bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of supportive extracorporeal treatment in liver transplantation recipients and advanced liver failure patients
Authors: OZDEMIR Fatma N. , TUTAL Emre , SEZER Siren , GÜR Gürden , BILGIC Ayse , HABERAL Mehmet 
Published: October 2006

AbstractRecently, continuous venovenous hemodiafiltration (CVVHDF) and plasmapheresis (PF) were suggested as supportive therapy options in combination with standard treatment in advanced liver failure. The aim of this study was to analyze the effects of supportive extracorporeal treatment (SET) in a group of patients with advanced hepatic failure. A total of 25 patients (7 women, 18 men; mean age, 39.3±15.4 years; 13 were transplant recipients [6 women, 7 men; mean age, 37.7±16.9 years]) were included. All patients were in hepatic coma and receiving standard coma and liver failure management when they received SET. Number of SET sessions; levels of serum blood urea nitrogen, creatinine, albumin, calcium, phosphorus, ammonia, alanine and aspartate aminotransferase, and total/conjugated bilirubin; and prothrombin times (PTT) before and after SET were recorded retrospectively. 7.7±7.9 SET sessions were performed. Thirteen liver transplant recipients required SET for an average of 9.7±8.3 days after transplantation. Serum ammonia and bilirubin levels were lower after termination of supportive therapy when compared with initial levels (p<0.0001 and p<0.005 respectively). During follow‐up, hepatic encephalopathy and liver failure resolved in 11 patients, while 14 patients (7 transplant recipients) died. There was no significant difference between patients in either group except that PTT was shorter in patients who survived (p<0.01). Further analyses revealed that in surviving patients, ammonia clearance was higher (p<0.01). In patients with advanced liver failure, or liver transplants, CVVHDF and/or PF could be supportive options combined with standard treatment.
Cystatin C in critically ill patients treated with continuous venovenous hemofiltration
Authors: BAAS Marije C. , BOUMAN Catherine S. C. , HOEK Frans J. , KREDIET Raymond T. , SCHULTZ Marcus J. 
Published: October 2006

AbstractAssessment of residual renal function in critically ill patients with acute renal failure (ARF) treated with continuous venovenous hemofiltration (CVVH) is difficult. Cystatin C (CysC) is a low‐molecular‐weight protein (13.3 kDa) removed from the body by glomerular filtration. Its serum concentration has been advocated for assessment of renal function in patients with kidney disease. To investigate whether the removal of CysC by CVVH is likely to influence its serum concentration, concentrations of CysC were measured in 3 consecutive samples in 18 patients with oliguric ARF treated with CVVH (2 L/hr). Samples were taken from the afferent and efferent blood lines and from the ultrafiltrate line. Concentrations of CysC did not change during the time interval studied. The mean serum concentrations of CysC were 2.25±0.45 mg/L in the afferent and 2.19±0.56 mg/L in the efferent samples (NS); ultrafiltrate concentrations of CysC were 1.01±0.45 mg/L. The sieving coefficient of CysC was 0.52±0.20; the clearance of CysC was 17.3±6.6 mL/min; and the quantity of CysC removed averaged 2.13 mg/hr. During CVVH (2 L/hr), the quantity of CysC removed is less than 30% of its production and no rapid changes in its serum concentration are observed. Therefore, CVVH (2 L/hr) is unlikely to influence serum concentrations of CysC significantly, which suggests that it can be used to monitor residual renal function during CVVH.
In search of an advance directive that works for end‐stage renal disease patients
Authors: BARTLOW Bruce 
Published: October 2006

AbstractAlthough loss, disability, and death are constant possibilities for any end‐stage renal disease patient, very few have planned for the last of life. Currently available Advance Directives (ADs) are refusal of specific therapies in only specific but nebulous circumstances. They fail to provide positive guidance for a patient's remaining time. Without addressing goals, quality of life, reversibility of medical problems, and desired end‐of‐life (EOL) care, such ADs are useless. End‐stage renal disease providers are generally untrained and unsupported in offering guidance. Financial, emotional, and structural factors collude to justify ignoring EOL planning. Several alternative ADs are offered, along with a goal‐directed approach to EOL counseling for patients and staff.
Coagulation cascade
Authors: GREEN David 
Published: October 2006

