bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two cases of AlphaCor surgery performed using a small incision technique
Authors: Crawford Geoffrey J , Eguchi Hiroshi , Hicks Celia R 
Published: January 2005

AbstractThe authors have evaluated the AlphaCor artificial cornea (previously Chirila KPro) in human patients since 1998, utilizing an intrastromal technique requiring extensive corneal lamellar dissection and recommending conjunctival flaps in all cases. Recent availability of low‐profile instruments has facilitated a simpler technique, which was first evaluated in two subjects followed for over 1 year prior to recommending the technique for wider adoption. The new technique is presented and illustrated herein, and its benefits and limitations compared with the traditional AlphaCor implantation are discussed.
Effect of p53 codon 72 polymorphism on p53 protein expression in pterygium
Authors: Tsai Yi‐Yu , Chang Kong‐Chao , Lee Huei , Cheng Ya‐Wen , Tsai Fuu‐Jen , Tseng Sung‐Huei , Ao Hei Sio , Chau Pak Sam 
Published: January 2005

Abstract Background: The p53 protein is expressed in pterygial epithelium, but the reported prevalence of its expression varies widely. Although the cause of this variation is unknown, several factors that may play a role have been investigated, but without conclusive findings. In the present study, the role of p53 codon 72 polymorphism, and that of both age and gender, on p53 expression in pterygium was investigated. Methods: Pterygium and blood samples were harvested from 55 patients undergoing pterygium surgery. The pterygial specimens were studied immunohistochemically using antibodies against p53 protein. Polymerase chain reaction based analysis was used to resolve the p53 codon 72 polymorphism. Results: Thirty‐one (56.4%) of the 55 pterygial specimens were positive for p53 staining. The distributions of the three genotypes of the p53 codon 72 polymorphism in the p53‐positive and ‐negative staining groups were not statistically different. The allelic frequency in the two groups was also not statistically different, nor was there any significant difference between both groups with respect to age or gender. Conclusions: A correlation between p53 codon 72 polymorphism, sex and gender and p53 protein expression was not found.
Serum oxidant/antioxidant balance in exfoliation syndrome
Authors: Yılmaz Ayça , Adıgüzel Ufuk , Tamer Lülüfer , Yıldırım Özlem , Öz Özay , Vatansever Halil , Ercan Bahadır , Değirmenci Ula¸s , Atik Uğur 
Published: January 2005

Abstract Background: To evaluate the relationship between the serum oxidant–antioxidant balance and the presence of exfoliation syndrome (XFS) in a prospective study. Methods: The study group comprised 27 cases of XFS. Serum concentrations of myeloperoxidase, malondialdehyde, vitamins A, C and E, catalase and total antioxidant were measured and compared with an independent group by t‐test. Results: Serum myeloperoxidase, vitamins A and E, catalase and total antioxidant parameters were not statistically different among the groups (P > 0.05). Serum vitamin C concentrations were significantly lower and malondialdehyde concentrations were significantly higher in cases of XFS when compared with the control group (P = 0.008 and P = 0.002, respectively). Conclusion: An altered oxidant–antioxidant balance may play a role in the pathogenesis of XFS.
Treatments for choroidal and retinal neovascularization: a focus on oligonucleotide therapy and delivery for the regulation of gene function
Authors: Marano Robert J , Rakoczy P Elizabeth 
Published: January 2005

AbstractBlinding eye diseases caused by neovascularization of the retinal tissue are the leading cause of blindness in Western societies. Current treatments, such as laser photocoagulation, are limited in their effectiveness at halting the progression of angiogenesis and are unable to reduce the number of vessels once they have developed. In addition, although complete blindness is often avoided, vision is often permanently impaired by the treatment itself. Several less invasive treatments are being developed and one of these is oligonucleotide gene therapy in which short stretches of nucleotides are being used as inhibitors of key, metabolic processes involved in angiogenesis. Combined with this is the development of new and improved nucleotide chemistries aimed at overcoming many of the problems associated with oligonucleotide gene therapy, such as poor longevity because of endonuclease activity. In addition, advancements in delivery systems have further enhanced the efficacy of oligonucleotide gene therapy by increasing cellular penetration and localizing delivery to specific cell types and organs.
Experimental study of the killing effects of oxymatrine on human colon cancer cell line SW1116
Authors: ZOU Jian , RAN Zhi Hua , XU Qi , XIAO Shu Dong 
Published: January 2005

