bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Anxiety in Partners of Patients with a Cardioverter‐Defibrillator: The Role of Indication for ICD Therapy, Shocks, and Personality
Authors: PEDERSEN SUSANNE S. , VAN DEN BERG MARTHA , ERDMAN RUUD A.M. , VAN SON JENNY , JORDAENS LUC , THEUNS DOMINIC A.M.J. 
Published: January 2009

Background: The partner of the implantable cardioverter‐defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared to their partners, and (2) the extent to which the partner's personality is a more important determinant of partner distress than patient clinical characteristics, using a prospective design.
Methods: Consecutively implanted ICD patients (n = 196) and their partners (n = 196) completed a set of psychological questionnaires at baseline and 6 months after implantation.
Results: Analysis of variance with repeated measures showed that partners had significantly higher levels of anxiety compared to patients (F(1,390) = 16.431; P < 0.001) but not depressive symptoms (F(1,390) = 0.186; P = 0.67). There was a significant overall reduction in anxiety (F(1,390) = 79.552; P < 0.001) and depressive symptoms (F(1,390) = 39.868; P < 0.001) over 6 months, with group (i.e., patient vs partner) exerting a stable effect on anxiety (F(1,390) = 0.966; P = 0.33) and depressive symptoms (F(1,390) = 0.025; P = 0.87). These results remained in adjusted analysis. Determinants of anxiety and depressive symptoms in partners included secondary prophylaxis in patients (Ps < 0.001–0.002), Type D personality of the partner (Ps < 0.001–0.001), secondary prophylaxis by shock interaction (P = 0.002; anxiety only), and secondary prophylaxis by Type D interaction (Ps = 0.001–0.003).
Conclusions: Partners had higher levels of anxiety but not depression than ICD patients. Partner distress could be attributed not only to the partner's personality, but also to patient clinical characteristics, primarily secondary prophylaxis for ICD therapy. These results indicate that information on the clinical characteristics of the patient in addition to partner characteristics may help identify partners at risk of distress.
New or Aggravated Heart Failure during Long‐Term Right Ventricular Pacing after AV Junctional Catheter Ablation
Authors: POÇI DRITAN , BACKMAN LOTTA , KARLSSON THOMAS , EDVARDSSON NILS 
Published: January 2009

Background: Atrioventricular junctional ablation (AVJA) improves symptoms and quality of life in patients with pharmacologically resistant atrial fibrillation (AF). However, long‐term right ventricular stimulation has also been reported to lead to deterioration of the left ventricular function. We retrospectively analyzed the incidence of new or aggravated heart failure (HF) during long‐term right ventricular stimulation following AVJA.
Methods: Two hundred thirteen patients (110F:103M), 73 ± 10 years old, were followed for a period of 6 ± 3 years after AVJA. Forty‐nine patients (23%) were known to have HF before AVJA. New HF was diagnosed if at least two of the following criteria were present: NYHA class >2, an LVEF <45%, and medication for HF. Aggravated HF was defined as an increase in the functional class and/or new prescription of medication for HF. All‐cause death was a secondary endpoint.
Results: During follow‐up, 26% of the patients with known HF showed an aggravation of HF, while 13% developed new symptoms of HF. High age and low EF were independent predictors of new or aggravated HF and of new HF, while none of the tested variables predicted aggravation of known HF. The all‐cause mortality was 16%, where high age and coronary artery disease were found to be independent predictors.
Conclusion: AVJA followed by right ventricular pacing was associated with aggravated HF in 23% of patients with known HF, while development of new symptoms of HF occurred much less often during follow‐up (13%). The majority of patients who underwent AVJA continued to do well during long‐term follow‐up.
Outcomes in Adolescents with Postural Orthostatic Tachycardia Syndrome Treated with Midodrine and β‐Blockers
Authors: LAI CINDY C. , FISCHER PHILIP R. , BRANDS CHAD K. , FISHER JENNIFER L. , PORTER CO‐BURN J. , DRISCOLL SHERILYN W. , GRANER KEVIN K. 
Published: January 2009

