bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Technique for Resection of Invasive Tumors Involving the Trigone Area of the Bladder in Dogs: Preliminary Results in Two Dogs
Authors: SAULNIER‐TROFF FRANCOIS‐GUILLAUME , BUSONI VALERIA , HAMAIDE ANNICK 
Published: July 2008

Objective—To describe a surgical technique for resection of the entire bladder neck, including the trigone and proximal urethra in dogs with invasive tumors causing life‐threatening urinary tract obstruction.Study Design—Clinical case reports.Animals—Dogs (n=2) with bladder tumors.Methods—Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs.Results—Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure.Conclusion—En‐bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis.Clinical Relevance—In dogs with invasive bladder tumors causing life‐threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion.
TP53 Gene Mutations in Canine Osteosarcoma
Authors: KIRPENSTEIJN JOLLE , KIK MARJA , TESKE ERIK , RUTTEMAN GERARD R. 
Published: July 2008

Objective—To investigate mutations of the TP53 gene in canine osteosarcoma (OS).Study Design—Clinical historic cohort study.Animals—Client‐owned dogs.Methods—OS (n=59) were screened for mutations of the complete TP53 gene using polymerase chain reaction and the mutation was analyzed by single‐strand conformational polymorphism. Clinical outcome of dogs with TP53‐mutated OS were compared with dogs with OS without a mutation after complete surgical excision of the primary tumor.Results—TP53 gene mutations were observed in 24 of 59 (40.7%) OS; 3 mutated OS had 2 mutations. The alterations consisted mainly of point mutations (74%). Dogs with mutated OS had a significantly shorter survival time (ST) after surgery than dogs with normal tumor TP53 gene expression (P=.03). Other significant prognosticators for ST and disease‐free interval included elevated serum alkaline phosphatase (P<.01) and tumor grade (P=.01).Conclusion—TP53 genetic mutations are common in canine OS and may have a prognostic value.Clinical Relevance—Mutations of the TP53 gene may influence survival and should be considered when evaluating canine OS.
Marginal Excision of Low‐Grade Spindle Cell Sarcoma of Canine Extremities: 35 Dogs (1996–2006)
Authors: STEFANELLO DAMIANO , MORELLO EMANUELA , ROCCABIANCA PAOLA , IUSSICH SELINA , NASSUATO CLAUDIA , MARTANO MARINA , SQUASSINO CHIARA , AVALLONE GIANCARLO , ROMUSSI STEFANO , BURACCO PAOLO 
Published: July 2008

Objective— To evaluate recurrence rate and disease‐free interval (DFI) of dogs with low‐grade soft tissue spindle cell sarcoma of the extremities treated by marginal excision.Study Design— Retrospective study.Animals— Dogs (n=35) with soft tissue low‐grade spindle cell sarcoma.Methods— Medical records were reviewed and dogs that had marginal surgical resection of low‐grade soft tissue spindle cell sarcoma at or distal to elbow and stifle were included.Results— Histopathologic margins were dirty (12 dogs), clean but close (12), and clean (11). Follow‐up after surgery occurred from 210 to 2202 days (minimum, 180 days). Local recurrence and metastatic rates were 10.8% and 0%, respectively. Median DFI and survival time were not reached, because <50% of dogs died of disease‐related events. Mean DFI and mean survival time were 697.8 days (95% CI: 559.7–836 days) and 703.5 days (95% CI: 566.6–840.5 days), respectively. There were no significant differences among survival functions stratified by histologic margins.Conclusion— Marginal surgical excision without adjuvant treatment of low‐grade soft tissue spindle cell sarcoma of the extremities results in a low local recurrence rate.Clinical Relevance— Low‐grade spindle cell sarcomas located at or distal to the elbow and stifle joints can be excised without need for wide or radical surgery.
Histologic Prognosticators in Feline Osteosarcoma: A Comparison with Phenotypically Similar Canine Osteosarcoma
Authors: DIMOPOULOU MARIA , KIRPENSTEIJN JOLLE , MOENS HESTER , KIK MARJA 
Published: July 2008

