bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of MRI Findings and Neuropsychological Functioning after the First Recognized Seizure
Authors: Byars Anna W. , DeGrauw Ton J. , Johnson Cynthia S. , Fastenau Philip S. , Perkins Susan M. , Egelhoff John C. , Kalnin Andrew , Dunn David W. , Austin Joan K. 
Published: April 2007

Summary:  Purpose: To explore relationships between MRI abnormalities of the brain and neuropsychological functioning in children who were evaluated following their first recognized seizure. Methods: Subjects were children aged 6 to 14 years with a first recognized seizure within the past 3 months who participated in a larger prospective study of child adaptation. The 249 children with neuropsychological testing and neuroimaging were studied. Children underwent neuropsychological examination an average of 2.8 months and MRI examination an average of 1.3 months after the first recognized seizure. On factor analysis four factors were found for neuropsychological function: LANG = Language, PS = Processing Speed, EC = Executive/ Construction, VMEM = Verbal Memory and Learning. For analysis, structural abnormalities found on MRI were classified as significant (yes/no) based on whether they were presumed to be related to the seizure condition. Results: On MRI, 34 (14%) had structural abnormalities that were judged to be significant in that they were possibly related to their seizures. Children with significant abnormalities had significantly lower estimated IQ scores and significantly lower language, processing speed, executive/constructional ability, and verbal memory and learning factor scores than did children without significant abnormalities. Conclusions: Children who have structural brain abnormalities at onset have slightly lower cognitive functioning overall, and all neuropsychological domains seemed to be affected relatively equally. This pattern was apparent even when we restricted the analysis to children with intellectual functioning in the broadly normal range.
Nonconvulsive Status Epilepticus in a Neurological Intensive Care Unit: Profile in a Developing Country
Authors: Narayanan Jaishree T. , Murthy Jagarlapudi M. K. 
Published: April 2007

Summary: Purpose:Nonconvulsive status epilepticus (NCSE) is an under‐recognized cause of altered mental status. There are hardly any reported data on NCSE in developing countries.Material and Methods:Prospectively 210 consecutive patients with altered mental status admitted to neurological intensive care unit (NICU) of a tertiary care center in south India were studied for the frequency of NCSE. All patients were evaluated initially with 60‐min emergent EEG (EmEEG) and subsequently by continuous EEG (cEEG) monitoring.Results:Of the 210 with altered mental status admitted to NICU, the diagnosis of NCSE was established in 22 (10.5%) patients, in 12 (55%) patients with 60‐min EmEEG and in 10 (45%) after cEEG monitoring for 12 to 48 hours.Of the 22 patients with NCSE, 32% had subtle motor phenomena, these were not an initial presenting features, but were apparent during cEEG recording. Acute medical or neurologic etiology was the risk factor in 68% of patients. Central nervous system (CNS) infections and cortical sino‐venous thrombosis (CSVT), respectively, accounted for 23% and 14% of the etiologies. Intravenous midazolam terminated NCSE in 19 patients and valproate in 2. Of the 15 patients with acute symptomatic NCSE, 4 (18%) had poor prognosis (3 deaths and one persistent vegetative state). The etiological risk factors in the 9 (41%) patients with excellent outcome included epilepsy (3), remote symptomatic (2), cryptogenic (1), and metabolic and drugs (3).Conclusions:The frequency of NCSE in the current study was comparable with those in prior reports from developed countries. CNS infections accounted for about a fifth of the etiology. Outcome was excellent in patients with nonacute symptomatic NCSE. Initial 60‐min EmEEG may be performed in establishing the diagnosis of NCSE, but almost half of patients with NCSE will be missed with this approach.
Sodium Valproate, Hyperandrogenism and Altered Ovarian Function in Indian Women with Epilepsy: A Prospective Study
Authors: Prabhakar Sudesh , Sahota Preeti , Kharbanda Parampreet Singh , Siali Ravinder , Jain Vanita , Lal Vivek , Khurana Dheeraj 
Published: April 2007

