bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of stitch density on seam strength, seam elongation, and seam efficiency
Authors: Chowdhary Usha , Poynor Donna 
Published: September 2005

AbstractThe study investigated seam efficiency, seam strength and seam elongation of three stitch densities for a premium muslin. The tensile and seam strength were tested on INSTRON. Seam efficiency was calculated in percentages and t‐test and Analysis of Variance (anova) were used to test the hypotheses. Findings provided scientific basis for conventional practices in the field. Possibilities for future extension of the work are discussed.
Reviews: The Current State of Nonuremic Applications for Extracorporeal Blood Purification
Authors: Briglia Andrew E. 
Published: September 2005

ABSTRACTDespite the commonly accepted indications for hemodialysis and extracorporeal depuritive techniques, some clinicians have come to rely on blood purification for clinical states where the targeted substance for removal differs from uremic waste products. Over the last decade, a number of studies have emerged to help define the application of extracorporeal blood purification (ECBP) to these “nonuremic” indications. This review describes the application of extracorporeal blood purification in clinical states including sepsis, rhabdomyolysis, congestive heart failure, hepatic failure, tumor lysis syndrome, adult respiratory distress syndrome, intravenous contrast exposure, and lactic acidosis. Additional comments are provided to review existing literature on thermoregulation and osmoregulation, including acute brain injury.
Influence of Hypertension on Cardiovascular Outcomes in Hemodialysis Patients
Authors: Birchem Jessica A. , Fraley Matthew A. , Senkottaiyan Neelavathi , Alpert Martin A. 
Published: September 2005

ABSTRACTCardiovascular disease is a leading cause of morbidity and mortality in chronic hemodialysis patients. Most patients with chronic kidney disease have hypertension and its prevalence remains high following renal replacement therapy. Early studies suggested that hypertension was a risk factor for total and cardiovascular mortality in chronic hemodialysis patients, but the results of more recent studies have caused experts to question these assertions. Systolic hypertension, widened pulse pressure, and nondipping may be better predictors of mortality compared to diastolic hypertension or increased mean arterial pressure. Hypertension in hemodialysis patients is a risk factor for left ventricular hypertrophy (LVH), diastolic dysfunction, and congestive heart failure; good blood pressure control may promote its regression. Atherosclerosis and ventricular arrhythmias may also be linked to hypertension. Thus blood pressure control with a focus on systolic pressure appears to be a prudent strategy to improve cardiovascular outcomes in hemodialysis patients.
Clinical Waste Generation from Renal Units: Implications and Solutions
Authors: Hoenich Nicholas A. , Levin Robert , Pearce Catherine 
Published: September 2005

ABSTRACTThe treatment of end‐stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in renal units. Many of the waste items generated also contain polyvinyl chloride (PVC) whose incineration is environmentally sensitive. Furthermore blood tubing sets contain plasticizers such as di(2‐ethylhexyl) phthalate (DEHP), which is known to pose health risks to specific groups of patients. The generation of clinical waste in a dialysis unit is analyzed, issues associated with disposal are discussed, and approaches toward a cost‐effective, environmentally sustainable clinical waste management program are reviewed.
Conversion of Temporary Hemodialysis Catheters to Permanent Hemodialysis Catheters: A Retrospective Study of Catheter Exchange versus Classic de novo Placement
Authors: Falk Abigail , Prabhuram Nagarathna , Parthasarathy Saudhamini 
Published: September 2005

ABSTRACTMany clinicians believe that de novo access is required when converting temporary hemodialysis (HD) catheters to long‐term or permanent catheters. However, since vascular access sites are at a premium in the dialysis patient, it is important to preserve existing central venous catheters and conserve future access sites. In this retrospective study, data from 94 patients referred to interventional radiology for placement of long‐term, tunneled HD catheters between July 2001 and September 2002 were reviewed. The study group consisted of 42 patients in whom the temporary catheter was exchanged for a peel‐away sheath and a tunneled catheter inserted using the existing venous access site. The control group included 52 patients who received traditional de novo placement of permanent catheters. Based on available follow‐up data, we report a 100% technical success rate, with 72% patency at 30 days in the study group (n = 32; mean age 58 years). By comparison, de novo catheter placement (n = 35; mean age 59 years) yielded a 100% technical success rate, with 83% patency at 30 days. The overall infection rate was 0.30 per 100 catheter‐days (total 3036 catheter‐days) and 0.36 per 100 catheter‐days (total 3295 catheter‐days), respectively (χ2 = 0.64, p ≥ 0.05). There was no incidence of exit site infection, tunnel infection, or florid sepsis in either group. Likewise, no stenosis or bleeding complication was noted. Thus conversion of a temporary HD catheter to a tunneled catheter using the same venous insertion site is safe, does not increase the risk of infection, and allows conservation of other central venous access sites.
Dialysis Rounds A Dialysis Case  Presentation and Discussion Edited by Roger A. Rodby : Long‐Term Intravenous Sodium Thiosulfate in the Treatment of a Patient with Calciphylaxis
Authors: Brucculeri Michael , Cheigh Jhoong , Bauer Gregory , Serur David 
Published: September 2005

