bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equilibrium of acidifying and alkalinizing metabolic acid–base disorders in cirrhosis
Authors: Funk Georg‐Christian , Doberer Daniel , Österreicher Christoph , Peck‐Radosavljevic Markus , Schmid Monika , Schneeweiss Bruno 
Published: May 2005

Abstract:Background and Aims: Conflicting results exist with regard to metabolic acid–base status in liver cirrhosis, when the classic concept of acid–base analysis is applied. The influence of the common disturbances of water, electrolytes and albumin on acid–base status in cirrhosis has not been studied. The aim of this study was to clarify acid–base status in cirrhotic patients by analyzing all parameters with possible impact on acid–base equilibrium.Patients and Methods: Fifty stable cirrhotic patients admitted to a university hospital. Arterial acid–base status was analyzed using the principles of physical chemistry and compared with 10 healthy controls.Results: Apart from mild hypoalbuminemic alkalosis, acid–base state was normal in Child–Pugh A cirrhosis. Respiratory alkalosis was the net acid–base disorder in Child–Pugh B and C cirrhosis with a normal overall metabolic acid–base state (Base excess−1.0 (−3.6 to 1.6) vs 1.1 (−0.2 to 1.1) mmol/l, P=0.136, compared with healthy controls, median (interquartile range)). Absence of an apparent metabolic acid–base disorder was based on an equilibrium of hypoalbuminemic alkalosis and of dilutional acidosis and hyperchloremic acidosis.Conclusion: A balance of offsetting acidifying and alkalinizing metabolic acid–base disorders leaves the net metabolic acid–base status unchanged in cirrhosis.
Virological profiles in hepatitis B virus inactive carriers: monthly evaluation in 1‐year follow‐up study
Authors: Cacciola Irene , Spatari Giovanna , Pollicino Teresa , Costantino Lucy , Zimbaro Giovanni , Brancatelli Santa , Fenga Concettina , Caccamo Gaia , Squadrito Giovanni , Raimondo Giovanni 
Published: May 2005

Abstract: Study subject: We longitudinally evaluated the virological behaviour and the hepatitis B virus (HBV) genomic variability in inactive HBV surface antigen (HBsAg) chronic carriers.Patients and methods: Fourteen HBsAg‐positive healthy workers (13 inactive carriers and 1 with active HBV infection) were followed up for 12 months by monthly evaluation of aminotransferase, HBV DNA, and IgM anti HBV core antigen (IgM anti‐HBc) values. Moreover, HBV serum isolates from each case were amplified, cloned and sequenced to evaluate the presence of the potentially clinical relevant core‐promoter and precore mutations. The same technical procedures were used to examine the S gene of isolates from 3 randomly selected inactive carriers and the patients with active HBV infections.Results: Aminotransferase values were constantly normal in all cases. Viremia levels appear to fluctuate widely over time in each individual case, although the HBV DNA remained below 2 × 104 copies/ml in all samples. Only four serum samples from two inactive carriers had IgM anti‐HBc values higher than the specific cut‐off limit of the assay. Either wild type or core‐promoter/precore HBV variants or a mixture of them were detected in the inactive carriers. S gene nucleotide homology among the clones from the three inactive carriers and the subject with active infection was 98.9%, 98.3%, 98.1% and 98.2%, respectively.Conclusions: The degree of suppression of HBV replication in inactive carriers is variable over time, and the entity and quality of HBV variability is comparable between active and inactive carriers.
Allicin, the active component of garlic, prevents immune‐mediated, concanavalin A‐induced hepatic injury in mice
Authors: Bruck Rafael , Aeed Hussein , Brazovsky Eli , Noor Talia , Hershkoviz Rami 
Published: May 2005

