bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late Improvement in Blood Cell Filterability and Cardiac Function Following Open Heart Surgery
Authors: Belboul Ali , Al-Khaja Najib , El-Gatit Abdusalam , Bo Liu  , Roberts Donald , William-Olsson Göran 
Published: August 2008

Coronary artery bypass grafting (CABG) and valve replacement (VR) were performed in 50 patients respectively, and these two groups participated in a prospective study wherein the authors investigated the changes of blood cell fiterability, exercise tolerance, ejection fraction (EF), and NYHA classes. The CABG group showed significant (p < 0.001) improvement in both red cell filtration rate (RFR) and white cell filtration rate (WFR) at the follow-up time. This was still, however, significantly lower (p < 0.01) than the reference values of healthy individuals in the same age range. Similar results were also seen in the VR group regarding filterability. In the CABG group, significant improvements in exercise tolerance (p < 0.001), EF (p < 0.001), and NYHA classes (p < 0.001) were seen in the postoperative period. In the VR group a similar postoperative improvement was registered both in EF (p < 0.003) and NYHA classes (p < 0.001). This study demonstrates an improvement in exercise tolerance, EF, NYHA classes, RFR, and WFR in both groups postoperatively. However the blood cell filterability was still disturbed even two years postoperatively, suggesting that the effects of the primary disease were not reversed and that surgical treatment produced excellent palliation and a good potential to improve quality of life.
Modification of Myocardial Reperfusion by Exogenous Prostacyclin
Authors: Yee Edward S. , Hsieh Wen-Ren 
Published: August 2008

The multiple pharmacologic consequences of the antiplatelet, antithrombotic, and vasoactive effects of exogenous myocardial prostacyclin PGI2 on postischemic reperfusion were studied. In an isolated canine model, 20 hearts underwent one hour of cardioplegia arrest under moderate hypothermia (27-28 ° C) and one hour of no perfusion. Left ventricular function (peak systolic pressure [PSP], rate of rise of left ventricular pressure [dp/dt], compliance), myocardial edema, coronary blood flow, and oxygen content were measured and compared for control and PGI2 groups. While there were no differences in compliance or edema, there was an increase in both myocardial blood flow and oxygen delivery (p=0.025). This modification increased nutritive resuscitation of the ischemic heart during one hour of reperfusion and increased left ventricular function after ischemic arrest (PSP and dp/dt; p=0.04). Myocardial recovery after global ischemia is time-dependent with maximal resuscitation after one hour of supported reperfusion. PGI2 modified this time course by sustaining the coronary vasodilatory effects during the reperfusion hour with increased coronary blood flow, improved oxygen extraction, and enhanced myocardial performance (PSP and dp/dt). PGI2 can play an important role by providing maximal vasodilatory effects to enhance the nutritive recovery of postischemic myocardium.
Continuous Piezoelectric Pulse-Sensor Monitoring of Peripheral Vascular Reconstructions
Authors: Cavaye Douglas M. , Tabbara Marwan R. , Kopchok George E. , White Rodney A. 
Published: August 2008

Postoperative assessment of vascular surgical reconstructive procedures is most commonly performed by means of Doppler flowmetry or manual pulse palpation. Because these techniques are intermittent and can be subjective, the authors have investigated the application of a piezoelectric pulse sensor in monitoring distal pulses continuously in patients undergoing limb revascularization. By placing a piezoelectric sensor on the skin overlying an artery, systolic displacement of the underlying vessel wall and tissue is converted into a graphically displayed real-time waveform. Hardcopies of the waveforms (n = 90) were obtained at hourly postoperative intervals from a total of 10 patients undergoing vascular surgery for occlusive disease. In all cases, continuous monitoring confirmed ongoing patency of the reconstructions, despite impalpable distal pulses in 60% of the patients. The amplitudes of the waveforms increased (mean = 18%, range = 6% to 33%) during the first eight postoperative hours. Because of the small size and sensitivity of the sensor, this technique was especially useful in patients with foot lesions requiring occlusive dressings, or where sequential stenoses prevented accurate assessment of postoperative circulation by manual palpation or Doppler examination. The authors conclude that continuous postoperative piezoelectric pulse monitoring allows accurate, continuous assessment of limb revascularization and alleviates the subjective, time-consuming observations by physicians and ancillary personnel.
Immunoglobulin Treatment Before Vascular Surgery in Patients with Chronic Idiopathic Thrombocytopenia
Authors: Mastroroberto Pasquale , Chello Massimo , Marchese Antonietta R. 
Published: August 2008