Background: Postural orthostatic tachycardia syndrome (POTS) is associated with debilitating fatigue, dizziness, and discomfort in previously healthy adolescents. The effects of medical therapy have not been well studied in this patient population. This study assessed the relative efficacy and impact of drug therapy on the functioning and quality of life in adolescents with POTS.
Methods: A retrospective, single center, chart review analysis with a follow‐up written survey was conducted on a group of 121 adolescents who had undergone autonomic reflex screening at the Mayo Clinic from 2002 to 2005 as part of an evaluation for possible POTS.
Results: Of 121 surveys sent, 47 adolescents returned a completed survey. In this cohort of patients, the two most commonly prescribed drug therapies were midodrine (n = 13) and β‐blockers (n = 14). Patients in the midodrine group were comparable to patients in the β‐blocker group in gender, age, pretreatment postural heart rate changes, and months from initial evaluation to survey completion. More patients treated with a β‐blocker reported improvement after visiting Mayo Clinic (100% vs 62%, P = 0.016) and more attributed their progress to medication (63.6% vs 36.4%, P = 0.011) than did those treated with midodrine.
Conclusion: Treatment with both midodrine and β‐blockers was associated with overall improvement in POTS patients’ general health; however, adolescents taking β‐blockers were more likely than those taking midodrine to credit the role of medications in their improvement.
The influence of comorbidity on the risk of access‐related bacteremia in chronic hemodialysis patients
Authors: MAZONAKIS Emmanouil , STIRLING Catherine , BOOTH Karen L. , McCLENAHAN Jenny , HERON Neil , GEDDES Colin C. 
Published: January 2009

AbstractAccess‐related bacteremia is an important cause of morbidity in chronic hemodialysis patients. The incidence of bacteremia is higher in patients dialyzing through a tunneled central venous catheter (TCVC) compared with an arteriovenous fistula (AVF). Our aim was to explore if this is explained by patient comorbidity. Two groups of chronic hemodialysis outpatients were compared: all patients who dialyzed through a TCVC at any time during 2003 and were fit enough to subsequently have a functioning AVF or renal transplant even if it was after 2003 (Group 1; n=93); and all patients who dialyzed through a TCVC in 2003 and were not fit enough to have a functioning AVF or renal transplant (Group 2; n=119). Episodes of bacteremia (n=71) were identified and those not related to access were excluded. Patients in Group 1 were younger than Group 2 (57.5 years vs. 64.8 years; P=0.001). The incidences of bacteremia in Groups 1 and 2 were, respectively, 0.31 and 0.44 episodes per 1000 patient days while dialyzing through an AVF (P=0.77), and 2.21 and 2.27 per 1000 days while dialyzing through a TCVC (P=0.91). The 3‐year actual survival from January 1, 2003 to January 1, 2006 was significantly higher in Group 1 than in Group 2 (80.6% vs. 26.1%; P<0.0001) confirming the higher comorbidity of the patients in Group 2. Patients dialyzing through a TCVC (compared with an AVF) have a significantly higher risk of access‐related bacteremia, irrespective of comorbidity.
Quality of life is not related with liver disease severity but with anemia, malnutrition, and depression in HCV‐infected hemodialysis patients
Authors: AFSAR Baris , OZDEMIR Nurhan Fatma , SEZER Siren , HABERAL Mehmet 
Published: January 2009

AbstractHepatitis C virus (HCV) infection may deteriorate quality of life. The relationship between HCV infection and quality of life in hemodialysis (HD) patients is unknown. The demographic characteristics, comorbidities, biochemical parameters, and Malnutrition‐Inflammation Score (MIS) were recorded. Child‐Pugh classification, Beck Depression Inventory, and SF‐36 were performed. Liver histopathology was examined. Thirty‐two patients (21 Child‐Pugh‐A, 11 Child‐Pugh‐B) were included. There was high‐grade portal necroinflammatory activity in 14, high‐grade lobular necroinflammatory activity in 26, and hepatic fibrosis in 19 patients. Three patients had cirrhosis. Patients with a high stage of liver fibrosis had lower social functioning scores than patient with a low stage of fibrosis (P= 0.011). The only correlation was between aspartate aminotransferase and the physical function subscale (r=−0.395, P= 0.025). None of the SF‐36 scores differed between Child‐Pugh A and B patients. Instead, most of the SF‐36 subscale and summary scores were related with hemoglobin, albumin, MIS and Beck Depression Score. Quality of life in HCV‐infected HD patients was independent of liver disease severity anchors, but was correlated with anemia, malnutrition, and depression.
Pruritus in hemodialysis patients: The problem remains
Authors: MELO Natalia C. V. , ELIAS Rosilene M. , CASTRO Manuel Carlos M. , ROMAO Joao E. , ABENSUR Hugo 
Published: January 2009