Objective— To investigate the histologic characteristics of feline osteosarcoma (OS) and compare the histologic data with phenotypically comparable canine OS. The effects of histologic and clinical variables on survival statistics were evaluated.Study Design— Retrospective study.Animals— Cats (n=62) and dogs (22).Methods— Medical records of 62 cats with OS were reviewed for clinically relevant data. Clinical outcome was obtained by telephone interview. Histologic characteristics of OS were classified using a standardized grading system. Histologic characteristics in 22 feline skeletal OS were compared with 22 canine skeletal OS of identical location and subtype. Prognostic variables for clinical outcome were determined using multivariate analysis.Results— Feline OS was characterized by moderate to abundant cellular pleomorphism, low mitotic index, small to moderate amounts of matrix, high cellularity, and a moderate amount of necrosis. There was no significant difference between histologic variables in feline and canine OS. Histologic grade, surgery, and mitotic index significantly influenced clinical outcome as determined by multivariate analysis. Tumor invasion into vessels was not identified as a significant prognosticator.Conclusion— Feline and canine skeletal OS have similar histologic but different prognostic characteristics.Clinical Relevance— Prognosis for cats with OS is related to histologic grade and mitotic index of the tumor.
Hypotonic Water as Adjuvant Therapy for Incompletely Resected Canine Mast Cell Tumors: A Randomized, Double‐Blind, Placebo‐Controlled Study
Authors: BROCKS BOUVIEN A.W. , NEYENS ISABELLE J.S. , TESKE ERIK , KIRPENSTEIJN JOLLE 
Published: July 2008

Objective—To evaluate efficacy of hypotonic water as adjuvant therapy after marginal resection of canine mast cell tumors (MCT).Study Design—Double‐blinded, placebo‐controlled, prospective, randomized study.Animals—Dogs (n=30) with spontaneous, cutaneous, solitary MCT.Methods—The wound bed of MCT, resected with margins <0.5 cm, was injected with either hypotonic or isotonic water according to a standardized protocol. Follow‐up was obtained by clinical examination at 1, 2, 3, 6, and 12 months and annual telephone contact with the owner.Results—Eighteen dogs were treated with isotonic lactated Ringer's solution and 12 dogs with hypotonic distilled water. All MCT were stage 0 tumors and most grade II. Six tumors (4 isotonic, 2 hypotonic) recurred locally, 3 of these dogs died from disease‐related reasons within 4 months. The surviving 3 dogs were alive with a median survival time (ST) of 1092 days. The calculated 2‐year recurrence‐free rate was 92.7%; the 2‐year disease‐free rate 79.1%; and the 2‐year survival rate 89.5%. No significant differences in local recurrence and ST were observed between treatment groups. Histologic grading was the only significant prognosticator for ST and recurrence‐free periods.Conclusion—No significant differences in local recurrence and ST were observed between adjunctive hypotonic water and placebo treatment after marginal resection of solitary MCT.Clinical Relevance—Hypotonic water does not decrease the rate of local recurrence in dogs with solitary MCT after marginal surgical excision.
Reconstruction of Chest Wall Defects After Rib Tumor Resection: A Comparison of Autogenous, Prosthetic, and Composite Techniques in 44 Dogs
Authors: LIPTAK JULIUS M. , DERNELL WILLIAM S. , RIZZO SCOTT A. , MONTEITH GABRIELLE J. , KAMSTOCK DEBRA A. , WITHROW STEPHEN J. 
Published: July 2008

Objective—To compare short‐ and long‐term outcome and complications of chest wall reconstruction in dogs using autogenous, prosthetic, and composite autogenous–prosthetic techniques.Study Design—Historical cohort.Animals—Dogs (n=44) with spontaneous tumors arising from or involving the chest wall.Methods—Medical records were reviewed for dogs with rib and/or sternal tumors treated by chest wall resection and reconstruction. Signalment, preoperative clinical features, intraoperative findings and complications, reconstruction technique (autogenous muscle flap, prosthetic mesh, or composite autogenous–prosthetic technique), and short‐ (≤14 days) and long‐term (>14 days) postoperative complications were determined from the medical records and telephone contact with owners and referring veterinarians. Associations between chest wall reconstruction technique and postoperative complications were tested with Cox proportional hazards.Results—Chest wall defects were reconstructed with autogenous muscle flaps (29 dogs), prosthetic mesh (3), and a composite technique of prosthetic mesh and either autogenous muscle or omental pedicle flap (12). Early postoperative complications were recorded in 8 dogs (18.2%) and included seroma (5) and pleural effusion and peripheral edema (3). One dog had a late complication (2.3%) with a mesh‐related infection 767 days postoperatively. Overall, complications occurred in 10.3% of autogenous, 25.0% of composite, and 66.7% of prosthetic reconstructions. Chest wall reconstruction with Marlex mesh alone was associated with a significantly increased risk of postoperative complications compared with autogenous reconstruction (P=.027). Reconstruction of sternal defects (3), 2 of which were performed with Marlex mesh alone, was associated with a significantly increased risk of complications compared with lateral chest wall reconstructions (P=.037).Conclusions—Large chest wall defects can be reconstructed with autogenous and composite techniques, but prosthetic mesh should be covered with well‐vascularized autogenous muscle or omentum to decrease the risk of postoperative complications. Sternal defects should be reconstructed with rigid techniques.Clinical Relevance—Chest wall reconstruction with autogenous muscle flaps or a combination of autogenous techniques with prosthetic mesh is associated with a low rate of infection and other complications.
A Comparison of Acoustic Cardiography and Echocardiography for Optimizing Pacemaker Settings in Cardiac Resynchronization Therapy
Authors: ZUBER MICHEL , TOGGWEILER STEFAN , QUINN‐TATE LORI , BROWN LEI , AMKIEH ALI , ERNE PAUL 
Published: July 2008

