bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of cutaneous leishmaniasis with intralesional sodium stibogluconate
Authors: Solomon M , Baum S , Barzilai A , Pavlotsky F , Trau H , Schwartz E 
Published: February 2009

AbstractBackground  Cutaneous leishmaniasis is endemic in Israel. Leishmania major is the most prevalent species that cause cutaneous leishmaniasis. Current treatment options are limited and there are few investigations in search of alternative ones.Objective  This study aims to assess our experience with intralesional sodium stibogluconate (SSG) in the treatment of cutaneous leishmaniasis.Methods  A retrospective evaluation for all adult cases of cutaneous leishmaniasis treated by intralesional and intravenous SSG (Pentostam®, GlaxoSmithKline) between 2004 and 2006 was performed, for cases referred to a tertiary care university‐affiliated medical centre in Israel. Intralesional SSG was injected at 0.5 mL per lesion (50 mg). Treatment was repeated every 2–3 weeks for a total of 12 weeks. Intravenous SSG was administered at a dose of 20 mg/kg for 10–20 days.Results  Thirty‐three cases of cutaneous leishmaniasis were treated with intralesional SSG during the study period. The patients consist of 26 males and 7 females, mostly Israeli military personnel, and there were a total of 93 lesions. Within 3 months from treatment onset, 91% (30/33) had completed healing of the cutaneous lesions after an average of 3 treatments (range 1–6). Side‐effects were mild and were mostly pain during injection, with two patients developing mild local site reaction after the injection.Conclusions  Intralesional SSG treatment is safe, effective and well tolerated with minimal side‐effects.
Generalized‐onset seizures with secondary focal evolution
Authors: Williamson Randy , Hanif Samrina , Mathews Gregory C. , Lagrange Andre H. , Abou‐Khalil Bassel 
Published: February 2009

SummaryThe international seizure classification recognizes that partial‐onset seizures can become secondarily generalized, but generalized‐onset seizures are expected to remain generalized. We report six patients who had recorded seizures with generalized onset, but subsequent evolution into a focal discharge. The clinical seizure onset was generalized absence or myoclonic, and the most common subsequent clinical pattern was prolonged behavioral arrest with mild automatisms, and then postictal confusion. The ictal discharge started with generalized spike‐and‐wave activity and then acquired a focal predominance. Interictal epileptiform activity was generalized. There were no focal magnetic resonance imaging abnormalities. Four patients were misdiagnosed with complex partial seizures. All patients were initially refractory, but three became seizure‐free and three improved after treatment with antiepileptic medications appropriate for absence or myoclonic seizures. Generalized‐onset seizures that acquire focal features are easily misdiagnosed as complex partial. These seizures have a more favorable response to medications effective against generalized absence and myoclonic seizures.
Assessment of Atrial Conduction Time in Patients with Familial Mediterranean Fever
Authors: ACAR GURKAN , AKCAY AHMET , SAYARLIOGLU MEHMET , SOKMEN ABDULLAH , SOKMEN GULIZAR , KOROGLU SEDAT , GUNDUZ MEHMET , İSPIROGLU MURAT , TUNCER CEMAL 
Published: February 2009