AbstractPruritus is still one of the most common and disturbing symptoms of end‐stage renal disease. The objective of this study is to analyze the prevalence of pruritus in hemodialysis patients and the possible factors implicated in its genesis. In a cross‐sectional study, 101 patients on hemodialysis at our center were screened for pruritus. The relationship of various factors with pruritus was evaluated. Of the 101 patients included, 31(30.7%) had pruritus at the time of examination. Patients with pruritus were significantly older than those without pruritus (P=0.0027). Pruritus tended to be more prevalent in patients undergoing dialysis 3 times a week than in those undergoing daily dialysis, but the difference did not reach statistical significance (P=0.0854). Lower transferrin saturation levels were found in patients with pruritus than in those without pruritus (P=0.0144). C‐reactive protein levels were significantly higher in patients with pruritus than in those without pruritus (P=0.0013). There was no significant difference between the groups in the levels of the other inflammatory biomarkers measured. However, there was a tendency toward a correlation between the levels of α‐1‐glycoprotein and the intensity of pruritus (P=0.0834). Our results suggest a possible relationship of the inflammatory response upregulation to pruritus. Additionally, there was a positive relationship between pruritus and iron deficiency, possibly associated with inflammatory elevation of hepcidin. A better understanding of the factors implicated in the genesis of pruritus related to end‐stage renal disease is crucial in the development of more effective treatments for this symptom.
Importance of early dialysis for acute renal failure after an open‐heart surgery
Authors: IYEM Hikmet , TAVLİ Mine , AKCİCEK Fehmi , BÜKET Suat 
Published: January 2009

AbstractCoronary artery disease is a major cause of death in patients with a renal dysfunction. Among the patients who undergo coronary artery bypass grafting, renal dysfunction is known to be a major predictor of in‐hospital and out‐of‐hospital mortality. From 2004 to 2007, we performed elective open‐heart surgeries on 2380 patients in whom there was no primary renal failure. Of those patients, only 185 in whom acute renal failure (ARF) was developed were included in the study. The patients were divided into 2 groups: a late dialysis group (n=90) and an early dialysis group (n=95). The mean age of the patients was 62.3±6.4 in the late dialysis group and 64.5±5.2 in the early dialysis group. There were 32 female and 58 male patients in the late dialysis group and 36 female and 59 male patients in the early dialysis group. Acute renal failure developed only in 185 patients out of 2380 open‐heart surgery patients. The overall mortality in the 2380 open‐heart surgery patients was 1.97%. Mortality among the ARF patients was 5.9%. However, there was no significant difference in hospital mortality between the 2 groups. Major complications, such as postoperative pneumonia, prolonged ventilation time, arrhythmia, the number of times postoperative hemodialysis was performed, development of chronic renal failure, time spent in the intensive care unit and the period of hospitalization, sepsis, and low cardiac output, were significantly higher in the late dialysis group. There was no difference in mortality between the 2 groups. Early dialysis for open‐heart surgery patients who develop ARF postoperatively does not decrease mortality. However, it decreases morbidity, the amount of time spent in intensive care, and the period of hospitalization and thus reduces patient costs.
Controlling exit site infections: Does it decrease the incidence of catheter‐related bacteremia in children on chronic hemodialysis?
Authors: ONDER Ali Mirza , CHANDAR Jayanthi , COAKLEY Sheila , FRANCOEUR Denise , ABITBOL Carolyn , ZILLERUELO Gaston 
Published: January 2009

AbstractThe aim of this retrospective study was to investigate whether the application of a chlorhexidine‐impregnated dressing (Biopatch®) at the exit site of tunneled‐cuffed hemodialysis catheters has any effect on the incidence and etiology of catheter‐related bacteremia (CRB). This study was carried out over a 5‐year period in a single center, where, in the first 2½ years, the exit sites were cleansed with betadine at every hemodialysis session and then covered with a transparent dressing (pre‐Biopatch® Era). During the next 2½ years, Biopatch® was applied to the exit site once a week after cleansing with betadine, and then covered with a transparent dressing (Biopatch® Era). The application of Biopatch® significantly decreased the incidence of exit site infections (ESI) (P<0.05). However, there was no difference in the incidence of CRBs or their microbiological distribution. The improved ESI rate had no effect on the overall catheter survival time. The antimicrobial sensitivities of the Gram‐positive microorganisms were statistically different for the 2 different types of infections (P<0.05). In conclusion, even though Biopatch® is effective in decreasing the incidence of ESI, it has no effect on the incidence of CRB, the etiology of CRB, or the overall catheter survival time. The distinct difference between the antimicrobial sensitivities of the ESI and CRB suggests that they are not a spectrum of the same pathogenesis. These preliminary data support the intraluminal pathogenesis of CRB, rather than the exit site as a possible entry point for the extraluminal route.
Outcomes of endoluminal stenting for distal colorectal cancer: An institutional experience
Authors: Wong James C.H. , Cheung Hester Y.S. , Yau Kwok‐Kay , Chung Chi‐Chiu , Li Michael K.W. 
Published: January 2009

