bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tricuspid valve replacement after cardiac transplantation
Authors: Raghavan Ramya , Cecere Renzo , Cantarovich Marcelo , Giannetti Nadia 
Published: July 2006

Abstract:  Background:  Tricuspid regurgitation (TR) occurs commonly in transplanted hearts. Although theoretically attractive, tricuspid valve replacement (TVR) has not been widely investigated as a possible therapy in post‐transplant patients. The purpose of this study was to determine the safety of TVR in heart transplant patients and its effects on measurable clinical endpoints.Methods:  We acquired data by both retrospective chart review and prospective data collection in all patients who underwent TVR after cardiac transplantation.Results:  Nine patients were identified and followed for a period of six months. The age of patients at time of TVR was 62 ± 6.1 yr and their average time since transplantation was 12 ± 3.2 yr. Most patients demonstrated a reduction in their furosemide dose (105 ± 63 mg/d pre‐TVR vs. 67.5 ± 65 mg/d post‐TVR, p = 0.001) with a reduction in serum creatinine levels (188 ± 72 μmol/L pre‐TVR vs. 143 ± 42 μmol/L post‐TVR, p = 0.06). Additionally, we found a significant improvement in albumin values (32 ± 5 g/L pre‐TVR vs. 42 ± 3 g/L post‐TVR, p = 0.002) as well as an improvement in total bilirubin (35 ± 18 μmol/L pre‐TVR vs. 18 ± 5 μmol/L post‐TVR, p = 0.05). There was only one death in our series, in the only patient with known severe graft atherosclerosis.Conclusions:  TVR appears to be a safe procedure in patients without severe graft atherosclerosis with improvements in serum creatinine, albumin and total bilirubin values, in addition to a reduction in furosemide dose. This may reflect improved forward flow, improved symptomatology from TR as well as possible beneficial effects on nutritional status.
Quantification of a low cellular immune response to aid in identification of pediatric liver transplant recipients at high‐risk for EBV infection
Authors: Lee Timothy C. , Goss John A. , Rooney Cliona M. , Heslop Helen E. , Barshes Neal R. , Caldwell Yvette M. , Gee Adrian P. , Scott Jaymee D. , Savoldo Barbara 
Published: July 2006

Abstract:  Objective:  Uncontrolled EBV infection leading to lymphoproliferative disease is a significant cause of morbidity in pediatric orthotopic liver transplant (OLT) recipients. Herein, we describe the use of a novel immune assay, which quantifies the lymphocyte immune response and correlates the value to risk for EBV infection.Methods:  All patient data were prospectively collected between 2003 and 2005. The study included 18 pediatric liver transplant recipients, seven males and 11 females with a mean follow‐up of 47 months post‐OLT. Patient EBV load was monitored using real‐time quantitative PCR (qPCR). The ATP release (ng/mL) of CD3+ lymphocytes after mitogenic stimulation with phytohemagluttinin (PHA; Cylex Corporation) was used to quantitate patient immune response. Patients were stratified by EBV load: low (<1000 copies/μg DNA), medium (1000–4000 copies/μg DNA), and high (>4000 copies/μg DNA).Results:  Patients with low EBV loads had a significantly (p < 0.04) stronger immune response to PHA than patients with EBV load >1000 copies/μg DNA. Further analysis demonstrated that patients with ATP level <125 ng/mL had 100% probability of an EBV titer >4000 copies/μg DNA, when compared with 22% if the ATP level was between 125 and 400 ng/mL or only 15% if >400 ng/mL (p < 0.05). When immunosuppression was reduced, we observed an increase of the ATP release that correlated with a decrease of the EBV viral load.Conclusion:  In conclusion, this study investigates the use of a lymphocyte activation assay to closely measure the immunosuppression status of pediatric liver transplant recipients. Because measurement of EBV DNA load as a single parameter has a poor positive predictive value for development of PTLD, the association of these assays may be of help in the identification of patients at risk for PTLD.
Attitude of kidney patients on the transplant waiting list toward related‐living donation. A reason for the scarce development of living donation in Spain1
Authors: Martínez‐Alarcón L. , Ríos A. , Conesa C. , Alcaraz J. , González M.J. , Ramírez P. , Parrilla P. 
Published: July 2006

