Significance of Coronary Calcification for Prediction of Coronary Artery Disease and Cardiac Events Based on 64-Slice Coronary Computed Tomography Angiography

This work aims to validate the clinical significance of coronary artery calcium score (CACS) in predicting coronary artery disease(CAD) and cardiac events in 100 symptomatic patients (aged 37–87 years, mean 62.5, 81 males) that were followed up for a mean of 5 years. Our results showed that patients with CAD and cardiac events had significantly higher CACS than those without CAD and cardiac events, respectively. The corresponding data were 1450.42 ± 3471.24 versus 130 ± 188.29 (P 1000. Increased CACS (>100)was also associated with an increased frequency of multi-vessel disease. Nonetheless, 3 (20%) out of 15 patients with zero CACS had single-vessel disease. Significant correlation (P < 0.001) was observed between CACS and CAD on a vessel-based analysis for coronary arteries. It is concluded that CACS is significantly correlated with CAD and cardiac events

Rooming-In and Breastfeeding Duration in First-Time Mothers in a Modern Postpartum Care Center

Uncertainty concerning the associations between rooming-in and breastfeeding duration remains at postpartum care centers. This cross-sectional study investigated the associations between the rooming-in policy and continual exclusive breastfeeding among first-time mothers at a postpartum center. Of the 160 participants, only 12.5% (n = 20) implemented full rooming-in. At 3-month follow-up, 85% (n = 17) of those individuals were exclusively breastfeeding. At the same time point, no participant practicing partial rooming-in (n = 140) was exclusively breastfeeding. The generalized estimating equation analysis indicated that full (24 h) rooming-in was statistically associated with continual exclusive breastfeeding 1 month postpartum (odds ratio (OR) = 0.90, p &lt; 0.001) and 3 months postpartum (OR = 0.73, p &lt; 0.001). Significant factors associated with a first-time mother&rsquo;s willingness to practice full rooming-in included vaginal delivery, a prenatal decision to practice breastfeeding, and undergoing prenatal classes on both rooming-in and breastfeeding. Success with continual exclusive breastfeeding in the postpartum period is dependent on full rooming-in. The findings serve as a reference for promoting exclusive breastfeeding for the first 6 months, as recommended by the World Health Organization

Correlation evaluation of antioxidant properties on the monosaccharide components and glycosyl linkages of polysaccharide with different measuring methods

The relationships of antioxidant properties (AOPs), measured by four conventional in vitro methods, with monosaccharides and glycosyl linkages in the polysaccharide, were evaluated using multiple linear regression analysis with minor modifications. Polysaccharides extracted from culture broth filtrates of Lentinula edodes were used as model samples for evaluation. Results indicate that the composition of monosaccharides and the type of glycosyl linkage modulates the AOPs of the polysaccharides. The AOPs of the polysaccharides were dependent on the ratios of different monosaccharides in the composition. Among the monosaccharides, rhamnose was the most significant determinant factor associated with AOPs. The glycosyl linkages of the monosaccharides also affected the anti-oxidation characteristics of the polysaccharides. Specifically, the arabinose 1 -> 4 and mannose 1 -> 2 linkages of the side-chain were significantly related to the reducing power, whereas the glucose 1 -> 6 linkage and arabinose 1 -> 4 linkages were related to the scavenging on DPPH(-) radicals. (C) 2011 Elsevier Ltd. All rights reserved

Cardiac Troponin I Release After Transcatheter Atrial Septal Defect Closure Correlated With the Ratio of the Occluder Size to Body Surface Area

Cardiac troponin I (cTnI) is a very specific and sensitive marker of myocardial injury. The degree of myocardial injury associated with transcatheter atrial septal defect (ASD) closure in children is unknown. Methods: In a longitudinal study on children with ASD, cTnI serum concentrations were measured after transcatheter ASD closure. Implantation success, complications, and latest patient follow-up were described. Results: We inserted 73 Amplatzer septal occluders in 73 patients. Of these, we excluded two patients in whom the device embolized to the right ventricle the day after deployment. The median age was 4.5 years (range, 1.1–18.0) with 20 boys and 51 girls (male:female ratio, 1:2.6). The mean ASD size was 17±7 mm, and device size ranged from 7 mm to 38 mm. The Amplatzer size/body surface area ratio was validated by demonstrating positive correlation with cTnI elevation. In children who had a successful attempt, 30 samples had a cTnI value higher than 1.0 μg/L l at 6 hours after procedure. Six patients had a significant release of cTnI greater than normal limits (mean level of 1.51±0.26 μg/L). Conclusion: In our study, transcatheter ASD closure induced minor myocardial lesion, the extent of which depended on the ratio of the occluder size to body surface area (p<0.05) but not on the patient’s weight or preprocedural left ventricular ejection fraction

Transplantation of Unrelated Donor Umbilical Cord Blood for Nonmalignant Diseases: a Single Institution's Experience with 45 Patients