ABSTRACTCalciphylaxis is a disabling and life‐threatening complication that primarily affects patients who are dialysis dependent. This disease entity is characterized by calcification, intimal hypertrophy, and thrombosis of small vessels, which results in necrotizing, nonhealing ulcers. The development of these lesions portends a grim prognosis, as they are often accompanied by severe and sometimes fatal infectious complications. Although several strategies aimed at treating and preventing this affliction have been reported in the literature, the outcome for most patients with calciphylaxis remains quite poor. We describe an anuric hemodialysis patient who developed severe calciphylaxis that proved refractory to conventional treatment. Following extensive debridement of several wounds, intravenous sodium thiosulfate was utilized as an adjunctive therapy four times a week. Within 6 months, excellent wound healing ensued as well as a dramatic improvement in the lesions that were not previously resected. Aside from occasional nausea, these treatments were well tolerated, despite the development of an anion gap metabolic acidosis. After 34 months of continued treatment the patient remains free from disease recurrence and has demonstrated no untoward effect of prolonged therapy. In an effort to delineate the pharmacokinetics of this drug in a hemodialysis patient, serum thiosulfate levels were obtained 15 minutes after infusion as well as before and after subsequent dialysis treatments. Consistent with prior studies in anuric canines, we found measurable quantities of the drug more than 50 hours after treatment, in addition to a markedly elevated half life of 478 minutes. However, given the lack of significant toxicity, as well as a dramatic clinical improvement, we feel that sodium thiosulfate may have an important adjunctive role in the treatment of calciphylaxis in dialysis patients.
Pharmacokinetics of Gabapentin during Delivery, in the Neonatal Period, and Lactation: Does a Fetal Accumulation Occur during Pregnancy?
Authors: Öhman Inger , Vitols Sigurd , Tomson Torbjörn 
Published: September 2005

Summary:  Purpose: To study the pharmacokinetics of gabapentin (GBP) during delivery, lactation, and in the neonatal period. Methods: GBP concentrations in plasma and breast milk were determined with high‐performance liquid chromatography in samples from six women treated with GBP and in their offspring. Blood samples were obtained at delivery from mothers, from the umbilical cord, and from the newborns on three occasions during 2 days after delivery. GBP concentration also was determined in breast milk and in blood collected from five of the mothers and suckling infants 2 weeks to 3 months after birth. Results: The umbilical cord/maternal plasma concentration ratios ranged from 1.3 to 2.1 (mean, 1.7). GBP plasma concentrations in the neonates declined with an estimated half‐life of 14 h. Mean GBP plasma concentrations in the infants were 27% of the cord plasma levels (range, 12–36%) 24 h postpartum. The mean milk/maternal plasma concentration ratio was 1.0 (range, 0.7–1.3) from 2 weeks to 3 months. The infant dose of GBP was estimated to 0.2–1.3 mg/kg/day, equivalent to 1.3–3.8% of the weight‐normalized dose received by the mother. The plasma concentrations in the breast‐fed infants were ∼12% of the mother's plasma levels, but no adverse effects were observed. Conclusions: Our limited observations suggest an active transplacental transport of GBP, with accumulation in the fetus as a consequence. We suggest that this could be by the specific L‐type amino acid transporter 1 (LAT‐1), which is expressed in the placenta. Newborns seem to have a slightly lower capacity to eliminate GBP than do adults. Transfer of GBP to breast milk is extensive, but plasma concentrations appear to be low in suckling infants. No adverse effects were observed in the newborn. Although more data are needed, our observations suggest that breastfeeding in conjunction with GBP treatment is safe.
Benign Partial Epilepsy in Childhood: Selective Cognitive Deficits Are Related to the Location of Focal Spikes Determined by Combined EEG/MEG
Authors: Wolff Markus , Weiskopf Nikolaus , Serra Emilio , Preissl Hubert , Birbaumer Niels , Kraegeloh‐Mann Ingeborg 
Published: September 2005

