bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial meningitis and epilepsy
Authors: Murthy Jagaralapudi Murali K. , Prabhakar Sudesh 
Published: August 2008

Summary The high incidence and prevalence of epilepsy in developing countries has partly been attributed to an increased frequency of central nervous system (CNS) infections. Of the CNS infections, bacterial meningitis is endemic in many countries and several epidemics have also been reported in these regions. Unprovoked seizures and epilepsy (recurrent unprovoked seizures) can be long‐term sequelae of bacterial meningitis. The probability of developing an unprovoked seizure or epilepsy varies according to the etiologic agent responsible for meningitis and this probability appears to be higher for Streptococcus pneumoniae. The risk factors for late unprovoked seizures/epilepsy include early seizures during the acute phase of meningitis and persistent neurological deficits other than sensorineural hearing loss. The majority of unprovoked seizures occur within 5 years of the meningitis episode and tend to be recurrent. The burden of epilepsy associated with bacterial meningitis depends upon the incidence of the latter and hence is to some extent preventable. Implementing vaccination programs against the three most important meningeal pathogens can reduce the incidence of bacterial meningitis. In developed countries, a decline in the incidence of bacterial meningitis has been accomplished with the implementation of vaccination programs.
Viral encephalitis and epilepsy
Authors: Misra Usha Kant , Tan Chong Tin , Kalita Jayantee 
Published: August 2008

Summary Viral encephalitis presents with seizures not only in the acute stage but also increases the risk of late unprovoked seizures and epilepsy. Acute symptomatic and late unprovoked seizures in different viral encephalitides are reviewed here. Among the sporadic viral encephalitides, Herpes simplex encephalitis (HSE) is perhaps most frequently associated with epilepsy, which may often be severe. Seizures may be the presenting feature in 50% patients with HSE because of involvement of the highly epileptogenic frontotemporal cortex. The occurrence of seizures in HSE is associated with poor prognosis. In addition, chronic and relapsing forms of HSE have been described and these may be associated with antiepileptic drug‐resistant seizures. Among the epidemic (usually due to flaviviruses) viral encephalitides, Japanese encephalitis (JE) is most common and is associated with acute symptomatic seizures, especially in children. The reported frequency of acute symptomatic seizures in JE is 7–46%. Encephalitis due to other flaviviruses such as equine, St. Louis, and West Nile viruses may also manifest with acute symptomatic seizures. In Nipah virus encephalitis, seizures are more common in relapsed and late‐onset encephalitis in comparison to acute encephalitis (4% vs. 1.8%). Other viruses like measles, varicella, mumps, influenza, and entero‐viruses may cause seizures depending on the area of brain involved. There is no comprehensive data regarding late unprovoked seizures in different viral encephalitides. Prospective studies are required to document the risk of late unprovoked seizures and epilepsy following viral encephalitis due to different viruses as well as to determine the clinical characteristics, course, and outcome of post‐encephalitic epilepsy.
Helminthic parasites and seizures
Authors: Garcia Hector H. , Modi Manish 
Published: August 2008

Summary A large number of helminthic parasites are known to involve the central nervous system (CNS) and produce neurologic symptoms including seizures and epilepsy. Taenia solium (the pork tapeworm) is perhaps most widely prevalent and well known for its association with seizures and epilepsy. Many of the other helminthic disorders have fairly restricted geographic predilections and their occurrence in much of the remaining world is limited to rare cases among travelers and immigrants. Nonetheless, knowledge about the helminthic disorders, the life cycle of their causative agents, and their clinical manifestations and diagnostic features are important in order to recognize them.
Seizures in HIV‐seropositive individuals: NIMHANS experience and review
Authors: Satishchandra P. , Sinha Sanjib 
Published: August 2008

