bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Education Strategies to Improve Pneumococcal Vaccination Rates: Randomized Trial
Authors: Thomas Donna M. , Ray Susan M. , Morton Felicia J. , Drew Jennifer S. , Offutt Gardiner , Whitney Cynthia G. , Jacobson Terry A. 
Published: January 2023

Background The pneumococcal vaccine is widely underused. Patient education is one mechanism not widely explored for increasing vaccination rates. Objective To evaluate the effects of a culturally appropriate patient education videotape on pneumococcal vaccination rates among the clinic population of an inner-city public hospital. Methods Randomized, controlled trial comparing (1) a videotape-brochure group who both viewed the videotape and received a low-literacy brochure, (2) a videotape only group, and (3) a control group. Results Of 2,962 charts reviewed, 558 patients were randomized. The study population was 94% black, 73% female, and elderly (mean age 63.0 years) and 64% had less than a high school education. Patients in the videotape-brochure group were 2.5 (1.8, 3.5 95% CI) times more likely to discuss the vaccine with their physician (p < .001) and 3.5 (1.9, 6.5 95% CI) times more likely to receive the vaccine ( p < .001) than the control group. The videotape-brochure group was 1.6 (1.2, 2.1 95% CI) times more likely to discuss the vaccine ( p < .001) and 2.3 (1.4, 3.8 95% CI) times more likely to receive the vaccine (p = .002) than the video only group. Patients in the video only group were 1.6 (1.1, 2.3 95% Cl) times more likely to discuss the vaccine with their physician than the control group (p = .041) but were not more likely to receive the vaccine. Conclusion A culturally appropriate videotape along with a low-literacy brochure significantly increased pneumococcal vaccination rates and physician-patient discussion about the vaccine. These significant outcomes were not observed with use of videotape alone and were likely attributable to the effect of the brochure. We recommend that patient education initiatives to increase vaccination rates not focus solely on audiovisual media.
Perinatal Asphyxia in the Guinea Pig Leads to Morphologic but not Neurologic, Cognitive, or Behavioral Changes
Authors: Hoeger Harald , Bubna-Littitz Herrmann , Engelmann Mario , Schwerdtner Ingrid , Schmid Diethard , Lahoda Robert , Seidl Rainer , Lubec Gert , Lubec Barbara 
Published: January 2023

Background In a recent publication, we described neurodegeneration along with neurotransmitter deficits and impaired differentiation in the guinea pig 3 months following severe perinatal asphyxia (PA). We were therefore interested in the clinical features in terms of neurology, cognitive functions, and behavior. Methods We tested the long-term effects of PA in an animal model, which in the rat are well documented and resemble the clinical situation. Examinations consisted of an observational battery for motor and reflex functions and the acoustic startle response setting. We tested cognitive functions in the multiple T-maze and evaluated behavior using the elevated plus maze and open field studies. Results No neurologic deficits were observed in the observational battery, including the acoustic startle response. Cognitive functions of memory and learning were not impaired in the multiple T-maze. In the open field and in the elevated plus maze, the system to test anxiety-related behavior, guinea pigs performed well. Conclusion Our findings of patent neurology, cognitive functions, and behavior do not reflect the prominent morphologic findings of neurodegeneration. This is in agreement with corresponding studies on PA in the rat at the identical time point. We learned from this study that both test systems, although representing the standard in neuroscience, are either not sensitive enough or central nervous system lesions are clinically fully compensated.
Antioxidant Potential and Transferrin, Ceruloplasmin, and Lipid Peroxidation Levels in Women with Preeclampsia
Authors: Aksoy Hulya , Taysi Seyithan , Altinkaynak Konca , Bakan Ebubekir , Bakan Nuri , Kumtepe Yakup 
Published: January 2023