AbstractThe coagulation cascade is now recognized to be a series of proteolytic events mainly localized to the surface of activated platelets. Once platelets become activated by exposure to activated endothelium, they release mediators such as P‐selectin and von Willebrand factor that promote microvesicle formation and platelet adherence. The microvesicles fuse with the activated platelet membrane, providing tissue factor and its ligand, factor VIIa. Clotting factors bind to adjacent receptors on the membrane, enabling the cascading proteolytic cleavages of zymogens to active enzymes, culminating in thrombin generation. Fibrin formation thus occurs in the sheltered environment of the platelet membrane, where it is localized to the site of injury and protected from circulating inhibitors.
Management of hyperphosphatemia
Authors: KUHLMANN Martin K. 
Published: October 2006

AbstractHyperphosphatemia is a well recognized risk factor for cardiovascular mortality in dialysis patients. Despite advanced technology and regular and efficient dialysis treatment the prevalence of hyperphosphatemia is still high. The goal of normalization of serum phosphorus (iP) levels can only be reached by optimization of dialysis prescription in combination with individualized dietary and medical strategies. Due to the unique characteristics of intradialytic iP kinetics, dialysis treatment time and frequency are the most effective factors governing intradialytic iP removal. Although the combination of diffusive and convective removal by hemodiafiltration allows a further increase in iP mass removal, a neutral phosphorus balance without dietary restrictions and the use of phosphate binders has only be achieved by daily nocturnal hemodialysis. Strict dietary phosphate restriction bears the risk of inadequate protein intake and the development of protein/calorie malnutrition. Although phosphate binders (PB) can effectively lower serum iP levels into the normal range, this is rarely achieved in clinical practice probably due to inadequate relation of PB dose to dietary phosphorus intake. Developing methods to enable patients to self‐adjust phosphate binder dose to individual meal phosphate content, similar to adjusting insulin dose to carbohydrate intake, may lead to further improvements in phosphate management.
Evaluation of cortical bone by peripheral quantitative computed tomography in continuous ambulatory peritoneal dialysis patients
Authors: NEGRI Armando Luis , BARONE Roberto , LOMBAS Carola , BOGADO Cesar E. , ZANCHETTA Jose Ruben 
Published: October 2006

AbstractSeveral studies have suggested an increased prevalence of osteopenia in dialysis. Peripheral quantitative computed tomography (pQCT) is a new technique that allows the noninvasive evaluation of trabecular and cortical bone separately. The aim of the study was: (1) to evaluate cortical bone by pQCT in continuous ambulatory peritoneal dialysis (CAPD) patients and compare the data with that obtained in healthy controls; and (2) to correlate cortical bone parameters with bone mineral density (BMD) of the lumbar spine and femoral neck and total bone mineral content (TBMC). Cortical bone parameters were obtained in 22 CAPD patients and 27 healthy individuals at the distal radius using a Stratec XCT 960 pQCT machine. In the dialysis patients, we also determined BMD and TBMC by bone densitometry. Dialysis patients, compared with controls, showed a significant reduction in volumetric cortical BMD (VcBMD) (p=0.04) and cortical thickness (cThk) (p<0.0001) with a significant increase in radial total cross‐sectional area (TA) (p=0.006), endosteal circumference (p<0.0001), and buckling ratio (p<0.0001). In CAPD patients, total time on dialysis correlated negatively with radial total BMD (p<0.01) and VcBMD (p<0.01). Age correlated positively with TA (p<0.01), endosteal (p<0.01), and periosteal circumferences (p<0.01). Serum intact parathyroid hormone (PTH) levels correlated positively with endosteal (p=0.04) and periosteal perimeter (p=0.01). Total alkaline phosphatase correlated negatively with VcBMD (p<0.01), and positively with endosteal perimeter (p=0.02). Total bone mineral content correlated significantly with radial cortical content (p<0.001), cross‐sectional cortical area (cA; p<0.001), and cThk (p<0.01) but not with total radial BMD, VcBMD, or buckling ratio. No correlations were found between radial cortical parameters and BMD measured at the lumbar spine or femoral neck. We conclude that dialysis patients show cortical osteopenia with marked cortical thinning partially mediated by PTH action on bone. Total bone mineral content correlated with various radial cortical parameters (content, area, and thickness) but not with others. No correlations were found between cortical bone parameters measured at the peripheral skeleton with areal bone density measured at the axial skeleton. These findings suggest that pQCT may be a new tool in the assessment of bone fragility in dialysis patients.
Doppler echocardiograph evaluation of pulmonary hypertension in patients undergoing hemodialysis
Authors: TARRASS Faissal , BENJELLOUN Meryem , MEDKOURI Ghislaine , HACHIM Khadija , BENGHANEM Mohamed Gharbi , RAMDANI Benyounes 
Published: October 2006