Summary:  Purpose: Benign partial epilepsy (BPE) in childhood is characterized by the occurrence of interictal stereotyped focal spikes with variable localization in the EEG. Children with BPE often exhibit neuropsychological deficits. It is unclear whether a correlation exists between these deficits and the localization of spikes, several EEG studies giving inconsistent results. Magnetoencephalography (MEG) improves the accuracy of spike localization. Therefore by using combined MEG/EEG, we investigated the topographic relation between focal spikes and neuropsychological findings in children with BPE. Methods: Twenty‐seven children diagnosed consecutively with BPE were enrolled in the study. All were examined by combined MEG/EEG and magnetic resonance imaging (MRI). Location of spikes was determined by dipole source estimation. A standardized neuropsychological assessment was conducted, including Kaufman ABC battery, language tests, and motor performance series. All children with sufficient MEG data were included in the correlation analysis (N = 20). Results: Focal spikes were located in the perisylvian region in 13 children, in the occipital region in seven, and in the frontal region in one. Five children had bilateral or multiple foci. Children with left perisylvian spikes did not differ from the others in global IQ, but performed significantly lower in language tests (p = 0.01). Children with occipital spikes performed significantly lower in simultaneous information processing (p = 0.01), especially in visual transformation tasks. Conclusions: Combined MEG/EEG investigation is a useful tool to examine interictal focal spikes. Our results show a correlation between the location of spikes and selective cognitive deficits in children with BPE. These findings indicate that focal interictal spikes may interfere with complex cognitive functions.
Reliable Registration of Preoperative MRI with Histopathology after Temporal Lobe Resections
Authors: Eriksson Sofia H. , Free Samantha L. , Thom Maria , Harkness William , Sisodiya Sanjay M. , Duncan John S. 
Published: September 2005

Summary:  Purpose: Conventional and novel magnetic resonance imaging (MRI) techniques can detect cerebral abnormalities in patients with refractory focal epilepsies. Correlation of preoperative MRI and histopathology is important to validate MRI findings, but in practice is far from straightforward. Peroperative neuronavigation and placement of markers on tissue is of limited use in temporal lobe resections. MRI scanning of the resected specimen for registration with in vivo MRI is complicated by anisotropic tissue deformation. We have developed a method to facilitate registration of preoperative MRI with the resected specimen and to enable correlation of MRI findings with histopathology. Methods: Sixteen en bloc temporal lobe resections undertaken for refractory temporal lobe epilepsy were studied. The specimens were fixed in formalin and then cut coronally by using a cradle with parallel blades at 5‐mm intervals to ensure evenly thick tissue slices in the same orientation. Volumetric T1‐weighted preoperative MRIs were reformatted, and consecutive slices (0.94 mm) cut in the same orientation as the resected lobe were visually compared with photographs of tissue slices by two independent observers. Results: In 15 (94%) of 16 cases, a <2‐mm difference was found between the two observers' matches of MRI slices with tissue slices. In the last case, a 4‐mm difference was noted. In all cases, a consensus was reached by the two observers. The suggested MRI–histology matches were within the resections seen on postoperative scans. Conclusions: Careful labelling and postoperative handling and slicing ensured histopathologic tissue slices of uniform thickness and slicing angle. This technique can be applied to a range of MRI datasets, enabling exploration of the pathologic basis of abnormalities on conventional and novel MRI acquisitions.
Status Epilepticus and Tiagabine Therapy Revisited
Authors: Koepp Matthias J. , Edwards Mark , Collins Jayne , Farrel Fiona , Smith Shelagh 
Published: September 2005