Aim:  The present article aims to review the results of the use of the self‐expanding metallic stent (SEMS) in our institution for distal colorectal tumours, defined as tumours distal to the splenic flexure.Patients and methods:  SEMS was selectively offered to the following patients with distal colorectal tumours: (i) patients with clinically obstructed tumours; (ii) patients undergoing palliative treatment; and (iii) patients planned for neoadjuvant chemotherapy. All data, including outcomes and complications, were entered prospectively into a database. A review was carried out for those patients who underwent endoluminal stenting between February 2002 and August 2008.Results:  Sixty‐eight patients were evaluated with a median age of 68 years (range 39–91). The median follow up was 11 months. Of these, 53 patients received emergency stenting for acute intestinal obstruction, 12 had palliative stenting for endoscopically obstructive cancer and three had pre‐emptive stenting of locally advanced, stenotic rectal cancer before neoadjuvant chemo‐irradiation. The overall technical success and clinical success rates were 81% and 65%, respectively. Complications included four stent‐related perforations (5.9%) and seven distal migrations (10.3%). Twenty‐seven patients from the intestinal obstruction group and the three patients from the neoadjuvant chemo‐irradiation group subsequently underwent laparoscopic tumour resection with success.Conclusion:  In conclusion, our experience showed that SEMS is a useful adjunct in the management of distal colorectal cancer. Apart from being an alternative measure for palliation, SEMS is an effective and non‐invasive way for relieving obstruction in patients with obstructed tumours, allowing them to undergo subsequent one‐stage laparoscopic tumour resection. It is also useful in patients with locally advanced rectal cancer, in whom neoadjuvant chemo‐irradiation is planned.
Xanthogranulomatous cholecystitis: A rare condition with variable presentations
Authors: Tsang Yvonne Y.Y. , Cheung Yue‐Sun , Ng Wilson W.C. , Wong John , Lee Kit‐Fai , To Ka‐Fai , Lai Paul B.S. 
Published: January 2009

Aim:  Patients suffering from xanthogranulomatous cholecystitis have variable clinical presentations. The present study aims to evaluate the clinical presentations of the disease and the various surgical treatment strategies in the management of patients suffering from xanthogranulomatous cholecystitis.Methods:  This is a retrospective study in a university teaching hospital and a tertiary referral centre. The histopathological records of 5016 resected gallbladder specimens from January 1991 to June 2007 were reviewed and case notes of patients with a diagnosis of xanthogranulomatous cholecystitis were retrieved.Results:  Eighty‐six patients with xanthogranulomatous cholecystitis were identified. The spectrum of presentation was variable and a high proportion of patients had complicated pathology. Patients commonly presented with obstructive jaundice or acute cholecystitis. The proportion of patients with diabetes mellitus who presented with acute cholecystitis was higher than the local prevalence in this study. Conversion rate in laparoscopic cholecystectomy was also higher for patients with xanthogranulomatous cholecystitis.Conclusion:  The clinical presentation of xanthogranulomatous cholecystitis is variable. The disease commonly presents as obstructive jaundice or acute cholecystitis but it may mimic carcinoma of the gallbladder. The disease carries a higher rate of conversion if laparoscopic cholecystectomy was attempted.
Transoral robotic surgery: Establishment of a programme in Hong Kong
Authors: Vlantis Alexander C. , Ng Siu‐Kwan , Chan Hing‐Sang , Tong Michael C.F. , Van Hasselt Charles A. 
Published: January 2009

