bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Albumin Dialysis on Pharmacokinetics of Amphotericin B Colloidal Dispersion and Amphotericin B Lipid Complex
Authors: Weiler Stefan , Vogelsinger Helene , Joannidis Michael , Dunzendorfer Stefan , Bellmann Romuald 
Published: February 2011

AbstractAlbumin dialysis (AD) is a therapeutic option in severe cholestatic liver failure. However, it can significantly enhance drug elimination. Pharmacokinetic data on antimicrobial agents—in particular on antimycotics—administered under this clinical condition are very sparse. Therefore, amphotericin B (AMB) plasma concentrations were measured in two critically ill patients who were treated with AD because of severe cholestatic liver failure and were prescribed lipid formulated AMB—either AMB colloidal dispersion (ABCD) or AMB lipid complex (ABLC)—for suspected invasive fungal infection. AD was performed with the molecular adsorbent recirculating system (MARS). Lipid‐associated and liberated AMB were separately quantified on and off AD. The clearance of the liberated AMB fraction was not essentially affected (ABLC) or moderately enhanced during AD by a factor of 2.5 (ABCD). The clearance of the lipid‐formulated fraction was increased by a factor of 4 during AD (ABCD) or was similar (ABLC) on and off AD. Despite the fact that there was a four‐fold higher clearance of the lipid‐formulated fraction of ABCD, the clinically relevant area under the concentration time curve of the liberated AMB fraction was only moderately changed (by 37% in ABCD, 70% in ABLC) during AD. Thus, the effect of AD on lipid formulated AMB appears to be moderate. A daily dose of 5 mg/kg will probably lead to adequate plasma levels in patients on AD.
Characterization of Insulin Adsorption Behavior of Dialyzer Membranes Used in Hemodialysis
Authors: Abe Masanori , Okada Kazuyoshi , Ikeda Kazuya , Matsumoto Shiro , Soma Masayoshi , Matsumoto Koichi 
Published: February 2011

AbstractAlthough it has been reported that plasma insulin is removed by hemodialysis (HD), the mechanism for this has not been elucidated. We investigated the mechanism of insulin removal during HD treatment and the characteristics of insulin removal with three high‐flux membranes. In our in vivo study, 20 stable diabetic patients on HD were randomly selected for three HD sessions with three different membranes: polysulfone (PS), cellulose triacetate (CTA), and polyester polymer alloy (PEPA). Blood samples were obtained from the blood tubing at the arterial (A) site at the beginning and end of the sixth HD session to investigate insulin reduction in patients. At 1 h after the initiation of dialysis, blood samples were obtained from both the A and venous sites of the dialyzer to investigate the insulin clearance with the different membranes. There was a significant reduction in patients' plasma insulin at each time point with each of the three membranes. The insulin clearance with the PS membrane was significantly higher than that with the CTA and PEPA membranes. Although no difference was observed in the plasma insulin reduction rate between the three membranes in the total subject group, there was a significantly higher reduction rate with the PS membrane in insulin‐dependent diabetes mellitus subjects. The clearance of insulin in in vitro tests was significantly higher with the PS and PEPA membranes than with the CTA membrane in both new and clinically used dialyzers. Insulin was not detected in the dialysate or ultrafiltration fluids in either the in vivo or in vitro studies. The mechanism of plasma insulin clearance by HD is mainly by adsorption, and the amount of insulin adsorbed differed depending on the dialyzer membrane used.
Norepinephrine and Hospital Mortality in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy
Authors: Chou Che‐Yi , Yeh Hung‐Chieh , Chen Wei , Liu Jiung‐Hsiun , Lin Hsin‐Hung , Liu Yao‐Lung , Yang Ya‐Fei , Wang Shu‐Ming , Huang Chiu‐Ching 
Published: February 2011