Summary: Purpose:To determine whether antiepileptic treatment with tiagabine (TGB) is associated with an increased frequency of nonconvulsive status epilepticus (NCSE) in patients with refractory epilepsy.Methods:We reviewed retrospectively the medical and EEG records of all inpatients with refractory localization‐related epilepsy at the National Society for Epilepsy treated with TGB between January 1997 and December 2000. Clinical and electroencephalographic (EEG) data before, during, and after TGB therapy were evaluated in those patients who experienced a deterioration in seizure control suggestive of NCSE. Frequency of NCSE was determined in a comparable, non–TGB‐treated patient population.Results:Seven (7.8%) of 90 TGB‐treated patients were identified who experienced episodes of electroclinically confirmed NCSE. Serial EEGs showed deterioration during TGB treatment, with resolution of abnormality on discontinuation of TGB in all seven patients. During the same observation period, 32 (2.7%) of 1,165 non–TGB‐treated patients developed electroclinically defined NCSE.Conclusions:Treatment with TGB is associated with an increased frequency of NCSE in patients with refractory localization‐related epilepsy.
Tuberous Sclerosis Complex and the Ketogenic Diet
Authors: Kossoff Eric H. , Thiele Elizabeth A. , Pfeifer Heidi H. , McGrogan Jane R. , Freeman John M. 
Published: September 2005

Summary:  Purpose: Tuberous sclerosis complex (TSC) is a condition that is frequently associated with intractable, early‐onset epilepsy, and often is first seen as infantile spasms. If medications fail and no clear epileptogenic tuber is identified, nonpharmacologic therapies are often attempted. The use of the ketogenic diet specifically for children with TSC and epilepsy has not been previously described. Methods: A chart review was performed of patients with TSC treated with the ketogenic diet over a 5‐year period at Johns Hopkins Hospital and Massachusetts General Hospital. Results: Twelve children, ages 8 months to 18 years, were identified. Eleven (92%) children had a >50% reduction in their seizures at 6 months on the diet, and 8 (67%) had a >90% response. Five children had at least a 5‐month seizure‐free response. Diet duration ranged from 2 months to 5 years (mean, 2 years). Conclusions: In this limited‐duration case series of 12 patients, the ketogenic diet was a generally effective therapeutic modality for the intractable epilepsy occasionally seen in children with TSC.
Analysis of Chronic Seizure Onsets after Intrahippocampal Kainic Acid Injection in Freely Moving Rats
Authors: Bragin Anatol , Azizyan Avetis , Almajano Joyel , Wilson Charles L. , Engel Jerome 
Published: September 2005

Summary:  Purpose: The goal of this study was to analyze the transition period between interictal and ictal activity in freely moving rats with recurrent spontaneous seizures after unilateral intrahippocampal kainic acid (KA) injection. Methods: Pairs of tungsten electrodes (50 μm O/D) were implanted bilaterally under anesthesia at symmetrical points in the dentate gyrus (DG) and CA1 regions of anterior and posterior hippocampi and entorhinal cortex of adult Wistar rats. Stimulating electrodes were placed in the right angular bundle and KA was injected into the right posterior CA3 area of hippocampus after 1 week of baseline EEG recording. Beginning 24 h after injection, electrographic activity was recorded with video monitoring for seizures every day for 8 h/day for 60 days. Results: Seventy percent of seizures started locally in the DG ipsilateral to injection, with an increase in frequency of interictal EEG spikes (hypersynchronous type, HYP), and 26% of seizures started with a decrease of EEG amplitude with parallel increase in frequency (low‐voltage fast type, LVF). During HYP seizures, a significant increase was observed in amplitude of beta‐gamma range frequencies, ripple frequency, and fast ripple (FR) frequency, whereas during LVF seizure, an increase was noted only in the beta‐gamma range. In all cases but one, an EEG wave preceded ripple and FR oscillations. Before seizure onset, the amplitude of DG‐evoked responses to single pulses decreased, whereas the amplitude of the response to the second pulse delivered at 30‐ms interval increased. Conclusions: If ripple and FR oscillations indicate the seizure‐generating neuronal substrate, these areas must be small and widespread, so that the probability of recording from them directly is very low. The decreased response to electrical stimulation before seizures could indicate a protective inhibitory mechanism that contains or prevents seizure occurrence. The presence of decreased paired‐pulse suppression could indicate a network predisposition to follow an external input with a certain frequency.
Catheter Ablation of Long‐Lasting Persistent Atrial Fibrillation: Clinical Outcome and Mechanisms of Subsequent Arrhythmias
Authors: HAÏSSAGUERRE MICHEL , HOCINI MÉLÈZE , SANDERS PRASHANTHAN , SACHER FREDERIC , ROTTER MARTIN , TAKAHASHI YOSHIHIDE , ROSTOCK THOMAS , HSU LI‐FERN , BORDACHAR PIERRE , REUTER SYLVAIN , ROUDAUT RAYMOND , CLÉMENTY JACQUES , JAÏS PIERRE 
Published: September 2005