The authors describe 2 patients with chronic idiopathic thrombocytopenic purpura (ITP) associated with atherosclerotic peripheral vascular disease dem onstrated by Doppler examination and digital intravenous arteriography. Two weeks before surgical treatment, a daily venous infusion (for five days) of 400 mg/kg of immunoglobulin was performed. The platelet count at the be ginning of treatment was 23,000/mm3 in the first patient and 25,000/mm3 in the second. Ten days later, the patients had a good response with a platelets increase of 151,000/mm3 and 162,000/mm 3 respectively. Subsequently two aortobife moral operations were required without surgical or ITP-related complications. At the follow-up the platelet count was 110,000/mm3 in the first patient (ten months) and 132,000/mm 3 in the second (fourteen months). Their results suggest that an adequate preoperative preparation in patients with chronic ITP may lead to a good response without postoperative bleeding or other complications.
The Surgical Management of Vascular Ring Formed by Right Aortic Arch with Aberrant Left Subclavian Artery and Left Ligamentum Arteriosum—A Case Presentation
Authors: Hiekata Tomizo , Takei Hiroshi , Koyama Teruyuki , Endo Shin-ichi , Kashimura Tohko , Maeda Chohsei 
Published: August 2008

Reports on the surgical management of the vascular ring formed by the right aortic arch with aberrant retroesophageal left subclavian artery and ligamen tum arteriosum are relatively few. The authors present a case of a forty-four- year-old woman who had dysphagia lusoria caused by this abnormality. Surgical management, which was performed through a left posterolateral thoracotomy, included division of the ligamentum arteriosum and of the aber rant left subclavian artery, reanastomosis to the left common carotid artery, and resection of the Kommerell's diverticulum. Complete surgical management should include all of these procedures when the Kommerell's diverticulum causes an additional compression to the esopha gus. Only 2 such cases have been reported so far, including the presented case. The authors' experiences have proved that the posterolateral left thoracotomy provides a sufficient view for performing the complete surgical management of this abnormality.
Portopulmonary Shunt by Splenopneumopexy as a Treatment for Portal Hypertension Due to Extrahepatic Portal Vein Obstruction: Case Report
Authors: Tanaka Koki , Nakayama Hiromi , Yoshimine Meguru , Honbo Kenzo , Ohno Takashi , Taira Akira 
Published: August 2008

A case of secondary portal hypertension due to extrahepatic portal vein ob struction that was treated by splenopneumopexy approximately nine years ago is presented. The patient was a forty-seven-year-old man suffering from hema temesis. On preoperative portography, the portal trunk could not be visualized, and cavernous transformation of the portal vein and moderate esophageal varices were demonstrated. Splenopneumopexy for management of esophageal varices was accomplished as treatment. After the operation, significant portopulmonary shunt was devel oped and findings of the esophageal varices were improved. Results from pul monary and hepatic function tests after operation were essentially unchanged. For nine years since the operation he has had no episode of recurrent variceal bleeding. Splenopneumopexy, which diverts the portal blood into the pulmonary vein, is one of the shunt procedures used as treatment for portal hypertension. In Japan, endoscopic sclerotherapy is the first choice of treatment for variceal bleeding. However, splenopneumopexy is still useful as a treatment for patients with secondary portal hypertension such as extrahepatic portal vein obstruc tion.
Cranial Nerve Injury Associated with Surgery of the Carotid System
Authors: Papachristou Euripides , Dragojevic Dusan 
Published: August 2008

Injury of the cranial nerves during surgery of the carotid system is a rela tively common problem. The damage often escapes the attention of the surgeon, and its severity and consequences for the patient are not usually properly evalu ated. In this study the authors examined the immediate postoperative status of the cranial nerves in 404 patients who underwent 519 operative procedures for a variety of conditions affecting the carotid artery system. The authors identified 13 instances of injury (2.5%) 4 of which were perma nent (0.8%) and 9 transient (1.7%). The hypoglossal nerve was permanently injured in 2 instances (0.4%) and the recurrent laryngeal nerve in another 2 (0.4%). In 6 instances (1.2%) the injury to the hypoglossal was transient, as it was in 3 instances of recurrent laryngeal nerve injury (0.6%).
Tumor necrosis factor SNP haplotypes are associated with iron deficiency anemia in West African children
Authors: Atkinson Sarah H. , Rockett Kirk A. , Morgan Gareth , Bejon Philip A. , Sirugo Giorgio , O'Connell Maria A. , Hanchard Neil , Kwiatkowski Dominic P. , Prentice Andrew M. 
Published: August 2008