Background The aim of this study was to evaluate lipid peroxidation and antioxidant function in patients with preeclampsia and in normotensive pregnant women and to assess an association with the severity of the disease. Methods Twenty-one patients with mild preeclampsia, 15 patients with severe preeclampsia, and 19 normotensive pregnant women were included in the study. Plasma antioxidant potential (AOP) status, ceruloplasmin (Cp) and transferrin (Trf) levels as antioxidants, and malondialdehyde (MDA) levels as an indicator of lipid peroxidation were measured. Results Whereas the AOP and Trf levels of the severe and mild preeclampsia groups were found to be reduced, the MDA and Cp levels were increased compared with those of the normotensive pregnant group. There were statistically significant negative correlations between AOP and MDA in all groups. No differences were observed between the groups with severe and mild preeclampsia with respect to these analytes. Conclusion Our findings suggest that lipid peroxidation may be an important factor in the pathogenesis of preeclampsia and that plasma antioxidants and oxidants are altered in preeclampsia. However, these findings may not be useful in distinguishing women with severe and mild preeclampsia.
Perinatal Asphyxia Exerts Lifelong Effects on Neuronal Responsiveness to Stress in Specific Brain Regions in the Rat
Authors: Salchner Peter , Engidawork Ephrem , Hoeger Harald , Lubec Barbara , Singewald Nicolas 
Published: January 2023

Background Perinatal asphyxia (PA) causes irreversible damage to the brain of newborns and can produce neurologic and behavioral changes later in life. To identify neuronal substrates underlying the effects of PA, we investigated whether and how neuronal responsiveness to an established stress challenge is affected. Methods We used Fos expression as a marker of neuronal activation and examined the pattern of Fos expression in response to acute swim stress in 24-month-old rats exposed to a 20-minute PA insult. Results Swim stress produced a similar pattern of Fos expression in control and asphyxiated rats in 34 brain areas. Asphyxiated rats displayed a higher number of stress-induced Fos-positive cells in the nucleus of the solitary tract, parabrachial nucleus, periaqueductal gray, paraventricular hypothalamic nucleus, nucleus accumbens, caudate-putamen, and prelimbic cortex. No differences in the Fos response to stress were observed in other regions, including the locus ceruleus, amygdala, hippocampus, or septum. Conclusion These data provide functional anatomic evidence that PA has lifelong effects on neuronal communication and leads to an abnormal, augmented neuronal responsiveness to stress in specific brain areas, particularly in the main telencephalic target regions of the mesencephalic dopamine projections, as well as in a functionally related set of brain regions associated with autonomic and neuroendocrine regulation.
Serum Metalloproteinase 9 Levels in Patients with Coronary Artery Disease: A Novel Marker of Inflammation
Authors: Ferroni Patrizia , Basili Stefania , Martini Francesca , Cardarello Cristiano M. , Ceci Fabrizio , Franco Manuela Di , Bertazzoni Giuliano , Gazzaniga Pier Paolo , Alessandri Cesare 
Published: January 2023

Background The finding that expression of metalloproteinases (MMPs) is induced in atherosclerotic plaques prone to rupture suggests the possibility that patients with atherosclerotic diseases would show enhanced blood levels of MMPs and that MMPs might represent a potential inflammatory risk factor for atherosclerosis. Therefore, the present study was aimed at verifying whether MMPs may represent sensitive markers of inflammation in patients with coronary artery disease. Methods MMP-2, MMP-9, interleukin (IL)-6, C-reactive protein (CRP), and fibrinogen levels were measured in blood samples obtained from 66 cases with previous acute myocardial infarction and 66 control subjects similar for age, sex, and major atherosclerotic risk factors but without history or evidence of atherothrom-botic diseases. Results Biohumoral markers of inflammation and MMP-9 levels were significantly elevated in cases compared with controls (median values 40.6 versus 9.8 ng/mL; p < .0001), whereas MMP-2 levels did not differ between the two groups (median values 839 versus 873 ng/mL; p = .53). A direct correlation was found among MMP-9, CRP, IL-6, and fibrinogen levels. Conditional logistic regression analysis showed that MMP-9 is related to myocardial infarction (p = .006) even after adjusting for cardiovascular medications and CRP. Conclusion These findings suggest that measurement of serum MMP-9 levels may represent a novel marker of inflammation in patients with known coronary artery disease and might provide an index of plaque activity in this clinical setting.
Comparison of Echocardiography Using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function
Authors: Almeda Francis Q. , Hendel Robert C. , Macioch James E. , Sandelski Joanne , Parrillo Joseph E , Meyer Peter M. , Johnson Mahala , Daniels Maria L. , Go Vanessa U. , Feinstein Steven B. 
Published: January 2023