Summary:  Introduction:  Most Spanish transplant centers have on‐going living kidney transplant programs. However, such transplants are not increasing as a proportion of the total number of kidney transplants. The objective of this study is to analyze the attitude of kidney patients on the kidney transplant waiting list toward living kidney donation.Materials and methods:  The patients studied were selected from those included on the kidney transplant waiting list from November 2003 until September 2005 (n = 221). Attitude toward living donation was evaluated using a psychosocial questionnaire. It was completed in a direct personal interview with an independent health‐care worker from the Transplant Unit. Student's t‐test and the chi‐squared test were applied.Results:  Two hundred and fourteen patients completed the questionnaire (97%), of which 35% would accept a related living kidney if it were offered to them, 60% would prefer to wait on the waiting list and the remaining 5% are undecided. Up to 66% (n = 134) of patients report that a member of their family or a friend have offered them an organ for donation. Eighty‐nine percentage believe that there is some risk involved in living kidney donation, although it is not a factor that affects whether an organ would be accepted or not (p = 0.767). The psychosocial variables that affect attitude toward accepting a related living kidney are: (i) age: the youngest are those who are most likely to accept (40 vs. 45‐yr‐old; p = 0.010); (ii) descendents: patients without descendents are more likely to accept a living organ (56% vs. 27%; p < 0.000); (iii) marital status: a greater percentage of single respondents would be prepared to receive this type of transplant compared to the group of married respondents (55% vs. 30%. p = 0.007); and (iv) level of education: those with a higher level of education are more likely to accept a living organ (43% have secondary or university studies vs. 28% who only have primary education; p = 0.040).Conclusion:  Patients on the waiting list for a kidney transplant do not have a very favorable attitude toward receiving a related‐living donor organ, although members of their family have offered them one of their organs. The profile of a patient who would accept a related‐living donated kidney is a young, single person, without descendents, and with a high level of education.
Early and late histopathological changes in renal allografts procured by laparoscopic donor nephrectomy
Authors: Shimizu Tomokazu , Tanabe Kazunari , Miyamoto Naoshi , Tokumoto Tadahiko , Ishida Hideki , Toma Hiroshi , Yamaguchi Yutaka 
Published: June 2006

Abstract:  Introduction:  Subcapsular cortical damage (SCCD) is a characteristic pathological change, which is seen in renal allograft biopsy specimen obtained immediately after laparoscopic donor nephrectomy (LDN). In this study we evaluated the early and late histopathological effect of SCCD examining renal allograft biopsy specimens obtained after kidney transplantation.Materials and methods:  Laparoscopic donor nephrectomy was performed on 250 donors between July 2000 and September 2004 in our institution. Allograft biopsy of all 250 kidneys was performed immediately after LDN (zero hour biopsy). Of 250 biopsy specimens, 105 were diagnosed as SCCD and the allograft biopsy specimens obtained from 105 recipients after transplantation were enrolled in this study. All specimens were routinely examined by using light microscopy and immunofluorescence.Results:  In 87 patients 256 allograft biopsy specimens did not show post‐pathological changes of SCCD. Twenty biopsy specimens obtained from 18 recipients showed tubular necrosis and a partly tubular regeneration and patchy interstitial hemorrhage, which seemed to be caused by SCCD. Ten allograft biopsy specimens from nine recipients demonstrated residual pathologic changes in SCCD early after transplantation. The other 10 specimens from nine recipients had abnormal histopathologic changes including interstitial edema and fibrosis, tubular atrophy and glomerular sclerosis in the subcapsular cortex late after transplantation.Conclusion:  The early change of SCCD after transplantation remained intact and partial regeneration and the late showed subcapsular fibrosis with glomerular sclerosis. The incidence of the subcapsular lesions due to SCCD after transplantation was 17% in 105 allografts.
Incidence of positive C4d deposition in long‐term survival cases over 10 yr after renal transplantation
Authors: Namba Yukiomi , Oka Kazumasa , Moriyama Toshiki , Kyo Masahiro , Imamura Ryoichi , Shi Yi , Ichimaru Naotsugu , Isaka Yoshitaka , Takahara Shiro , Okuyama Akihiko 
Published: June 2006