AbstractPlasma levels of tumor necrosis factor-α (TNF-α) are significantly raised in malaria infection and TNF-α is thought to inhibit intestinal iron absorption and macrophage iron release. This study investigated putative functional single nucleotide polymorphisms (SNPs) and haplotypes across the major histocompatibility complex (MHC) class III region, including TNF and its immediate neighbors nuclear factor of κ light polypeptide gene enhancer in B cells (lκBL), inhibitor-like 1 and lymphotoxin alpha (LTA), in relation to nutritional iron status and anemia, in a cohort of 780 children across a malaria season. The prevalence of iron deficiency anemia (IDA) increased over the malaria season (P < .001). The TNF−308 AA genotype was associated with an increased risk of iron deficiency (adjusted OR 8.1; P = .001) and IDA (adjusted OR 5.1; P = .01) at the end of the malaria season. No genotypes were associated with IDA before the malaria season. Thus, TNF appears to be a risk factor for iron deficiency and IDA in children in a malaria-endemic environment and this is likely to be due to a TNF-α–induced block in iron absorption.
Atypical evening cortisol profile induces visual recognition memory deficit in healthy human subjects
Authors: Gilpin Heather , Whitcomb Daniel , Cho Kwangwook 
Published: August 2008

Abstract

Background
Diurnal rhythm-mediated endogenous cortisol levels in humans are characterised by a peak in secretion after awakening that declines throughout the day to an evening trough. However, a significant proportion of the population exhibits an atypical cycle of diurnal cortisol due to shift work, jet-lag, aging, and mental illness.

Results
The present study has demonstrated a correlation between elevation of cortisol in the evening and deterioration of visual object recognition memory. However, high evening cortisol levels have no effect on spatial memory.

Conclusion
This study suggests that atypical evening salivary cortisol levels have an important role in the early deterioration of recognition memory. The loss of recognition memory, which is vital for everyday life, is a major symptom of the amnesic syndrome and early stages of Alzheimer's disease. Therefore, this study will promote a potential physiologic marker of early deterioration of recognition memory and a possible diagnostic strategy for Alzheimer's disease.
Gemcitabine Plus Paclitaxel Versus Paclitaxel Monotherapy in Patients With Metastatic Breast Cancer and Prior Anthracycline Treatment
Authors: Albain Kathy S. , Nag Shona M. , Calderillo-Ruiz German , Jordaan Johann P. , Llombart Antonio C. , Pluzanska Anna , Rolski Janusz , Melemed Allen S. , Reyes-Vidal Jose M. , Sekhon Jagdev S. , Simms Lorinda , O'Shaughnessy Joyce 
Published: August 2008

Purpose The objective of this phase III global study was to compare the efficacy of gemcitabine plus paclitaxel (GT) versus paclitaxel in patients with advanced breast cancer. It was designed as a pivotal study for the approval of G for a breast cancer treatment indication. Patients and Methods Patients who relapsed after adjuvant anthracyclines were randomly assigned to gemcitabine,1,250 mg/m2 days 1 and 8 plus paclitaxel, 175 mg/m2 on day 1; or, to paclitaxel at same dose on day 1 (both arms administered every 21 days, unblinded). The primary end point was overall survival (OS) and secondary end points were time to progression (TTP), response rate (RR), progression-free survival, response duration, and toxicity. This final OS analysis was planned at 380 deaths. Results A total of 266 patients were randomly assigned to GT and 263 to paclitaxel. Median survival on GT was 18.6 months versus 15.8 months on paclitaxel (log-rank P = . 0489), with an adjusted Cox hazard ratio of 0.78 (95% CI, 0.64 to 0.96; P = .0187). The TTP was longer (6.14 v 3.98 months; log-rank P = .0002) and the RR was better (41.4% v 26.2%; P = .0002) on GT. There was more grade 3 to 4 neutropenia on GT and grade 2 to 4 fatigue and neuropathy were slightly more prevalent on GT. Conclusion This phase III study documents a role for gemcitabine in advanced breast cancer after anthracycline-based adjuvant therapy. The results establish GT as a reasonable choice for women who require cytoreduction with manageable toxicities and validate ongoing testing of GT in the adjuvant setting.
Economic Evaluation of Sunitinib Malate for the First-Line Treatment of Metastatic Renal Cell Carcinoma
Authors: Remák Edit , Charbonneau Claudie , Négrier Sylvie , Kim Sindy T. , Motzer Robert J. 
Published: August 2008