OBJECTIVE:  To study the killing effects of oxymatrine (OM) on a human colon cancer cell line, SW1116, and evaluate its antineoplastic mechanism.METHODS:  Methyl thiazolyl tetrazolium (MTT) analysis, flow cytometry, polymerase chain reaction (PCR)‐enzyme linked immunosorbent assay (ELISA) and RT‐PCR methods were used respectively to determine the killing effects of OM and its influence on cell cycle distribution, telomerase activity and the expressions of hTERT, c‐myc, p53 and mad1 in SW1116 cells.RESULTS:  Oxymatrine exhibited dose‐dependent killing effects on SW1116 cells and induced G1/G0‐phase arrest. It suppressed the telomerase activity of the cells in a dose‐ and time‐dependent manner. After OM administration, the expression of hTERT in the SW1116 cells decreased, those of p53 and mad1 increased, and the expression of c‐myc was unchanged.CONCLUSIONS:  Oxymatrine has dose‐dependent killing effects on SW1116 cells and its antineoplastic activity might be attributed to inhibition of telomerase activity by means of its effects on hTERT and the upstream regulating genes.
Acute management of a cyanotic episode in an infant after a Norwood procedure
Authors: Ginz Hans F. , Stotz Martin , Erb Thomas O. , Ummenhofer Wolfgang C. 
Published: January 2005

SummaryIn infants with a Norwood stage I reconstruction, the respiratory management to direct pulmonary to systemic blood flow ratio is of critical importance. Disturbance of this delicate blood‐flow balance can occur causing rapid deterioration of the infant's condition requiring urgent interventions. However, the emergency staff personnel that are generally the first to be called may not be familiar with these patients’ complex pathophysiology. We report on the resuscitation of an infant with a Norwood circulation who developed deep central cyanosis in an out‐of‐hospital environment. The infant deteriorated because of stenoses in both the neoaortic arch and the aortopulmonary shunt. Emergency therapy, especially for out‐of‐hospital treatment, can only consist of basic measures, which are discussed.
Caudal additives for postoperative pain management in children: S(+)‐ketamine and neostigmine
Authors: Almenrader N. , Passariello M. , D'amico G. , Haiberger R. , Pietropaoli P. 
Published: January 2005

SummaryBackground:  The aim of the present pilot study was to compare the analgesic efficacy of S(+)‐ketamine either alone or in combination with neostigmine for caudal blockade in pediatric surgery.Methods:  A total of 40 children were randomly assigned to receive after induction of general anesthesia either caudal S(+)‐ketamine 1 mg·kg−1 (group K, n = 20) or caudal S (+)‐ketamine 0.5 mg·kg−1 plus neostigmine 10 μg·kg−1 (group KN, n = 20). Anesthesia was maintained with sevoflurane and a laryngeal mask airway (LMATM), no additional analgesics were administered. Postoperative pain and sedation were assessed by the Children's Hospital of Eastern Ontario Pain Score and Ramsay scale for 24 h.Results:  No statistical difference in duration of analgesia and sedation was found. Mean duration of postoperative analgesia was 18 ± 9.4 h in group K and 21.8 ± 6.7 h in group KN. There was a significantly higher incidence of postoperative vomiting after administration of caudal ketamine with neostigmine (30% group KN Vs 0% group K; P < 0.05).Conclusions:  This pilot study demonstrates equianalgesic effects on postoperative pain relief in children with both caudal S(+)‐ketamine 1 mg·kg−1 and caudal S(+)‐ketamine 0.5 mg·kg−1 plus neostigmine 10 μg·kg−1. Further studies are required to confirm adoption of caudal neostigmine into routine clinical practice.
Automatic atrial tachycardia in an infant following general anesthesia
Authors: Tripi Paul A. , Dorostkar Parvin 
Published: January 2005

SummaryAutomatic atrial tachycardia (AAT) is a rare supraventricular tachyarrhythmia (<10% of all supraventricular tachycardias), which can present in infants or young children. There are no published reports of AAT occurring in an infant or child following noncardiac surgery and general anesthesia. This report describes the management of a previously healthy 5‐month‐old infant, who developed AAT in the postanesthesia care unit following an uneventful circumcision under general anesthesia.
Intravenous patient‐controlled analgesia using remifentanil in a child with Axenfeld‐Rieger syndrome*
Authors: Yalcin Cok Oya , Ozkose Zerrin , Atabekoglu Serap , Yardim Sahin 
Published: January 2005