Abstract:  Background:  The incidence of positive C4d deposition in peritubular capillaries (PTC) in long‐term survival cases remains controversial. Some incidences of positive C4d deposition in PTC in cases of long‐term survival less than 10 yr have been reported. We retrospectively examined the incidence of positive C4d deposition in long‐term survival cases over 10 yr after renal transplantation and the histological and clinical characteristics of the positive C4d staining cases.Methods:  We examined 14 protocol biopsy cases performed at Osaka University Hospital between March 2004 and March 2005. The average interval between the operation and the day of biopsy was 15.4 yr. Histological diagnosis was made in accordance with the Banff 97 classification. Paraffin‐embedded tissue was stained with polyclonal anti‐C4d antibody. Detection of donor‐specific antibody (DSA) was determined by flow cytometric assay. The cases were divided according to C4d positivity.Results:  Three of 14 cases (21.4%) were C4d positive and belonged to the C4d+/DSA+ group, while 11 cases were of the C4d−/DSA− group. There were no significant differences between the two groups in serum creatinine (sCr) or proteinuria at the time of biopsy. A trend towards decreasing rate of the inverse of sCr (1/sCr) in the C4d+/DSA+ group was noted. In the C4d+/DSA+ group, three transplant glomerulopathy (TGP) were identified. On the other hand, TGP were identified in six of 11 cases of the C4d−/DSA− group. We investigated the relevance of typical chronic rejection (CR) features and the positivity of C4d. No significant differences were observed between the CR features and C4d depositions in PTC (p = 0.26).Conclusion:  In long‐term survival cases with positive C4d, a trend towards decreasing rate of 1/sCr was revealed, but their histological characteristic features was not recognized.
Temperature and leaf wetness duration affect phenotypic expression ofRlm6‐mediated resistance toLeptosphaeria maculansinBrassica napus
Authors: Huang Yong‐Ju , Evans Neal , Li Zi‐Qin , Eckert Maria , Chèvre Anne‐Marie , Renard Michel , Fitt Bruce D. L. 
Published: July 2006

SummaryNear‐isogenicBrassica napuslines carrying/lacking resistance geneRlm6were used to investigate the effects of temperature and leaf wetness duration on phenotypic expression ofRlm6‐mediated resistance.Leaves were inoculated with ascospores or conidia ofLeptosphaeria maculanscarrying the effector geneAvrLm6. Incubation period to the onset of lesion development, number of lesions and lesion diameter were assessed. Symptomless growth ofL. maculansfrom leaf lesions to stems was investigated using a green fluorescent protein (GFP) expressing isolate carryingAvrLm6.L. maculansproduced large grey lesions on Darmor (lackingRlm6) at 5–25 °C and DarmorMX (carryingRlm6) at 25°C, but small dark spots and ‘green islands’ on DarmorMX at 5–20°C. With increasing temperature/wetness duration, numbers of lesions/spots generally increased. GFP‐expressingL. maculansgrew from leaf lesions down leaf petioles to stems on DarmorMX at 25°C but not at 15°C.We conclude that temperature and leaf wetness duration affect the phenotypic expression ofRlm6‐mediated resistance in leaves and subsequentL. maculansspread down petioles to produce stem cankers.
Comparison of Risk Factors Between Prehypertension and Hypertension in Korean Male Industrial Workers
Authors: Lee Ji Hyun , Hwang Seon Young , Kim Eun Jeong , Kim Mi Ja 
Published: June 2006

ABSTRACT
Objectives: To compare risk factors for prehypertension and hypertension in male industrial workers in Korea.Sample: Participants included 2,476 males aged 19–56 years who were employed in an airplane manufacturing industry.Methods: Health records of all subjects were analyzed during a biennial employee physical checkup that included a health survey questionnaire and blood tests.Results: Forty‐six percent of subjects had prehypertension and 15% had hypertension. Multivariate logistic regression analysis showed that, after adjustment for age, workplace, and risk variables, subjects who were currently alcohol drinkers, in blue collar jobs, body mass index (BMI) ≥25 kg/m2, and had cholesterol ≥201 mg/dl were 1.30, 1.28, 1.27, and 1.21 times more likely to have prehypertension respectively, compared with normotensives. Subjects with FBS≥121 mg/dl, BMI≥25 kg/m2, and age≥40 years were 2.47, 1.52, and 1.36 times more likely to have hypertension respectively, compared with prehypertensive subjects.Conclusions: Nurses working in the industrial sector should focus on education and counseling regarding the risk factors for prehypertension and hypertension, and they should emphasize the importance of healthy lifestyles and curbing obesity to help arrest the progression of prehypertension to hypertension.
Teaching Emergency Preparedness to Restricted‐Budget Families
Authors: Mack Shannon E. , Spotts Daniel , Hayes Atraya , Warner Joanne Rains 
Published: June 2006