Background: Increased inflammatory activity is known to be a pathophysiologic characteristic of atrial fibrillation. Familial Mediterranean fever (FMF) is a disease characterized by recurrent and sustained increased inflammatory activity. Atrial conduction abnormalities in these patients have not been investigated in terms of P‐wave duration, P‐wave dispersion (Pd), and atrial electromechanical delay measured by tissue Doppler echocardiography (TDE). We aimed to assess atrial conduction time in patients with FMF.
Methods: A total of 33 patients with FMF (13 males/20 females, 28.4 ± 12.5 years), and 33 controls (13 males/20 females, 28.5 ± 12.1 years) were included. Atrial electromechanical coupling (PA) and intra‐ and interatrial electromechanical delay were measured with TDE. From the 12‐lead electrocardiogram Pd was calculated.
Results: Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) was significantly higher in FMF patients (58.0 ± 9.0 vs 51.0 ± 5.8, P < 0.001). Interatrial (PA lateral–PA tricuspid) and intraatrial electromechanical delay (PA septum–PA tricuspid) were significantly longer in FMF patients (21.3 ± 7.4 vs 12.9 ± 4.6, P < 0.001 and 4.7 ± 5.5 vs 2.1 ± 1.7, P = 0.01, respectively). Also, Pd and maximum P‐wave duration were significantly higher in FMF patients (42.8 ± 7.9 vs 35.3 ± 6.1, P < 0.001 and 98.6 ± 9.0 vs 93.1 ± 8.5, P = 0.01, respectively). A positive correlation was detected between interatrial electromechanical delay and Pd (r = 0.622, P < 0.001). Plasma level of C‐reactive protein (CRP) correlated with interatrial electromechanical delay and Pd (r = 0.733, P < 0.001; and r = 0.427, P < 0.001, respectively).
Conclusion: This study shows that atrial electromechanical delay and Pd are prolonged in FMF patients. Atrial electromechanical delay is closely associated with Pd and plasma level of CRP.
Transfemoral Snaring and Stabilization of Pacemaker and Defibrillator Leads to Maintain Vascular Access During Lead Extraction
Authors: FISCHER AVI , LOVE BARRY , HANSALIA RIPLE , MEHTA DAVENDRA 
Published: February 2009

Background: Lead extraction is an effective method for removing pacemaker and defibrillator leads and to obtain venous access when central veins are occluded.
Objective: We report a series of patients who required lead extraction and preservation of vascular access requiring a vascular snare introduced from the femoral vein to provide traction on the lead. This technique allowed advancement of the extraction sheath beyond the level of vascular occlusion, preserving vascular access in all patients.
Methods: All patients had peripheral contrast venography performed immediately prior to the procedure to identify the site(s) of venous occlusion. An extraction sheath was employed and with direct manual traction, the lead tip pulled free from the myocardial surface prior to advancement of the sheath beyond the occlusion. A transfemoral snare was used to grasp the distal portion of the lead and traction was used to immobilize the lead.
Results: In all patients, transfemoral snaring of the leads was necessary to allow safe advancement of a sheath to open the occluded venous system. There were no complications in any of the patients.
Conclusion: Our series demonstrates the simple and safe technique of transfemoral lead snaring to assist lead extraction and maintain vascular access in the setting of venous occlusion, when the distal lead tip pulls free of the myocardium before an extraction sheath is passed beyond the point of venous obstruction.
Device Extraction in Adults with Congenital Heart Disease
Authors: CESARIO DAVID , KEDIA ROHIT , DESAI NIRAV , ABOULHOSN JAMIL , USLAN DANIEL , BOYLE NOEL , FUJIMURA OSAMU , SHEHATA MICHAEL , BUCH ERIC , SHIVKUMAR KALYANAM 
Published: February 2009

Background: Device extraction is a critical component in the treatment of patients with device‐related infections. Due to complex anatomic considerations, device extraction in adults with congenital heart disease presents unique challenges to the electrophysiologist.
Methods: Here, we present a series of device‐extraction cases performed in patients with transposition of the great arteries status post either Mustard or Senning surgical procedures that subsequently had permanent pacemakers placed and ultimately developed device‐related infections.
Results: All of these patients eventually underwent successful laser extractions of their infected devices resulting in complete removal of all hardware and resolution of their infections.
Conclusions: These cases illustrate that endovascular device extraction has been safely and effectively performed in adult patients with congenital heart disease, though further studies are needed to determine the procedural risks and success rates of this procedure in this patient population.
Long‐Term Nonoutflow Septal Versus Apical Right Ventricular Pacing: Relation to Left Ventricular Dyssynchrony
Authors: FLEVARI PANAYOTA , LEFTHERIOTIS DIONYSSIOS , FOUNTOULAKI KATERINA , PANOU FOTIS , RIGOPOULOS ANGELOS G. , PARASKEVAIDIS IOANNIS , KREMASTINOS DIMITRIOS Th. 
Published: February 2009

