bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poor Health‐Related Quality of Life of Patients with Indication for Chronic Cardiac Pacemaker Therapy
Authors: MARTIJN VAN ECK J.W. , VAN HEMEL NORBERT M. , KELDER JOHANNES. C. , VAN DEN BOS ARJAN A. , TAKS WILLIAM , GROBBEE DIEDERICK E. , MOONS KAREL G.M. ,   on behalf of the FOLLOWPACE investigators
Published: March 2008

Background:

Studies on health‐related quality of life (HRQoL) of patients awaiting pacemaker (PM) implantation are scarce, or executed in specific patient subgroups (regarding age or specific cardiac rhythm disorders). The purpose of this study was to systematically assess the HRQoL in a large unselected cohort of patients with a conventional indication for PM therapy.
Methods:

Pre‐PM implantation HRQoL (measured with the SF‐36 questionnaire, completed at hospital admission) of 818 consecutive Dutch patients included in the FOLLOWPACE study was compared with the HRQoL in a sample of the general Dutch population, and with several cohorts of patients with other conditions. Linear regression analysis was performed to analyze determinants of this HRQoL.
Results:

Almost all SF‐36 subscale scores were substantially and significantly lower in the PM patients compared to the general population, with P‐values < 0.001 in all SF‐36 subscales except for “pain” and “general health perception.” In the PM patients, presence of comorbidities, gender, and age were significantly associated with the overall physical component summary score (mean 38.8 ± 27 standard deviation) whereas the overall mental component summary score (46.8 ± 27.0) was associated with gender and age.
Conclusion:

The HRQoL of patients before first PM implantation is significantly lower than that of a general population and also various other patient populations. Physicians should be aware of this unfavorable condition and keep the time interval between the diagnosis of a cardiac rhythm disorder requiring PM implantation and the implantation procedure as short as possible.
Methamphetamine‐related Emergency Department Utilization and Cost
Authors: Hendrickson Robert G. , Cloutier Robert , John McConnell K. 
Published: March 2008

AbstractObjective:  To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use.Methods:  This was a prospective observational study. The authors performed a training program for ED clinicians on the acute and chronic effects of methamphetamine and the signs of methamphetamine abuse. A standardized two question survey was administered to clinicians concerning the relationship between the ED visit and the patient’s methamphetamine use. The survey was embedded in the patient tracking system and was required for all ED patients before disposition. Survey results were merged with administrative data on demographics, diagnosis, disposition, and charges. Univariate analyses were used to determine patient characteristics associated with methamphetamine‐related ED visits.Results:  The authors examined 15,038 ED visits over a 20‐week period from February 2006 to June 2006. There were a total of 353 methamphetamine‐related visits, for an average of 17.65 visits per week (2.4% of all visits). Hospital charges for methamphetamine‐related ED visits averaged $133,181 per week, for an estimated total of $6.9 M in annual charges. Methamphetamine‐related ED patients were more likely to be male (odds ratio [OR] 1.6, 95% confidence interval [CI] = 1.30 to 2.01), white (OR 1.8, 95% CI = 1.38 to 2.29), and uninsured (OR 3.2, 95% CI = 2.21 to 4.69). The top four medical conditions associated with methamphetamine‐related visits were mental health (18.7%), trauma (18.4%), skin infections (11.1%), and dental diagnoses (9.6%).Conclusions:  Methamphetamine abuse accounts for a modest but substantial proportion of ED utilization and hospital cost. Methamphetamine‐related ED visits are most commonly related to mental illness, trauma, skin, and dental‐related problems.
Ultrasonographic Investigation of the Effect of Inguinal Compression on the Cross‐sectional Area of the Femoral Vein
Authors: Kim Jin‐Tae , Lee Nan‐Ju , Na Hyo‐Seok , Jeon Yunseok , Kim Hee‐Soo , Kim Chong‐Sung , Kim Seong‐Deok 
Published: March 2008