Summary Seizures are not uncommon in patients with human immunodeficiency virus (HIV) infection, and with the upsurge in HIV infection this may be an important cause for acute symptomatic seizures. Seizures may rarely be the presenting manifestation of HIV infection. Opportunistic infections such as toxoplasmosis, tuberculosis, progressive multifocal leucoencephalopathy (PML), cryptococcal meningitis and polymicrobial infections, metabolic and electrolyte disturbances, and drugs are common causes of new‐onset seizures in HIV‐seropositive individuals. In the absence of any cause, primary HIV infection may be considered responsible for seizures. Because seizures tend to recur in and because they are a poor prognostic indicator in HIV infection, treatment with antiepileptic drugs (AEDs) is the norm. The treatment of HIV‐infected individuals with seizures comprises of the administration of AEDs, specific treatment of the underlying conditions, and antiretroviral drugs. Clinicians must consider both therapy‐compromising drug–drug and drug–disease interactions while choosing appropriate AEDs. The ideal AED in this setting is one that does not affect viral replication, have limited protein binding, and have no effects on the hepatic cytochrome P450 enzyme system. The risks for AED‐induced allergic skin rash appears to be high in HIV‐seropositive individuals.
The effects of antimicrobial and antiepileptic treatment on the outcome of epilepsy associated with central nervous system (CNS) infections
Authors: Singh Gagandeep , Prabhakar Sudesh 
Published: August 2008

SummaryThe course and outcome of epilepsy following central nervous system (CNS) infections has been poorly characterized. Likewise, the impact of antimicrobial treatment as well as other preventative and therapeutic interventions on the development of epilepsy following neurological infectious disorders has been insufficiently studied. The CNS infections that can cause epilepsy may be either acute or chronic‐recurrent. For most acute infections, for example, viral encephalitis and bacterial meningitis, the effect of specific antimicrobial treatment on the development of epilepsy cannot be studied in a controlled manner due to logistic and ethical reasons. In the specific case of neurocysticercosis (NCC), the risk of seizures in the short term is reduced following either anthelminthic or corticosteroid treatment or both. The effect of anthelminthic treatment on seizure outcome in the long term has not been studied. Finally, treatment with antiepileptic drugs (AEDs) needs to be optimally defined in the case of epilepsy associated with neurological infectious disorders.
Perspectives on interactions between antiepileptic drugs (AEDs) and antimicrobial agents
Authors: Desai Joy 
Published: August 2008

Summary In the treatment of seizures and epilepsy associated with central nervous system (CNS) infections, drug–drug interactions may significantly and unexpectedly impact outcome not only of epilepsy but also of the infectious disorders in both emergent and chronic care situations. A case is described in whom, the administration of the antimicrobial agent, meropenem presumably reduced serum valproate concentrations resulting in impaired seizure control. Other situations are reviewed in which interactions between antiepileptic drugs (AEDs) and antimicrobial agents may be of clinical significance. These include: (1) seizure management in individuals with neurocysticercosis, (2) management of seizures in patients with lobar tuberculomas, (3) management of seizures due to cerebral abscess, and (4) management of seizures in HIV‐seropositive individuals.
Status epilepticus produces chronic alterations in cardiac sympathovagal balance
Authors: Metcalf Cameron S. , Radwanski Przemyslaw B. , Bealer Steven L. 
Published: August 2008

SummaryPurpose:  Status epilepticus (SE) activates the autonomic nervous system, increasing sympathetic nervous system control of cardiac function during seizure activity. However, lasting effects of SE on autonomic regulation of the heart, which may contribute to mortality following seizure activity, are unknown. Therefore, autonomic control of cardiac function was assessed following SE.Methods:  Using Sprague‐Dawley rats after 1–2 weeks of recovery from lithium‐pilocarpine‐induced SE or control procedures, we tested overall sympathovagal control of the heart, the individual contributions of the sympathetic and parasympathetic components of the autonomic nervous system, and baroreflex sensitivity.Results:  SE induced a chronic shift in sympathovagal balance toward sympathetic dominance resulting from decreased parasympathetic activity. Baroreflex sensitivity to increased blood pressure was also decreased, likely resulting from diminished vagal activation.Discussion:  Chronic alterations in autonomic regulation of cardiac function, characterized by increased sympathetic dominance, occur following SE and likely contribute to subsequent increased cardiac risk and mortality.
Cellular mechanisms of cobalt‐induced hippocampal epileptiform discharges
Authors: He Jiwei , Hsiang Hwa‐Lin , Wu Chiping , Mylvagnanam Shanthini , Carlen Peter L. , Zhang Liang 
Published: August 2008