Summary:  Purpose: To assess the association of long‐term sodium valproate therapy with reproductive endocrine disorders in Indian women with generalized epilepsy. Methods: Clinical parameters, ovarian morphology, and serum reproductive hormone concentrations were evaluated in 30 clinically normal and eumenorrheic reproductive age women with generalized epilepsy who were newly initiated on valproate. Longitudinal evaluations were done in 25 of these women after 1 year, and in some of them after 2 and 3 years of therapy. Results: Of the 25 women who completed 1 year follow‐up, we observed clinically relevant weight gain in 40%, hirsutism in 20%, menstrual abnormalities in 24%, polycystic ovaries (PCO) in 16%, polycystic ovarian syndrome (PCOS) in 20%, and a significant increase in mean serum testosterone (p = 0.046). A significant positive correlation existed between weight gain and the development of menstrual abnormalities (r = 0.66, p < 0.0001), hirsutism (r = 0.53, p = 0.006) and PCO (r = 0.51, p = 0.012). No correlation existed between weight change and serum reproductive hormonal changes. Yearly follow‐up for next 2 years in some of these women revealed persistence of menstrual abnormalities, hirsutism and PCO, a significant linear increase in mean body weight, body mass index, and serum testosterone concentrations, and an increase in serum LH levels from second year onwards. Limitations: Limitations include small sample size and a high dropout rate on follow‐up. Conclusions: Long‐term valproate therapy in Indian women with generalized epilepsy is associated with development of hirsutism, significant weight gain, stable or progressive alterations in reproductive hormonal function, and ultimately a higher occurrence of PCOS.
The Incidence of First Provoked and Unprovoked Seizure in Pediatric Patients with and without Psychiatric Diagnoses
Authors: McAfee Andrew T. , Chilcott Karen E. , Johannes Catherine B. , Hornbuckle Ken , Hauser W. Allen , Walker Alexander M. 
Published: April 2007

Summary:  Purpose: To estimate the rate of new‐onset afebrile provoked and unprovoked seizure in a general pediatric population and subgroups of patients with and without psychiatric diagnoses other than attention deficit hyperactivity disorder (ADHD). Methods: A retrospective cohort study of 133,440 pediatric patients, between the ages of 6 and 17 years, and without history of seizure or prior use of anticonvulsant medications, with follow‐up during 2003. The data source for this study was Ingenix's research database containing pharmacy and medical claims for members of a large US‐based managed care organization. The main outcome measure was new‐onset nonfebrile seizure. Incidence rates of seizure and 95% confidence intervals (CI) were calculated and expressed as rates per 100,000 person‐years. Results: There were 132 new‐onset provoked and unprovoked seizures in 78,423 person‐years of follow‐up among the general pediatric population sample. The incidence rate of seizure among the general pediatric population was 168 per 100,000 p‐y (95% CI 141–200). The incidence rate of seizure among patients without psychiatric diagnoses was 149 per 100,000 p‐y (95% CI 122–180). The incidence rate of seizure among patients with psychiatric diagnoses other than ADHD was 513 per 100,000 p‐y (95% CI 273–878). There were increases in the incidence rates of seizure in all of the seizure risk factor groups, but this was more pronounced among males ages 6–12 with psychiatric diagnoses. Conclusions: The results of this study are consistent with previous reports showing that pediatric patients with psychiatric disorders have a higher incidence rate of seizure than the general pediatric population.
Increased Drinking During Withdrawal From Intermittent Ethanol Exposure Is Blocked by the CRF Receptor Antagonistd‐Phe‐CRF(12–41)
Authors: Finn Deborah A. , Snelling Christopher , Fretwell Andrea M. , Tanchuck Michelle A. , Underwood Lisa , Cole Maury , Crabbe John C. , Roberts Amanda J. 
Published: April 2007