AbstractObjectives:  The reverse Trendelenburg position increases the cross‐sectional area (CSA) of the femoral vein, making it easier to cannulate, although this position is potentially harmful in hypovolemic patients. The authors hypothesized that compression above the femoral vein increases the CSA of the femoral vein during emergency cannulation.Methods:  Ultrasound was used to measure the CSA of the femoral vein of 20 healthy volunteers. The following five measurements were made inferior to the inguinal crease: 1) in the horizontal supine position (control), 2) with inguinal compression 2 cm above the inguinal crease (at the point of arterial pulsation and its medial side), 3) in the Trendelenburg position 15°, 4) in the Trendelenburg position 15° plus inguinal compression, and 5) in the reverse Trendelenburg position 15°.Results:  Femoral vein CSA was increased by 35% by inguinal compression in the horizontal supine position (p < 0.001) and was decreased by the Trendelenburg position (p < 0.001). However, inguinal compression increased the CSA by 66% in the Trendelenburg position (p < 0.001). The reverse Trendelenburg position also increased the CSA of the femoral vein by 50% (p < 0.001).Conclusions:  Inguinal compression presents an alternative method for increasing the CSA of the femoral vein for venous catheterization in normal patients.
Safety and Clinical Effectiveness of Midazolam versus Propofol for Procedural Sedation in the Emergency Department: A Systematic Review
Authors: Hohl Corinne Michèle , Sadatsafavi Mohsen , Nosyk Bohdan , Anis Aslam Hayat 
Published: March 2008

AbstractObjectives:  To synthesize the evidence comparing the adverse event (AE) profile and clinical effectiveness of midazolam and propofol for procedural sedation (PS) in adults in the emergency care setting.Methods:  The authors conducted a systematic review of randomized controlled trials (RCTs) and observational studies reporting the use of either midazolam and/or propofol for adult PS in the emergency department (ED). A systematic search strategy was developed and applied to six bibliographic reference databases. Three emergency medicine journals, the Canadian Adverse Drug Reaction Newsletter, and conference proceedings were hand‐searched. Retrieved articles were reviewed and data were abstracted using standardized data collection. Trial quality was assessed using the Jadad score. The outcomes assessed were the proportion of patients with AEs and the pooled mean difference in the proportion of patients with successful PS.Results:  Of 229 articles identified, 28 met the inclusion criteria for the analysis of AEs. Only one major AE to PS was found, resulting in no statistically significant difference in the proportion of major AEs between agents. Four studies were RCTs that met the inclusion criteria for the analysis of clinical effectiveness. Two trials met criteria for good quality. The RCTs enrolled between 32 and 86 patients, and the most common indications for PS were orthopedic reductions and cardioversions. There was a nonsignificant difference in the proportion of patients with successful PS in favor of propofol (effect difference 2.9%, 95% confidence interval (CI) = –6.5 to 15.2).Conclusions:  The authors found no significant difference in the safety profile and the proportion of successful PS between midazolam and propofol for adults in the ED.
A Cost‐effectiveness Analysis of Propofol versus Midazolam for Procedural Sedation in the Emergency Department
Authors: Hohl Corinne Michèle , Nosyk Bohdan , Sadatsafavi Mohsen , Anis Aslam Hayat 
Published: March 2008

AbstractObjectives:  To determine the incremental cost‐effectiveness of using propofol versus midazolam for procedural sedation (PS) in adults in the emergency department (ED).Methods:  The authors conducted a cost‐effectiveness analysis from the perspective of the health care provider. The primary outcome was the incremental cost (or savings) to achieve one additional successful sedation with propofol compared to midazolam. A decision model was developed in which the clinical effectiveness and cost of a PS strategy using either agent was estimated. The authors derived estimates of clinical effectiveness and risk of adverse events (AEs) from a systematic review. The cost of each clinical outcome was determined by incorporating the baseline cost of the ED visit, the cost of the drug, the cost of labor of physicians and nurses, the cost and probability of an AE, and the cost and probability of a PS failure. A standard meta‐analytic technique was used to calculate the weighted mean difference in recovery times and obtain mean drug doses from patient‐level data from a randomized controlled trial. Probabilistic sensitivity analyses were conducted to examine the uncertainty around the estimated incremental cost‐effectiveness ratio using Monte Carlo simulation.Results:  Choosing a sedation strategy with propofol resulted in average savings of $17.33 (95% confidence interval [CI] = $24.13 to $10.44) per sedation performed. This resulted in an incremental cost‐effectiveness ratio of –$597.03 (95% credibility interval –$6,434.03 to $6,113.57) indicating savings of $597.03 per additional successful sedation performed with propofol. This result was driven by shorter recovery times and was robust to all sensitivity analyses performed.Conclusions:  These results indicate that using propofol for PS in the ED is a cost‐saving strategy.
Clinicopathologic Conference: A 28‐year‐old Woman with Perioral Cyanosis and Low Oxygen Saturation
Authors: Sankoff Jeffrey , Louie Andrew D. 
Published: March 2008