Background: Cardiac resynchronization therapy (CRT) is useful in managing patients with refractory heart failure. To increase efficacy, pacemaker settings are optimized, with Doppler echocardiography being the preferred method. Recently, acoustic cardiography, an automated method that records, analyzes, and displays simultaneous ECG and heart sound data, has been developed. In this study, the suitability of acoustic cardiography as an alternative to Doppler echocardiography in CRT optimization is evaluated.
Methods: We studied 43 CRT patients undergoing optimization. Using Doppler echocardiography, we determined the optimal atrioventricular (AV) delay with a transmitral flow assessment. For optimization of the interventricular (VV) delay, we used the left ventricular outflow tract velocity time integral (VTI). For acoustic cardiography, we used the electromechanical activation time (EMAT, the interval from QRS onset to the S1). Reproducibility of echocardiography and acoustic cardiography was determined by programming 10 different delay settings twice in random order.
Results: All 43 subjects underwent AV optimization, and 14 had CRT devices allowing VV optimization. While the intraobserver variability of EMAT and Doppler echocardiography parameter was similar (9.9% vs 8.5%), the reproducibility of EMAT was the highest (r = 0.91) and VTI was the lowest (r = 0.35). The correlation between the optimal AV delays determined by EMAT versus transmitral flow assessment was 0.86 (P < 0.001). The correlation between the optimal VV delays determined by EMAT versus VTI was 0.58 (P < 0.05), perhaps due to the poor reproducibility of the VTI.
Conclusion: For CRT optimization, acoustic cardiography provides results similar to echocardiography but with improved reproducibility and ease of use.
A Radial Global Dyssynchrony Index as Predictor of Left Ventricular Reverse Remodeling after Cardiac Resynchronization Therapy
Authors: ASCIONE LUIGI , IENGO RAFFAELE , ACCADIA MARIA , RUMOLO SALVATORE , CELENTANO EDUARDO , D'ANDREA ANTONELLO , DE MICHELE MARIO , MUTO CARMINE , CARRERAS GIOVANNI , MAGLIONE MARCO , TUCCILLO BERNARDINO , ROELANDT JOS 
Published: July 2008

Background: Cardiac mechanical efficiency requires that opposing left ventricular regions are coupled both in shortening and lengthening during the same phase of cardiac cycle. Aim of this study was to evaluate whether global measures of mechanical dyssynchrony are able to predict reverse remodeling of the left ventricle in patients receiving cardiac resynchronization therapy (CRT).
Methods: Sixty‐two patients underwent a clinical examination, including New York Heart Association class evaluation and 6‐minute walking distance and both echocardiographic study before and 6 months after CRT. Intraventricular dyssynchrony was evaluated by two‐dimensional strain echocardiography, measuring the amount of uncoordinated contraction and relaxation between septum and free wall for both longitudinal and radial function and was presented as the longitudinal global dyssynchrony index (LGDI) and the radial global dyssynchrony index (RGDI). Reverse remodeling was defined by a left ventricular end systolic volume reduction ≥ 15%.
Results: After CRT 39 patients showed reverse remodeling. In this group, RGDI (0.74 ± 0.26 vs 0.32 ± 0.30; P = 0.0001) and LGDI (0.52 ± 0.28 vs 0.30 ± 0.24; P = 0.002) were significantly higher than in nonresponders. A receiver‐operating characteristic curve analysis showed that RGDI >0.47 and LGDI >0.34 had a sensitivity and a specificity to predict reverse remodeling of 87% and 74%, 82%, and 74%, respectively. Stepwise forward multiple logistic regression analysis showed that RGDI (O.R.:13.4; 95%C.I.:4.2–120.5; P < 0.0001) was an independent determinant of a positive response to CRT.
Conclusion: A radial global dyssynchrony index predicts left ventricular reverse remodeling after CRT.
Left Ventricular Diastolic Filling Prior to Cardiac Resynchronization Therapy: Implications for Atrioventricular Delay Programming
Authors: WAGGONER ALAN D. , DE LAS FUENTES LISA , FADDIS MITCHELL N. , GLEVA MARYE J. , SPENCE KAREN E. , DAVILA‐ROMAN VICTOR G. 
Published: July 2008