Abstract: Background/Aim: Allicin, the immunologically active component of garlic, has been found to affect oxidative stress and immune response in several experimental systems. In the present study, we examined the ability of allicin to prevent immune‐mediated, concanavalin A (Con A)‐induced liver damage in mice.Methods: Mice were pretreated with allicin for 7 days before their inoculation with Con A (15 mg/kg). The serum levels of liver enzymes and liver histology were examined 24 h after Con A administration. The effect of Con A and allicin on serum levels of tumor necrosis factor‐α (TNF‐α) and nuclear factor‐κB (NF‐κB) activation in the liver were examined 2 h after Con A administration, in a separate group of rats, and the effect of allicin on Con A‐induced expression of inducible nitric oxide synthase (iNOS) was determined by western blot analysis 24 h after Con A injection.Results: The histopathologic damage in the mouse livers, and the Con A‐induced increase of aminotransferases and TNF‐α were markedly inhibited in the mice pretreated with allicin before Con A injection (P<0.01). NF‐κB binding activity to the nucleus, which increased 2 h after Con A administration, was attenuated by allicin. The expression of iNOS protein which was induced following Con A administration was significantly attenuated by allicin. In vitro studies showed that allicin inhibited TNF‐α‐mediated T cell adhesion to extracellular matrix components and to endothelial cells. Allicin also inhibited TNF‐α‐mediated intercellular adhesion molecule‐1 and vascular cell adhesion molecule‐1 expression on human vascular endothelial cells.Conclusions: This study demonstrates that immune‐mediated liver damage in mice can be prevented by allicin, probably because of its immunomodulatory effects on T cells and adhesion molecules and inhibition of NF‐κB activation.
Difficulties in Achieving the K/DOQI Practice Guidelines for Bone and Mineral Metabolism
Authors: González Esther A. , Al‐Aly Ziyad , Martin Kevin J. 
Published: June 2005

ABSTRACTHyperparathyroidism and alterations in bone and mineral metabolism are known to occur early in the course of chronic kidney disease (CKD). The etiology of these abnormalities is multifactorial. Phosphate retention and alterations in vitamin D metabolism play important roles. The recent practice guidelines from the National Kidney Foundation (NKF) have emphasized the need to approach these problems early in the course of CKD by measuring the levels of parathyroid hormone when glomerular filtration rates (GFRs) fall to less than 60 ml/min. If hyperparathyroidism is detected, then treatment must be undertaken to try to prevent its progression. Strict guidelines have been proposed for the management of these alterations in bone and mineral metabolism when kidney disease progresses to CKD stage V. Although the initial recommendations were often opinion based, evidence is accumulating to support these views. However, with our current therapeutic armamentarium, there is considerable difficulty in achieving these practice guidelines for calcium, phosphorus, calcium‐phosphorus product, and parathyroid hormone on a sustained basis. New therapeutic agents are becoming available that will help with phosphorus control and control of hyperparathyroidism, and minimize the calcium load. Additional beneficial effects of vitamin D analogs are being uncovered and are being intensively investigated. It is hoped that with attention to these practice guidelines, control of the abnormalities of mineral metabolism will be improved and will lead to improved patient outcomes.
Dialyzer Reuse and Patient Outcomes: What Do We Know Now?
Authors: Robinson Bruce M. , Feldman Harold I. 
Published: June 2005

ABSTRACTAlthough some hemodialysis (HD) providers in the United States have recently embarked on programs to discontinue dialyzer reprocessing, the practice of dialyzer reuse is still much more common in the United States than in many other countries. Continuation of reprocessing programs has been justified chiefly as an effort to deliver HD with biocompatible and often expensive higher flux dialysis membranes. However, this rationale is considerably less compelling with the decrease in cost for most types of HD membranes and with ongoing debates about the relative effectiveness of HD membranes according to flux and other characteristics. While it is highly likely that mandated quality control standards have limited catastrophic events, such as outbreaks of blood‐borne bacterial infections that can occur due to poor dialyzer reprocessing techniques, hemodialyzer reprocessing remains vulnerable to poor implementation. Reprocessing is no longer indicated in order to improve blood‐membrane biocompatibility, due to the marked decrease in first‐use syndrome since the widespread adoption of synthetic dialysis membranes. Rather, the possibility exists that certain chronic inflammatory responses observed with dialyzer reuse may be deleterious, although these relationships remain speculative. While observational studies have not consistently demonstrated a large excess mortality attributable to reuse, the association of reuse to mortality remains uncertain. Evaluation of the safety of particular reprocessing techniques, germicides, and cleaners has been even harder to examine. Given the widespread availability of inexpensive biocompatible HD membranes and persistent uncertainties about the safety of dialyzer reprocessing, it is time for providers to reexamine their rationale for continuing hemodialyzer reprocessing programs.
The Failed Renal Transplant: In or Out?
Authors: Bennett William M. 
Published: June 2005