AbstractThe authors present a case of a 28‐year‐old woman on trimethoprim/sulfamethoxazole for 9 months, who presented to the emergency department with weakness, shortness of breath, and cyanosis. The patient’s clinical course is outlined. A discussion of the potential etiologies, as well as the clinical management, is provided.
Adjunctive Atropine Is Unnecessary during Ketamine Sedation in Children
Authors: Brown Lance , Christian‐Kopp Sarah , Sherwin Thomas S. , Khan Aqeel , Barcega Besh , Denmark T. Kent , Moynihan James A. , Kim Grace J. , Stewart Gail , Green Steven M. 
Published: March 2008

AbstractBackground:  The prophylactic coadministration of atropine or other anticholinergics during dissociative sedation has historically been considered mandatory to mitigate ketamine‐associated hypersalivation. Emergency physicians (EPs) are known to omit this adjunct, so a prospective study to describe the safety profile of this practice was initiated.Objectives:  To quantify the magnitude of excessive salivation, describe interventions for hypersalivation, and describe any associated airway complications.Methods:  In this prospective observational study of emergency department (ED) pediatric patients receiving dissociative sedation, treating physicians rated excessive salivation on a 100‐mm visual analog scale and recorded the frequency and nature of airway complications and interventions for hypersalivation.Results:  Of 1,090 ketamine sedations during the 3‐year study period, 947 (86.9%) were performed without adjunctive atropine. Treating physicians assigned the majority (92%) of these subjects salivation visual analog scale ratings of 0 mm, i.e., “none,” and only 1.3% of ratings were ≥ 50 mm. Transient airway complications occurred in 3.2%, with just one (brief desaturation) felt related to hypersalivation (incidence 0.11%, 95% confidence interval = 0.003% to 0.59%). Interventions for hypersalivation (most commonly suctioning) occurred in 4.2%, with no occurrences of assisted ventilation or intubation.Conclusions:  When adjunctive atropine is omitted during ketamine sedation in children, excessive salivation is uncommon, and associated airway complications are rare. Anticholinergic prophylaxis is not routinely necessary in this setting.
Trends in Charges and Payments for Nonhospitalized Emergency Department Pediatric Visits, 1996–2003
Authors: Hsia Renee Y. , MacIsaac Donna , Palm Erin , Baker Laurence C. 
Published: March 2008

AbstractObjectives:  To compare charges and payments for outpatient pediatric emergency visits across payer groups to provide information on reimbursement trends.Methods:  Total charges and payments for emergency department (ED) visits Medicaid/State Children’s Health Insurance Program (SCHIP), privately insured, and uninsured pediatric patients from 1996 to 2003 using data from the Medical Expenditure Panel Survey. Average charges per visit and average payments per visit were also tracked, using regression analysis to adjust for changes in patient characteristics.Results:  While charges for pediatric ED visits rose over time, payments did not keep pace. This led to a decrease in reimbursement rates from 63% in 1996 to 48% in 2003. For all years, Medicaid/SCHIP visits had the lowest reimbursement rates, reaching 35% in 2003. The proportion of visits from children insured by Medicaid/SCHIP also increased over the period examined. In 2003, after adjustment, charges were $792 per visit from children covered by Medicaid/SCHIP, $913 for visits from uninsured children, and $952 for visits from privately insured children.Conclusions:  Reimbursements for outpatient ED visits in the pediatric population have decreased from the period of 1996 to 2003 in all payer groups: public (Medicaid/SCHIP), private, and the uninsured. Medicaid/SCHIP has consistently paid less per visit than the privately insured and the uninsured. Further research on the effects of these declining reimbursements on the financial viability of ED services for children is warranted.
Sinus floor augmentation with recombinant human growth and differentiation factor‐5 (rhGDF‐5): a histological and histomorphometric study in the Goettingen miniature pig
Authors: Gruber Rudolf M. , Ludwig Arwed , Merten Hans‐Albert , Achilles Mirjam , Poehling Sylke , Schliephake Henning 
Published: March 2008