Aim:  To establish a transoral robotic surgery (TORS) programme for the surgical management of head and neck pathology including oropharyngeal lesions, and to carry out a TORS tonsillectomy.Methods:  Training for otolaryngologists was planned and undertaken. Off‐site robotic training of otolaryngologists was conducted by a robotic company trainer. Visits to established international TORS programmes were made. A suitable patient was identified with the intention of undergoing a TORS tonsillectomy and evaluating the outcome.Results:  A patient successfully underwent a transoral robotic surgery tonsillectomy using a surgical robot system without intraoperative or postoperative complications or sequelae.Conclusions:  A transoral robotic surgery programme, including training for otorhinolaryngologists, has been established. A tonsillectomy, a feasible procedure easily carried out, was done using a surgical robot system without complications.
COMBINED TOXIC EFFECTS OF TYPICAL MUTAGENS – DIMETHYLPHENOL, TRIBROMETHANE AND DINITROANILINE, ON UNICELLULAR GREEN ALGAE DUNALIELLA SALINA
Authors: ZHU YUE‐HUI , JIANG JIAN‐GUO 
Published: January 2009

ABSTRACT By the use of the Organization for Economic Co‐operation and Development (OECD) standard method for algal growth inhibition test, the combined toxicities test (48 h, EC50) for Dunaliella salina was conducted with the four kinds of mixtures to study the application of toxicological test with algae in water quality monitoring. Using dimethylphenol, tribromethane and dinitroaniline as the typical mutagenic toxicants, their concentrations were set according to the national drinking water health standard (GB5749‐85). Four groups of the tests were set by combining any two of the three compounds, while another group was the control group. D. salina was cultivated in these groups and the EC50 of each group was obtained. Results showed that when dimethylphenol and tribromethane were combined, the inhibit action to the growth of D. salina showed a weak synergism; when the dimethylphenol and dinitroaniline were combined, the inhibit action was additive action; when tribromethane and dinitroaniline were combined, the inhibit action showed antagonism; when all the three kinds of compounds were combined, the inhibit action was also antagonism. It was concluded that the application of toxicological test with D. salina in water quality monitoring is feasible.PRACTICAL APPLICATIONDerived from water environmental contaminants or the processing of water treatment, dimethylphenol, tribromethane and dinitroaniline are potential residues in drinking water, which may cause toxicity, mutagenicity and teratogenicity to the human body even in trace amounts. Thus, the test and evaluation of the dose‐response for these compounds is very important. In addition, the three compounds may occur in water together and the combined toxicity tests between them to investigate the combined effects become necessary. In this study, Dunaliella salina, a unicellular green algae, was used as the test organism to perform the investigation. These tests were preferred because they are simple, cost‐effective and efficient, and D. salina is easily cultured. The methods established in this study are practicable and will provide further studies with useful reference information.
OCCURRENCE OF VIBRIO PARAHAEMOLYTICUS IN DIFFERENT FINFISH AND SHELLFISH SPECIES
Authors: DAS B. , MANNA S.K. , SARKAR P. , BATABYAL K. 
Published: January 2009

ABSTRACT Occurrence of Vibrio parahaemolyticus was examined in 293 samples of finfish and Penaeus monodon from wholesale fish markets in Kolkata, India, by standard culture technique. The bacterium was isolated from 45.83% of shellfish and 16.73% of finfish samples. Among finfishes, about 30% of Chela laubuca and Otolithoides biauritus, and 18–21% of Lates calcarifer, Ompok bimaculatus and Herpadon nehereus samples were contaminated. The bacterium was mostly recovered from intestinal contents (32.25%) as compared to skin (11.95%) and gill tissue (16.43%). Seasonal variation in occurrence of the bacterium was also recorded. The occurrence was slightly more in seafishes (21.74%) as compared to estuarine (16.04%) and freshwater fishes (13.83%), and in demersal fish species (19.35%) posing health risk to the consumers.PRACTICAL APPLICATIONS / SIGNIFICANCE OF THE STUDYAlthough seafoods, especially molluscan shellfishes, are known to carry Vibrio parahaemolyticus and are common sources of human infection, presence of the bacterium in finfishes is less documented. We have examined presence of V. parahaemolyticus in 20 finfish and shellfish species in India. Relative occurrences of the bacterium in finfishes from different habitats (sea, estuarine and freshwater) and in pelagic/benthopelagic or demersal fish species give new insights about distribution of the bacterium in nature. Data on unequal distribution of the pathogen in different fish and shellfish species will be helpful to the food industry, as well as the fish‐eating community, ensuring fish food safety.