Background: Catheter ablation of atrial fibrillation (AF) is challenging in patients with long‐standing persistent AF. The clinical outcome and subsequent arrhythmia recurrence after using an ablation method targeting multiple left atrial sites with the aim of achieving acute AF termination has not been characterized. Methods: Sixty patients (mean age: 53 ± 9 years) with persistent AF (mean duration: 17 ± 27 months) were prospectively followed after catheter ablation. Catheter ablation targeting the following sites was performed in a random sequence: (i) electrical isolation of all pulmonary veins (PV); (ii) disconnection of other thoracic veins; (iii) atrial ablation at sites possessing complex electrical activity, activation gradients, or short cycle lengths. Finally, linear ablation of the LA roof and mitral isthmus was performed if sinus rhythm was not restored following energy delivery to the above sites. At 1, 3, 6, and 12 months after ablation, patients underwent clinical review and 24‐hour ambulatory ECG monitoring to identify asymptomatic arrhythmia. Repeat mapping and catheter ablation was performed in any patient experiencing recurrent atrial tachycardia (AT). Clinical success was defined as the absence of any sustained atrial arrhythmia. Results: AF terminated during ablation in 52 patients (87%). The fluoroscopy and procedural durations were 84 ± 30 minutes and 264 ± 77 minutes, respectively. Three months after ablation, sustained ATs were documented in 24 patients (associated with AF in 2). Mapping in 23 patients showed a single AT in 7 while multiple ATs were observed in 16. Macroreentry was confirmed to be due to gaps in the ablation lines, while focal ATs originated from discrete sites or isthmuses near the left atrial appendage, coronary sinus, pulmonary veins, or fossa ovalis; these sites were similar to those at which the greatest impact was observed on the fibrillatory process during the initial ablation procedure. After repeat ablation, at 11 ± 6 months of follow‐up, 57 patients (95%) were in sinus rhythm and 3 developed recurrent AF or AT. All patients in sinus rhythm demonstrated improved exercise capacity and all but 2 had evidence of atrial transport as assessed by Doppler echocardiography (mitral A wave velocity 34 ± 17 cm/sec) by 6 months. Conclusion: Catheter ablation of long‐lasting persistent AF associated with acute AF termination achieves medium to long‐term restoration and maintenance of sinus rhythm in 95% of patients. Arrhythmia recurrence in the majority of patients is AT.
PREVALENCE AND RESISTANCE TO ANTIBIOTICS FOR AEROMONAS SPECIES ISOLATED FROM RETAIL FISH IN TURKEY
Authors: YUCEL N. , ASLIM B. , BEYATLI Y. 
Published: September 2005

ABSTRACT Mesophilic aeromonads are among the most common bacteria in water habitats throughout the world, and these bacteria frequently cause disease in fishes. They are also causative agents of acute diarrheal disease in man following ingestion water. In this study, a total of 132 market fish (64 freshwater and 68 seawater) samples representing were collected in Ankara (Turkey) and investigated for the presence of Aeromonas spp. They were isolated from 106 (80.3%) out of the 132 fish samples tested. The distribution of Aeromonas spp. varied depending on the samples (gill, intestine, liver, kidney) examined. In freshwater samples, the predominant species was A. caviae (66.0%), followed by A. hydrophila (22.6%) and A. veroni bv. sobria (11.6%). In seawater samples, the predominant species was found A. veroni bv. sobria (41.5%), followed by A. hydrophila (30.1%) and A. caviae (28.3%). The 132 isolated Aeromonas spp. strains were further examined for hemolytic, lipolytic and proteolytic activity. Of the present isolates, more than 80% (A. veroni bv. sobria, A. hydrophila) were positive for hemolysin activities. Lipolytic and proteolytic activity of identified strains were found in more lower incidence. All aeromonads (A. hydrophila, A. veroni bv. sobria, A. caviae) strains showed resistance to ampicillin, cephalothin and trimethoprim. The least resistance was found for chloramphenicol (9.0%). In contrast, all the strains were susceptible to ciprofloxacin and ceftriaxone. In Turkey, there have been few studies on Aeromonas and its virulence factors. This study therefore highlights an important incidence of Aeromonas spp., with virulence and antibiotic resistance, isolated from fish intended for human consumption in Turkey.