Purpose To assess the cost effectiveness and cost utility of sunitinib malate as a first-line treatment in metastatic renal cell carcinoma (mRCC) compared with interferon-alfa (IFN-α) and interleukin-2 (IL-2) from a US societal perspective. Methods A Markov model was developed to simulate disease progression and to determine progression-free survival, total life-years (LYs), and quality-adjusted life-years (QALYs) gained. Model parameters were derived from the pivotal trial of sunitinib, published literature, government sources, and clinical experts’ opinions. The model included trial-based adverse events (AEs). Costs of drug treatment, routine follow-up, AEs, disease progression, and best supportive care (BSC) of terminally ill patients were included. Results were tested using probabilistic and deterministic sensitivity analyses. Results Treatment with sunitinib is associated with a gain in progression-free years of 0.41 and 0.35 over IFN-α and IL-2. The estimated gains over IFN-α were 0.11 LYs and 0.14 QALYs, and over IL-2 were 0.24 LYs and 0.20 QALYs. Both IFN-α and sunitinib treatments dominate IL-2 treatment; the incremental cost-effectiveness ratio of sunitinib versus IFN-α was $18,611 per progression-free year gained and $67,215 per LY gained, and the cost-utility ratio is $52,593 per QALY gained (at a 5% discount rate). Sensitivity analyses found the results to be most sensitive to utility values during treatment, the cost of sunitinib, and the cost of BSC. Model results were robust to changes in other model variables. Conclusion These results suggest that sunitinib is a cost-effective alternative to IFN-α as a first-line treatment for mRCC.
Psychological Reactions, Quality of Life, and Body Image After Bilateral Prophylactic Mastectomy in Women At High Risk for Breast Cancer: A Prospective 1-Year Follow-Up Study
Authors: Brandberg Yvonne , Sandelin Kerstin , Erikson Staffan , Jurell Göran , Liljegren Annelie , Lindblom Annika , Lindén Ann , von Wachenfeldt Anna , Wickman Marie , Arver Brita 
Published: August 2008

Purpose To prospectively evaluate body image, sexuality, emotional reactions (anxiety, depression), and quality of life in a sample of women having increased risk for breast cancer before and 6 months and 1 year after bilateral prophylactic mastectomy (BPM), and to compare preoperative expectations of the operation with postoperative reactions concerning the impact on six areas of the women's lives. Patients and Methods A total of 90 of 98 consecutive women who underwent BPM during October 1997 to December 2005 were included. Data were collected by self-administered questionnaires (eg, Hospital Anxiety and Depression scale, Swedish Short Term-36 Health Survey, Body Image Scale, Sexual Activity Questionnaire) before the operation (n = 81), and 6 (n = 71) and 12 months (n = 65) after BPM. Results Anxiety decreased over time (P = .0004). No corresponding difference was found for depression. No differences in health-related quality of life over time were found, with one exception. A substantial proportion of the women reported problems with body image 1 year after BPM (eg, self consciousness, 48%; feeling less sexually attractive, 48%; and dissatisfaction with the scars, 44%). Sexual pleasure was rated lower 1-year post-BPM as compared with before operation (P = .005), but no differences over time in habit, discomfort, or activity were found. Conclusion No negative effects on anxiety, depression, and quality of life were found. Anxiety and social activities improved. Negative impact on sexuality and body image was reported.
Systems Pathology Approach for the Prediction of Prostate Cancer Progression After Radical Prostatectomy
Authors: Donovan Michael J. , Hamann Stefan , Clayton Mark , Khan Faisal M. , Sapir Marina , Bayer-Zubek Valentina , Fernandez Gerardo , Mesa-Tejada Ricardo , Teverovskiy Mikhail , Reuter Victor E. , Scardino Peter T. , Cordon-Cardo Carlos 
Published: August 2008

