bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of moxifloxacin in uncomplicated pelvic inflammatory disease: the MONALISA study
Authors: Judlin P , Liao Q , Liu Z , Reimnitz P , Hampel B , Arvis P 
Published: August 2010

Please cite this paper as: Judlin P, Liao Q, Liu Z, Reimnitz P, Hampel B, Arvis P. Efficacy and safety of moxifloxacin in uncomplicated pelvic inflammatory disease: the MONALISA study. BJOG 2010;117:1475–1484.Objective  To evaluate the efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole in uncomplicated pelvic inflammatory disease (uPID) in Asia.Design  Prospective, randomised, double‐blind, double‐dummy, parallel‐group study.Setting  Multicentre, multinational study in the inpatient and/or outpatient setting.Population  Women (aged ≥18 years) with uPID (defined as PID with no pelvic or tubo‐ovarian abscess on pelvic ultrasonography and at laparoscopic examination) and not requiring intravenous treatment.Methods  Women received a 14‐day course of either oral moxifloxacin, 400 mg once daily, or oral levofloxacin, 500 mg once daily, plus oral metronidazole, 500 mg twice daily. Additionally, a single dose of ceftriaxone, 250 mg intramuscularly, was administered to women who had a positive screening test for Neisseria gonorrhoeae.Main outcome measures  The primary measure of efficacy was clinical response at test‐of‐cure (TOC) (7–14 days after the last dose of study drug) in the per‐protocol population. Noninferiority of moxifloxacin to the comparator regimen was demonstrated if lower limit of 95% CI was >−15%. Other measures were clinical response during therapy and at 4‐week follow up, microbiological response at TOC, and safety.Results  A total of 460 women were randomised to the study. For the primary measure of efficacy (clinical cure at TOC), moxifloxacin was noninferior to levofloxacin plus metronidazole (moxifloxacin: 152/194, 78.4%; comparator 155/190, 81.6%; 95% CI −10.7 to +4.9). The most commonly isolated pathogens at baseline included Neisseria gonorrhoeae, Chlamydia trachomatis, Escherichia coli, Staphylococcus aureus, Peptostreptococcus spp., Proteus mirabilis, Streptococcus agalactiae and Klebsiella pneumoniae. Bacteriological success rates were high and comparable between treatment arms (microbiologically valid populations, moxifloxacin 27/30, 90.0%; comparator 22/26, 84.6%; 95% CI −12.7 to +20.3). Both treatments were well tolerated.Conclusions  Moxifloxacin monotherapy, 400 mg once daily for 14 days, is an effective and well‐tolerated oral treatment for women with uPID.
Strategies of women patrons of music and theatre in Rome: Maria Mancini Colonna, Queen Christina of Sweden, and women of their circles
Authors: DE LUCCA VALERIA 
Published: August 2010

Cultural life in late seventeenth‐century Rome was enormously enriched by women's support of music and musicians, theatre, and public entertainments. This essay explores the patronage of Maria Mancini Colonna, Queen Christina of Sweden and women of their circles, the resonance of their sponsorship of musical or theatrical events in Rome during the 1660s and 1670s, and their self‐fashioning as patrons. The picture that results from this investigation shows that patronage offered women the possibility to express their desires, accomplish diplomatic endeavours, and even respond to the criticisms of their detractors in acceptable ways.Furthermore, by examining mostly chronicles compiled by their male contemporaries (avvisi di Roma), correspondence, and memoirs, this essay aims also at exploring the challenges and methodological avenues available to scholars whose study of women's patronage cannot be supported by the proof of financial support to a musician or to sponsor an event.The much broader idea of patronage that emerges from such a study indicates that the path is open for music historians for more studies on women's struggles to produce, inspire, influence, and commission music, theatrical entertainment, and cultural activities in early modern Rome.
Prospective Observation of CAD/CAM Titanium‐Ceramic‐Fixed Partial Dentures: 3‐Year Follow‐Up
Authors: Boeckler Arne F. , Lee Heeje , Psoch Andrea , Setz Juergen M. 
Published: August 2010