SummaryPurpose: To explore the cellular mechanisms of cobalt‐induced epileptiform discharges in mouse hippocampal slices.Methods: Hippocampal slices were prepared from adult mice and briefly exposed to a CoCl2‐containing external solution. Population and single cell activities were examined via extracellular and whole‐cell patch recordings.Results: Brief cobalt exposure induced spontaneous, ictal‐like discharges originating from the CA3 area. These discharges were suppressed by anticonvulsants, gap junction blockers, or by raising extracellular Ca2+, but their generation was not associated with overall hyperexcitability or impairment in GABAergic inhibition in the CA3 circuit. Electroencephalographic ictal discharges of similar waveforms were observed in behaving rats following intrahippocampal cobalt infusion.Discussion: Mechanisms involving activity‐dependent facilitation of gap junctional communication may play a major role in cobalt‐induced epileptiform discharges.
Development of a Re‐Positionable Aortic Stent‐Valve: A Preliminary Study in Swine
Authors: HASHIMOTO MASAYUKI , KAMINOU TOSHIO , OHUCHI YASUFUMI , NAKAMURA KIYOSHI , SUGIURA KIMIHIKO , ADACHI AKIRA , KAWAI TSUYOSHI , IHAYA TAKASHI , OGAWA TOSHIHIDE 
Published: August 2008

Background: Placement of aortic stent‐valves in the proper position is difficult due to the high velocity and oscillation of blood flow and anatomical characteristics. To address this problem, a re‐positionable stent‐valve was designed and examined in a preliminary animal experiment.
Methods: Protocols for this animal study were approved by the institutional Animal Care and Use Committee. An umbrella‐shaped polyurethane valve was attached at the tip of newly devised re‐positionable metallic stent. The prosthesis (re‐positionable stent‐valve) was implanted in 5 female pigs via the right carotid artery using a 10‐F introducer (Group A). As a control, the stent‐without‐valve was implanted in 4 female pigs (Group B). Efficacy of the valve was assessed by aortography and aortic pressure measurement. Animals were sacrificed 1 hour after stent‐valve implantation for macroscopic examination.
Results: The stent‐valve was successfully implanted in all pigs. In Group A, aortography showed good function of the polyurethane valve. No significant change in diastolic pressure was noted during valve testing. In Group B, aortography and aortic pressure measurement showed massive aortic regurgitation following dysfunction of the native aortic leaflets. Post‐mortem examination showed small amounts of thrombus inside the polyurethane umbrella in Group A.
Conclusion: Placement of the re‐positionable stent‐valve seems feasible and effective. However, the problem of thrombus formation inside the umbrella valve should be solved in future studies.
Genetic Association Studies in Nursing Practice and Scholarship
Authors: Underwood Patricia C. , Read Catherine Y. 
Published: August 2008

Purpose: To explore the role of genetic association studies in risk assessment for common complex diseases.
Organizing Framework: An introduction to the types of genetic association studies is followed by a discussion of their potential use in risk assessment for age‐related macular degeneration and type 2 diabetes mellitus. The benefits and limitations of this burgeoning technology are explored and related to nursing practice and scholarship.
Conclusions: Nurses in practice must be prepared to assist clients with decisions about seeking and interpreting results from genetic association studies and nurse researchers must apply current guidelines for conducting robust studies and applying the results of such studies in clinical practice.
Clinical Relevance: Data collected from genetic association studies will increasingly be used to identify novel prevention and treatment strategies for many complex diseases. An understanding of the principles that underlie this new science is essential for nurses in all areas of clinical practice as they design, test, and implement appropriate intervention and prevention strategies based on genetic association studies.
Cultural Perspectives in Feeding Difficulty in Taiwanese Elderly With Dementia
Authors: Chang Chia‐Chi , Roberts Beverly L. 
Published: August 2008

