bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Electrophysiological Effects of Dipyridamole on Sinus Node Function in Patients with Sick Sinus Syndrome
Authors: Yeşil Murat , Bayata Serdar , Postacl Nursen , Aydin Çetin 
Published: July 2008

One of the most widely used tests for evaluation of sinus node function is sinus node recovery time (SNRT), which requires right heart catheterization. On the other hand SNRT has high specificity but only moderate sensitivity in the diagnosis of sick sinus syndrome (SSS). The authors studied acute electrophysiologic effects of dipyridamole (0.40 mg/kg IV) in 16 patients with clinical SSS. All of them had normal SNRT and had undergone permanent DDD pacemaker implantation. By the aid of temporary pacing inhibition, the authors noninvasively measured the corrected sinus node recovery time (SNRTc) and sinus cycle length (SCL) before and after dipyridamole administration. SCL was slightly decreased from a mean basal value of 1025 ±323 to 913 ±213 msec after dipyridamole administration (mean -10%), but this was not statistically signif icant. SNRTC was increased from a mean basal value of 344 ±91 to 606 ±156 msec after dipyridamole administration (+76% P≤0.004). These results suggest that dipyridamole must be used cautiously in patients with SSS. Intravenous dipyridamole may be a useful test to assess sinus node function. SNRT measurement after intravenous dipyridamole may increase sensitivity of this test in patients with suspected SSS and normal SNRT.
Effect of Coacervated α-Elastin on Proliferation of Vascular Smooth Muscle and Endothelial Cells
Authors: Ito Shigeki , Ishimaru Shin , Wilson Samuel E. 
Published: July 2008

The arterial wall injury associated with arterial graft implantation causes smooth muscle cells (SMCs) in the media to migrate and proliferate in the intima at the graft-artery junction resulting in anastomotic intimal hyperplasia (AIH). An important step in devel oping a small-diameter prosthesis may be to stimulate endothelialization and thereby inhibit AIH. In this study, we investigated the effect of coacervated and crosslinked α-elastin on proliferation of SMCs and endothelial cells (ECs) in vitro. Coacervation is an important step in the conversion of proelastin to make an elastin fiber in vivo. SMCs and ECs were prepared from porcine aortic media and endothelium, respec tively. SMCs and ECs (three to five passages, 4 x 10 4 cells/well) were seeded onto 12 well plates, coated and crosslinked with 0 or 10 mg/mL of coacervated α-elastin. After the 1st, 2nd, or 3rd day of cultivation, proliferation was assayed by scintillation counting of [3H]-thymidine incorporation. For the 4th day only, 0, 0.1, 1, 10 mg/mL concentration of coacervated α-elastin was coated and crosslinked. (continued on next page) SMC proliferation (1st, 2nd day: p<0.005; 3rd, 4th day: p<0.0001) was significantly inhibited over time and dose dependently, eg, 0.1 mg/mL (45.7 ±2.3%: % of control p<0.005), 1 mg/mL (5.9 ±0.7%, p<0.0005), 10 mg/mL (2.8 ±0.4%, p<0.0005). EC proliferation was inhibited over time by 10 mg/mL of coacervated α-elastin (2nd, 3rd day: p<0.005; 4th day: p<0.0001), but proliferation (132.8 ±9.9%: % of control p=NS) was stimulated by 0.1 mg/mL of coacervated α-elastin. These results suggest that coating and crosslinking a coacervated α-elastin into the structure of arterial prosthesis may inhibit AIH and stimulate endothelialization.
Perspectives in the Treatment of Dyslipidemias in the Prevention of Coronary Heart Disease
Authors: Borgia Maria C. , Medici Francesco 
Published: July 2008