Background:Studies in rodents have determined that intermittent exposure to alcohol vapor can increase subsequent ethanol self‐administration, measured with operant and 2‐bottle choice procedures. Two key procedural factors in demonstrating increased alcohol intake are the establishment of stable alcohol self‐administration before alcohol vapor exposure and the number of bouts of intermittent vapor exposure. The present studies provide additional behavioral validation and initial pharmacological validation of this withdrawal‐associated drinking procedure.Methods:Studies at 2 different sites (Portland and Scripps) examined the effect of intermittent ethanol vapor exposure (3 cycles of 16 hours of ethanol vapor+8 hours air) on 2‐hour limited access ethanol preference drinking in male C57BL/6 mice. Separate studies tested 10 or 15% (v/v) ethanol concentrations, and measured intake during the circadian dark. In one study, before measuring ethanol intake after the second bout of intermittent vapor exposure, mice were tested for handling‐induced convulsions (HICs) indicative of physical dependence on ethanol. In a second study, the effect of bilateral infusions of the corticotropin‐releasing factor (CRF) receptor antagonistd‐Phe‐CRF(12–41) (0.25μg/0.5μL) into the central nucleus of the amygdala (CeA) on ethanol intake was compared in vapor‐exposed animals and air controls.Results:Intermittent ethanol vapor exposure significantly increased ethanol intake by 30 to 40%, and the mice had higher blood ethanol concentrations than controls. Intra‐amygdala infusions ofd‐Phe‐CRF(12–41) significantly decreased the withdrawal‐associated increase in ethanol intake without altering ethanol consumption in controls. Following the second bout of intermittent vapor exposure, mice exhibited an increase in HICs, when compared with their own baseline scores or the air controls.Conclusions:Intermittent alcohol vapor exposure significantly increased alcohol intake and produced signs of physical dependence. Initial pharmacological studies suggest that manipulation of the CRF system in the CeA can block this increased alcohol intake.
Radiofrequency identification technology can standardize and document blood collections and transfusions
Authors: Sandler S. Gerald , Langeberg Al , DeBandi Leo , Gibble Joan , Wilson Charles , Feldman Charles L. 
Published: April 2007

BACKGROUND: We evaluated the potential for radiofrequency (RF) transponder microchips to standardize and document key steps in the blood collection and transfusion process.STUDY DESIGN AND METHODS: Using the blood center's standard operating procedures for blood collections, we programmed a laptop computer and 10 multiwrite 256‐byte RF microchips to prompt operators to enter data for key steps in blood collection. Before collections, RF microchips were attached to blood collection sets at the blood center. In parallel with actual collections, we added data to the microchips with the computer and a hand‐held scanner‐programmer. After labeling, we shipped the RF microchip‐tagged blood units to the hospital where unit‐related data (whole blood number, ABO and Rh, expiration date, special laboratory test results) were uploaded from the RF microchip to the transfusion service's information system. The microchip was subsequently used as a cross‐match label for blood unit–recipient matching.RESULTS: Data were successfully uploaded to the RF microchip at key steps during blood collections. Software programs in the laptop computer and hand‐held scanner‐programmer successfully prompted operators to enter key data. At any stage in a blood collection, authorized operators were able to review electronic records of prior steps using the laptop computer or by scanning the microchip attached to the blood bag. Unit‐related data were successfully transferred to the hospital transfusion service through the RF microchip. These data were successfully incorporated in the RF microchip cross‐match label, which was used to confirm recipient–blood unit matching at the bedside.CONCLUSION: RF microchips can collect key data during blood collections, facilitate information transfer from the blood center to the hospital, and confirm recipient–blood unit matching at the bedside before transfusions.
Prevention of bedside errors in transfusion medicine (PROBE‐TM) study: a cluster‐randomized, matched‐paired clinical areas trial of a simple intervention to reduce errors in the pretransfusion bedside check
Authors: Murphy Michael F. , Casbard Angela C. , Ballard Sally , Shulman Ira A. , Heddle Nancy , Aubuchon James P. , Wendel Silvano , Thomson Amanda , Hervig Tor , Downes Katharine , Carey Patricia M. , Dzik Walter H. ,   on behalf of the BEST Research Collaborative
Published: April 2007