ABSTRACTWith the increased number of renal transplants being performed in the United States, there are also increasing numbers of early and long‐term allograft failures. Patients with failed allografts require reentry into the end‐stage renal disease (ESRD) system. If an allograft is producing little in the way of morbidity, it seems reasonable to continue the patient on low‐dose immunosuppressive therapy to avoid sensitization while leaving the allograft in. This is particularly true if the allograft is providing enough renal function to keep the patient off dialysis. However, if the patient is having serious morbidity that may be due to the retained, failed kidney transplant, it may be necessary to remove the allograft kidney, which often shows ongoing inflammation. This may restore erythropoietin responsiveness and contribute to the overall benefit of the patient. The optimal protocol for withdrawal of immunosuppression in this circumstance has not been established by any scientific studies, and the effect of allograft nephrectomy on sensitization status and the ability to receive a crossmatch‐negative retransplant are controversial. The author's personal approach is presented.
Genetics in Dialysis Series Editors: Bertrand L. Jaber and Vaidyanathapuram S. Balakrishnan: Gene Polymorphism Association Studies in Dialysis: Cardiovascular Disease
Authors: Rao Madhumathi , Jaber Bertrand L. , Balakrishnan Vaidyanathapuram S. ,   for the DialGene Consortium
Published: June 2005

ABSTRACTCardiovascular disease (CVD) is the most important cause of morbidity and mortality in dialysis patients. The high prevalence of CVD is due to the cumulative effects of multiple risk factors from the early stages of chronic kidney disease (CKD). Familial predispositions to CVD, CKD, and their respective risk factors are well known, and it is likely that genetic factors determine the interindividual variability in risks for disease. Advances in genomic technology have facilitated the study of genetic variation—most commonly single nucleotide polymorphisms (SNPs) in candidate genes—and their associations with disease. This review examines CVD in dialysis patients as a model of a complex disease, discusses the approach to gene polymorphism association studies, including the roles of gene–environment and gene–gene interactions and provides an overview of available studies.
ASDIN Original Investigations: Venous Mapping Using Venography and the Risk of Radiocontrast‐Induced Nephropathy
Authors: Asif Arif , Cherla Gautam , Merrill Donna , Cipleu Cristian D. , Tawakol Jan Bijan , Epstein David L. , Lenz Oliver 
Published: June 2005

ABSTRACTVenous mapping using venography has been considered to be the gold standard for identifying veins suitable for arteriovenous fistula (AVF) creation. By utilizing a radiocontrast medium, however, venography introduces the risk of radiocontrast‐induced nephropathy. The risk of this complication in the chronic kidney disease (CKD) population has not been previously studied. Twenty‐five consecutive patients (CKD stage 4 and 5) undergoing venography were enrolled in this study. Patients were advised not to fast for the procedure and were encouraged to take oral fluids. Radiocontrast‐induced nephropathy was defined as a 20% decrease in the estimated glomerular filtration rate (GFR) from the baseline value at 48 hours after contrast administration. Weekly telephone calls were made for a total of 4 weeks to assess the need for dialysis. Venography was performed by interventional nephrology using 10–20 cc of low osmolarity contrast medium. Data were collected prospectively. Median age was 48.9 ± 7.8 years and 52% of the patients had diabetes. Complete sets of pre‐ and postprocedure GFRs were available in 21 patients. At 48 hours, there were no differences between the pre‐ and postprocedure GFRs. At the third week, one patient developed flu‐like symptoms with severe gastroenteritis and was hospitalized for volume depletion. This patient initiated dialysis during the hospital stay. We conclude that at 48 hours, our cohort did not develop radiocontrast‐induced nephropathy. During the 4‐week phone call follow‐up, only one patient needed dialysis. Large‐scale studies with a longer follow‐up using GFR estimation are needed to confirm these preliminary findings.
Fluoroscopy‐Assisted Placement of Peritoneal Dialysis Catheters by Nephrologists
Authors: Zaman Fahim , Pervez Aslam , Atray Naveen K. , Murphy Sara , Work Jack , Abreo Kenneth D. 
Published: June 2005