Abstract Purpose: There is lack of knowledge about the clinical performance of computer‐aided design/computer‐aided manufacturing (CAD/CAM) titanium‐ceramic‐fixed partial dentures (FPDs). The purpose of this study was to evaluate CAD/CAM titanium‐ceramic FPDs after 3 years in function. Materials and Methods: Thirty‐one FPDs were fabricated for 23 patients. The Ti frameworks were completely fabricated using CAD/CAM technology, and the low‐fusing porcelain was veneered. After confirming there were no mechanical or biological complications, the FPDs were cemented using zinc phosphate cement. The patients were recalled at 12, 24, and 36 months after cementation to examine for the presence of any mechanical complications, such as fractures of the veneering porcelain or the supportive framework, or biological complications, including caries, gingivitis, or periodontitis. The periodontal condition was measured using probing depth (PD), bleeding on probing (BOP), and plaque index (PI). Success and survival rates were estimated using the Kaplan‐Meier analysis. Results: There were four cohesive and three adhesive porcelain fractures, but no framework fractured. The Kaplan‐Meier cumulative success rate of the CAD/CAM titanium‐ceramic crown with regard to mechanical complications was 76.4%, and the cumulative survival rate was 96.8% after 3 years of use. One patient developed caries, but the condition was not associated with marginal discrepancy. No other biological complications were reported. The periodontal parameters demonstrated a tendency that slightly increased up to 24 months and was maintained by 36 months. At the end of the follow‐up, PD was 2.86 mm, percentile of surface with BOP was 23.5, and PI was 0.45. Conclusion: The CAD/CAM titanium‐ceramic FPDs survived in the mouths of patients without major complications for 3 years, although the risk of porcelain fracture appeared to be relatively high.
Retrospective Evaluation of Clinical Characteristics, Pharmacotherapy and Healthcare Resource Use among Patients Prescribed Pregabalin or Duloxetine for Diabetic Peripheral Neuropathy in Usual Care
Authors: Gore Mugdha , Zlateva Gergana , Tai Kei‐Sing , Chandran Arthi Bala , Leslie Douglas 
Published: August 2010

AbstractObjective:  To evaluate treatment patterns and costs among patients with painful diabetic peripheral neuropathy (pDPN) newly prescribed pregabalin or duloxetine in usual care settings.Methods:  Using the PharMetrics® Database, patients with pDPN (ICD‐9‐CM codes 357.2 or 250.6x) newly prescribed pregabalin or duloxetine were identified. Patients initiated on duloxetine (n = 713; mean age 55.4 ± 9.5 years) were propensity score‐matched with patients initiated on pregabalin (n = 713; mean age 56.3 ± 9.3 years). Prevalence of comorbidities, pain‐related pharmacotherapy and healthcare resource use/costs (pharmacy, outpatient, inpatient, total) were examined during the 12 months preceding (pre‐index) and following (follow‐up) the date of the first pregabalin or duloxetine prescription.Results:  Both cohorts had multiple comorbidities and a substantial pain medication burden. Among pregabalin patients, use of other anticonvulsants (35.6% vs. 24.7%) and tricyclic antidepressants significantly decreased (18.2% vs. 13.7%) and serotonin‐norepinephrine reuptake inhibitors (SNRIs) increased (7.9 % vs. 12.9%) in the follow‐up period; all P values < 0.05. Among duloxetine patients, use of other SNRIs (8.7% vs. 5.2%) and selective serotonin reuptake inhibitors decreased significantly (32.1% vs. 18.9%) in the follow‐up period, but there were increases for anticonvulsants (42.1% vs. 48.4%), benzodiazepines (25.5% vs. 32%), and sedative/hypnotics (22.6% vs. 25.8%); all P values < 0.05. Among pregabalin and duloxetine patients there were increases (P < 0.05) in pharmacy, outpatient, and total healthcare costs from the pre‐index to the follow‐up period. Total medication costs in the follow‐up period were significantly higher for duloxetine (median $6,763 [IQR $3,970–$10,914]) relative to pregabalin (median $6,059 [IQR $3,277–$9,865]); P = 0.0017.Conclusions:  Patients with pDPN prescribed pregabalin and duloxetine were characterized by a substantial comorbidity and pain medication burden. Although there were no differences in total healthcare costs, medication costs were significantly higher in the duloxetine cohort relative to the pregabalin cohort.
Where Federalism Didn’t Fail
Authors: Derthick Martha 
Published: August 2010