AbstractHigh‐dose vasopressor use is associated with increasing mortality in patients with septic shock. We conducted this study to determine if the high‐dose of vasopressor used before the initiation of continuous renal replacement therapy (CRRT) is associated with increasing mortality in critically ill patients. We retrospectively reviewed all patients who underwent CRRT in the medical intensive care unit of China Medical University Hospital between 2003 and 2007. The association between mortality and highest vasopressors (dopamine and norepinephrine [NE]) dose used were analyzed using Kaplan–Meier analysis and multivariate Cox regression. A total of 279 patients (170 men and 109 women) treated with CRRT in medical intensive care were reviewed and 237 (84.9%) died. In Kaplan–Meier analysis with log‐rank test, dopamine dose of ≥20 µg/kg/min and NE dose of ≥0.3 µg/kg/min were significantly linked to mortality (P = 0.007 and <0.001). In multivariate Cox proportional hazards regression, NE dose of ≥0.3 µg/kg/min, Acute Physiology and Chronic Health Evaluation II score, and low platelet count were independently linked to mortality. The hazard ratios and 95% confidence interval (CI) were 1.771 (95% CI: 1.247–2.516, P = 0.001), 1.035 (95% CI: 1.012–1.058, P = 0.003), and 0.997 (95% CI: 0.996–0.999, P = 0.003), respectively. Critically ill patients treated with very high dose of NE before the initiation of CRRT have a very high mortality rate regardless of the acute kidney injury stage.
Effects of Spermidine and p‐Cresol on Polymorphonuclear Cell Apoptosis and Function
Authors: de Carvalho Jr Jose Tarcisio G. , Dalboni Maria A. , Watanabe Renato , Peres Alines T. , Goes Miguel A. , Manfredi Silvia R. , Canziani Maria E. , Cendoroglo Gabriel S. , Guimarães‐Souza Nadia , Batista Marcelo C. , Cendoroglo Miguel 
Published: February 2011

AbstractPolymorphonuclear leukocytes (PMNs) from chronic kidney disease (CKD) patients display accelerated apoptosis and dysfunction, which may predispose CKD patients to infections. In this study, we investigated the effect of spermidine and p‐cresol on apoptosis and function on PMN from healthy subjects. We measured the effect of spermidine and p‐cresol on apoptosis, ROS production unstimulated and stimulated (S. aureus and PMA) and expression of CD95, caspase 3, and CD11b on PMN. After incubation with p‐cresol and spermidine, we did not observe any changes in apoptosis, viability or expression of caspase 3 and CD95 in PMN from healthy subjects. PMN incubated for 10 minutes with spermidine demonstrated a significant reduction in spontaneous, S. aureus and PMA‐stimulated ROS production. p‐cresol induced a decrease in PMA‐stimulated ROS production. Spermidine and p‐cresol also induced a decrease in the expression of CD11b on PMN. Spermidine and p‐cresol decreased the expression of CD11b and oxidative burst of PMN from healthy subjects and had no effect on PMN apoptosis and viability.
Molecular Biology‐Based Assessment of Vitamin E‐Coated Dialyzer Effects on Oxidative Stress, Inflammation, and Vascular Remodeling
Authors: Calò Lorenzo A. , Naso Agostino , D'Angelo Angela , Pagnin Elisa , Zanardo Marco , Puato Massimo , Rebeschini Mirka , Landini Silvano , Feriani Mariano , Perego Angelo , Malagoli Andrea , Zagatti Riccardo , Calzavara Piergianni , Cascone Carmelo , Davis Paul A. 
Published: February 2011

AbstractCardiovascular disease represents the most common cause for the excess of morbidity and mortality found in end‐stage renal disease (ESRD) and has prompted the exploration of multiple approaches to improve outcomes in these patients. Cardiovascular risk factors such as increased oxidative stress (OxSt) and inflammation are found in ESRD patients. A vitamin E‐coated dialyzer using polysulfone membranes has been suggested to have positive effects on these factors. This 1‐year study evaluated in 25 ESRD patients under chronic dialysis, the effects of a vitamin E‐coated membrane (VitabranE ViE) “ex vivo” on mononuclear cells, OxSt, and inflammation‐related biochemical and molecular biology markers using a molecular biology approach. p22phox, heme oxygenase (HO)‐1, plasminogen activator inhibitor (PAI)‐1 protein level, and phosphorylated extracellular signal‐regulated kinase (pERK)1/2 status were evaluated at the beginning of the study, after 6 months and after 12 months by Western blot analysis and oxidized low‐density lipoprotein (OxLDL) plasma level by enzyme‐linked immunosorbent assay, alongside vascular remodeling assessment as measured by carotid intima‐media thickness (IMT) in a subgroup of nine randomly selected patients. p22phox, PAI‐1, OxLDL, and pERK all decreased with VitabranE use, while HO‐1 increased. Carotid IMT did not increase. Treatment with VitabranE significantly decreases the expression of proteins and markers relevant to OxSt and inflammation tightly associated with cardiovascular disease, and it appears highly likely that VitabranE use will provide a benefit in terms of cardiovascular protection.
Rescue Extracorporeal Life Support for Acute Verapamil and Propranolol Toxicity in a Neonate
Authors: De Rita Fabrizio , Barozzi Luca , Franchi Gianluigi , Faggian Giuseppe , Mazzucco Alessandro , Luciani Giovanni Battista 
Published: February 2011