SummaryPatient‐controlled analgesia (PCA) using intravenous opioids is increasing in popularity for children aged 5 years and over. To our knowledge there are no reports on the use of PCA in children with remifentanil in the postoperative period. We report successful use of remifentanil for intravenous (IV) PCA in a child scheduled for suprasellar arachnoid cystectomy with Axenfeld–Rieger syndrome who needed good postoperative analgesia because of accompanying serious problems.
Near‐infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation
Authors: WEISS MARKUS , DULLENKOPF ALEXANDER , KOLAROVA ANNA , SCHULZ GABRIELE , FREY BERNHARD , BAENZIGER OSKAR 
Published: January 2005

SummaryBackground:  The aim of the study was to elucidate easily determinable laboratory and vital parameters in clinical practice to explain variability of near‐infrared spectroscopic cerebral oxygenation readings in critically ill newborns and infants using the NIRO 300 spectrometer.Methods:  Near‐infrared spectroscopy (NIRS) cerebral tissue oxygenation index (cTOI) was measured on the forehead of critically ill neonates and infants with existing arterial and/or central venous access. We recorded patient characteristics and simultaneously determined sedation state, hemodynamic, respiratory and laboratory data, such as arterial blood gas analysis, electrolytes, hemoglobin and arterial lactate concentration, blood glucose and central venous oxygen saturation. Data were compared using linear, multiple and forward stepwise regression analysis (P < 0.05).Results:  A total of 155 neonates and infants aged from 0 to 365 days (median 12 days) were studied. cerebral tissue oxygenation index (cTOI) values ranged from 32.1 to 91.0% (60.5 ± 11.5%). Simple linear regression analysis revealed significant associations between cTOI and arterial oxygen saturation (r = 0.254, P = 0.001), transcutaneously measured arterial oxygen saturation (r = 0.320, P ≤ 0.0001), central venous oxygen saturation (r = 0.489, P < 0.0001), arteriovenous oxygen extraction (r = 0.445, P < 0.0001) and presence of a cardiac shunt (r = 0.250, P = 0.024). Multiple regression analysis and forward stepwise regression revealed two independent, significant predictors for cTOI, namely SvO2 (P < 0.0001) and presence or absence of a cardiac shunt (P = 0.003). SvO2 alone explained 23.9% of the variability of cTOI. The addition of the variable ‘cardiac shunt’ improved the model to 33%.Conclusions:  Based on our study results cerebral tissue oxygenation readings by the NIRO 300 near‐infrared spectrometer is influenced by central venous oxygen saturation, which partially explains intersubject variability of NIRS cerebral oxygenation readings.
Intravenous ketamine sedation for painful oncology procedures
Authors: EVANS DAN , TURNHAM LUCY , BARBOUR KATHRYN , KOBE JEFF , WILSON LAURA , VANDEBEEK CHRISTINE , J. MONTGOMERY CAROLYNE , ROGERS PAUL 
Published: January 2005

SummaryBackground: The aim of the study was to determine the efficacy and adverse effects of intravenous (i.v.) ketamine sedation administered by nonanesthetist physicians for painful procedures.Methods: A single‐agent, procedural sedation protocol using titrated doses of ketamine i.v. (maximum 2 mg·kg−1) was conducted in outpatient pediatric oncology patients undergoing lumbar puncture (LP), bone marrow biopsy/aspiration (BMBx/A) or combination (LP/BMBx/A) in a tertiary care setting. The efficacy of analgesia and sedation (ability to perform the procedure), procedure duration, recovery time and the occurrence of adverse events are described.Results: Fifty‐eight subjects of a median age of 5 years (1–13) and median weight of 20 kg (10.5–68) underwent 119 sedations. An LP was performed in 73% of cases, a BMBx/A in 13% and LP/BMBx/A in 13%. Efficacy was 100% and the mean dose of ketamine was 1.3 mg·kg−1(0.4). The mean duration of the procedure was 6.6 min (4.2) and the recovery time was 11 min (4–45). Two subjects (1.7%) had a hypoxemia (SpO2of <94%). No major airway complications occurred. The prevalence of hypertension (systolic > 20% at 5 min) was 54%. The median pain visual analogue score (VAS) for an observer was 0 (range 0–3) and caregiver was 0 (range 0–4). The median VAS for satisfaction (observer) was 10 (range 7–10) and caregiver VAS was also 10 (range 5–10). At 24 h after discharge, the incidence of bad dreams was 3.3%; vomiting, 10.8%; and abnormal behavior, 4.2%.Conclusion: Ketamine i.v. up to 2 mg·kg−1is an effective sedative for oncology procedures using a defined protocol.
A Cost‐Benefit Analysis of External Hip Protectors in the Nursing Home Setting
Authors: Honkanen Lisa A. , Schackman Bruce R. , Mushlin Alvin I. , Lachs Mark S. 
Published: January 2005