Background: The programmed atrioventricular delay (AVD) is an important determinant of the response in left ventricular (LV) systolic performance during cardiac resynchronization therapy (CRT). It is not well established if the optimal AVD for CRT may be influenced by the LV diastolic filling pattern.
Methods: Thirty patients were studied pre‐ and post‐CRT at programmed AVD of 60–160 ms. Doppler measurements included the aortic and mitral velocity time integral (VTI), mitral early (E) and late diastolic filling (A) wave velocities, E‐ and A‐wave VTI, and diastolic filling time (DFT). The optimal AVD for each of the Doppler variables was defined by the maximal improvement compared to pre‐CRT. Patients were grouped by the pre‐CRT mitral inflow pattern as impaired relaxation (IR, mitral E/A ≤1, n = 15) or pseudonormalized/restrictive filling (PNF/RF, mitral E/A >1, n = 15).
Results: The percentage of improvement in aortic VTI was greater in the PNF/RF group (P = 0.03). Mitral E‐wave velocity decreased in the PNF/RF group (P < 0 .001), E‐wave VTI increased in both groups (P < 0 .05) and A‐wave VTI increased in the PNF/RF group. DFT increased in both groups. The optimal AVD that maximized aortic VTI was longer than the AVD that improved DFT.
Conclusions: The effects of various programmed AVD during CRT on the response in LV stroke volume and diastolic filling are influenced by the pre‐CRT LV filling characteristics. AVD optimization based on maximizing DFT is shorter compared to the aortic VTI method.
Leisure‐Time Activities of Patients with ICDs: Findings of a Survey with Respect to Sports Activity, High Altitude Stays, and Driving Patterns
Authors: KOBZA RICHARD , DURU FIRAT , ERNE PAUL 
Published: July 2008

Background: Physicians who are caring for patients with implantable cardioverter‐defibrillators (ICDs) are regularly confronted with questions concerning daily activities. This study evaluates the habits of ICD patients with respect to sports activities, stays at high‐altitude, and driving patterns.
Methods: A survey was performed in 387 patients with ICDs who were followed at two hospitals in Switzerland. The special‐designed questionnaire addressed lifestyle practices concerning sports activity, high‐altitude visits, and driving motor vehicles.
Results: Fifty‐nine percent of ICD patients participated in some kind of sports activity; an ICD shock was experienced in 14% of these patients. Fifty‐six percent of the patients reported a stay at high altitudes at least 2,000 m above the sea level; 11% of them stayed regularly above 2,500 m; 4% of these patients experienced an ICD shock during high altitude stay. Seventy‐nine percent of the patients drove a motor vehicle; 2% of them experienced an ICD shock during driving, but none of them reported loss of consciousness or a traffic accident.
Conclusion: It is accepted that ICD patients disqualify for competitive sports. However, the patients may be encouraged to continue leisure‐time physical activities at low‐to‐moderate intensity. Staying at high altitudes and driving motor vehicles are very rarely associated with ICD shocks. Therefore, these activities that are likely to contribute to a better quality of life should not be discouraged in most ICD recipients in the absence of other medical reasons.
Shocks, Personality, and Anxiety in Patients with an Implantable Defibrillator
Authors: VAN DEN BROEK KRISTA C. , NYKLÍČEK IVAN , VAN DER VOORT PEPIJN H. , ALINGS MARCO , DENOLLET JOHAN 
Published: July 2008