AbstractPulmonary hypertension (PH) has been reported in hemodialysis (HD) patients, but data regarding its incidence and mechanisms are scarce. The aims of this study was to evaluate the prevalence of unexplained PH in long‐term HD patients, and to examine some possible etiologic factors for its occurrence. The prevalence of PH was estimated by Doppler echocardiography in a cohort of 86 stable patients on HD via arteriovenous access for more than 12 months. All the patients underwent full clinical evaluation, chest radiography, and a standard 12‐lead echocardiograph. Laboratory investigation included a mean of 12 months (serum calcium, phosphorus, parathormone (PTH), alkaline phosphatase, lipids, and hemoglobin). Pulmonary hypertension was defined as pulmonary artery systolic pressure >35 mmHg as determined by Doppler echocardiography using the modified Bernoulli equation. Pulmonary hypertension was detected in 23 patients (26.74%). Of those with PH, left ventricular hypertrophy was seen in 13 patients (56.52%), and valvular calcifications in 6 patients (26.08%). There were no significant differences between both groups with regard to age, sex, duration of dialysis, shunt location, and all the biological parameters of the study. The presence of PH was not related to the level of PTH, or the severity of other metabolic abnormalities. This study demonstrates a high prevalence of PH among patients with ESRD receiving long‐term HD via surgical arteriovenous access. The role of the vascular access, anemia, or secondary hyperparathyroidism as the etiology of PH in HD patients did not hold in this study.
Surveillance cultures of tunneled cuffed catheter exit sites in chronic hemodialysis patients are of no benefit
Authors: ROSENBAUM Debbie , MacRAE Jennifer M. , DJURDJEV Ognjenka , LEVIN Adeera , WERB Ron , KIAII Mercedeh 
Published: October 2006

AbstractCatheter‐related infections are a major cause of morbidity and mortality in hemodialysis (HD) patients. This study evaluated the utility of surveillance swab cultures (Ssc) of tunneled cuffed catheter (TCC) exit sites as a prediction and prevention strategy for infection. A 6‐month prospective‐controlled trial with 94 chronic HD patients with a TCC who received monthly Ssc and were stratified by dialysis day into topical therapy based on Ssc results (Group A) or no therapy (Group B). Outcomes were exit site infection (ESI) and catheter‐associated bacteremia (CAB). The overall monthly prevalence of positive Ssc was 14.9%. There was no difference in the number of positive Ssc (17.7% vs. 11.6%, p>0.05) or ESI (19.6% vs.16.3%, p>0.05) between Groups A and B, respectively. Catheter‐associated bacteremia was higher in Group A (17.7% vs. 4.7%, p=0.05). There were significantly more ESI in the patients treated for a positive Ssc. In Group A, the incidence of ESI was significantly higher in those treated for a positive vs. negative Ssc (55% vs. 12%, p=0.009) and CAB rates trended higher with positive Ssc (22.2% vs. 16.7%, p>0.05). The strategy of treating positive surveillance cultures is not beneficial. Positive Ssc do not predict the occurrence of catheter‐related infection, and treatment of these cultures may lead to increased infection rates.
Prevalence rate of Cryptosporidium infection in hemodialysis patients in Iran
Authors: SEYRAFIAN Shiva , PESTEHCHIAN Nader , KERDEGARI Maryam , YOUSEFI Hossein Ali , BASTANI Bahar 
Published: October 2006