Objectives:To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective.Design:A state‐transition Markov model considering short‐term and long‐term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and functional status. Costs, transition probabilities between health states, and estimates of hip protectors' effectiveness were derived from published secondary data.Setting:Nursing home facilities in the United States.Participants:Hypothetical cohort of permanent nursing home residents aged 65 and older without a previous hip fracture.Intervention:Program of hip protectors reimbursed by Medicare.Measurements:Number of fractures, life years, and dollars saved.Results:Three pairs of hip protectors replaced annually would result in a weighted average lifetime absolute risk reduction for hip fracture of 8.5%, with net lifetime savings to Medicare of $223 per resident. When the annual cost of hip protectors is less than $151 per person, relative risk of fracture is less than or equal to 0.65 with hip protectors, or adherence is greater than 42%, hip protectors are cost saving to Medicare over a wide range of assumptions. Extrapolating these results to the estimated population of U.S. nursing home residents without a previous hip fracture, Medicare could save $136 million in the first year of a hip‐protector reimbursement program.Conclusion:From a Medicare perspective, hip protectors are a cost‐saving intervention in the nursing home setting when hip protector effectiveness is less than or equal to 0.65 over the remaining lifetime of subjects.
Blood Pressure Response to Strength Training May Be Influenced by Angiotensinogen A–20C and Angiotensin II Type I Receptor A1166C Genotypes in Older Men and Women
Authors: Delmonico Matthew J. , Ferrell Robert E. , Meerasahib Anish , Martel Greg F. , Roth Stephen M. , Kostek Matthew C. , Hurley Ben F. 
Published: January 2005

Objectives: To determine the influence of angiotensinogen (AGT) A–20C, M235 T, and angiotensin II type 1 receptor (AGTR1) A1166C genotypes on resting blood pressure (BP) response to strength training (ST) in older men and women.Design: Prospective intervention study with retrospective genotyping.Setting: University of Maryland Exercise Physiology Laboratory.Participants: Seventy sedentary, healthy older men (n=34) and women (n=36).Intervention: Approximately 23 weeks of ST performed 3 days per week.Measurements: Resting BP was measured on six separate occasions before and after ST for each subject. AGT and AGTR1 genotyping was performed retrospectively from each subject's genomic deoxyribonucleic acid.Results: Systolic BP decreased in C‐allele carriers at the AGT A–20C locus with ST (122±1 to 116±2 mmHg, P<.05), which was significantly greater than the decrease in the A homozygotes (126±1 to 123±1 mmHg, P<.05). At the AGTR1 A1166C locus, diastolic BP decreased to a greater extent in the C‐allele carriers (76±1 to 70±2 mmHg, P<.05) than in the A homozygotes (75±1 to 72±1 mmHg, P<.05).Conclusion: The AGT A–20C and AGTR1 A1166C genotypes may influence resting BP response to ST, such that C‐allele carriers at each of these loci reduce their resting BP in response to ST to a greater extent than A homozygotes.
A 5‐Year Prospective Assessment of the Risk Associated with Individual Benzodiazepines and Doses in New Elderly Users
Authors: Tamblyn Robyn , Abrahamowicz Michal , Berger Roxane du , McLeod Peter , Bartlett Gillian 
Published: January 2005