Background: Right ventricular (RV) apical pacing deteriorates left ventricular (LV) function. RV nonoutflow (low) septal pacing may better preserve ventricular performance, but this has not been systematically tested. Our aim was to assess (1) whether long‐term RV lower septal pacing is superior to RV apical pacing regarding LV volumes and ejection fraction (EF), and (2) if the changes in LV dyssynchrony imposed by pacing are related to the long‐term changes in LV volumes and EF.
Methods: In thirty‐six patients with atrioventricular (AV) block, a dual‐chamber pacemaker was implanted. The ventricular electrode was placed either at the apex or at the lower septum, in a randomized sequence. Twenty‐four to 48 hours following implantation, we measured LV volumes, EF, and LV dyssynchrony (by tissue Doppler imaging), both with and without pacing. Patients were reassessed echocardiographically after 12 months.
Results: Lower septal pacing induced a more synchronized pattern of LV contraction changes (P < 0.05). Following 12 months, differences were observed between groups regarding LV volumes and EF. EF increased within the septal group (from 52 ± 3.3% to 59 ± 3.0%, P < 0.05). A significant inverse relation was documented between changes in LV dyssynchrony and changes in EF (r =−0.64, P < 0.05).
Conclusions: In patients with AV block, RV nonoutflow septal pacing represents an attractive alternative, since it preserves better and may even improve LV volumes and EF. Late changes in EF are associated with the changes in LV dyssynchrony imposed by pacing.
Monitoring Intrathoracic Impedance with an Implantable Defibrillator Reduces Hospitalizations in Patients with Heart Failure
Authors: CATANZARITI DOMENICO , LUNATI MAURIZIO , LANDOLINA MAURIZIO , ZANOTTO GABRIELE , LONARDI GABRIELE , IACOPINO SAVERIO , OLIVA FABRIZIO , PEREGO GIOVANNI B. , VARBARO ANNAMARIA , DENARO ALESSANDRA , VALSECCHI SERGIO , VERGARA GIUSEPPE ,   on behalf of the Italian Clinical Service Optivol‐CRT Group
Published: February 2009

Purpose: Some implantable cardioverter‐defibrillators (ICDs) are now able to monitor intrathoracic impedance. The aim of the study was to describe the use of such monitoring in clinical practice and to evaluate the clinical impact of the fluid accumulation alert feature of these ICDs.
Methods and Results: Five hundred thirty‐two heart failure (HF) patients implanted with these ICDs were followed up for 11 ± 7 months. A clinical event (CE) was deemed to have occurred if it resulted in hospitalization or milder manifestations of HF deterioration. Three hundred sixty‐two acute decreases in intrathoracic impedance (Z events) occurred in 230 patients. Of these episodes, 171 (47%) were associated with a CE within 2 weeks of the Z event. In another 71 (20%) Z events, drug therapy was adjusted despite the absence of overt signs of clinical deterioration. The rate of unexplained Z events was 0.25 per patient‐year and 25 hospitalizations were not associated with Z events. The audible alert was disabled in a group of 102 patients (OFF group). HF hospitalizations occurred in 29 (7%) patients in the ON group and 20 (20%, P < 0.001) patients in the OFF group. The rate of combined cardiac death and HF hospitalization was lower in patients with Alert ON (log‐rank test, P = 0.007).
Conclusions: The ICD reliably detected CE and yielded low rates of unexplained and undetected events. The alert capability seemed to reduce the number of HF hospitalizations by allowing timely detection and therapeutic intervention.
Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory
Authors: Thorell L.‐H. 
Published: February 2009

Objective:  Studies from three independent laboratories report varying relationships between electrodermal hyporeactivity and suicidal behavior in depressed patients. The aims of this study were to explain that variation, to assess the discriminative validity of electrodermal hyporeactivity for suicide and suicide attempts and to suggest a tentative explanation model.Method:  A meta‐analysis was performed of 279 depressed patients and 59 healthy subjects.Results:  The sensitivity was 96.6% and specificity 92.9% of electrodermal hyporeactivity for suicide and 83.3% and 92.7%, respectively, for suicide and/or violent attempts. The shares of hyporeactives were strongly significantly and greatly larger in high than in low suicidal propensity groups, P‐value ranging from 4.7 × 10−8 to 1.1 × 10−14.Conclusion:  The high discriminative validity and the emerging links over a proposed interest‐limiting precognitive set to cognitive theory of suicide encourage clinical application of tests of electrodermal reactivity. The study offers a series of testable hypotheses constituting a new platform for suicidological research in depression.
Augmentation of clozapine with a second antipsychotic – a meta‐analysis of randomized, placebo‐controlled studies
Authors: Taylor D. M. , Smith L. 
Published: February 2009