ABSTRACT
Objectives: To fulfill the health teaching and promotion responsibilities of public health nurses, a teaching intervention was devised to prepare low‐income, low‐resource families to survive a worst‐case disaster scenario. The purpose of this study is to introduce that plan.Design: Teaching sessions were held to increase awareness about disaster preparedness and to provide the resources necessary for preparing disaster kits on a restricted budget.Sample: This project focused on families enrolled at the Children's Relief Nursery in Portland, Oregon's St. Johns District.Measurements: Posttest assessments and client follow‐up at 3, 6, and 12 months were used to assess the effectiveness of the curriculum and follow‐through on kit preparation.Results: A replicable teaching tool was successfully developed, and the interest and commitment of community partners dedicated to assisting restricted‐budget families was secured.Conclusions: States' disaster plans hinge on individuals' implementation of their own survival plans, and it is vital that these individuals be made aware of their responsibility. It is truly a matter of life and death that families possess the skills, knowledge, and resources to carry out a disaster survival plan successfully, and it is the ethical responsibility of the public health nurse to intervene.
A Validation and Potential Modification of the Pneumonia Severity Index in Elderly Patients with Community‐Acquired Pneumonia
Authors: Naito Tateaki , Suda Takafumi , Yasuda Kazumasa , Yamada Takashi , Todate Akihito , Tsuchiya Tomoyoshi , Sato Jun , Chida Kingo , Nakamura Hirotoshi 
Published: July 2006

OBJECTIVES: To evaluate the discriminatory power of the Pneumonia Severity Index (PSI) in elderly patients with community‐acquired pneumonia (CAP) and to improve its performance.DESIGN: Retrospective review of 193 patients from 1999 to 2001 to derive prognostic rules. The rules were prospectively validated in 144 patients from 2002 to 2003.SETTING: Iwata City Hospital, a 400‐bed general hospital.PARTICIPANTS: Patients aged 80 and older who had CAP and were admitted to the hospital.MEASUREMENTS: Predictors of 30‐day mortality were identified using logistic regression analysis, and several rules were constructed by combining the PSI and the independent predictors. Classification and regression tree analysis was also used for constructing rules. Sensitivity and specificity were calculated.RESULTS: The original PSI, which defines PSI Class IV and V as a high‐risk group, did not perform well in discriminating survivors from nonsurvivors (sensitivity 100%, specificity 15%), whereas a modified PSI, which defines only PSI Class V as a high‐risk group, performed better (sensitivity 86%, specificity 63%). Three predictors for mortality were identified independent from the modified PSI: performance status (PS) Grade 3 or higher, anorexia, and partial pressure of carbon dioxide of 50 mmHg or greater. By combining the modified PSI and PS, the performance could be further improved (sensitivity 79%, specificity 80%).CONCLUSION: The modified PSI could identify low‐risk patients more accurately than the original PSI. In addition, by combining the modified PSI with PS, higher performance was obtained. Such information would aid physicians in clinical decision‐making without overestimating the risk for elderly patients with CAP.
Characteristics of 32 Supercentenarians
Authors: Schoenhofen Emily A. , Wyszynski Diego F. , Andersen Stacy , Pennington JaeMi , Young Robert , Terry Dellara F. , Perls Thomas T. 
Published: July 2006

OBJECTIVES: To report phenotypic characteristics of 32 age‐validated supercentenarians.DESIGN: Case series.SETTING: U.S.‐based recruitment effort.PARTICIPANTS: Thirty‐two supercentenarians.MEASUREMENTS: Multiple forms of proof were used to validate age claims. Sociodemographic, activities of daily living, and medical history data were collected.RESULTS: Age range was 110 to 119. Fifty‐nine percent had Barthel Index scores in the partially to totally dependent range, whereas 41% required minimal assistance or were independent. Few subjects had a history of clinically evident vascular‐related diseases, including myocardial infarction (n=2, 6%) and stroke (n=4, 13%). Twenty‐two percent (n=7) were taking medications for hypertension. Twenty‐five percent (n=8) had a history of cancer (all cured). Diabetes mellitus (n=1, 3%) and Parkinson's disease (n=1, 3%) were rare. Osteoporosis (n=14, 44%) and cataract history (n=28, 88%) were common.CONCLUSION: Data collected thus far suggest that supercentenarians markedly delay and even escape clinical expression of vascular disease toward the end of their exceptionally long lives. A surprisingly substantial proportion of these individuals were still functionally independent or required minimal assistance.
Age and the Risk of Warfarin‐Associated Hemorrhage: The Anticoagulation and Risk Factors In Atrial Fibrillation Study
Authors: Fang Margaret C. , Go Alan S. , Hylek Elaine M. , Chang Yuchiao , Henault Lori E. , Jensvold Nancy G. , Singer Daniel E. 
Published: July 2006