BACKGROUND: Transfusion of the incorrect blood component is a frequent serious incident associated with transfusion and often involves misidentification of the patient and/or the unit of blood. The objective of this study was to assess the effect of a simple intervention designed to improve performance of the bedside check and to observe the durability of any effect. The intervention was a tag on blood bags reminding staff to check the patient's wristband. The tag was positioned in such a way that the transfusionist was required to remove the tag to spike the unit.STUDY DESIGN AND METHODS: The intervention was tested in a multicenter cluster‐randomized controlled trial incorporating short‐term and long‐term follow‐up periods. The primary endpoint was the proportion of patients transfused with red cell units for whom the key elements of the bedside check were all correctly completed.RESULTS: Fifteen matched‐paired clinical areas at 12 participating hospitals in six countries were included in the trial. Combining data from all participating hospitals, the bedside check was correctly performed in 37 percent of transfusions during the baseline audit period. There was no evidence of a favorable effect of the intervention immediately after its introduction (pooled odds ratio, 1.09; 95% confidence interval, 0.54‐2.17). There was similarly no evidence of a favorable effect after continued use of the intervention for an additional 8 weeks.CONCLUSIONS: A simple intervention in the form of a barrier warning label on blood bags reminding staff to check the patient's wristband failed to improve bedside transfusion practice. The robust study design developed for this study could be applied to investigate other interventions to improve the safety of bedside transfusion practice.
Coexistence of autoantibodies and alloantibodies to red blood cells due to blood transfusion
Authors: Ahrens Norbert , Pruss Axel , Kähne Andreas , Kiesewetter Holger , Salama Abdulgabar 
Published: April 2007

BACKGROUND: Autoantibodies (AUTO) to red blood cells (RBCs) are frequently associated with alloantibodies (ALLO). The mechanism for the coexistence of these antibodies is obscure.STUDY DESIGN AND METHODS: Between August 1998 and June 2006, all in‐ and outpatients of the Charité University Hospital, Berlin, with detectable AUTO were included in this study. Serologic examination was performed with standard techniques for the detection of RBC antibodies.RESULTS: A total of 717 patients were found to have AUTO, with ALLO observed in 200 of these patients (28%). The history of antibody production could be evaluated in 98 of the 200 patients. Both AUTO and ALLO were due to RBC transfusion in 73 cases (75%) and peripheral blood progenitor cell transplantation in 6 cases (6%). Nine (9%) patients were primarily alloimmunized and subsequently developed AUTO. The remaining 10 (10%) patients were primarily autoimmunized and later developed ALLO. Only 6 of these patients had chronic idiopathic autoimmune hemolytic anemia.CONCLUSION: The majority of AUTO associated with ALLO appears to be due to RBC transfusion that must be recognized as a major cause for autoimmunization.
Evaluation of the COM.TEC cell separator in predicting the yield of harvested CD34+ cells
Authors: Movassaghi Kamran , Jaques Gabrielle , Schmitt‐Thomssen Angela , Fischer Eike G. , Paulus Margit , Heuft Hans G. , Schwella Nimord 
Published: April 2007

BACKGROUND: This multicenter study was performed with the intention to evaluate the exactness of the predicted CD34+ cell yield calculated by two leukapheresis programs of the cell separator COM.TEC upon the number of donor's circulating CD34+ cells and the blood volume processed.STUDY DESIGN AND METHODS: Patients and healthy donors (n = 166) received mobilization by chemotherapy and/or granulocyte colony‐stimulating factor and underwent CD34+ cell harvest by the leukapheresis programs MNC or RV‐PBSC (n = 203).RESULTS: CD34+ cells were collected by 112 harvests on MNC and by 91 collections on RV‐PBSC. The median collection efficiency of CD34+ cells was significantly better for the program MNC than for RV‐PBSC (p < 0.001): 67% (31‐109) vs. 42% (19‐100). The collected CD34+ cell yield was in median more exactly by MNC than by RV‐PBSC (p < 0.001): 85% (31‐176) vs. 59% (22‐110) of the predicted value. Concentrates obtained by RV‐PBSC showed in median significantly higher percentages of mononuclear cells (p < 0.001) and CD34+ cells (p < 0.001), 86% (43‐99) vs. 56% (25‐95) and 1.2% (0.2‐14.3) vs. 0.4% (0.1‐6.0), and had lower contaminations by erythrocytes (p < 0.001) and platelets (p < 0.001), 13 mL (4‐48) vs. 25 mL (5‐60) and 1.9 × 1011 vs. 3.1 × 1011, than those harvested by MNC.CONCLUSION: The significantly better collection efficiency of CD34+ cells and the more exact prediction of the harvested CD34+ cell yield make the leukapheresis program MNC a safe and efficient procedure. However, concentrates collected by RV‐PBSC are of a better cellular quality with a significantly higher percentage of mononuclear and CD34+ cells and a lower contamination by erythrocytes and platelets.
A cluster‐randomized controlled trial of a blood conservation algorithm in patients undergoing total hip joint arthroplasty
Authors: Wong Cindy J. , Vandervoort Margaret K. , Vandervoort Suzanne L. , Donner Allan , Zou Guangyong , MacDonald John K. , Freedman John , Karkouti Keyvan , MacDonald Steven J. , Feagan Brian G. 
Published: April 2007

