bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Economic Characteristics of Patients with Painful Neuropathic Disorders in Germany
Authors: Berger Ariel , Toelle Thomas , Sadosky Alesia , Dukes Ellen , Edelsberg John , Oster Gerry 
Published: October 2008

AbstractUsing a large database with information from general practitioners (GP) throughout Germany, we identified all adults (age ≥18 years) with encounters for painful neuropathic disorders (PNDs) between August 1, 2005 and July 31, 2006 (PND patients). We also constituted an age‐ and sex‐matched comparison group, consisting of randomly selected patients without any GP encounters for PNDs during the same period. Selected characteristics were then compared between PND patients and those in the comparison group over the 1‐year study period. The study sample consisted of 275,685 PND patients and a similar number in the matched comparison group; mean age was 53.7 years, and 57% were women. PND patients were more likely than matched comparators to have encounters for various comorbidities, including circulatory system disorders (47% vs. 20%, respectively), depression (9% vs. 2%), and anxiety (4% vs. 1%) (all P < 0.01). They also were more likely to have received pain‐related medications (57% vs. 13% for comparison group; P < 0.01)—most commonly, nonsteroidal anti‐inflammatory drugs, benzodiazepines, and opioids, and less often, tricyclic antidepressants and anti‐epileptics. PND patients averaged 7.3 more GP visits during the year (mean [95% CI] = 9.9 [9.9, 9.9] vs. 2.6 [2.6, 2.7] for comparison group); they also had significantly more specialist referrals and physician‐excused absences from work (all P < 0.01). Patients with PNDs under the care of GPs in Germany have comparatively more comorbidities and higher levels of use of healthcare services. The pain‐related medications that these patients receive raise concerns that PNDs may not be optimally treated in these settings.
Intracranial Hemorrhage After Percutaneous Radiofrequency Trigeminal Rhizotomy
Authors: Rath Girija P. , Dash Hari H. , Bithal Parmod K. , Goyal Vinay 
Published: October 2008

AbstractRadiofrequency thermocoagulation (RFT) of trigeminal ganglion is a commonly performed percutaneous procedure for the management of trigeminal neuralgia. However, it is not free from potentially life‐threatening complications. A case of intracranial hemorrhage following RFT, which was managed conservatively, is reported. The authors suggest that coagulation parameters be normalized and intra‐procedural blood pressure controlled while performing this technique. As RFT is carried out as an ambulatory procedure, absence of any intracranial complication must be ascertained clinically before the patient is discharged.
Evaluation of potential immune response and in vivo survival of riboflavin‐ultraviolet light–treated red blood cells in baboons
Authors: Goodrich Raymond P. , Murthy Krishna K. , Doane Suzann K. , Fitzpatrick Christy N. , Morrow La Shayla , Arndt Patricia A. , Reddy Heather L. , Buytaert‐Hoefen Kimberley A. , Garratty George 
Published: October 2008