ABSTRACTIn the early 1950s and 1960s, peritoneal dialysis (PD) was used primarily to treat patients with acute renal failure. Continuous ambulatory peritoneal dialysis (CAPD) was introduced in 1976 and continues to gain popularity as an effective method of renal replacement therapy for patients with end‐stage renal disease (ESRD). The PD catheter is inserted into the abdominal cavity either by a surgeon, interventional radiologist, or nephrologist. We have adopted a percutaneous approach with fluoroscopic guidance for PD catheter insertion that is easy, safe, and provides good patency and infection rate results. In this article we describe the technique and our results. From August 2000 to May 2003, 34 PD catheters out of 36 were successfully inserted using the percutaneous fluoroscopic technique in selected patients referred from the nephrology clinic. All the PD catheters were placed in our Interventional Nephrology Vascular Suite by nephrologists.
Fellows’ Forum: Ocular Abnormalities Associated with Advanced Kidney Disease and Hemodialysis
Authors: Evans Ryan D. , Rosner Mitchell 
Published: June 2005

ABSTRACTPatients undergoing chronic hemodialysis (HD) are subject to the unique effects of both uremia and the dialysis procedure on multiple organ systems. Many patients on chronic HD suffer from chronic eye diseases, such as diabetic retinopathy and glaucoma, and the interaction of these diseases with the dialysis procedure can lead to worsening of vision. This review focuses on the common eye diseases seen in patients undergoing chronic HD and how the dialysis procedure and the uremic state impact the visual system.
Consistent Efficacy, Tolerability, and High Levels of Satisfaction With Almotriptan 12.5 mg When Used to Treat Multiple Migraine Attacks in Routine Clinical Practice
Authors: Diener Hans‐Christoph 
Published: June 2005

Objective.—To assess the efficacy, tolerability, and patient satisfaction with almotriptan 12.5 mg across multiple migraine attacks in routine clinical settings.Background.—The efficacy and tolerability of almotriptan have been well‐documented in clinical trials. Less information is available about patient acceptance of therapy under normal prescribing conditions in routine practice.Methods.—This was a prospective, open‐label surveillance study conducted on 899 adults with documented attacks fulfilling the IHS criteria for migraine in medical practices of 307 neurologists and primary care physicians across Germany from June 2001 to April 2002. Patients were eligible for inclusion in the study if they were being treated for the first time with almotriptan. Main outcome measures were pain relief, pain free, consistency, tolerability, and satisfaction with almotriptan 12.5 mg when used to treat multiple migraine attacks.Results.—A total of 899 patients with migraine treated 1 (18.4%), 2 (25.9%), or 3 (55.6%) migraine attacks with almotriptan for a total of 2131 attacks. Pain relief at 2 hours was achieved in 84.5% of attacks; pain free was achieved in 41.4%. Consistency of almotriptan 12.5 mg (at least 2 out of 3 attacks successfully treated) was 87.3%. Most patients (88.5%) indicated that they were “satisfied” or “very satisfied” with their treatment with almotriptan and 80.3% of patients expressed that almotriptan 12.5 mg therapy was better than their prior therapy. Physicians' global assessment of the efficacy of almotriptan 12.5 mg was judged to be “good” and “very good” in 87.6% of the patients, and tolerability was considered to be “good” and “very good” in 96.3% of patients. More than 92% of physicians indicated that they would continue to prescribe almotriptan for their patients.Conclusion.—The high levels of efficacy, consistency, and tolerability of almotriptan 12.5 mg observed in this postmarketing surveillance study are not only consistent with the findings of controlled clinical trials but also resulted in high rates of patient and physician satisfaction with almotriptan and patient preference for almotriptan over prior acute treatments, including other triptans.
Resolution of Concentration–Response Differences in Onset of Effect Between Subcutaneous and Oral Sumatriptan
Authors: Freidank‐Mueschenborn Edda , Fox Anthony W. 
Published: June 2005