The potential benefits of unrelated donor bone marrow transplantation are offset by the immunologic complications of graft-versus-host disease (GVHD) and infection. We used cryopreserved umbilical cord blood (UCB) as a strategy to reduce the risks of GVHD and treatment-related mortality (TRM) and improved survival. Data on 45 patients with median age of 4.5 years who received transplants between October 2003 and February 2009 for the treatment of nonmalignant diseases were evaluated. As of May 15, 2009, the median follow-up was 25 months (range: 3-66). The majority (82%) of patients received an HLA-mismatched graft. The median infused total nucleated cell dose was 7.6×107/kg and CD34+ count 4.0×105/kg. Primary graft failure was encountered after 4 transplantations (8%). Log-rank tests and Cox regression analyses were used to determine the effects of various demographic, graft-related, and treatment factors on engraftment, GVHD, TRM, graft failure, and survival. Incidences of neutrophil and platelet engraftment were 88% and 82%, respectively. The incidence of severe grade III-IV acute GVHD (aGVHD) was 42%. Five-year overall survival (OS) and disease-free survival (DFS) were 88.1% and 77.1%, respectively. The cumulative incidence of TRM at 2 years was 12.0%. When cell dose and other factors are optimal, unrelated CBT is a promising approach for curative therapy of nonmalignant diseases

A Comparative Study of Stone Re-Treatment after Lithotripsy

The high recurrence rate has always been a problem associated with urolithiasis. This study aimed to explore the effectiveness of single interventions, combined therapies, and surgical and nonsurgical interventions. Herein, three lithotripsy procedures&mdash;extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopic lithotripsy (URSL)&mdash;were assessed and a retrospective cohort was selected in order to further analyze the association with several risk factors. Firstly, a population-based cohort from the Taiwan National Health Insurance Research Database (NHIRD) from 1997 to 2010 was selected. In this study, 350 lithotripsy patients who underwent re-treatment were followed up for at least six years to compare re-treatment rates, with 1400 patients without any lithotripsy treatment being used as the comparison cohort. A Cox proportional hazards regression model was applied. Our results indicate that the risk of repeat urolithiasis treatment was 1.71-fold higher in patients that received lithotripsy when compared to patients that were not treated with lithotripsy (hazard ratio (HR) 1.71; 95% confidence interval (CI) = 1.427&ndash;2.048; p &lt; 0.001). Furthermore, a high percentage of repeated treatment was observed in the ESWL group (HR 1.60; 95% CI = 1.292&ndash;1.978; p &lt; 0.001). Similarly, the PCNL group was also independently associated with a high chance of repeated treatment (HR 2.32; 95% CI = 1.616&ndash;3.329; p &lt; 0.001). Furthermore, age, season, level of care, and Charlson comorbidities index (CCI) should always be taken into consideration as effect factors that are highly correlated with repeated treatment rates

Effectiveness of Cognitive-behavioral Program on Pain and Fear in School-aged Children Undergoing Intravenous Placement

[[abstract]]Purpose: This study aimed to evaluate the effects of cognitive-behavioral program on pain and medical fear in hospitalized school-aged children receiving intravenous (IV) placement. Methods: This study used an quasi-experimental design. Thirty-five participants were assigned to the experimental group and 33 to the control group in the acute internal medicine ward of a children's hospital. The cognitive-behavioral program entailed having the patients read an educational photo book about IV placement before the procedure and having them watch their favorite music video during the procedure. The outcome measures were numeric rating scales for pain intensity and fear during the procedure. Results: After applying the cognitive-behavioral program, the mean scores on pain and fear decreased in the experimental group. However, the difference in pain intensity between these two groups was nonsignificant. The intensity of fear in the experimental group was significantly lower than that in the control group. Conclusion: In this study, the cognitive-behavioral program used with school-aged hospitalized children promoted less fear during IV placement. The results of this study can serve as a reference for empirical nursing care and as care guidance for clinical IV injections involving children

Treatment Outcomes for Hepatoblastoma: Experience of 35 Cases at a Single Institution

Hepatoblastoma is the most common malignant liver tumor in children. Comparative studies have elucidated the optimal pre- or postoperative chemotherapeutic regimens. The aim of this study was to investigate the prognostic significance of baseline tumor characteristics for overall survival and disease-free survival in children with hepatoblastoma. Methods: There were 19 male and 16 female children with a median age of 19 months at diagnosis (range: 1–169 months) in our institution between February 1990 and June 2009. We reviewed the clinical presentation, serum α-fetoprotein level at diagnosis, histological subtype, treatment, and outcomes. Results: Twenty-seven patients (78%) underwent neoadjuvant chemotherapy. The majority of patients subsequently underwent either hemihepatectomy (56%) or bisegmentectomy (16%). Only six patients underwent extended hepatic resection, and one of them required rescue liver transplantation. During follow-up, six patients died of progressive disease and two of perioperative mortality. Four of the six who died had pulmonary metastases at the time of diagnosis or follow-up. The median survival time was 28 months (range: 1–181 months). Five-year overall survival was 67.7% (95% confidence interval: 52.0–87.8%) and disease-free survival was 60.2% (95% confidence interval: 41.9–86.5%). Conclusion: The potential down-staging effect of neoadjuvant chemotherapy on hepatoblastoma might facilitate remission and convert unresectable tumors into operable ones