In this review the indications for the available treatments for dyslipidemias in the preven tion of coronary heart disease (CHD) are considered, and their efficacy according to the latest studies is analyzed. As data sources the authors used the main multicenter studies performed in the last twenty years to evaluate primary and secondary prevention of CHD by correcting dyslipidemias as well as the results of meta-analyses of these studies. All treatments considered were found effective in preventing CHD morbidity and mortality to some extent. In particular, the combination of diet with niacin or hydroxymethylglu taryl coenzyme A (HMG CoA) reductase inhibitors seems to give the best results. These drugs induce a marked reduction of total and low-density lipoprotein (LDL) cholesterol and an increase of high-density lipoprotein (HDL) cholesterol concentrations. The use of diet, niacin, and HMG CoA reductase inhibitors reduces total as well as specific mortality. Treatment of dyslipidemia to prevent CHD depends on the pattern and severity of dyslipi demia, the presence of overt CHD, and the patient's response to diet. Pharmacologic treatment should be started only after dietary modifications have been tried and must be combined with diet. Drug side effects must also be considered, for they may affect patient compliance. High levels of total and LDL and low levels of HDL cholesterol are major risk factors for coronary atherosclerosis. Correcting lipid abnormalities can reduce the risk of devel opment or progression of CHD. Diet and drugs are the main instruments available to normalize lipid levels. The choice of drug to combine with diet must be based on its specific effects on lipid metabolism, side effects, and efficacy in reducing CHD.
Diagnosis of Deep Venous Thrombosis by Use of Soluble Necrosis Factor Receptor
Authors: Taheri S.A. , Lazar Facs L. , Haddad G. , Castaldo R. , Wilson M. , Mousa S. 
Published: July 2008

The purpose of this clinical study was to find a relationship between soluble tumor necrosis factor (TNF) receptor, deep venous thrombosis (DVT), and pulmonary emboli (PE). Clinical diagnosis of deep venous thrombosis and pulmonary emboli is a major dilemma for the clinician. Most existing tests are technician dependent, are expensive, or require sophisticated equipment. Advances in molecular biology will permit investigation of the value of TNF receptor as a test for screening, diagnosis, and evolution of DVT and PE. Forty patients with diagnosis of DVT, documented by real-time ultrasound imaging, were the subject of this clinical study. Five cc of plasma from each patient was studied by enzyme-linked immunosorbent assay (Elisa) for measurement of soluble TNF receptor. Significantly increased concentration of plasma-soluble TNF receptor was present in patients with DVT as opposed to normal individuals. There was a close relationship between plasma concentration of soluble TNF receptor and evaluation of the disease. In this preliminary clinical study, it appears that plasma measurement of soluble TNF receptor could be used as a clinical test for diagnosis of DVT and PE.
Prediction of Peak Oxygen Consumption in Patients with Intermittent Claudication
Authors: Womack Christopher J. , Hyman Brian A. , Gardner Andrew W. 
Published: July 2008

Determination of peak oxygen consumption (VO2peak) is considered important for assessing a patient's functional capacity and for exercise prescription. However, the equipment necessary to obtain accurate determination of Vo2peak is not always available in clinical settings. The present study sought to develop an equation to estimate VO2peak in peripheral arterial occlusive disease (PAOD) patients with intermittent claudication and to determine independent predictors of VO2peak in this population. One hundred and fifty-seven patients with intermittent claudication were assigned to either a validation group (n = 105) or a cross-validation group (n = 52). Medical history, height, weight, body mass index (BMI), age, gender, smoking status, resting and postexercise ankle/brachial systolic pressure index (ABI), and time to maximal claudication pain and maximal heart rate from an incremental graded exercise test (GXT) were used as potential independent predictors of VO2peak. Time to onset of maximal claudication pain, maximal heart rate, and BMI were all independently associated with VO2peak. These variables were used to estimate VO2peak by the following equation: VO2peak (mL/kg/min) = (0.00872 x maximal claudication pain time [sec] ) + (0.02839 x maximal heart rate [b/min] ) - (0.12034 x BMI) + 10.11411 r = 0.71, r2 = 0.50, standard error of estimate = 2.02 mL/kg/min, p < 0.0001 There was no significant difference between the estimated and actual VO2peak in the cross-validation group, and the coefficient of variation between estimated and actual VO 2peak in this group was 18.3%. There was no significant difference between the corre lation coefficient for the relationship between estimated and actual VO2peak in the cross- validation group (r = 0.61) and the multiple correlation coefficient from the validation group (r = 0.71). Results of this study suggest that a multiple regression equation can be used to estimate VO2peak in patients with intermittent claudication by measuring time to maximal claudication pain and maximal heart rate from a GXT and by measuring BMI.
Patients with Coronary Collaterals and Normal Left Ventricular Systolic Function: Clinical, Hemodynamic, and Angiographic Characteristics
Authors: Carmel Sara , Gueron Moshe , Ilia Reuben 
Published: July 2008