AbstractExtracorporeal life support (ECLS) to manage acute antiarrhythmic drugs toxicity in neonates has never been reported. Here presented is a case of venoarterial extracorporeal membrane oxygenation support in a newborn with refractory low cardiac output as a result of acute Ca‐channel and β‐receptor antagonist toxicity for treatment of paroxysmal supraventricular tachycardia (SVT). Shortly after onset of ECLS, the baby recovered sinus rhythm and subsequent bouts of SVT were controlled by amiodarone infusion and repeated DC shocks. Weaning was possible on the 5th day after implant, once recovery of the left ventricular function and optimization of the antiarrhythmic medication were achieved. In neonates with severe but potentially reversible cardiac dysfunction caused by drug toxicity, ECLS can maintain cardiac output and vital organ perfusion while allowing time for drug redistribution, metabolism, and clearance.
Modularity in Developmental Biology and Artificial Organs: A Missing Concept in Tissue Engineering
Authors: Lenas Petros , Luyten Frank P. , Doblare Manuel , Nicodemou‐Lena Eleni , Lanzara Andreina Elena 
Published: February 2011

AbstractTissue engineering is reviving itself, adopting the concept of biomimetics of in vivo tissue development. A basic concept of developmental biology is the modularity of the tissue architecture according to which intermediates in tissue development constitute semiautonomous entities. Both engineering and nature have chosen the modular architecture to optimize the product or organism development and evolution. Bioartificial tissues do not have a modular architecture. On the contrary, artificial organs of modular architecture have been already developed in the field of artificial organs. Therefore the conceptual support of tissue engineering by the field of artificial organs becomes critical in its new endeavor of recapitulating in vitro the in vivo tissue development.
Donation After Cardiac Death: Dynamic Graft Reconditioning During or After Ischemic Preservation?
Authors: Koetting Martina , Minor Thomas 
Published: February 2011

AbstractThe benefit of gaseous oxygenation during storage of liver grafts from donors after cardiac death should be investigated as applied either during the whole period of preservation or only for the last 2 h prior to reperfusion. Rat livers were explanted 30 min after cardiac arrest of the donor and cold‐stored (CS) for 20 h. Some grafts were subjected to venous systemic oxygen persufflation (VSOP) either for 20 h or for only 2 h subsequent to 18 h of CS. Viability of the livers was assessed thereafter by warm reperfusion in vitro. Twenty hours VSOP and 18 h CS + 2 h VSOP prevented mitochondrial protein breakdown of mitochondrial heat shock protein 70 and promoted a significant and approximately twofold increase in hepatic oxygen consumption, bile production, and energetic recovery upon warm reperfusion. No differences were seen whether VSOP was performed for 20 h or for only 2 h prior to reperfusion. Both techniques significantly abrogated parenchymal enzyme loss (alanine aminotransferase, aspartate aminotransferase) upon reperfusion compared with simple 20 h CS. An increase in perfusate levels of the mitochondrial enzyme glutamate dehydrogenase was observed only in the 20 h VSOP group. In conclusion, viability of donation after cardiac death liver grafts can still be augmented, similarly to continuous aerobic storage, by only endischemic reconditioning, both protocols preventing initial mitochondrial dysfunction and subsequent tissue injury.
Novel Approach for Designing a Low Weight Hip Implant Used in Total Hip Arthroplasty Adopting Skeletal Design Techniques
Authors: Sivarasu Sudesh , Beulah Pearline , Mathew Lazar 
Published: February 2011

AbstractAseptic loosening is the major cause of failure of hip implants after total hip arthroplasty. Stress shielding of the femur is known to be the principal factor involved in the aseptic loosening of hip implants. Solid stems are found to have a greater rigidity; therefore, they transfer less load proximally, which results in greater stress shielding of the proximal femur. A stem of low stiffness alone would not suffice in achieving a reduced or optimal stress shielding. The femoral stem of the light weight hip implant has a skeletal design with a hexagonal base and neck cross‐section. This novel design would ameliorate the implant fixation, aid in optimal rigidity, enhance the medullary revascularization, and offer better mobility to the patient.
What Blood Temperature for an Ex Vivo Extracorporeal Circuit?
Authors: Rimmelé Thomas , Bishop Jeffrey , Simon Peter , Carter Melinda , Kong Lan , Lee Minjae , Singbartl Kai , Kellum John A. 
Published: February 2011