BACKGROUND: Pathogen reduction methods have the potential to modify blood components, resulting in immunologic reactions or compromised blood components. This study evaluated the hypothesis that there is no immune response to riboflavin‐and‐ultraviolet [UV]‐light–treated red blood cells (RBCs), as observed by serology and by survival of RBCs in circulation.STUDY DESIGN AND METHODS: Three baboons were in each treatment group: 1) untreated (negative control), 2) quinacrine mustard (QM)‐treated (positive control), and 3) riboflavin‐and‐UV light–treated (test group) RBCs. In the immunization phase, autologous test or control RBCs were injected subcutaneously on Days 0, 21, 42, and 49. Plasma samples from these days were tested against test or control RBCs by flow cytometry and standard serology. On Day 56, autologous 51Cr‐labeled test or control RBCs were injected. Blood samples were taken over 21 days after injection to determine RBC survival (t1/2).RESULTS: Untreated and riboflavin‐and‐UV‐light–treated RBCs showed no evidence of significant immunoglobulin G (IgG) binding after incubation with autologous plasma. RBC‐bound IgG was detected on QM‐treated RBCs after incubation with autologous plasma. This antibody was inhibited by QM, as demonstrated by a hapten inhibition study. t1/2 values for the untreated and riboflavin‐and‐UV‐light–treated RBCs were 7.3 ± 0.8 and 7.5 ± 1.7 days, respectively; the t1/2 value for QM‐treated RBCs was 2.3 ± 2.9 days.CONCLUSION: Treatment with riboflavin and UV light did not render RBCs immunogenic. Positive controls indicated that immunization promoted an immune response. In the 51Cr‐labeled RBC survival phase of the study, riboflavin‐and‐UV‐light–treated RBCs exhibited behavior similar to negative control RBCs. Detrimental immunologic or functional side effects were not observed.
The accuracy of natriuretic peptides (brain natriuretic peptide and N‐terminal pro‐brain natriuretic) in the differentiation between transfusion‐related acute lung injury and transfusion‐related circulatory overload in the critically ill
Authors: Li Guangxi , Daniels Craig E. , Kojicic Marija , Krpata Tami , Wilson Greg A. , Winters Jeffrey L. , Moore S. Breanndan , Gajic Ognjen 
Published: October 2008

BACKGROUND: The diagnostic workup of transfusion‐related acute lung injury (TRALI) requires an exclusion of transfusion‐associated circulatory overload (TACO). Brain natriuretic peptide (BNP) and N‐terminal pro‐brain natriuretic (NT‐pro‐BNP) accurately diagnosed TACO in preliminary studies that did not include patients with TRALI.STUDY DESIGN AND METHODS: In this prospective cohort study, two critical care experts blinded to serum levels of BNP and NT‐pro‐BNP determined the diagnosis of TRALI, TACO, and possible TRALI based on the consensus conference definitions. The accuracy of BNP and NT‐pro‐BNP was assessed based on the area under the receiver operating curve (AUC).RESULTS: Of 115 patients who developed acute pulmonary edema after transfusion, 34 were identified with TRALI, 31 with possible TRALI, and 50 with TACO. Median BNP was 375 pg per mL (interquartile range [IQR], 123 to 781 pg/mL) in TRALI, 446 pg per mL (IQR, 128 to 743 pg/mL) in possible TRALI, and 559 pg per mL (IQR, 288 to 1348 pg/mL) in TACO patients (p = 0.038). The NT‐pro‐BNP levels among patients with TRALI, possible TRALI, and TACO differed significantly with a median value of 1559 pg per mL (IQR, 629 to 5114 pg/mL), 2349 pg/mL (IQR, 919 to 4610 pg/mL), and 5197 pg/mL (IQR, 1695 to 15,714 pg/mL; p = 0.004), respectively. The accuracy of BNP and NT‐pro‐BNP to diagnose TACO was moderate with an AUC of 0.63 (95% confidence interval [CI], 0.51‐0.74) and 0.70 (95% CI, 0.59 to 0.80).CONCLUSIONS: Natriuretic peptides are of limited diagnostic value in a differential diagnosis of pulmonary edema after transfusion in the critically ill patients.
Notes on Post‐Secular Society
Authors: HABERMAS JÜRGEN 
Published: October 2008

The resurgence of political Islam and the endurance of broad religious belief in the most modern of societies—America—has created a crisis of faith among secularists. If modernity no longer implies a secular outlook, and secularism, by definition, cannot generate any values beyond an indifferent tolerance of all belief, what role will religion play in the 21st century?In an interesting confluence of reflection, Jürgen Habermas, one of Europe's leading secular liberal thinkers, argues that secular citizens must be open to religious influence, especially since the very identity of Western culture is rooted in Judeo‐Christian values. In his political afterlife, Tony Blair has converted to Catholicism and established a Faith Foundation to press for religious literacy because “you can't understand the modern world unless you understand the importance of religious faith.”Similarly, when Pope Benedict XVI visited secular France in September, President Nicholas Sarkozy scandalized the lay establishment by saying, like Habermas, that “rejecting a dialogue with religion would be a cultural and intellectual error.” He called for “a positive secularism that debates, respects and includes, not a secularism that rejects.”Despite the flurry of controversy over a recent spate of books extolling the virtues of atheism in the wake of Islamist terrorism, the more interesting issue by far is the emergence of post‐secular modernity.
God and the Political Planet
Authors: DEBRAY RÉGIS 
Published: October 2008