AbstractCryptosporidium is one of the most common causes of diarrhea in the world, which can be severe and prolonged in immunocompromised patients. We compared the prevalence rate of Cryptosporidium infection in hemodialysis patients and 2 control groups (i.e., their healthy family members and normal population). Stool specimens of 104 adult outpatient chronic hemodialysis patients, their 91 healthy family members, and 140 healthy individuals were examined for the presence of Cryptosporidium oocysts by using a modified acid‐fast staining method. Twelve (11.5%) dialysis patients were infected with Cryptosporidium. This was significantly higher than 4 (4.4%), and 5 (3.6%) cases in the 2 control groups, respectively (p<0.05). There was no significant difference between the 2 control groups. The prevalence rate of Cryptosporidium infection did not correlate with patients' sex, age, duration of dialysis, history of kidney transplantation, or history of taking immunosuppressive drugs. However, it was significantly higher in diabetics vs. nondiabetics (19.4% vs. 8.3%, respectively, p<0.05). Our results indicate that the prevalence rate of Cryptosporidium infection is considerably higher in dialysis patients than in the general population. Moreover, dialyzed diabetic patients had the highest rate of infection. As hemodialysis patients are candidates for renal transplantation, general preventive measures against acquiring Cryptosporidium infection must be considered.
Stability of nutritional parameters during a 5‐year follow‐up in patients treated with sequential long‐hour hemodialysis
Authors: CHAZOT Charles , VO‐VAN Cyril , BLANC Corinne , HUROT Jean Marc , JEAN Guillaume , VANEL Thierry , TERRAT Jean Claude , CHARRA Bernard 
Published: October 2006

AbstractProgressive nutritional impairment has been recently reported during conventional hemodialysis (HD) treatment. We studied the nutritional parameters during a 5‐year follow‐up in HD patients. Thirty‐three patients (15F/18M; 65 years old at the study start) filled out a 3‐day food questionnaire once a year between 1995 and 1999 (study group). Twenty patients, who did not fill out the food records during this period served as a control group (control group). The food record was run by the renal dietician using a dedicated software, providing daily energy and protein intakes (DEI and DPI). Serum albumin, normalized protein equivalent of nitrogen appearance (nPNA), and postdialysis body weight (BW) at the time of food record were collected in the study group and from the patient chart in the control group. The energy intake in the study group and the protein intake in both groups were close to the recommended intakes in ESRD patients. Protein intake assessed from food questionnaire or from urea kinetics were not statistically different. Using ANOVA for repeated measures, no difference along the 5 years was found for daily energy intake, daily protein intake, nPNA, and BW in the study group. The BW and nPNA remained stable in the control group. Hence, this study does not confirm the progressive nutritional impairment reported in the HEMO study, whereas the patients' age and vintage are largely higher in the present study. The role of a large dialysis dose in maintaining nutritional status in HD patients is discussed.
Prognostic implications of clinical practice guidelines among hemodialysis patients
Authors: CHANG John J. , CONCATO John , WELLS Carolyn K. , CROWLEY Susan T. 
Published: October 2006

AbstractAlthough the National Kidney Foundation (NKF) has published clinical practice guidelines for the management of risk factors for cardiovascular disease, these guidelines have not been tested rigorously for their effectiveness. We conducted an observational study among patients with end‐stage kidney disease to examine the prognostic impact of threshold levels recommended by the NKF for blood pressure, hemoglobin, calcium‐phosphate product, parathyroid hormone, low‐density lipoprotein, and glycosylated hemoglobin. The study population (N=197) was assembled from a previously completed randomized trial examining arteriovenous graft thrombosis. Cox proportional hazard analysis was used to calculate hazard ratios for the association of levels outside guideline recommended targets and death, adjusting for age, comorbidity, race, and albumin. The proportion of patients outside guideline targets ranged from 33% to 81%, and the impact of levels outside guideline targets on mortality varied substantially. Elevated calcium‐phosphate product and glycosylated hemoglobin had harmful effects, with adjusted hazard ratios of 1.58 (95% CI 1.00–2.50; p=0.050) and 2.21 (95% CI 0.99–4.97; p=0.054), respectively. Nontarget levels for blood pressure, hemoglobin, and parathyroid hormone had little effect, with adjusted hazard ratios of 1.15 (95% CI 0.74–1.78; p=0.542), 1.04 (95% CI 0.65–1.68; p=0.866), and 0.90 (95% CI 0.50–1.61; p=0.722), respectively. Elevated low‐density lipoprotein had a paradoxically beneficial effect, with an adjusted hazard ratio of 0.48 (95% CI 0.23–1.00; p=0.049). These results suggest that the prognostic impact of current threshold levels recommended by select NKF guidelines on mortality is variable. Accordingly, the development and implementation of clinical practice guidelines should be accompanied by corresponding efforts to confirm their impact on patient outcomes. Such efforts are essential for the improvement of guidelines and to inform health policy optimally.
APPLICATION OF NUCLEIC ACID SEQUENCE‐BASED AMPLIFICATION FOR THE DETECTION OF VIABLE FOODBORNE PATHOGENS: PROGRESS AND CHALLENGES
Authors: RODRÍGUEZ‐LÁZARO DAVID , HERNÁNDEZ MARTA , D’AGOSTINO MARTIN , COOK NIGEL 
Published: October 2006