Background Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent. Hypothesis We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA). Methods In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions. Results By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25% (CI 1.3–9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67% (CI 0.4–8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent. Conclusions LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.
Biologic Effects of Parathyroid Hormone Metabolites: Implications for Renal Bone Disease
Authors: Akhtar Irme , Gonzalez Esther A. 
Published: January 2023

Renal bone disease or renal osteodystrophy is the term used to describe the spectrum of histologic abnormalities encountered in patients with chronic kidney disease (CKD). The patterns of bone histology encountered in the setting of CKD range from states of high bone turnover, such as osteitis fibrosa, the result of hyperparathyroidism, to states of abnormally low bone turnover, such as adynamic bone.1 The major factors involved in the pathogenesis of secondary hyperparathyroidism include phosphate retention as glomerular filtration rate decreases and low levels of calcitriol as renal mass is reduced. Both of these factors may lower serum calcium and therefore stimulate parathyroid hormone (PTH) secretion. In addition to these indirect effects, low levels of calcitriol and high serum phosphorus have been shown to have direct effects on the parathyroid gland to increase PTH secretion. The pathogenetic factors involved in the development of adynamic bone disease are less well understood, but it appears that oversuppression of PTH and the use of vitamin D compounds may play a role. Thus, in the management of renal osteodystrophy, it is important to be able to monitor and treat hyperparathyroidism effectively while at the same time avoiding oversuppression of PTH. In this regard, accurate measurements of circulating PTH levels are an essential guide in the management of renal bone disease. It is well accepted that PTH is present in the circulation in the form of both the intact 84-amino acid peptide and a variety of truncated fragments.2–4 Although the role of the intact PTH molecule as a major regulator of mineral ion homeostasis is well established, the actions of PTH fragments have remained poorly understood. In this review, we discuss the generation of PTH metabolites and the evidence supporting their biologic activity and their potential role in renal bone disease.
Neutrophil Adhesion Molecule Expression in Familial Mediterranean Fever: Discordance between the Intravascular Regulation of β2 Integrin and L-Selectin Expression in Acute Attack
Authors: Molad Yair , Fridenberg Amir , Bloch Konstantine , Langevitz Pnina , Mukamel Masza , Sulkes Jaqueline , Pras Mordechai , Livneh Avi 
Published: January 2023

Background To determine the surface expression of neutrophil β2 integrin (CD11b/CD18) and L-selectin (LS) adhesion molecules in patients with familial Mediterranean fever (FMF) and to investigate the in vitro regulation of their expression in response to chemoattractant stimuli. Methods Neutrophil surface expression of CD11b and LS molecules was analyzed by flow cytometry in anticoagulated whole blood drawn from FMF patients and normal controls, and the in vitro regulation of these molecules induced by the chemoattractant N-formyl-methionyl-leucyl-phenylalanine (FMLP) was assayed. Results Patients during acute FMF attacks showed a statistically significant increased neutrophil surface CD11b compared with normal controls (mean fluorescence intensity: 22.8 ± 13.7 vs 12.8 ± 10.41, respectively; p = .03). There was no difference in LS expression between the groups. Neutrophils of FMF patients regulate CD11b and LS expression induced by chemoattractant (FMLP) stimulation to a degree similar to that in controls. Conclusions: β2 Integrin is up-regulated during an acute attack of FMF in dissociation with LS expression, suggesting a unique nonchemoattractant-mediated neutrophil activation.
Nitric Oxide Induces Apoptosis in Spleen Lymphocytes from MRL/lpr Mice
Authors: Dates Jim C. , Gilkeson Gary S. 
Published: January 2023