BACKGROUND: The optimum strategy for reducing allogeneic blood transfusion in patients undergoing total hip joint arthroplasty (THJA) is unknown.STUDY DESIGN AND METHODS: The effectiveness of a comprehensive blood conservation algorithm (BCA) was evaluated by means of a cluster randomization trial. Thirty hospitals performing primary THJA were randomly assigned to implement the algorithm or to continue with usual care (UC). Subsequently, the institutional rate of allogeneic transfusion was determined for 60 consecutive patients who underwent surgery at each site. The BCA consisted of patient and provider education, hemoglobin‐based recommendations for specific blood conservation strategies (recombinant human erythropoietin [rHuEPO] or autologous blood donation [ABD]) and transfusion guidelines. The main outcome measure was the institutional allogeneic transfusion rate.RESULTS: One hospital withdrew consent after randomization, resulting in 14 hospitals assigned to BCA and 15 to UC. In the BCA arm, the institutional rates of rHuEPO use and ABD participation were 20.1 and 27.1 percent compared to 0.6 and 25.8 percent, respectively, in the UC arm. The allogeneic transfusion rate was substantially reduced in hospitals assigned to the BCA group (p = 0.02; absolute risk reduction, 9.6% [26.1% UC vs. 16.5% BCA]). Multivariate analysis of patient‐level data showed that assignment to the UC arm was an independent risk factor for allogeneic transfusion (p = 0.037; odds ratio, 1.8; 95% confidence interval, 1.0‐3.1) when adjusted for other prognostic factors. No differences were observed in the use of autologous blood.CONCLUSION: A comprehensive approach to blood conservation was superior to UC for reducing allogeneic transfusion in patients undergoing THJA.
Toward better renoprotection: Lessons from angiotensin receptor blockers
Authors: MIYATA Toshio , TAKIZAWA Shunya 
Published: April 2007

AbstractThe rising tide of chronic kidney disease (CKD), especially diabetic nephropathy, has become a worldwide catastrophe. However, therapeutic options to prevent or retard the progression of CKD still remain very limited. The understanding of its molecular mechanisms and the delineation of tools able to modify them are thus of critical importance. The discovery that some antihypertensive agents inhibiting the renin‐angiotensin system, such as angiotensin II type 1 receptor blockers, protect the kidney opens new therapeutic perspectives. In this article, we focus on their renoprotective actions beyond blood pressure lowering.
Quality of life of end‐stage renal disease patients and study on the implementation of nocturnal home hemodialysis in Greece
Authors: STAVRIANOU Kallirroi , PALLIKARAKIS Nicolas 
Published: April 2007

AbstractThe aim of this study was to measure the overall health‐related quality of life of patients receiving hemodialysis in Greece and to assess willingness, motivation, and concerns about participating in a nocturnal home hemodialysis program. This review measured successfully the quality of life of 146 end‐stage renal disease (ESRD) patients undergoing hemodialysis in 10 hemodialysis centers all over Greece and studied the factors that affect their choice to adopt a specific treatment. Physical and mental health status and health‐related quality of life, measured by the Kidney Disease Quality of Life Short Form accompanied by the demographic data gathered, provide information that can help to improve ESRD patient care in Greece. A comparison with the Greek general population identifies lower physical functioning scores for the ESRD patients, while the mental functioning scores are comparable with those of the Greek general population. Moreover, it is important to notice the willingness expressed by half of the patients to participate in a potential program of nocturnal home hemodialysis.