One hundred and twenty consecutive patients with significant coronary artery disease, normal left ventricular systolic function, and coronary collaterals were compared with 111 patients with the same characteristics but with no collaterals. No significant differ ences were found between the two groups in hypertension, diabetes mellitus, and smoking. The left ventricular end diastolic pressure was 16.4 ± 7 in the study group and 16.9 ±6.9 in the controls (NS). Significantly more diseased vessels were observed in the study group than in the control group (2.1 ±0.6 versus 1.7 ±0.6, p = < 0.001 ) . One hundred and one totally occluded vessels were found in the study group but only two in the control group. The richest collateral supply was to the right coronary artery: 94 sources to 85 diseased vessels (111%) including 66 sources to 52 totally occluded arteries (127%); to the left anterior descending: 59 sources to 89 diseased vessels (66%) including 37 sources to 33 totally occluded arteries (112%). The poorest supply was to the left circumflex: 17 sources to 69 diseased vessels (25%), including nine sources to 16 totally occluded arteries (56%). No collaterals were observed in 14 totally occluded vessels in the study group and in two of the controls, while the systolic function at rest was still normal. It is suggested that coronary collaterals are important in preserving left ventricular systolic and diastolic performance at least at rest. Not readily visible collaterals may also prevent systolic dysfunction.
Doppler-Based Diagnosis of Restenosis After Femoropopliteal Percutaneous Transluminal Angioplasty: Sensitivity and Specificity of the Ankle/Brachial Pressure Index Versus Changes in Absolute Pressure Values
Authors: Radak Djordje , Labs Karl-Heinz , Jäger Kurt A. , Bojić Milovan , Popović Aleksandar D. , Radak Djordje 
Published: July 2008

The aim of this study was to investigate the sensitivity and specificity of changes of the ankle/brachial pressure index (ABI) and changes in absolute ankle pressure values to detect restenosis in patients who underwent femoropopliteal percutaneous transluminal angioplasty (PTA).In total, 171 patients were followed up prospectively for 12 months; sensitivity and specificity of Doppler-based diagnosis were calculated with duplex scanning as the gold standard. The criteria for restenosis were: (1) a loss of 50% of the ABI increase or (2) loss of 50% of the absolute ankle systolic pressure, gained by PTA. For both criteria, different cut-off points (minimum increase of ABI or ankle pressure gained by PTA) were evaluated.The overall sensitivity and specificity of the ABI criterion was 67% and 80%, respec tively. The introduction of cut-off points (the minimum ABI increase gained by PTA), ranging between ≥ 0.13 and ≥ 0.35, did not markedly improve the results. The overall sensitivity and specificity of the absolute ankle pressure criterion again was poor (59% and 81 %). With the introduction of cut-off points (the minimum increase of absolute ankle pressure gained by PTA) ranging between ≥ 15 mm Hg and ≥ 20 mm Hg, the sensitivity and specificity of the criterion improved to acceptable 92% and 96%, respectively.It is concluded, that in the long-term follow-up of PTA patients, the "loss of 50% ankle pressure" criterion will detect restenosis with reasonable accuracy in those patients, in whom an increase in systolic ankle pressure ≥20 mm Hg is warranted.
A New Scoring System for the Detailed Description of the Distribution and Thrombotic Burden in Deep Leg Vein Thrombosis
Authors: Björgell Ola , Nilsson Paul E. , Svensson Peter J. , Bergqvist David , Björgell Ola 
Published: July 2008