AbstractAim: The aim of this study was to test the hypothesis that recombinant human growth and differentiation factor‐5 (rhGDF‐5) enhances bone formation in sinus floor augmentations in miniature pigs.Material and methods: The maxillary sinus floors in 12 adult female Goettingen minipigs were augmented with β‐tricalcium phosphate (β‐TCP) on one side. The contralateral test side was augmented using two concentrations of rhGDF‐5 (400 μg rhGDF‐5/g β‐TCP; 800 μg rhGDF‐5/g β‐TCP) delivered on β‐TCP (six animals each). One dental implant was inserted into each sinus floor augmentation. After 4 and 12 weeks, histological and histomorphometric assessment of non‐decalcified histological specimens was performed.Results: The results showed significantly higher mean values of volume density (VD) of newly formed bone using the concentration of 400 μg/g β‐TCP (22.8%) compared with the respective control (8%) after 4 weeks (P=0.05).The bone‐to‐implant contact rates were also significantly enhanced after 4 weeks between test sites (400 μg: 41.9%; 800 μg: 40.6%) and control sites (400 μg: 7.8%; 800 μg: 16.4%) (400 μg: P=0.024; 800 μg: P=0.048).Conclusion: It is concluded that rhGDF‐5 delivered on β‐TCP significantly enhanced early bone formation compared with β‐TCP alone in sinus lift procedures in miniature pigs.
Soft tissue dehiscence coverage around endosseous implants: a prospective cohort study
Authors: Burkhardt R. , Joss A. , Lang N. P. 
Published: March 2008

AbstractAim: To evaluate the healing outcome of soft tissue dehiscence coverage at implant sites.Material and methods: Ten patients with one mucosal recession defect at an implant site and a contralateral unrestored clinical crown without recession were recruited. The soft tissue recessions were surgically covered using a coronally advanced flap in combination with a free connective tissue graft. Healing was studied at 1, 3 and 6 months post‐operatively.Results: Soft tissue dehiscences were covered with a coronal overcompensation of the flap margin up to 1.2 mm after the procedure. After 1 month, the coverage shrank to a mean of 75%, after 3 months to 70% and after 6 months to 66%.Conclusions: The implant sites revealed a substantial, clinically significant improvement following coronal mucosal displacement in combination with connective tissue grafting, but in none of the sites, a could complete implant soft tissue dehiscence coverage be achieved.
Resonance frequency analysis of stability on ITI implants with osteotome sinus floor elevation technique without grafting: a 5‐month prospective study
Authors: Lai Hong‐Chang , Zhang Zhi‐Yong , Wang Feng , Zhuang Long‐Fei , Liu Xin 
Published: March 2008

AbstractObjective: The aim of the present study was to (1) monitor the stability changes of ITI implants placed in atrophic posterior maxillary ridges with osteotome sinus floor elevation (OSFE) without grafting during the first 5 months of healing utilizing resonance frequency analysis (RFA) and (2) determine the factors that affect the implant stability quotient (ISQ) at placement and healings.Material and methods: Forty‐two ITI implants were placed in the posterior maxilla in 32 patients with OSFE without bone grafting. The residual vertical bone height ranged from 4 to 8 mm (average 6.36 mm). Bone type was classified into one to four groups according to the Lekholm and Zarb index. ISQ was tested on the day of surgery and consecutively at 2, 4, 6, 8, 12, 16, and 20 weeks by RFA.Results: The 40 osseointegrated implants represented a survival rate of 95.2%. All the 40 implants achieved good primary stability and reached a comparably high stability at 16 weeks postoperation with a dip between 2 and 6 weeks in the stability curve. There was no significant difference of ISQ between type3 and type4 bone at implant placement and follow‐up. The mean ISQ and its changing pattern did not demonstrate a statistically significant difference according to the pretreatment vertical bone height and implant length.Conclusions: The findings of this study indicated that uneventful osseointegration may be predictable applying OSFE alone with no grafting in atrophic posterior maxilla. Residual bone height (RBH), implant length, and bone type did not seem to affect the implant stability in this clinical situation.
Effect of periodontal treatment on IL‐1β, IL‐1ra, and IL‐10 levels in gingival crevicular fluid in patients with aggressive periodontitis
Authors: Toker Hulya , Poyraz Omer , Eren Kaya 
Published: March 2008