The governmental response to Hurricane Katrina was not the unalloyed failure that is often portrayed. The response was a mixture of success and failure. Successes occurred when a foundation had been laid for intergovernmental cooperation, as with the largely successful pre‐landfall evacuation of Greater New Orleans, the multistate mobilization of the National Guard, and the search and rescue operations of the U.S. Coast Guard and the Louisiana Department of Wildlife and Fisheries. Postmortems should draw lessons from such successes rather than concentrate entirely on the numerous failures.
It is now clear that a challenge on this scale requires greater federal authority and a broader role for the armed forces—the institution of our government most capable of massive logistical operations on a moment’s notice. —President George W. Bush, September 15, 2005 I can say with certainty that federalizing emergency response to catastrophic events would be a disaster as bad as Hurricane Katrina. The current system works when everyone understands, accepts, and is willing to fulfill their responsibilities…. the bottom‐up approach yields the best results. —Florida governor Jeb Bush, October 19, 2005
Market Discipline in the Individual Annuity Market
Authors: Carson James M. , Doran James S. , Dumm Randy E. 
Published: August 2010

AbstractTheoretical expectations related to market discipline generally suggest a positive relationship between firm financial strength and price. We examine market discipline in the individual annuity market by measuring annuity contract yields during the accumulation phase and find that, among other results, firm financial strength is positively related to yield (i.e., negatively related to price). We argue that this apparent anomaly can be viewed as a form of market discipline itself, for at least four related reasons, the foremost reason being that in order to compete in the asset accumulation market, an insurer has an incentive to provide a track record of historically strong credited interest rates within the annuity. In addition, the credited interest rates within an annuity are only revealed ex post over time, thus diminishing consumer ability to impose traditional market discipline relating firm financial strength and price, and also enabling financially weaker insurers to impose higher ex post prices in the form of lower realized annuity yields.
Current of Injury Predicts Acute Performance of Catheter‐Delivered Active Fixation Pacing Leads
Authors: REDFEARN DAMIAN P. , GULA LORNE J. , KRAHN ANDREW D. , SKANES ALLAN C. , KLEIN GEORGE J. , YEE RAYMOND 
Published: August 2010

Background:

During pacemaker lead (PPML) implantation, the implanter must assess lead stability (fixation) and pacing threshold adequacy. Implanters rely principally on lead impedance (IMP) and pacing threshold measurements after fixation of the PPML to determine adequacy of pacing sites. Continuously monitoring lead parameters during fixation might better identify predictors of acute lead stability and performance.
Methods:

At the time of PPML implantation with a catheter delivered, fixed screw, 4‐Fr PPML (Medtronic 3830, Minneapolis, MN, USA) patients underwent measurements of R‐wave amplitude, slew rate, and current of injury (COI) (maximum and at 80 ms) during each turn of the helix. Lead stability was tested with traction applied to the lead body.
Results:

Eighteen patients (age 70 ± 9 years, 9 males) were studied. Right ventricular lead positioning was attempted 43 times; 26 positions demonstrated good fixation and 18 had satisfactory threshold. Sites of good fixation consistently showed larger COI (maximum and at 80 ms) compared to poor fixation sites throughout each turn of the helix; R wave, slew rate, and IMP did not differ significantly. When all measures of COI were examined in a stepwise regression model only the final measure of COI at 80 ms proved significantly associated with acute stability (P = 0.032).
Conclusions:

Lead stability and threshold adequacy are predictable from assessment of the magnitude of injury current. Continuous monitoring of lead parameters during fixation does not appear to confer any benefit over assessment of the parameters after final rotation of the lead. A negative COI is associated with poor threshold and/or fixation.
Morphology‐Enhanced Atrial Event Classification Improves Sensing in Pacemakers
Authors: LEWALTER THORSTEN , TUININGA YPE , FRÖHLIG GERD , REMERIE SUSANN , EBERHARDT FRANK , SCHMIDT JÖRG , VAN GROENINGEN CHRIS , WOHLGEMUTH PETER 
Published: August 2010

Background:

In atrial‐based pacing, appropriate therapy and reliable diagnostics depend on detection and discrimination of atrial signals. Accurate classification of atrial events is mainly confounded by oversensing of ventricular far‐field R‐wave signals (FFRW), but attempts to reject FFRWs by manipulating atrial sensitivity and/or postventricular atrial blanking period (PVAB) may result in undersensing (especially of atrial fibrillation, AF) or in 2:1 atrial flutter detection. The objective of this study is therefore to evaluate if such methods can be improved by morphology‐enhanced atrial event classification (MORPH).
Methods:

Twenty‐four‐hour ambulatory atrial electrograms were recorded from continuous telemetry of digital pacemakers. Half of the recording was used for collecting two individual morphology parameters that discriminated P‐waves from FFRWs in every patient (learning phase). The other half was used to test the MORPH algorithm against traditional methods (classification phase).
Results:

In 44/48 patients, data were suitable for analysis. Average P and FFRW amplitudes were 1.96 mV versus 0.61 mV (P < 0.001). The interval between ventricular events and FFRW oversensing (VA interval) averaged at 14 ms during sensing and at 118 ms during pacing in the ventricle. Compared to nominal (“Factory”) settings, the MORPH algorithm improved the sensitivity for P‐wave recognition from 97.2% to 99.2%, the specificity from 91.9% to 99.96%, and the accuracy from 95.3% to 99.4% (P < 0.01 for all).
Conclusions:

By improving atrial signal discrimination, morphology analysis of atrial electrograms allows for high atrial sensitivity settings, and potentially improves the reliability of atrial arrhythmia diagnostics in heart rhythm devices.
Transthoracic Versus Transesophageal Cardioversion of Atrial Fibrillation under Light Sedation: A Prospective Randomized Trial
Authors: SANTINI LUCA , GALLAGHER MARK M. , PAPAVASILEIOU LIDA P. , ROMANO VALENTINA , TOPA ALESSIA , DI BATTISTA LUCIANO , ARACRI MAURIZIO , ROMEO FRANCESCO 
Published: August 2010

Background:

Electrical cardioversion (ECV) of atrial fibrillation (AF) is limited by a 5–10% failure rate and by the expense arising from a perceived need for general anesthesia. A transesophageal approach using light sedation has been proposed as a means of augmenting the success rate and avoiding the need for general anesthesia. We hypothesized that the high rate of success and the lower energy requirement associated with biphasic cardioversion might eliminate any advantage of the transesophageal approach.
Methods:

We randomly assigned 60 patients attending for ECV of persistent AF to a transesophageal or a transthoracic approach. Sedation of moderate depth was achieved with intravenous midazolam. The dose of midazolam was titrated in the same manner in both groups.
Results:

Sinus rhythm was restored in 29/30 patients (97%) in each group using a similar number of shocks for both groups (1.3 ± 0.6 transesophageal vs 1.4 ± 0.7 transthoracic, P = NS) with a similar procedure duration (14.1 ± 8.2 minutes vs 13.8 ± 7.5 minutes, P = NS). Both groups received similar doses of midazolam (4.2 ± 2.7 mg vs 4.4 ± 2.8 mg, P = NS) and both reported a similar discomfort score in (0.9 ± 1.3 vs 1.1 ± 1.8, P = NS). No complication occurred in either group.
Conclusion:

AF may be cardioverted safely and effectively by either a transthoracic or a transesophageal approach. The use of sedation of moderate depth renders cardioversion by either approach acceptable. As transesophageal ECV shows no clear advantage, transthoracic cardioversion should remain the approach of first choice.
Acute Conversion of Persistent Atrial Fibrillation During Dofetilide Initiation
Authors: COTIGA DELIA , ARSHAD AYSHA , AZIZ EMAD , JOSHI SANDEEP , KONERU JAYANTHI N. , STEINBERG JONATHAN S. 
Published: August 2010

Background:

Dofetilide (D) is a highly selective blocker of the rapid component of the delayed rectifier potassium current and was approved for the treatment of atrial fibrillation (AF) based on a satisfactory safety/efficacy profile from trials in patients with left ventricle (LV) dysfunction or heart failure. The dose‐dependant acute conversion rates (<72 hours) were reported to be in the range of 6–30%. We hypothesized that the acute pharmacological conversion rate of D is higher than previously reported if used in a healthier cohort of patients with persistent AF.
Methods and Results:

Eighty consecutive patients received D dosing per Cockroft‐Gault adjustment for creatinine clearance and QTc intervals. Patients were 61 ± 10 years, 79% male, ejection fraction (EF) 53 ± 13%, coronary artery disease 20%, and left atrial dimension 4.1 ± 0.2 cms. The duration of the treated AF episode was a median of 19 days (range 10–113 days). All patients received D while on telemetry for at least six dosing intervals. After 2.2 ± 1.2 doses, 77% of patients converted to sinus rhythm (SR) and 23% did not and required direct current (DC) cardioversion. Acute pharmacological conversion rates were: 20% for D 125 mcg bid, 44% for 250 mcg bid, and 85% for 500 mcg bid. None of the patients had torsade de pointes and none had to stop D for intolerance. Failure to convert to SR on D alone was associated with larger left atrium (LA) diameter (P = 0.04), longer duration of AF (P = 0.02), and use of lower dosages of D (P = 0.04).
Conclusions:

D had an unusually high pharmacological conversion rate, demonstrated an incremental dose response, and was well tolerated and safe, in a relatively healthy adult cohort with persistent AF. In addition to D dose, pharmaco‐conversion was predicted by LA size and AF duration. D is a desirable alternative for conversion of AF in a variety of clinical settings.
Deglutition Induced Atrial Tachycardia and Atrial Fibrillation
Authors: KANJWAL YOUSUF , IMRAN NASER , GRUBB BLAIR 
Published: August 2010

Deglutition induced supraventricular tachycardia is an uncommon condition postulated to be a vagally mediated phenomenon due to mechanical stimulation. Patients usually present with mild symptoms or may have severe debilitating symptoms. Treatment with Class I agents, beta blockers, calcium channel blockers, amiodarone and radiofrquency catheter ablation has shown to be successful in the majority of reported cases. We report the case of a 46‐year‐old healthy woman presenting with palpitations on swallowing that was documented to be transient atrial tachycardia with aberrant ventricular conduction as well as transient atrial fibrillation. She was successfully treated with propafenone with no induction of swallowing‐induced tachycardia after treatment. This is also the first case to show swallowing‐induced atrial tachycardia and atrial fibrillation in the same patient.
Follow‐Up of CRT‐ICD: Implications for the Use of Remote Follow‐Up Systems. Data from the InSync ICD Italian Registry
Authors: LUNATI MAURIZIO , GASPARINI MAURIZIO , SANTINI MASSIMO , LANDOLINA MAURIZIO , PEREGO GIOVANNI B. , PAPPONE CARLO , MARZEGALLI MAURIZIO , ARGIOLAS CARLO , MURTHY ANANT , VALSECCHI SERGIO ,   on behalf of the InSync ICD Italian Registry Investigators.
Published: August 2010

Background: Launch of remote follow‐up systems in Europe is currently underway. However, there is insufficient understanding of postimplant practices with respect to device follow‐up, reprogramming of device features, and postshock clinic visits.
Methods: We analyzed device‐stored data from patients implanted with biventricular defibrillators (CRT‐ICD) to characterize the management of patients in current clinical practice and the potential impact of remote follow‐up systems.
Results: Two hundred and seventeen patients were identified, all with complete device‐data for at least one year. Over a follow‐up period of 570 ± 158 days, 1,959 device interrogations were performed. Of these, the majority (1,280, 65%) involved the reprogramming of device parameters. The mean time interval between interrogations was 70 ± 25 days. Overall, a marked reduction of interrogations requiring reprogramming was observed between the first six months of follow‐up and subsequent periods (from 3.6 ± 1.8 to 1.1 ± 1.0 interrogations/six months). A mean of 6.0 ± 5.9 device parameters was reprogrammed during the first six months of follow‐up, versus 4.4 ± 5.6 (P = 0.000) during the subsequent period. From multivariate analysis, a higher‐than‐median number of interrogations was found to be significantly associated with defibrillator shocks (OR:2.51; 95%CI:1.42–4.42). Following a shock, a total of 133 interrogations in 60 patients were performed with 80% of these occurring within five days of the shock, and 49% did not require device reprogramming.
Conclusion: Six months after implant, reprogramming of device parameters is significantly less frequent, making the use of remote follow‐up systems a practical alternative for patients and physicians. Moreover, a considerable portion of post‐shock interrogations does not involve reprogramming and may therefore be performed remotely.