The scoring system most commonly used to date to describe the thrombotic burden of deep vein thrombosis (DVT) excludes several deep vein segments and is thereby of limited use in research. The aim of this prospective, comparative study was to develop a new scoring and distribution system that would include all major deep veins of the leg and pelvis. In total, 247 consecutive patients were included, of whom 105 had a positive phlebography. The positive phlebographies were registered in the new system and the result was compared with that obtained by the Marder system. In 72% (76/105) of the patients the DVT distribution was not completely described and the thrombotic burden was significantly underestimated by the Marder system. Of these, 12% (13/105) were not scored at all, thus representing false-negative investiga tions. It was possible to score all DVTs and important vein segments of these patients with the new system. The scoring system previously used excludes several deep vein segments. A description of the important vein segments, where DVT is shown to originate and propagate, is mandatory in a scoring system designed for the purpose of research of DVT and later detected deep vein insufficiency. The new system meets this demand.
Circulating Cytokines and Complements in Chronic Heart Failure
Authors: Koşar Feridun , Varol Ercan , Ileri Mehmet , Ayaz Selime , Hisar Ismet , Kisacik Halil , Koşar Feridun 
Published: July 2008

Elevated levels of cytokines and complements have been reported in patients with advanced heart failure, but the exact clinical significance remains unclear. Therefore, assessments correlated with hemodynamic and clinical variables may provide important insight into the actions of cytokines and complements in chronic heart failure. The authors evaluated the clinical significance of cytokines and complements. The study included 60 subjects (50 men, 10 women); 34 had idiopathic dilated cardiomy opathy (DCM) and 26 had ischemic heart disease (IHD). Tumor necrosis factor alpha and interleukin-2 receptor concentrations in chronic heart failure were greater than in control subjects (20.0 ±0.4 vs 18.0 ±0.5 pg/mL, p<0.05 and 817.23 ±63.50 vs 642.75 ±27.31 pg/mL, p<0.05, respectively). There was no significant difference between DCM and IHD patients in circulating levels of the cytokines and the components complements (p=NS). Additionally, although functional classes III and IV heart failure patients showed a tendency to increase the levels of the cytokines and the component complements, these differences were not statistically significant (p=NS). Similarly, correlation analysis showed that the levels of the circulating cytokines and the component complements had independent value for mortality. These results suggest that humoral and cellular immunity abnormalities may play an important role in the pathogenesis of heart failure and dilated cardiomyopathy.
Experimental Inhibition of Protamine Cardiotoxicity by Prostacyclin
Authors: Fehmi Katircioğlu S. , Ulus Tulga , Yamak Birol , Saritaş Zülfikar , Yildiz Ülkü 
Published: July 2008

Twelve animals (26 ± 5 kg) were subjected to the study. In this experimental study, the authors used prostacyclin to inhibit the toxic metabolite release during protamine admin istration. Animals were divided into two equal groups. Six animals received prostacyclin (the prostacyclin group), and the other six animals did not receive any additional treatment (the control group). All cardiac output and biochemical measurements were evaluated at baseline; before cardiopulmonary bypass; and at 5, 30, and 60 minutes after protamine administration. The measured cardiac index showed that the hearts treated with prostacyclin had satis factory preservation of left ventricular function. Metabolic and biochemical data showed that the tumor necrosis factor level was raised significantly in the control group (20.75 ± 2.2 in the control group and 13.75 ± 2.5 pg/mL in the prostacyclin group). Also, E and P selectin levels were elevated in the control group, but this change was less marked in the prostacyclin group. In addition, the intracellular adhesion molecule-1 (ICAM-1) level was significantly higher in the control group than in the prostacyclin group (9.26 ±2.13 in the control group and 5.13 ± 1.66 ng/mL in the prostacyclin group). The authors observed that prostacyclin inhibited the toxic mediator release during heparin reversal with protamine. This inhibition is one way of protecting the myocardium reserves from protamine cardiotoxicity.
Staffing provision for early head injury rehabilitation
Authors: Pentland Brian , Barnes Michael P 
Published: July 2008

A questionnaire was sent to seven rehabilitation units in the UK which were recognized for expertise in the early rehabilitation of head injury patients. Information was obtained about the type of patients treated in the units, the number of beds available and staffing levels. In addition, the consultants' opinions were sought on optimal staffing levels for a hypothetical 20-bed unit for the early management of severe head injury. There was a wide variation in the staffing levels in the different neurorehabilitation units. The average therapy time available varied from six to 24.6 hours per week. The views of the four consultants who gave opinions about optimal staffing levels were similar and paralleled the levels recommended by other professional bodies.
A pilot study of patient rated disability and the need for aids in Parkinson's disease
Authors: Mutch WJ , Swallow MW , Baker M. , Beazley J. , Oxtoby M. 
Published: July 2008