The resurgence of political Islam and the endurance of broad religious belief in the most modern of societies—America—has created a crisis of faith among secularists. If modernity no longer implies a secular outlook, and secularism, by definition, cannot generate any values beyond an indifferent tolerance of all belief, what role will religion play in the 21st century?In an interesting confluence of reflection, Jürgen Habermas, one of Europe's leading secular liberal thinkers, argues that secular citizens must be open to religious influence, especially since the very identity of Western culture is rooted in Judeo‐Christian values. In his political afterlife, Tony Blair has converted to Catholicism and established a Faith Foundation to press for religious literacy because “you can't understand the modern world unless you understand the importance of religious faith.”Similarly, when Pope Benedict XVI visited secular France in September, President Nicholas Sarkozy scandalized the lay establishment by saying, like Habermas, that “rejecting a dialogue with religion would be a cultural and intellectual error.” He called for “a positive secularism that debates, respects and includes, not a secularism that rejects.”Despite the flurry of controversy over a recent spate of books extolling the virtues of atheism in the wake of Islamist terrorism, the more interesting issue by far is the emergence of post‐secular modernity.
Globalization Is Running Out of Fuel
Authors: Klein Naomi 
Published: October 2008

Globalization may not be coming apart at the seams—yet—but the seams are ever more apparent. Rising fuel prices challenge a model of global transportation based on cheap energy, reinforcing the possibility of decoupling through great regionaliza‐tion of trade. Already, 50 percent of trade among ASEAN plus China and Japan is among each other.The Wall Street meltdown has spread a lack of confidence in the American financial system and the model of deregulation which stimulated rapid globalization of capital flows.Along with other developments, all this raises the question of whether the United States is prepared to operate successfully in a world it no longer dominates.An anti‐globalization leader, a former US labor secretary, a top American intellectual and a Nobel laureate address these issues.
Electrocardiographic Activity before Onset of Postoperative Atrial Fibrillation in Cardiac Surgery Patients
Authors: OVREIU MIRELA , NAIR BALA G. , XU MENG , BAKRI MOHAMED H. , LI LIANG , WAZNI OUSSAMA , FAHMY TAMER , PETRE JOHN , STARR NORMAN J. , SESSLER DANIEL I. , BASHOUR C. ALLEN 
Published: October 2008

Background:Electrocardiographic (ECG) characteristics were analyzed in postoperative cardiac surgery patients in an attempt to predict development of new‐onset postoperative atrial fibrillation (AF).Methods:Nineteen ECG characteristics were analyzed using computer‐based algorithms. The parameters were retrospectively analyzed from ECG signals recorded in postoperative cardiac surgery patients while they were in the cardiovascular intensive care unit (CVICU) at our institution. ECG data from 99 patients (of whom 43 developed postoperative AF) were analyzed. A bootstrap variable selection procedure was applied to select the most important ECG parameters, and a multivariable logistic regression model was developed to classify patients who did and did not develop AF.Results:Premature atrial activity (PAC) was greater in AF patients (P < 0.01). Certain heart rate variability (HRV) and turbulence parameters also differed in patients who did and did not develop AF. In contrast, P‐wave morphology was similar in patients with and without AF. Receiver operating curve (ROC) analysis applied to the model produced a C‐statistic of 0.904. The model thus correctly classified AF patients with more than a 90% sensitivity and a 70% specificity.Conclusion:Among the 19 ECG parameters analyzed, PAC activity, frequency‐domain HRV, and heart rate turbulence parameters were the best discriminators for postoperative AF.
Nonischemic Dilated Cardiomyopathy: Results of Noninvasive and Invasive Evaluation in 310 Patients and Clinical Significance of Bundle Branch Block
Authors: BREMBILLA‐PERROT BEATRICE , ALLA FRANÇOIS , SUTY‐SELTON CHRISTINE , HUTTIN OLIVIER , BLANGY HUGUES , SADOUL NICOLAS , CHOMETON FRÉDÉRIC , GROBEN LAURENT , LUPORSI JEAN D. , ZANNAD NOURA , ALIOT ETIENNE , CEDANO JUANICO , AMMAR SONIA , ABDELAAL AHMED , JUILLIÈRE YVES 
Published: October 2008