AbstractEx vivo circuits are commonly used to evaluate biomaterials or devices used for extracorporeal blood purification. However, various aspects of the ex vivo circuit, apart from the circuit materials, may affect inflammation and coagulation. One such aspect is temperature. The aim of this study was to evaluate the influence of different blood temperature conditions on inflammation parameters in an ex vivo circuit. Blood was collected from 20 healthy volunteers and run through three different experimental conditions for 4 h: a miniaturized ex vivo extracorporeal circuit equipped with a blood warmer set to 37°C, the same circuit without the warmer (23°C), and a tube placed in an incubator at 37°C (no circuit). We measured the granulocyte macrophage colony‐stimulating factor, the tumor necrosis factor, and the interleukin (IL)‐1β, IL‐6, IL‐8, and IL‐10 concentrations at baseline, 15, 60, 120, and 240 min. Human leukocyte antigen (HLA)‐DR, CD11b, CD11a, CD62L, tumor necrosis factor alpha converting enzyme, annexin V expression, and NFkB DNA binding were measured in monocytes and polymorphonuclear neutrophils (PMNs) using flow cytometry at baseline, 120 min, and 240 min. While cytokine production over time was very slight at room temperature, levels increased by more than 100‐fold in the two heated conditions. Differences in the expression of some surface markers were also observed between the room temperature circuit and the two heated conditions (CD11b PMN, P < 0.0001; HLA‐DR Mono, P = 0.0019; and CD11a PMN, P < 0.0001). Evolution of annexin V expression was also different over time between the three groups (P = 0.0178 for monocytes and P = 0.0011 for PMNs). A trend for a greater NFkB DNA binding was observed in the heated conditions. Thus, for ex vivo studies using extracorporeal circuits, heating blood to maintain body temperature results in significant activation of inflammatory cells while hypothermia (room temperature) seems to suppress the leukocyte response. Both strategies may lead to erroneous conclusions, possibly masking some specific effects of the device being studied. Investigators in this field must be aware of the fact that blood temperature is a crucial confounding parameter and the type of “background noise” they will face depending on the strategy adopted.
Five‐Year Results of 121 Consecutive Patients Treated With Extracorporeal Membrane Oxygenation at Fu Wai Hospital
Authors: Hei Feilong , Lou Song , Li Jingwen , Yu Kun , Liu Jinping , Feng Zhengyi , Zhao Ju , Hu Shengshou , Xu Jianping , Chang Qian , Liu Yinglong , Wang Xu , Liu Ping , Long Cun 
Published: February 2011

AbstractSince 2004, our institution has adopted venoarterial (VA) extracorporeal membrane oxygenation (ECMO) for patients who otherwise could not be weaned from cardiopulmonary bypass and patients experiencing cardiogenic shock and/or pulmonary dysfunction unresponsive to conventional treatments. In this study, we reviewed our experience with ECMO support and tried to identify predictors of in‐hospital mortality. We retrospectively analyzed the clinical records of 121 consecutive patients receiving ECMO. Patients were divided into adult and pediatric groups and analyzed separately. Demographics, clinical characteristics at the time of ECMO implantation, ECMO‐related complications, and in‐hospital mortality were collected. Logistic regression analyses were performed to investigate predictors of mortality. A P value ≤0.05 was accepted as significant. Sixty‐eight adult patients and 53 pediatric patients were included in this study. In adult patients, 52 were weaned from ECMO and 43 survived upon discharge. After univariate analysis, ECMO setup location, receiving cardiopulmonary resuscitation before ECMO, leg ischemia, hemolysis, acute renal failure (ARF), neurological dysfunction, and multiple organ dysfunction syndrome were associated with in‐hospital death. In multiple logistic regression analyses, leg ischemia (OR 14.68, 95% CI 1.67–129.1), ARF (OR 12.14, 95% CI 2.5–58.8), and neurological dysfunction (OR 49.0, 95% CI 2.28–1051.96) were risk factors associated with in‐hospital mortality. Patients put on ECMO in the operating room had a better chance of survival (OR 0.078, 95% CI 0.013–0.417). In pediatric patients, 30 were weaned from ECMO and 26 survived upon discharge. After univariate analysis, age, weight, and eight ECMO complications were associated with in‐hospital death. In multiple logistic regression analyses, ARF (OR 24.0, 95% CI 4.2–137.3) was a risk factor associated with in‐hospital mortality. A P value of 0.921 and >0.99 was obtained by the Hosmer–Lemeshow test, and the area under the curve was 0.863 and 0.867 for adult and pediatric patients, respectively. The overall survival rate was 57%. ECMO is a justifiable alternative treatment for refractory cardiac and/or pulmonary dysfunction which could rescue more than 50% of carefully selected patients. Higher survival rates could be achieved by preventing ECMO complications.
Clinical Effectiveness of Centrifugal Pump to Produce Pulsatile Flow During Cardiopulmonary Bypass in Patients Undergoing Cardiac Surgery
Authors: Gu Y. John , van Oeveren Willem , Mungroop Hubert E. , Epema Anne H. , den Hamer Inez J. , Keizer Jorrit J. , Leuvenink Ron P. , Mariani Massimo A. , Rakhorst Gerhard 
Published: February 2011