OBJECTIVES: To assess whether older age is independently associated with hemorrhage risk in patients with atrial fibrillation, whether or not they are taking warfarin therapy.DESIGN: Cohort study.SETTING: Integrated healthcare delivery system.PARTICIPANTS: Thirteen thousand five hundred fifty‐nine adults with nonvalvular atrial fibrillation.MEASUREMENTS: Patient data were collected from automated clinical and administrative databases using previously validated search algorithms. Medical charts were reviewed from patients hospitalized were for major hemorrhage (intracranial, fatal, requiring ≥2 units of transfused blood, or involving a critical anatomic site). Age was categorized into four categories (<60, 60–69, 70–79, and ≥80), and multivariable Poisson regression was used to assess whether major hemorrhage rates increased with age, stratified by warfarin use and adjusted for other clinical risk factors for hemorrhage.RESULTS: A total of 170 major hemorrhages were identified during 15,300 person‐years of warfarin therapy and 162 major hemorrhages during 15,530 person‐years off warfarin therapy. Hemorrhage rates rose with older age, with an average increase in hemorrhage rate of 1.2 (95% confidence interval (CI) 1.0–1.4) per older age category in patients taking warfarin and 1.5 (95% CI=1.3–1.8) in those not taking warfarin. Intracranial hemorrhage rates were significantly higher in those aged 80 and older (adjusted rate ratio=1.8, 95% CI=1.1–3.1 for those taking warfarin, adjusted rate ratio=4.7, 95% CI=2.4–9.2 for those not taking warfarin) than in those younger than 80.CONCLUSION: Older age increases the risk of major hemorrhage, particularly intracranial hemorrhage, in patients with atrial fibrillation, whether or not they are taking warfarin. Hemorrhage rates were generally comparable with those reported in previous randomized trials, indicating that carefully monitored warfarin therapy can be used with reasonable safety in older patients.
Predicting the Risk of Hospital Admission in Older Persons—Validation of a Brief Self‐Administered Questionnaire in Three European Countries
Authors: Wagner Jan T. , Bachmann Lucas M. , Boult Chad , Harari Danielle , Von Renteln‐Kruse Wolfgang , Egger Matthias , Beck John C. , Stuck Andreas E. 
Published: July 2006

OBJECTIVES: To validate the Probability of Repeated Admission (Pra) questionnaire, a widely used self‐administered tool for predicting future healthcare use in older persons, in three European healthcare systems.DESIGN: Prospective study with 1‐year follow‐up.SETTING: Hamburg, Germany; London, United Kingdom; Canton of Solothurn, Switzerland.PARTICIPANTS: Nine thousand seven hundred thirteen independently living community‐dwelling people aged 65 and older.MEASUREMENTS: Self‐administered eight‐item Pra questionnaire at baseline. Self‐reported number of hospital admissions and physician visits during 1 year of follow‐up.RESULTS: In the combined sample, areas under the receiver operating characteristic curves (AUCs) were 0.64 (95% confidence interval (CI)=0.62–0.66) for the prediction of one or more hospital admissions and 0.68 (95% CI=0.66–0.69) for the prediction of more than six physician visits during the following year. AUCs were similar between sites. In comparison, prediction models based on a person's age and sex alone exhibited poor predictive validity (AUC ≦ 0.57). High‐risk individuals (Pra score ≧ 0.5) were 2.3 times as likely (95% CI=2.1–2.6) as low‐risk individuals to have a hospital admission, and 2.1 times as likely (95% CI=2.0–2.2) to have more than six physician visits.CONCLUSION: The Pra instrument exhibits good validity for predicting future health service use on a population level in different healthcare settings. Administrative data have shown similar predictive validity, but in practice, such data are often not available. The Pra is likely of high interest to governments and health insurance companies worldwide as a basis for programs aimed at health risk management in older persons.