Objective:  Inadequate response to clozapine treatment is frequently encountered in practice and augmentation strategies have been developed in an attempt to improve response. Aims of the study were to evaluate the therapeutic effect of adding an antipsychotic drug to clozapine treatment.Method:  Meta‐analysis of randomized, placebo‐controlled studies of antipsychotic augmentation of clozapine treatment.Results:  Ten studies (including 522 subjects) met inclusion criteria. Antipsychotic augmentation showed significant benefit over the addition of placebo on only one outcome measure examined [mean effect size for rating scale score (BPRS/PANSS) −0.180, 95% CI −0.356 to −0.004]. Antipsychotic augmentation showed no advantage on withdrawals from trials (risk ratio 1.261, 95% CI 0.679–2.345) or on CGI scores (effect size −0.661, 95% CI −1.475 to 0.151). Duration of study was not associated with outcome (P = 0.95). There was no evidence of publication bias.Conclusion:  In studies lasting up to 16 weeks, the addition of an antipsychotic to clozapine treatment has marginal therapeutic benefit. Longer and larger trials are necessary to demonstrate the precise therapeutic utility of antipsychotic co‐therapy with clozapine.
Simulation of a mycological KOH preparation – e‐learning as a practical dermatologic exercise in an undergraduate medical curriculum
Authors: Bernhardt Johannes , Hye Florian , Thallinger Sigrid , Bauer Pamela , Ginter Gabriele , Smolle Josef 
Published: February 2009

Summary Background: Mycological KOH preparation is one of the most popular practical laboratory skills in dermatology. The study addresses the question whether an interactive simulation program enhances knowledge of students about this procedure. Methods: 166 students, 107 female and 59 male, participated. We separated our study in three phases: pretest, completing the simulation three times and post‐test. In the pre‐ and post‐test we recorded the number of correct steps of the mycological KOH preparation listed by the students. The full text feedback was explored by content analysis. Results: In the pre‐test the students listed an average of 3.1 ± 2.2 correct steps, compared to 8.8 ± 1.2 correct steps after completing the simulation (p < 0.001). Furthermore, the improvement was significant for each individual step. There were no significant differences between male and female students. In content analysis of the feedback, positive statements prevailed with 78.3%, compared to only 1.8% critical items. Conclusion: Our study shows that an interactive computer simulation program of mycological KOH preparation results in a significant learning effectiveness as far as recall of the correct procedural steps is concerned. Furthermore, subjective acceptance by students is high.
On a level field: the utility of studying native and non‐native species in successional systems
Authors: Meiners Scott J. , Rye Timothy A. , Klass Jeremy R. 
Published: February 2009

AbstractQuestions: How do successional systems contribute to our understanding of plant invasions? Why is a community‐level approach important in understanding invasion? Do native and non‐native plant species differ in their successional trajectories within communities?Location: Northeastern United States, in the Piedmont region of New Jersey. Previously farmed since the 1700s, ten fields were experimentally retired from agriculture beginning in 1958.Methods: Fifty years of permanent plot data were used to quantify the population demographics of the 84 most abundant species during succession. These measures were then used to compare native, non‐native and non‐native invasive species' population dynamics in succession.Results: Once basic life‐history characteristics were accounted for, there were no differences in the population dynamics of native, non‐native, and non‐native invasive plant species. However, the species pool in this study was biased towards ruderal species, which largely constrained non‐native species to early succession.Conclusion: Successional systems are crucial to our understanding of invasions as they constrain all species to the role of colonizer. By focusing on the whole community, rather than on individual problematic species, we found no systematic differences between native and non‐native species. Thus, knowing simple life‐history information about a species would be much more useful in setting management priorities than where the species originated.
Tree age is a key factor for the conservation of epiphytic lichens and bryophytes in beech forests
Authors: Fritz Örjan , Niklasson Mats , Churski Marcin 
Published: February 2009