Background: Studies have examined the relationship between shocks and anxiety, but little is known about the role of personality. Our aim was to examine the determinants of self‐reported and interviewer‐rated anxiety following implantable cardioverter defibrillator (ICD) implantation.
Methods: At baseline, that is, 0–3 weeks following ICD implantation, 308 ICD patients (82% men, mean age = 62.6 years) completed the DS14 (Type D personality) and ASI (anxiety sensitivity). The STAI (self‐reported symptoms of state‐anxiety) was assessed at baseline and follow‐up, which was 2 months following ICD implantation. At this follow‐up, the HAM‐A interview (interviewer‐rated anxiety) was assessed in a subsample (57%); the occurrence of ICD shocks was deduced from medical records.
Results: Analysis of covariance (ANCOVA) for repeated measures showed a significant interaction effect between time and shocks (F = 9.27, P = 0.003) with patients who had experienced a shock experiencing higher levels of self‐reported anxiety at follow‐up. The main effects of Type D personality (F = 33.42, P < 0.0001) and anxiety sensitivity (F = 66.31, P < 0.0001) were significant, indicating that these patients scored higher on self‐reported anxiety across time points. Multivariable linear regression analyses yielded Type D personality (β= 0.18, P = 0.021) and anxiety sensitivity (β= 0.19, P = 0.016), but not shocks, as independent predictors of interviewer‐rated anxiety. Covariates included gender, marital status, education, age, ICD indication, cardiac history, and comorbidity.
Conclusions: Type D personality and anxiety sensitivity were independent predictors of both self‐reported and interviewer‐rated anxiety outcomes while ICD shocks were related to an increase in levels of self‐reported anxiety only. Identification and support of ICD patients with Type D personality, increased anxiety sensitivity, or shocks is important.
Peripheral Arterial Disease Alters Heart Rate Variability in Cardiovascular Patients
Authors: GOERNIG MATTHIAS , SCHROEDER RICO , ROTH TINO , TRUEBNER SANDRA , PALUTKE INGO , FIGULLA HANS R. , LEDER UWE , VOSS ANDREAS 
Published: July 2008

Background: Autonomic regulation analysis is useful in risk stratification of ventricular tachycardia and sudden cardiac death in chronic heart failure (CHF). Heart rate variability (HRV) reflects the condition of autonomic regulation. For analyzing the autonomic control the whole cardiovascular system has to be considered. Therefore, the aim of our study was to assess the influence of peripheral arterial disease (PAD) on the autonomic regulation.
Methods: In 53 men (age: 67 ± 11 years) from the cardiovascular unit we compared standard HRV parameters in 27 with (ankle brachial index, ABI < 0.9) and 26 patients without (ABI >0.9) PAD as well as with 12 healthy subjects as reference. High‐resolution electrocardiograms were recorded over 30 minutes under resting conditions. Pulse wave velocity as well as ABI was estimated using the vascular screening system VASERA.
Results: In cardiac patients with PAD, we found both significant differences in linear and nonlinear HRV parameters. Higher increase of low‐than high‐frequency components indicated higher elevated sympathetic than vagal activation. Altered autonomic control can be interpreted as a compensatory mechanism for diminished vascular arteriolar vasodilator capacity in PAD. To maintain the arterial blood pressure, an elevated setpoint of sympathovagal balance is required.
Conclusions: Our data indicate PAD alters the HRV in cardiaovascular patients. PAD should be considered in the assessment of cardiac autonomic regulation especially in risk stratification.
Time‐Domain and Morphological Analysis of the P‐Wave. Part I: Technical Aspects for Automatic Quantification of P‐Wave Features
Authors: CENSI FEDERICA , RICCI CHIARA , CALCAGNINI GIOVANNI , TRIVENTI MICHELE , RICCI RENATO P. , SANTINI MASSIMO , BARTOLINI PIETRO 
Published: July 2008

Introduction: Time‐domain and morphological analysis of P‐wave from surface electrocardiogram has been extensively used to identify patients prone to atrial arrhythmias, especially atrial fibrillation (AF). However, since no standard procedure exists for P‐wave preprocessing, standardization of cut‐off values for P‐wave duration and morphological features is difficult. This study is a methodological investigation of P‐wave preprocessing procedures for automatic time‐domain and morphological analysis.
Methods: We compared, on simulated and real data, the P‐wave template obtained applying three alignment algorithms with that obtained without alignment, in terms of template error, shift error, P‐wave duration, and morphological parameters. We also proposed automatic algorithms for estimation of P‐wave duration.
Results: We found that alignment is necessary for a reliable extraction of P‐wave template by the averaging procedure, in order to perform time‐domain and morphological analysis. On simulated and real data, the error on P‐wave duration can be as high as 30 ms on a template obtained without alignment; if alignment procedure is performed, the error on P‐wave duration is negligible. Analogously, morphological features are correctly estimated only on a P‐wave template obtained with P‐waves alignment. We also found that the proposed algorithm for the automatic estimation of the P‐wave duration gave reliable results.