Background MRL/MpJ -Tnfrsf6 lpr(MRL/ lpr) mice, a murine model of systemic lupus erythematosus (SLE), have defective expression of Fas, substantially reducing signaling for apoptosis via this mechanism. However, it is known that MRL//pr mice have increased spontaneous apoptosis of leukocytes. These conflicting observations have stimulated interest in apoptosis in this SLE model. MRL/ lpr mice overproduce nitric oxide (NO) as autoimmune disease progresses. In vitro administration of NO may induce or decrease apoptosis depending on the cell type. Therefore, we hypothesized that NO induces MRL/ lpr spleen lymphocyte apoptosis independent of Fas receptor engagement. Methods Percentages of apoptotic spleen lymphocytes from MRL/ lpr and BALB/cJ mice were determined ex vivo after in vivo treatment with NG-monomethyl-l-arginine (NMMA), a nitric oxide synthase (NOS) inhibitor. After culture in varying concentrations of a slow-acting NO donor, the following were determined in spleen lymphocytes: (1) levels of apoptosis, (2) the effect of phorbol myristate acid (PMA) on levels of NO-induced apoptosis, and (3) protein kinase C (PKC) activity. Results Spleen lymphocytes from MRL/ lpr mice with active disease had increased levels of ex vivo apoptosis when compared with BALB/cJ controls. This increase was reduced by pharmacologic inhibition of NOS in MRL/ lpr but not in BALB/cJ mice. Exogenous administration of NO in vitro reduced PKC activity and induced apoptosis in MRL/ lpr spleen lymphocytes, an effect that could be reduced via coadministration of PMA in vitro. Conclusion These results suggest that NO plays a role in spleen lymphocyte apoptosis in MRL/ lpr mice, possibly via inhibition of PKC, despite a Fas defect.
Effect of Adventitial Dissection in Brachiobasilic Arteriovenous Fistulae Opened in Children as Vascular Access for Hemodialysis on Patency and Maturation of Fistulae
Authors: Karabay Ozalp , Bak Mustafa , Silistreli Erdem , Calkavur Sebnem , Yurekli Ismail , Agin Hasan , Acikel Unal 
Published: January 2023

Background Recently, therapy of pediatric patients with chronic renal failure has been carried out using hemodialysis, peritoneal dialysis, or renal transplant. In this study, we prospectively investigated the role of adventitial dissection (performed on brachiobasilic arteriovenous fistulae in the antecubital area) in the patency rate, maturation, and early initiation of dialysis among pediatric cases undergoing chronic hemodialysis. Methods Thirty children (7 male and 23 females) were included in this study. They were operated on at the Department of Cardiovascular Surgery of Alsancak State Hospital and Dokuz Eylul University between March 2001 and June 2003. Their mean age was 12.3 ± 2.9 years (range 7–17 years), and their mean weight was 25.5 ± 7.9 kg (range 16–44 kg). Children who underwent only brachiobasilic arteriovenous fistula operation were included. Group 1 ( n = 15) consisted of those who underwent adventitial dissection, and group 2 ( n = 15) consisted of those not receiving the adventitial dissection procedure. Results The procedure was conducted by the same surgeon, and follow-up examinations were done at the Department of Pediatric Nephrology by investigators masked to treatment groups. Conclusion There were no significant differences in age, sex, existence of preoperative hypertension, diameter of vein measured preoperatively, and first day of dialysis between the groups. In 29 cases, a palpable thrill was noted at the operation site. Hemodialysis had been initiated after the fourth week, when the fistulae had matured. The mean duration of follow-up was 12.53 ± 8.98 months in group 1 and 11.85 ± 7.55 months in group 2 ( p = .880). In group 1, one case developed fistula infection in the second month and one case developed lymphatic drainage. In group 2, one case developed early thrombosis, one case developed hematoma, and one case developed transient ischemia owing to arterial spasm in the ipsilateral limb. One case in each group developed minimal edema in the forearm, which was treated conservatively. The primary patency rate was 93.3% in both groups, whereas the secondary patency rate was 100% in group 1. Adventitial dissection performed on the vein during arteriovenous fistula formation does not result in any additional benefit with respect to fistula maturation, early initiation of dialysis, and patency. Among pediatric patients with chronic renal failure, in cases of inappropriate forearm veins, brachial arteriovenous fistulae performed with a meticulous surgical technique should be the procedure of choice because it is associated with minimal complications and a high patency rate.
Intercellular Adhesion Molecule 1 (ICAM-1) Gene Variant is Associated with Coronary Artery Calcification Independent of Soluble ICAM-1 Levels
Authors: Reilly Muredach P. , Wolfe Megan L. , Dykhouse Jennifer , Reddy Karthik , Localio A. Russell , Rader Daniel J. 
Published: January 2023