Objective.—To investigate whether the concentration–response relationships for onset of effect of oral and subcutaneous (s.c.) sumatriptan differ, and if so, then to explore whether a single model for the onset of effect can nonetheless be found for multiple dose sizes and both routes of administration.Methods.—Active and placebo response rates and mean plasma concentrations were collected from the literature for 0 ≤t≤ 2 hours. Plasma concentration–response relationships were plotted. Logarithmic models for the onset of effect (ie, active response rates), characterized by convexity factor A and location parameter B were constructed from the same data.Results.—The concentration–response relationships for s.c. and oral sumatriptan are qualitatively different. A single logarithmic model for the onset of effect provides good estimates of observed response rates during the first 2 hours post‐dose for multiple dose sizes after both oral and s.c. routes of administration. The precision of this model resides in both its variables. Location parameters for this model differ for similar absolute doses by the two routes of administration. However, curve convexity (representing rate of onset of effect) is related to absolute dose (and hence plasma concentration) in the same way for sumatriptan tablets and injections.Conclusions.—No simple plasma concentration–response relationship exists that is sufficiently robust to apply to both s.c. and oral sumatriptan. There are separate pharmacokinetic–pharmacodynamic relationships for rate of onset and extent of effect. The design of exploratory clinical trials for new acute therapies for migraine may be more efficient when these factors are considered, and these factors may help to describe the gap between experimental and ordinary clinical environments.
Validation of a Questionnaire for the Detection of Cluster Headache
Authors: Torelli P. , Beghi E. , Manzoni G. C. 
Published: June 2005

Background.—In the absence of biological markers, the diagnosis of cluster headache (CH) rests on clinical evidence as reported through ad‐hoc interviews.Objective.—The aim of this study was to validate a 16‐item self‐administered questionnaire designed to screen CH cases.Methods.—The questions were based on the second edition of the International Headache Society classification (ICHD‐II) criteria for CH (n = 12) and on specific disease features (n = 3). Answers to each question were either “Yes,”“No,” or “Don't know.” The validity of this screening tool was assessed using a two‐step procedure. In Step 1, the 16 questions were submitted to 30 healthy subjects with different cultural backgrounds to verify content clarity. In Step 2, the questionnaire was given to 71 patients (32 women and 39 men) aged 15 to 78 years (mean 37.5 years), who were seen at the University of Parma Headache Center with a diagnosis of CH (episodic, 17; chronic, 13), migraine (without aura, 18; with aura, 3), and tension‐type headache (episodic, 16; chronic, 4) according to the ICHD‐II criteria. Sensitivity, specificity, and the positive and negative predictive values were calculated for each question as measures of validity.Results.—Severity, unilaterality, and location of pain had the highest sensitivity (100%), but low (34.1%) or fairly low specificity (61.0% and 58.5%, respectively). In contrast, a positive response to lithium or verapamil had a 66.7% sensitivity and a 97.6% specificity. Sensitivity and specificity were 100% and 90.2% for duration of attacks (<180 to 240 minutes), and 90.0% and 92.7% for compulsory movements, respectively. The best discriminatory pattern for symptom detection was unilaterality of pain and the presence of at least five of the following seven features: pain severity and location, duration, frequency and daily recurrence of attacks, rhinorrhea and restlessness as accompanying symptoms.Conclusions.—Our findings confirm that this questionnaire is a useful method for CH screening in epidemiological studies.
Triggers of Motion Sickness in Migraine Sufferers
Authors: Drummond Peter D. 
Published: June 2005

Objective.—To determine whether susceptibility to motion sickness provoked by unexpected movement is associated with susceptibility to visually induced motion sickness in migraine sufferers.Background.—Migraine sufferers are unusually susceptible to motion sickness, but the mechanism of this susceptibility is not well understood. Possibilities include vestibular dysfunction secondary to vasomotor disturbances during migraine attacks, hyperexcitability of brainstem circuits that produce symptoms of motion sickness and migraine, and heightened susceptibility to visual illusions of movement.Method.—A motion sickness susceptibility questionnaire that listed common triggers of motion sickness was filled out by 42 migraine sufferers and 39 headache‐free controls of similar age and sex distribution to migraine sufferers.Results.—A greater proportion of migraine sufferers than controls reported that traveling in cars and buses, reading in the car, using playground equipment, watching wide‐screen movies and movement simulators, induced motion sickness. However, visually induced motion sickness appeared to be independent of motion sickness to most movement‐related stimuli in migraine sufferers.Conclusions.—The lack of association between susceptibility to movement‐induced and visually induced motion sickness implies that more than one mechanism increases susceptibility to motion sickness in migraine sufferers.