In a questionnaire survey 71/96 members of the Belfast branch of the Parkinson's Disease Society reported their use of existing aids and their need for new aids. They selfrated their disability over a wide range of day-to-day functions, including transferring and turning in bed, selfcare, general mobility, independent living and communication. Thirty-one people had a particularly helpful aid. Only 16 people mentioned problems where a new aid might be helpful, but a number of these were already available. Comments were in general not about aids but rather the need for therapy, problems with drugs and the variability of the disease. Large numbers of patients were dependent in many daily tasks including 55% and 44% respectively needing help to bathe and dress. 31 % were dependent walking indoors and 73% could not use public transport by themselves. Clues to both the usefulness and limitations of aids were provided and require further exploration. There is a need for an overall support strategy in which expert assessment of daily living tasks and the provision of appropriate aids can play an important part. Doctors, therapists and patients all require more information on these topics.
The Leeds Family Placement Scheme: an evaluation of its use as a rehabilitation resource
Authors: Geddes Jml , Clayden AD , Chamberlain MA 
Published: July 2008

The Leeds Family Placement Scheme (FPS) was designed to provide short term support for vulnerable stroke patients on discharge from hospital. Suitable patients were discharged into the care of 'substitute families': lay carers recruited from the community and trained by staff of a rehabilitation unit. Patients received care from their substitute family for an average of eight weeks during which time specific targets were met and a phased return home organized. Placements were supervised, guided and monitored by a key worker: an occupational therapist with counselling skills. All patients taking part in the FPS showed improvement during placement. Comparison of a group of 10 placed patients and a control group of 61 unplaced patients, all with recent stroke, showed a statistically significant increase between three and twelve month poststroke Barthel scores in placed patients (mean scores 73.0 and 87.0 respectively). No overall improvement was observed in the control group (mean scores 74.4 and 75.7 respectively). The decline in social and home-based activities following stroke was comparable in the two groups. While recognizing the limitations of this small study, it is suggested that the use of trained lay carers and a key worker can maximize the benefits gained by intensive hospital rehabilitation.
Improving recall of health service information
Authors: Wilson Barbara 
Published: July 2008

A group of health service professionals was asked to listen to tape recorded summaries of four health related problems (memory impairment, visual object agnosia, unilateral visual neglect and behaviour disorder). Each summary was presented in one of the following ways: 1) using professional terms and jargon; 2) using simplified language; 3) categorizing the material; 4) combining simplified language and categorization. The order of presentation was counterbalanced across subjects. Following a distractor task, each subject was asked to write down as much as he or she could remember. Results were scored 'blind'. The use of professional terms and jargon resulted in significantly poorer recall than the other methods. Simplification and categorization were not significantly different from each other in terms of the amount of information recalled. The combined method was superior to all other methods. It is hoped that this study will enable health workers to recognize the importance of presenting information in a simplified and structured manner.
The changing pattern of wheelchair provision
Authors: Dudley NJ , McMahon M. 
Published: July 2008

The last 20 years has seen a substantial increase in the number of wheelchair users: in 1973, Fenwick estimated that 137 000 wheelchairs were on loan in England and Wales; in 1990, Kettle and Rowley estimated that 500 000 chairs were on ioan from the Disablement Services Authority. In a survey of requests for new wheelchairs over two separate one-month periods, it was found that 310 requests resulted in the supply of 302 wheelchairs. Females received 66.6% of the chairs. The ages of the recipients ranged from three to 98 years old (average 71). Patients aged 60 and over received 79.8% of all chairs supplied. Attendant-propelled chairs accounted for 75.2% of chairs supplied, and 19.2% were self-propelled. The leading diagnostic groups for provision were: arthritis (21.5%); cerebrovascular disease (19.2%); chronic obstructive airways disease/asthma (16.5%); and ischaemic heart disease/congestive cardiac failure (13.6%) When compared with the earlier two national surveys there have been changes in the age of wheelchair users, the diagnoses necessitating the use of a wheelchair, and the type of wheelchair used. These changes are inter-related and are likely to be driven by an increasingly elderly population.