AbstractQuestions: What factors limit the distribution of epiphytic lichens and bryophytes at plot and tree level in beech forests? At what ages do epiphytic species, and species of conservation concern in particular, occur along a chronosequence of beech?Location: South‐west Sweden.Method: Five hundred and seventy‐one age‐determined trees from 37 plots distributed among 29 beech‐dominated stands were surveyed along with a number of environmental (16) and substrate (seven) variables in a landscape of ca. 550 ha. Non‐metric multidimensional scaling (NMS) and indicator species analysis (ISA) were used for data analysis.Results: Plots containing old trees, confined to the base of slopes and with low impacts of recent forestry (thinning), generally had a high richness of species of conservation concern. Richness of common species and red‐listed bryophytes were mostly related to the surveyed bark area. At tree level, primary factors explaining both species richness and composition were age, diameter at breast height and moss cover. There was a gradual replacement of tree age ranges for 58 lichens and 37 bryophytes along the chronosequence of beech. Red‐listed lichens favoured damaged beech trees (≥180 years), whereas red‐listed bryophytes were found on old and young stems in dense stands.Conclusions: Tree age exerts a profound influence on epiphytic lichens and bryophytes growing on beech. Many of the habitat specialists were found mainly on old beech because they inhabit specific substrates that occur on older trees. The association to high tree age commonly excludes red‐listed lichens from conventionally managed beech forests with a 100‐ to 140‐year rotation period.
The success of succession: a symposium commemorating the 50th anniversary of the Buell‐Small Succession Study
Authors: Cadenasso M.L. , Meiners S.J. , Pickett S.T.A. 
Published: February 2009

AbstractMotivation: The Buell‐Small Succession Study (BSS) is the longest running study of post agricultural succession in North America. To honor this program, a symposium at the Ecological Society of America meetings was organized to explore the state of succession theory and its contribution to the field of ecology and its application to restoration. The BSS was originally motivated by two controversies in the literature during the 1950's. The first was between a community versus and individual basis of secondary succession. The second was the validity of the Initial Floristic Composition hypothesis.Location: Hutcheson Memorial Forest, Somerset, New Jersey, USAMethods: Vegetation composition and cover has been continuously quantified in permanent plots established in 10 old fields.Continued Research Motivation: The rich data set has documented population and community dynamics and the spatio‐temporal controls and historical contingencies that influence those dynamics. The regulation of community dynamics continues to be a line of inquiry as does the application of results to restoration and understanding the dynamics of non‐native species.Conclusions: Long term vegetation studies are uncommon in ecology yet they are uniquely valuable for understanding system dynamics – particularly if the studies capture periodic events or system shifts such as droughts and invasions by non‐native species. Resilient long term studies, of which the BSS is an example, maintain methods and data structure while allowing motivating questions to evolve along side advancements in the theoretical and conceptual realms of the field. Succession continues to serve as a basic tenet of ecology which is demonstrated by the papers making up this special issue.
Ever since Clements: from succession to vegetation dynamics and understanding to intervention*
Authors: Pickett S.T.A. , Cadenasso M.L. , Meiners S.J. 
Published: February 2009

AbstractIntroduction: This paper surveys a framework for vegetation dynamics to provide conceptual background for a series of papers addressing the role of vegetation dynamics in restoration.Richness of the foundation: Classical succession theory provides key ingredients for contemporary process studies of vegetation dynamics. The contemporary framework incorporates processes identified by Gleason and other critics of Clements' theory.Multiple causality: The Clementsian causes, when expanded to include interaction and to clarify net effects, accommodate those now recognized in vegetation dynamics.A mature successional framework: A hierarchical framework has emerged to evaluate the causes of vegetation dynamics. The framework identifies the general causes as site availability, species availability, and species performance.Differentials as drivers: Differentials in any of the three general causes can drive change in plant communities. Each general cause consists of specific mechanisms.A model template: To predict vegetation dynamics trajectories, models are required. A model template is presented to operationalize the hierarchical framework. Outcomes are contingent on species pools and environmental contexts and may be progressive or retrogressive.Relationships of frameworks: Other contemporary frameworks in biology relate to vegetation dynamics.Application to restoration: The vegetation dynamics framework is relevant to restoration through linkages with landscape ecology, disturbance ecology, competition, invasion ecology, and community assembly. The differentials of site availability, species availability, and species performance suggest the processes and strategies available for restoration.Conclusions: A synthetic framework of vegetation brings together the mechanisms required for successful restoration.