Future Role?
Authors: Fortunati Lorraine Neeley , Floerchinger‐Franks Ginger 
Published: August 2010

PurposeTo describe men's desired involvement in family planning and to determine the services desired by potential male clients.Data SourcesUsing a self‐administered questionnaire, this study surveyed male partners of family planning clients and men attending sexually transmitted disease (STD) clinics at an urban health department. Perceived health concerns, contraceptive attitudes and practices, and desired involvement in family planning currently and in the future were targeted.ConclusionsRespondents reported desiring involvement in family planning decisions, although reported behaviors often conflicted with this desire. Routine physical examinations and receipt of health information were perceived to be important, while “male only” clinics were not. Respondents were willing to attend partners' family planning appointments if asked and were willing to help pay for the chosen contraceptive. Provision of vasectomy services was perceived as important. Prevention of cancer, STDs, and impotence were the three highest health concerns reported.Implications for PracticeMen want to be partners in family planning and will access services if available. Current political and social policies are demanding more personal responsibility for the outcome of unintended pregnancies. In response to political and social demands, Title X family planning clinics are refocusing services to include men.
Beyond Sexual Assessment: Lessons Learned from Couples Post Radical Prostatectomy
Authors: Monturo Cheryl A. , Rogers Patricia D. , Coleman Meghan , Robinson Joanne P. , Pickett Mary 
Published: August 2010

PurposeTo share selected experiences of advanced practice nurses (APNs) who implemented a home‐based nursing protocol related to psychosexual function for couples following radical surgery for prostate cancer.Data SourcesSelected research‐based articles, the PLISSIT Model for sexual rehabilitation counseling, and the authors' experiences.ConclusionsFive lessons related to communicating about sexuality and intimacy were synthesized from the experience, including examining knowledge and selfawareness regularly, using a structured interview guide to facilitate the process, developing a trusting relationship with the couple, attending to verbal and nonverbal cues, and providing information about the full range of sexual expression.Implications for PracticeInclude an assessment of sexual health as an integral part of a general health assessment. Patients do not generally volunteer information about their sexual concerns unless the subject is introduced by the APN.
The Effect of Age, Gender, Risk Level and Glycosylated Hemoglobin in Predicting Foot Amputation in HMO Patients with Diabetes
Authors: Watts Sharon A. , Daly Barbara , Anthony Mary , McDonald Patricia , Khoury Allan , Dahar Wendy 
Published: August 2010

PurposeTo determine if age, gender, risk level and glucosylated hemoglobin could predict foot amputations in HMO patients with diabetes.Data SourcesA retrospective chart review of a non‐random sample of 27 patients with amputation and 110 randomly selected patients without amputation during the same time period. Chi‐square, t‐tests and logistic regression were used to analyze the data.ConclusionsThere was no significant difference between the group with amputation and those without amputation in age or gender. However, there was a significant difference between the two groups in the risk stratification (p=.005) and glycosylated hemoglobin levels (p=.058).Implications for PracticeNurse practitioners can effectively screen for amputation risk factors and closely monitor glycosylated hemoglobin levels of diabetic patients to reduce the incidence of vascular complications and related lower extremity amputation.
Chronic Obstructive Pulmonary Disease
Authors: Goolsby Mary Jo 
Published: August 2010

Each month the Journal of the American Academy of Nurse Practitioners' clinical practice guideline (CPG) column reviews a different set of clinical recommendations. It is important that those in practice be aware of guidelines applicable to the needs of their patients and judge the available guidelines. This month, the CPG addresses the fourth major cause of morbidity and mortality in the United States: COPD. This article addresses the need to identify persons at risk in order to minimize avoidable risk factors, as well as how to diagnose and manage the various stages of the disease.Readers are encouraged to suggest specific CPGs for future columns or to request that the editor search for and summarize a CPG addressing a common health problem. Readers are also invited to submit a manuscript reviewing CPGs that they find helpful in their area of practice.