AbstractAim: The aim of this study was to examine the effect of phase I periodontal treatment on the levels of interleukin (IL)‐1β, IL‐1ra, and IL‐10 in gingival crevicular fluid (GCF) in patients with generalized aggressive periodontitis (G‐AgP).Material and Methods: Data were obtained from 15 patients with aggressive periodontitis and 15 healthy controls. GCF was collected from at least four pre‐selected sites (one shallow, at least two moderate, or at least one deep pockets) in patients with G‐AgP. In the healthy group, GCF samples were collected from one site. The cytokine levels were determined by an enzyme‐linked immunosorbent assay. Probing depth, clinical attachment level (CAL), gingival and plaque indices, and bleeding on probing were measured. The GCF sampling and clinical measurements were recorded at baseline and 6 weeks later after periodontal treatment.Results: IL‐1β levels were significantly higher at the moderate and deep pocket sites compared with the shallow sites (p<0.05). After periodontal therapy, IL‐1β levels were significantly reduced in the moderate and deep pocket sites (p<0.05). IL‐1ra levels at baseline of the moderate and deep pocket sites were significantly lower than the control sites (p<0.05). IL‐10 levels were similar in all pockets and did not change after periodontal therapy.Conclusions: The periodontal treatment improves the clinical parameters in G‐AgP, and this improvement is evident in deep pocket sites for pocket depth and CAL values. These results confirm that IL‐1β is effective for evaluating the periodontal inflammation and can thus be used as a laboratory tool for assessing the activity of periodontal disease.
Oral status and its association with obesity in Southern Brazilian older people
Authors: Hilgert Juliana Balbinot , Hugo Fernando Neves , Sousa Maria da Luz Rosário de , Bozzetti Mary Clarisse 
Published: March 2008

Background and objective:  The loss of a functional dentition imposes eating difficulties and food avoidance, which may be detrimental in terms of nutritional status and health. The objective of this study was to investigate whether tooth loss and edentulism that were not rehabilitated with dental prostheses were associated with obesity among elderly in Southern Brazil.Materials and methods:  A random sample of 872 independently living elderly was evaluated by means of a cross‐sectional study. Socio‐demographic, medical history and behaviour data were assessed using a standardised questionnaire. Two trained dentists assessed the number of teeth and use of prostheses in accordance with the WHO criteria. Height and weight were assessed and used to generate body mass index (BMI = weight (kilos)/height (cm)2) data. Participants were categorised into non‐obese (BMI ≤ 30) or obese (BMI > 30). Multivariate logistic regression was used to model the relationship between number of teeth and use of dental prostheses with obesity adjusting for confounders.Results:  Multivariate logistic regression revealed that edentulous persons wearing only upper dentures (OR = 2.34, 95% CI 1.18–4.27) and dentate participants with one to eight teeth wearing 0‐to‐1 prosthesis (OR = 2.96, 95% CI 1.68–5.19) were more likely to be obese.Conclusion:  The results show that a poorer oral status, represented by having fewer teeth that were not replaced by dental prostheses, was associated with obesity in Southern Brazil older people, suggesting a close relationship between poor oral status and systemic conditions that may have important clinical implications.
Food Habits and Livestock Depredation of Sympatric Jaguars and Pumas in the Iguaçu National Park Area, South Brazil
Authors: De Azevedo Fernando Cesar Cascelli 
Published: March 2008

ABSTRACTUnderstanding coexistence between sympatric felines with similar body sizes, such as jaguarsPanthera oncaand pumasPuma concolor, requires knowledge of the way these predators consume and partition food resources. Yet the importance of livestock predation on jaguar and puma coexistence is poorly known. I investigated food habits and patterns of livestock depredation of jaguar and pumas in the Iguaçu National Park (INP) in southern Brazil. From 1997 to 2001, I collected scats opportunistically on trails and roads in INP and visited ranches on the border of INP. I found that jaguars relied mostly on large and medium‐sized wild prey species, while pumas concentrated on medium‐sized prey species. Livestock was the fifth most frequent prey found in jaguar scats but the most important one in terms of biomass consumed. Jaguar and puma diets differed significantly when all prey items were compared and also when livestock was excluded from the jaguar diet. Jaguar predation on livestock was considerably higher than predation by pumas. However, predation was not substantial relative to availability of livestock, and cattle likely constitute an alternative source of prey for jaguars. Degree of diet overlap between jaguar and puma in INP suggests that coexistence was likely driven by exploitative competition through some degree of food partitioning. My results highlight the importance of more actions toward increasing numbers of large ungulates to preserve the population of jaguars in INP.