Background Although circulating levels of soluble intercellular adhesion molecule 1 (slCAM-1) predict cardiovascular events, no studies have examined intercellular adhesion molecule 1 (ICAM-1) gene variants, plasma slCAM-1 levels, and atherosclerosis in the same sample. Methods We examined the association of the ICAM-1 K469E gene variant and plasma slCAM-1 with coronary artery calcification (CAC) in 632 asymptomatic subjects, recruited on the basis of a family history of premature cardiovascular disease. Results In age-adjusted ordinal regression, slCAM-1 levels were associated with CAC (odds ratio [OR] [95% confidence interval (CI)] 1.30 [1.04–1.6] per 100 ng/dL slCAM-1; p = .02), but this association was lost after adjusting for traditional risk factors (OR [95% CI] 0.9 [0.69–1.16]). In men, but not women (interaction p = .018), the ICAM-1 K469E GG genotype predicted lower CAC after adjusting for traditional risk factors (OR [95% CI] 0.33 [0.17–0.61]; p = .001) and further controlling for plasma slCAM-1 (OR [95% CI] 0.27 [0.14–0.52]; p < .001). Conclusions: In a study sample specifically selected for the characteristic of a family history of premature coronary heart disease, ICAM K469E GG was associated with lower CAC scores in men but not women even after controlling for plasma levels of slCAM-1. These studies suggest that ICAM-1 variants may modulate atherosclerosis in humans and provide support for the concept that inflammatory gene polymorphisms may influence atherosclerosis independent of plasma levels of their gene products.
Factors related to white thrombi in acute ischemic stroke in cancer patients
Authors: Ikeda Hiroyuki , Ishibashi Ryota , Kinosada Masanori , Uezato Minami , Hata Hidenobu , Kaneko Ryosuke , Hayashi Tomoko , Yamashita Haruki , Nukata Ryotaro , Takada Kensuke , Kurosaki Yoshitaka , Chin Masaki , Yamagata Sen 
Published: January 2023

Objectives Thrombi in cerebral large vessel occlusion associated with active cancer are often fibrin and platelet-rich white thrombi. However, evaluating the thrombus composition in a short time before thrombectomy is often ineffective. We sought to determine factors related to white thrombi in acute ischemic stroke due to large vessel occlusion in cancer patients. Methods Consecutive cancer patients undergoing thrombectomy for acute ischemic stroke due to large vessel occlusion between January 2018 and May 2022 were retrospectively reviewed. The patients were classified into white thrombus and red thrombus groups on the basis of the pathological findings of retrieved thrombi. Patient characteristics and laboratory findings were compared between the two groups. Results There were 12 patients in the white thrombus group and 11 patients in the red thrombus group. Active cancer was significantly more in the white thrombus group than in the red thrombus group (91.7% vs. 36.3%, p = 0.0094). Internal carotid artery occlusion was significantly less in the white thrombus group than in the red thrombus group (0% vs. 36.4%, p = 0.037). Among laboratory findings, D-dimer levels were an independent factor associated with white thrombi (odds ratio 8.97 [95% confidence interval 1.71–368.99], p < 0.0001). The cutoff value of D-dimer levels for predicting white thrombi was 3.5 μg/mL (83.3% sensitivity and 100% specificity). Conclusions In acute ischemic stroke in cancer patients, active cancer, no internal carotid artery occlusion, and higher D-dimer levels (≥3.5 μg/mL) may be associated with occlusion with fibrin and platelet-rich white thrombi.