AbstractAlthough the centrifugal pump has been widely used as a nonpulsatile pump for cardiopulmonary bypass (CPB), little is known about its performance as a pulsatile pump for CPB, especially on its efficacy in producing hemodynamic energy and its clinical effectiveness. We performed a study to evaluate whether the Rotaflow centrifugal pump produces effective pulsatile flow during CPB and whether the pulsatile flow in this setting is clinically effective in adult patients undergoing cardiac surgery. Thirty‐two patients undergoing CPB for elective coronary artery bypass grafting were randomly allocated to a pulsatile perfusion group (n = 16) or a nonpulsatile perfusion group (n = 16). All patients were perfused with the Rotaflow centrifugal pump. In the pulsatile group, the centrifugal pump was adjusted to the pulsatile mode (60 cycles/min) during aortic cross‐clamping, whereas in the nonpulsatile group, the pump was kept in its nonpulsatile mode during the same period of time. Compared with the nonpulsatile group, the pulsatile group had a higher pulse pressure (P < 0.01) and a fraction higher energy equivalent pressure (EEP, P = 0.058). The net gain of pulsatile flow, represented by the surplus hemodynamic energy (SHE), was found much higher in the CPB circuit than in patients (P < 0.01). Clinically, there was no difference between the pulsatile and nonpulsatile groups with regard to postoperative acute kidney injury, endothelial activation, or inflammatory response. Postoperative organ function and the duration of hospital stay were similar in the two patient groups. In conclusion, pulsatile CPB with the Rotaflow centrifugal pump is associated with a small gain of EEP and SHE, which does not seem to be clinically effective in adult cardiac surgical patients.
Cesare Lombroso and epilepsy 100 years later: An unabridged report of his original transactions
Authors: Monaco Francesco , Mula Marco 
Published: February 2011

SummaryCesare Lombroso (1835–1909) still represents one of the most famous and, at the same time, controversial figures of neuropsychiatry. His idea of the “atavist” criminal, prisoner of his/her biologic inheritance, became extremely popular in Western countries. Unfortunately, Lombroso’s theory of a strict connection between epilepsy and the criminal personality exerted a long‐lasting negative influence on both medical and public opinion, and strongly contributed to the stigmatization of patients with epilepsy. In this report, we aim to present the complete and unabridged series of passages of Cesare Lombroso’s works, published only in the Italian language, discussing the issue of epilepsy and crime. All original Italian quotations are offered and an English translation is provided. Although we believe that the medical profession must be well aware of the “evil” distortions generated by Lombrosian theories, which clearly emerge from his original transactions, any comment is deliberately avoided because, in our opinion, people and their ideas must be judged in accordance with the historical period to which they belonged.
Early postnatal exposure of rats to lamotrigine, but not phenytoin, reduces seizure threshold in adulthood
Authors: Forcelli Patrick A. , Gale Karen , Kondratyev Alexei 
Published: February 2011

SummaryIn view of previous reports of changes in seizure susceptibility in adult rats exposed to phenobarbital or diazepam as pups, we examined the effects of early life exposure to lamotrigine and phenytoin, two commonly used antiepileptic drugs (AEDs), for their effect on seizure threshold in adult rats. We found that pups exposed to lamotrigine for 6 days during the second postnatal week had a significantly lower threshold for pentylenetetrazole‐evoked seizures when tested as adults. In contrast, phenytoin exposure during the second postnatal week was without a significant effect on seizure threshold in adults. Seizure scores at threshold were comparable across all groups tested. The dose of lamotrigine used in our study (20 mg/kg) was below that required to cause developmental neuronal apoptosis, whereas the dose of phenytoin used (50 mg/kg) was above that required for developmental neurotoxicity. Therefore, our findings suggest that neurodevelopmental alterations in seizure susceptibility may occur via mechanisms that are independent of those responsible for neural injury or teratogenesis. Our findings support the possibility that therapy with certain AEDs during pregnancy or infancy may alter seizure susceptibility later in life, a possibility that should be taken into account when examining early life factors that contribute to seizure susceptibility in adulthood.