Objective: To investigate factors related to feeding difficulty that is shown in the interaction between nursing assistants and elderly residents with dementia.
Methods: Forty‐eight residents and 31 nursing assistants were observed during meal times in a congregate dining room of a Taiwanese nursing home specializing in dementia care. Residents' eating behaviors, the dining environment, interactions between the nursing assistant and the residents, and feeding strategies used by nursing assistants were observed. Nutritional data for residents were collected from medical charts. The EdFED Scale #2 and interviews of nursing assistants provided information about feeding difficulty. Interviews also provided data on strategies used to address feeding difficulties.
Findings: The most frequent feeding difficulty was refusal to eat (37.5%). The strategies used by nursing assistants were limited. Nursing assistants stated they needed more training to address feeding difficulty in residents with dementia.
Conclusions: Future research should be focused on the interface between the residents and nursing assistants who must identify various feeding difficulties and select appropriate interventions.
Clinical Relevance: Results might provide information that can be used to develop effective interventions and promote high‐quality mealtime care in patients with dementia.
A Causal Model of Health‐Related Quality of Life in Thai Patients With Heart‐Failure
Authors: Krethong Phuangphaka , Jirapaet Veena , Jitpanya Chanokporn , Sloan Rebecca 
Published: August 2008

Background: Heart failure is an increasing global health problem which adversely affects all aspects of a patient's health‐related quality of life (HRQOL).
Purpose: The hypothesized causal model of HRQOL in Thai heart‐failure patients was based on Wilson and Cleary's HRQOL conceptual model. We examined causal relationships among bio‐physiological status, symptoms, functional status, general health perception (GHP), and HRQOL shown in the model, and added an additional item–social support.
Methods: A stratified four‐stage random sampling method was used to obtain 422 heart‐failure patients 18 years of age and older who visited nine outpatient hospital clinics from five regions of Thailand including metropolitan Bangkok. In addition to the participants' personal medical records, research instruments consisted of a personal information questionnaire, the Enhancing Recovery in Coronary Heart Disease Social Support Instrument, Cardiac Symptom Survey, the New York Heart Association functional classification system, a 100‐mm horizontal visual analogue scale of GHP, and the Minnesota Living with Heart Failure Questionnaire. Data were analyzed using SPSS and AMOS computer programs.
Results: The model fit well with the empirical data (χ2=19.87, df=13, p=0.10, GFI =0.99, and RMSEA=0.04). Symptom status was the most influential factor affecting HRQOL by both direct and indirect effects through functional status and GHP. Social support was the least influential factor affecting HRQOL. Social support had a negative direct effect on HRQOL, but had a positive indirect effect on HRQOL through symptom status and GHP.
Conclusions: HRQOL was affected by each variable proposed in our causal model of HRQOL in Thai heart‐failure patients. Symptom status had the strongest effect on HRQOL.
Clinical Relevance: A comprehensive symptom management and prevention program that includes the described health outcome measures could lead to improved HRQOL for Thai heart‐failure patients, and perhaps others.
Hospital Nurses' Perception of the Geriatric Nurse Practice Environment
Authors: Boltz Marie , Capezuti Elizabeth , Bowar‐Ferres Susan , Norman Robert , Secic Michelle , Kim Hongsoo , Fairchild Susan , Mezey Mathy , Fulmer Terry 
Published: August 2008

Purpose: To test the relationship between nurses' perceptions of the geriatric nurse practice environment (GNPE) and perceptions of geriatric‐care delivery, and geriatric nursing knowledge.
Design: A secondary analysis of data collected by the New York University Hartford Institute Benchmarking Service staff using a retrospective, cross‐sectional, design.
Methods: Responses of 9,802 direct‐care registered nurses from 75 acute‐care hospitals in the US that administered the GIAP (Geriatric Institutional Assessment Profile) from January 1997 to December 2005 were analyzed using linear mixed effects modeling to explore associations between variables while controlling for potential covariates.
Findings: Controlling for hospital and nurse characteristics, a positive geriatric nurse practice environment was associated with positive geriatric care delivery (F=4,686, p<.0001) but not geriatric nursing knowledge. The independent contribution of all three dimensions of the geriatric nurse practice environment (resource availability, institutional values, and capacity for collaboration) influences care delivery for hospitalized older‐adult patients.
Conclusions: Organizational support for geriatric nursing is an important influence upon quality of geriatric care.
Clinical Relevance: Hospitals that utilize an organizational approach addressing the multifaceted nature of the GNPE are more likely to improve the hospital experience of older adults.
Creating a Healthy Workplace for New‐Generation Nurses
Authors: Lavoie‐Tremblay Mélanie , Wright David , Desforges Nicole , Gélinas Céline , Marchionni Caroline , Drevniok Ulrika 
Published: August 2008