ABSTRACT Nucleic acid sequence‐based amplification (NASBA) is a sensitive transcription‐based amplification system that uses a battery of three enzymes (avian myeloblastosis virus reverse transcriptase, RNase H and T7 RNA polymerase) leading to a main amplification product of single‐stranded RNA, and is specifically designed for the specific detection of RNA. NASBA is an established diagnostic tool in clinical use, with a theoretically bigger analytical sensitivity than reverse transcription‐polymerase chain reaction (RT‐PCR) for pathogen detection, but is not progressing toward implementation in food analysis. This is unfortunate, because it has a potential for detection of viable cells through selective amplification of messenger RNA, even in a background of genomic DNA, which PCR does not possess. However, in some instances, an unexpected amplification of genomic DNA has been observed using the NASBA technique. The availability of methods for rapid, sensitive and selective detection of viable microbial pathogens in foods is a goal worth pursuing, and a developmental effort to explore and capitalize on NASBA's potential in this regard could be worthwhile. We review in this work the current status and the future application of this technique in food microbiology diagnostics.
COMPARISON OF PETRIFILM AEROBIC COUNT PLATES AND DE MAN–ROGOSA–SHARPE AGAR FOR ENUMERATION OF LACTIC ACID BACTERIA
Authors: NERO LUÍS AUGUSTO , BELOTI VANERLI , DE AGUIAR FERREIRA BARROS MÁRCIA , ORTOLANI MARIA BEATRIZ TASSINARI , TAMANINI RONALDO , DE MELO FRANCO BERNADETTE DORA GOMBOSSY 
Published: October 2006

ABSTRACT This study aimed to compare Petrifilm aerobic count (AC) plates (3M Microbiology, St. Paul, MN) and de Man–Rogosa–Sharpe (MRS) agar for enumeration of lactic acid bacteria (LAB). The study was conducted with suspensions of 10 species of LAB prepared in reconstituted powdered milk. Raw milk samples, without any added bacteria, were also tested. For selective enumeration in Petrifilm AC plates, the suspensions of LAB and the raw milk samples were submitted to decimal dilutions in MRS broth prior to plating. Petrifilm AC and MRS agar plates were incubated in jars at 30C for 72 h, in microaerophilic conditions (Campygen, Oxoid, Basingstoke, U.K.). Differences in counts in the two culture media were not significant (P ≤ 0.05), regardless of the species of the LAB. Results presented high correlation indexes for both LAB suspensions (r = 0.9922, r2 = 0.9845, P = 0.00) and raw milk samples (r = 0.9841, r2 = 0.9685, P = 0.00). These results indicate that the advantages of using Petrifilm AC plates for a rapid enumeration in aerobic microorganisms can be extended for enumeration of LAB in foods. Their convenience is particularly interesting for testing fermented milk products.
COMPARISON OF CONVENTIONAL PLATING AND SIMPLATE METHODS FOR ENUMERATION OF AEROBIC MICROORGANISMS, COLIFORM AND ESCHERICHIA COLI IN FARM ENVIRONMENTAL SAMPLES
Authors: PANGLOLI PHILIPUS , JACKSON FELIX , RICHARDS HAROLD A. , MOUNT JOHN R. , DRAUGHON F. ANN 
Published: October 2006

ABSTRACT The objective of this study was to compare conventional plating to SimPlate methods for enumeration of aerobic microorganisms, coliforms and Escherichia coli in samples from farm animals and their environment. Samples evaluated included rectal swabs, fecal material, bedding, litter and feed and soil from beef and dairy cattle, swine and poultry farms. Standard method agar pour plating and conventional violet red bile agar with 4‐methylumbelliferyl β‐D‐glucuronide were compared to the SimPlate total plate count‐color indicator method for aerobic counts and the SimPlate coliform and E. coli color indicator method for total coliforms and E. coli counts, respectively. Overall, the SimPlate methods produced counts that were not significantly different (P > 0.05) from those of the conventional methods. Population counts from the SimPlate methods were highly correlated with colony‐forming unit counts from the conventional methods with r = 0.90, 0.94 and 0.94 for aerobic counts, total coliforms and E. coli, respectively. Thus, the data from this study indicate that SimPlate methods are comparable and reliable for enumeration of aerobic microorganisms, coliforms and E. coli in environmental farm samples.