Background:

The survival of patients with idiopathic dilated cardiomyopathy (IDCM) at III and IV stages of New York Heart Association (NYHA) is decreased in those with a bundle branch block (BBB) compared to those without BBB. Less is known on the prognosis of patients at earlier stages of NYHA and who had a left BBB (LBBB) or right BBB (RBBB). We sought to evaluate the prevalence and the clinical significance of LBBB or RBBB in patients with IDCM and classes I and II of NYHA.
Methods:

Clinical data, noninvasive, and invasive studies were consecutively collected in 310 patients, with IDCM, followed up to 4.8±3.7 years.
Results:

Seventy‐six patients (25%) had LBBB, 21 (7%) had RBBB, and 212 had no BBB. Patients with BBB were older than other patients (P < 0.009). Left ventricular ejection fraction (LVEF) was lower in LBBB than in RBBB and other patients (P < 0.05). Syncope was more frequent in BBB than in absence (P < 0.05). Incidence of spontaneous ventricular tachycardia (VT) and atrial fibrillation, VT induction, total cardiac events, and sudden death were similar in the presence or absence of BBB. Deaths by heart failure and heart transplantations tended to be more frequent in BBB than in absence.
Conclusions:

LBBB was present in 25% of patients with IDCM; RBBB was rare. Patients with BBB were older and had more frequent syncope than patients without BBB; LVEF was lower in LBBB than in RBBB or in absence of BBB. BBB did not increase the risk of spontaneous VT, VT induction, or sudden death, and tended to increase deaths by heart failure and the indications of heart transplantation.
ICD Implantation and Arrhythmia‐Free Survival in Patients with Depressed LV Function Following Surgery for Valvular Heart Disease
Authors: YANG FELIX , SHAH BINDI , IWAI SEI , MARKOWITZ STEVEN M. , LERMAN BRUCE B. , STEIN KENNETH M. 
Published: October 2008

Background:

Although prophylactic implantable cardioverter‐defibrillator (ICD) implantation is beneficial in patients with severe ischemic cardiomyopathy, it is unclear whether patients with cardiomyopathy due to valvular heart disease have a similar benefit.
Methods:

We followed 17 patients (14 men/three women, age 62 ± 13 years, left ventricular ejection fraction [LVEF] 29 ± 10%) who had nonischemic valvular cardiomyopathy, underwent valvular heart surgery (aortic valve replacement, mitral valve replacement, and/or mitral valve repair), and subsequently had an electrophysiology study (EPS), for a median of 2.8 years. These patients were compared with 34 patients with prior myocardial infarction and no significant valvular heart disease, who were matched (1:2) for age, gender, LVEF, EPS result, T‐wave alternans result, and ICD placement. Occurrence of arrhythmias was ascertained from ICD device clinic follow‐up and vital status was determined using the National Death Index.
Results:

There were no differences between the groups in overall survival (P = 0.24) or arrhythmia‐free survival (P = 0.38), and the 2‐year arrhythmia‐free survival was 82% for the valvular patients versus 73% for the ischemic patients. Among patients with ICDs, there was no difference between the groups in overall survival (P = 0.34), time to first appropriate ICD therapy (P = 0.54), and arrhythmia‐free survival (P = 0.51).
Conclusion:

Patients with valvular cardiomyopathy and residual left ventricular dysfunction following valvular surgery who underwent a tailored approach to ICD implantation had similar overall and arrhythmia‐free survival as patients with ischemic cardiomyopathy.
Insulin‐Treated Type 2 Diabetes Is Associated with a Decreased Survival in Heart Failure Patients after Cardiac Resynchronization Therapy
Authors: MANGIAVACCHI MAURIZIO , GASPARINI MAURIZIO , GENOVESE STEFANO , PINI DANIELA , KLERSY CATHERINE , BRAGATO RENATO , ANDREUZZI BRUNO , MUNICINÒ ANNAMARIA , REGOLI FRANÇOIS , GALIMBERTI PAOLA , CERIOTTI CARLO , GRONDA EDOARDO 
Published: October 2008

Background:

Cardiac resynchronization therapy (CRT) improves cardiac performance and survival in patients with congestive heart failure. Recent observations suggest that diabetes is associated with a worse outcome in these patients. The aim of the study was to investigate the effect of diabetes and insulin treatment on outcome after CRT.
Methods:

Diabetic status and insulin treatment were assessed in 447 patients who underwent CRT (males 80.8%, mean age 65.7 ± 9.7 years, ejection fraction 29.9 ± 6.11%). Patients were stratified in three groups according to the presence or absence of diabetes and insulin treatment.
Results:

Nondiabetic patients were 366 (79.6%), noninsulin‐treated diabetic patients 62 (13.9%), insulin‐treated diabetic patients 29 (6.5%). The estimated death rate was 5.15 per 100 patients‐year in the nondiabetic group, 8.63 in noninsulin‐treated diabetics (HR 1.59, P = 0.240), and 15.84 in insulin‐treated diabetics (HR 3.05, P = 0.004). Cardiac mortality accounted for 81% of deaths in nondiabetic patients and for 56% of deaths in diabetic patients. Diabetic patients tended to have a worse recovery of left ventricular ejection fraction over time (P = 0.057) and of the distance at 6‐minute walking test (6MWT) (P = 0.018).
Conclusions:

Insulin‐treated diabetes is associated with a worse functional recovery and a higher mortality in patients with advanced heart failure after CRT. While cardiac death accounts for the majority of deaths in nondiabetic patients, a relevant proportion of the mortality in diabetic patients seem to result from noncardiac causes.
A Blended Sensor Restores Chronotropic Response More Favorably than an Accelerometer Alone in Pacemaker Patients: The LIFE Study Results
Authors: COMAN JAMES , FREEDMAN ROGER , KOPLAN BRUCE A. , REEVES RUSSELL , SANTUCCI PETER , STOLEN KIRA Q. , KRAUS STACIA M. , MEYER TIMOTHY E. 
Published: October 2008

Background:

Adaptive rate sensors used in permanent pacemakers incorporate an accelerometer (XL) to increase heart rate with activity. Limited data exists regarding the relative benefit of a blended sensor (BS) (XL and minute ventilation) versus XL alone in restoring chronotropic response (CR) in chronotropically incompetent (CI) patients.
Methods:

One thousand five hundred thirty‐eight patients from the limiting chronotropic incompetence for pacemaker recipients (LIFE) study were implanted with a pacemaker and 1,256 patients had data collected at 1 month. Patients performed a treadmill test 1‐month postimplant while programed in nonrate responsive mode (DDD‐60) to determine CI. Only patients who completed at least three exercise stages and achieved a peak perceived exertion ≥16 were included in the analyses. The metabolic chronotropic relationship (MCR) slope was used to evaluate CR in 547 patients. Patients were randomized to XL or BS with a conservative fixed rate response factor (XL = 8, MV = 4). CI patients performed a follow‐up 6‐month treadmill test.
Results:

CI prevalence in this patient population (n = 547) was 34%. No differences in baseline characteristics existed between groups. Although both groups showed significant within‐group improvements in MCR slope from 1 to 6 months (both P < 0.001), the BS group had a significantly higher MCR slope at 6 months compared to the XL group (P = 0.011). Improvement in quality of life (QOL) did not differ between groups.
Conclusions:

In this general pacemaker population with CI, a BS programed empirically restores CR more favorably than an XL sensor programed nominally. Further studies are needed to determine if individual sensor optimization would lead to improvement in functional capacity, higher MCR slopes, and QOL.
Optimal Site for Atrial Lead Implantation in Myotonic Dystrophy Patients: The Role of Bachmann's Bundle Stimulation
Authors: NIGRO GERARDO , RUSSO VINCENZO , VERGARA PASQUALE , D'ANDREA ANTONELLO , GREGORIO GRAZIA DI , POLITANO LUISA , NIGRO GIOVANNI , CALABRÒ RAFFAELE 
Published: October 2008

Aim:

The aim of this study was to identify the optimal site for atrial lead implantation in myotonic dystrophy type 1 (MD1) patients.
Methods:

The atrial pacing lead was positioned in the high‐lateral right atrial wall (site A), then in the right atrial appendage (site B), and finally on the interatrial septum (site C) in 22 patients. Pacing and sensing thresholds were obtained for all sites. The lead was repositioned and fixed at the optimal site, defined as the location with the lowest pacing and the highest sensing thresholds.
Results:

Mean pacing thresholds were 1.46 ± 0.32 V at site A, 1.45 ± 0.33 V at site B, and 0.84 ± 0.24 V at site C. P‐wave amplitude was 1.52 ± 0.45 mV at site A, 1.52 ± 0.49 mV at site B, and 2.60 ± 0.48 mV at site C. Atrial lead was implanted at site C in all patients without complications.
Conclusions:

Interatrial septum in the region of Bachmann's Bundle seems to be the optimal site for atrial lead implantation in MD1 patients.
A Randomized Trial of the Effect of Automated Ventricular Capture on Device Longevity and Threshold Measurement in Pacemaker Patients
Authors: KOPLAN BRUCE A. , GILLIGAN DAVID M. , NGUYEN LUC S. , LAU THEODORE K. , THACKERAY LISA M. , BERG KELLIE CHASE ,   for the ULTRA Study Investigators
Published: October 2008

Background:

An automatic capture (AC) algorithm adjusts ventricular pacing output to capture the ventricle while optimizing output to 0.5 V above threshold. AC maintains this output and confirms capture on a beat‐to‐beat basis in bipolar and unipolar pacing and sensing.
Objective:

To assess the AC algorithm and its impact on device longevity.
Methods:

Patients implanted with a pacemaker were randomized 1:1 to have the AC feature on or off for 12 months. Two threshold tests were conducted at each visit— automatic threshold and manual threshold. Average ventricular voltage output and projected device longevity were compared between AC on and off using nonparametric tests.
Results:

Nine hundred ten patients were enrolled and underwent device implantation. Average ventricular voltage output was 1.6 V for the AC on arm (n = 444) and 3.1 V for the AC off arm (n = 446) (P < 0.001). Projected device longevity was 10.3 years for AC on and 8.9 years for AC off (P < 0.0001), or a 16% increase in longevity for AC on. The proportion of patients in whom there was a difference between automatic threshold and manual threshold of ≤0.5 V through follow‐up was 99.0% (95% CI: 98.6, 99.3). The average difference between automatic threshold and manual threshold was 0.07 V (P = 0.002).
Conclusions:

This study showed that automatic threshold testing at follow‐up provided comparable information to manually measured threshold testing. AC provided a significant increase in projected device longevity compared to standard programing.