Objectives:To determine the risk of injury associated with the new use of individual benzodiazepines and dosage regimens in the elderly.Design:Prospective database cohort study with 5 years of follow‐up.Setting:Quebec, Canada.Participants:Two hundred fifty‐three thousand two hundred forty‐four persons aged 65 and older who were nonusers of benzodiazepines in the year before follow‐up.Measurements:Population‐based hospitalization and prescription and medical services claims databases were used to compare the risk of injury during periods of benzodiazepine use with those of nonuse. Periods of use were measured for 10 insured benzodiazepines by drug and dose as time‐dependent covariates. Injury was defined as the first occurrence of a nonvertebral fracture, soft‐tissue injury, or accident‐related hospital admission. Patient age, sex, previous injury history, concomitant medication use, and comorbidity were measured as fixed and time‐dependent confounders. Cox proportional hazards models were used to estimate the risk of injury with benzodiazepine use and to determine the extent to which patient characteristics, differences in dosage, or in the effect of increasing dosage for individual drugs explained differences between drugs.Results:More than one‐quarter (27.6%) of 253,244 elderly were dispensed at least one prescription for a benzodiazepine, and 17.7% of elderly were treated for at least one injury during follow‐up, of which fractures were the most common. Patient characteristics, systematic differences in the risk of injury in elderly prescribed different benzodiazepines, and differences in dosage prescribed for individual drugs confounded the risk of injury with benzodiazepine use. The risk of injury with increasing dosage varied by drug from a hazard ratio of 0.92 (95% confidence interval (CI)=0.60, 1.42) for alprazolam to 2.20 (95% CI=1.39, 3.47) for flurazepam per 1 standardized adult dose increase.Conclusion:The risk of injury varied by benzodiazepine, independent of half‐life, as did the risk associated with increasing dosage for individual products. Higher doses of oxazepam, flurazepam, and chlordiazepoxide are associated with the greatest risk of injury in the elderly.
Making Difficult Decisions About Hospice Enrollment: What Do Patients and Families Want to Know?
Authors: Casarett David , Crowley Roxane , Stevenson Carolyn , Xie Sharon , Teno Joan 
Published: January 2005

Objectives: To define patients' and families' priorities for information about hospice.Design: Cross‐sectional interview.Setting: Urban, not‐for‐profit, Medicare‐certified hospice.Participants: Patients and families recruited from consecutive hospice information visits.Measurements: Understanding of hospice, assessment of the relative importance of eight categories of information (by direct rating and ranking tasks), and nurse observation of shared decision making between patient and family (5‐point scale).Results: Interviews were conducted with 237 patients and families at a hospice information visit. Forty percent (n=94) said that they knew anything about hospice. Most often, family members made the enrollment decision (n=132, 57%). Of the eight categories of information, patients and families placed the greatest importance on visit frequency (n=143, 60%), payment for hospice (n=140, 59%), and the practical help that hospice provides (n=123, 52%). Principal component factor analysis reduced the categories to three distinct factors reflecting concerns related to impending death, practical support, and changes from established patterns of care.Conclusion: Most patients and families who are referred for a hospice information visit know little about hospice and have substantial information needs. Referring physicians and hospice teams may be able to better support hospice enrollment decisions by anticipating common priorities for information.
Risk Factors for Potentially Harmful Informal Caregiver Behavior
Authors: Beach Scott R. , Schulz Richard , Williamson Gail M. , Miller L. Stephen , Weiner Myron F. , Lance Charles E. 
Published: January 2005

Objectives: Caring for a sick or disabled relative has been linked to compromised caregiver health, and risk factors for negative caregiver outcomes have been studied extensively, but little attention has been given to care recipient and caregiver health as risk factors for potentially harmful behavior by informal caregivers. This article explores such risk factors.Design: Structured interviews from baseline assessment of the Family Relationships in Late Life Study.Setting: Three U.S. communities.Participants: Referred, volunteer sample of 265 caregiver/care recipient dyads. Caregivers were primarily responsible for care of an impaired, community‐residing family member aged 60 and older and providing help with at least one activity of daily living (ADL) or two instrumental activities of daily living (IADLs).Measurements: Self‐reported care recipient demographics, cognitive status, need for care, and self‐rated health; self‐reported caregiver demographics, cognitive status, amount of care provided, self‐rated health, physical symptoms, and depression. Care recipient reports of potentially harmful caregiver behavior, including screaming and yelling, insulting or swearing, threatening to send to a nursing home, and withholding food, were the main outcome variable.Results: The following were significant risk factors for potentially harmful caregiver behavior: greater care recipient ADL/IADL needs (odds ratio (OR)=1.12, 95% confidence interval (CI)=1.03–1.22), spouse caregivers (vs others; OR=8.00, 95% CI=1.71–37.47), greater caregiver cognitive impairment (OR=1.20, 95% CI=1.04–1.38), more caregiver physical symptoms (OR=1.07, 95% CI=1.01–1.13), and caregivers at risk for clinical depression (OR=3.47, 95% CI=1.58–7.62).Conclusion: Potentially harmful caregiver behavior is more likely in spouse caregiving situations and when care recipients have greater needs for care and caregivers are more cognitively impaired, have more physical symptoms, and are at risk for clinical depression. This risk profile is similar to that for negative caregiver outcomes.