PurposeFor patients with prostate cancer treated by radical prostatectomy, no current personalized tools predict clinical failure (CF; metastasis and/or androgen-independent disease). We developed such a tool through integration of clinicopathologic data with image analysis and quantitative immunofluorescence of prostate cancer tissue.Patients and MethodsA prospectively designed algorithm was applied retrospectively to a cohort of 758 patients with clinically localized or locally advanced prostate cancer. A model predicting distant metastasis and/or androgen-independent recurrence was derived from features selected through supervised multivariate learning. Performance of the model was estimated using the concordance index (CI).ResultsWe developed a predictive model using a training set of 373 patients with 33 CF events. The model includes androgen receptor (AR) levels, dominant prostatectomy Gleason grade, lymph node involvement, and three quantitative characteristics from hematoxylin and eosin staining of prostate tissue. The model had a CI of 0.92, sensitivity of 90%, and specificity of 91% for predicting CF within 5 years after prostatectomy. Model validation on an independent cohort of 385 patients with 29 CF events yielded a CI of 0.84, sensitivity of 84%, and specificity of 85%. High levels of AR predicted shorter time to castrate prostate-specific antigen increase after androgen deprivation therapy (ADT).ConclusionThe integration of clinicopathologic variables with imaging and biomarker data (systems pathology) resulted in a highly accurate tool for predicting CF within 5 years after prostatectomy. The data support a role for AR signaling in clinical progression and duration of response to ADT.
Palliative Thoracic Radiotherapy for Lung Cancer: A Systematic Review
Authors: Fairchild Alysa , Harris Kristin , Barnes Elizabeth , Wong Rebecca , Lutz Stephen , Bezjak Andrea , Cheung Patrick , Chow Edward 
Published: August 2008

Purpose The optimal dose of radiotherapy (RT) to palliate symptomatic advanced lung cancer is unclear. We systematically reviewed randomized controlled trials (RCTs) of palliative thoracic RT. Methods RCTs comparing two or more dose fractionation schedules were reviewed using the random-effects model of a freely available information management system. The relative risk and 95% CI for each outcome were presented in Forrest plots. Exploratory analysis comparing dose schedules after conversion to the time-adjusted biologically equivalent dose (BED) was performed to investigate for a dose-response relationship. Results A total of 13 RCTs involving 3,473 randomly assigned patients were identified. Outcomes included symptom palliation, overall survival, toxicity, and reirradiation rate. For symptom control in assessable patients, lower-dose (LD) RT was comparable with higher-dose (HD), except for the total symptom score (TSS): 65.4% of LD and 77.1% of HD patients had improved TSS (P = .003). Greater likelihood of symptom improvement was seen with schedules of 35 Gy10 versus lower BED. At 1 year after HD and LD RT, 26.5% versus 21.7% of patients were alive, respectively (P = .002). Sensitivity analysis suggests this survival improvement was seen with 35 Gy10 BED schedules compared with LDs. Physician-assessed dysphagia was significantly greater in the HD arm (20.5% v 14.9%; P = .01), and the likelihood of reirradiation was 1.2-fold higher after LD RT. Conclusion No significant differences were observed for specific symptom-control end points, although improvement in survival favored HD RT. Consideration of palliative thoracic RT of at least 35 Gy10 BED may therefore be warranted, but must be weighed against increased toxicity and greater time investment.
Influence of Pre- and Postdiagnosis Physical Activity on Mortality in Breast Cancer Survivors: The Health, Eating, Activity, and Lifestyle Study
Authors: Irwin Melinda L. , Smith Ashley Wilder , McTiernan Anne , Ballard-Barbash Rachel , Cronin Kathy , Gilliland Frank D. , Baumgartner Richard N. , Baumgartner Kathy B. , Bernstein Leslie 
Published: August 2008

Purpose To investigate the association between pre- and postdiagnosis physical activity (as well as change in prediagnosis to postdiagnosis physical activity) and mortality among women with breast cancer. Patients and Methods This was a prospective observational study of 933 women enrolled onto the Health, Eating, Activity, and Lifestyle Study who were diagnosed with local or regional breast cancer between 1995 and 1998 and observed until death or September 2004, whichever came first. The primary outcomes measured were total deaths and breast cancer deaths. The primary exposures were physical activity in the year before and 2 years after diagnosis and the pre- to postdiagnosis change in physical activity. Results Compared with inactive women, the multivariable hazard ratios (HRs) for total deaths for women expending at least 9 metabolic equivalent hours per week (approximately 2 to 3 h/wk of brisk walking) were 0.69 (95% CI, 0.45 to 1.06; P = .045) for those active in the year before diagnosis and 0.33 (95% CI, 0.15 to 0.73; P = .046) for those active 2 years after diagnosis. Compared with women who were inactive both before and after diagnosis, women who increased physical activity after diagnosis had a 45% lower risk of death (HR = 0.55; 95% CI, 0.22 to 1.38), and women who decreased physical activity after diagnosis had a four-fold greater risk of death (HR = 3.95; 95% CI, 1.45 to 10.50). Conclusion Moderate-intensity physical activity after a diagnosis of breast cancer may improve prognosis.