Purpose: To examine dimensions of the psychosocial work environment that influence the psychological health of new‐generation nurses.
Background: While much work has been done concerning the health of nurses in general, research on the relationship between the nursing work environment and the psychological well‐being of new‐generation nurses at the start of their careers is limited.
Design: A correlational descriptive design was used for this quantitative study. Survey data were collected from new nurses (N=309) whose names were obtained from a provincial licensing registry in Quebec, Canada.
Findings: Among new nurses, 43.4% stated that they have a high level of psychological distress. These nurses were significantly more likely to perceive an imbalance between effort expended on the job and rewards received, low decisional latitude, high psychological demands, high job strain, as well as low social support from colleagues and superiors (p ≤ 0.05).
Conclusions: Understanding the relationship between the work environment and health as experienced by new‐generation nurses is imperative for creating interventions to successfully recruit and retain these young nurses.
Clinical Relevance: Generation Y nurses in Quebec, faced with high levels of psychological distress because of their exposure to difficult nursing work environments, might leave the profession thereby exacerbating an already salient nursing shortage.
The Development of Advanced Nursing Practice Globally
Authors: Sheer Barbara , Wong Frances Kam Yuet 
Published: August 2008

Purpose: To examine the development of advanced nursing practice globally.
Methods: Data were collected from documentary resources available in the International Nurse Practitioners/Advanced Practice Nurse Network (INP/APNN) of the International Council of Nurses. The areas examined were guided by the “key informant survey on advanced nursing practice self‐administered questionnaire.” Two core members of the INP/APNN who have rich experience in global advanced nursing development analyzed the data.
A total of 14 countries and three regions from five continents were included in the analyses. The development of advanced nursing practice in these areas is facilitated by a need for better access to care in a cost‐containment era and the enhancement of nursing education to postgraduate level. The mechanism for regulation of practice is in place in some countries.
Conclusions: Confirms the development of advanced practice in nursing is a global trend.
Clinical Relevance: APNs can improve global health with points to enhanced education in nursing and regulation of advanced practice.
Long‐term antidepressant treatment in bipolar disorder: meta‐analyses of benefits and risks
Authors: Ghaemi S. N. , Wingo A. P. , Filkowski M. A. , Baldessarini R. J. 
Published: August 2008

Objective:  Long‐term antidepressant (AD) treatment for depression in bipolar disorder (BPD) patients is highly prevalent, but its benefits and risks remain uncertain, encouraging this meta‐analysis of available research.Method:  We reviewed randomized controlled trials for BPD involving ≥6 months of treatment with AD ± mood stabilizer (MS) vs. placebo ± MS, using meta‐analyses to compare reported risks of new depression vs. mania.Results:  In seven trials (350 BPD patients) involving 12 contrasts, long‐term treatments that included ADs yielded 27% lower risk of new depression vs. MS‐only or no treatment [pooled relative risk, RR = 0.73; 95% CI 0.55–0.97; number‐needed‐to‐treat (NNT) = 11], but 72% greater risk for new mania [RR = 1.72; 95% CI 1.23–2.41; number‐needed‐to‐harm (NNH) = 7]. Compared with giving an MS‐alone, adding an AD yielded neither major protection from depression (RR = 0.84; 95% CI 0.56–1.27; NNT = 16) nor substantial increase in risk of mania (RR = 1.37; 95% CI 0.81–2.33; NNH = 16).Conclusion:  Long‐term adjunctive AD treatment was not superior to MS‐alone in BPD, further encouraging reliance on MSs as the cornerstone of prophylaxis.