bluuebunny/crossref_metadata_2025 huggingface dataset:
Asthma in Children and Adults: A Shared Biological and Molecular Basis
Authors: Renzi Paolo M
Published: May 2016

The objective of this paper is to describe the important clinical, physiological, immunological and biological similarities among asthmatic infants, children and adults. A comparison of the reported clinical presentation, physiological changes, histology and cellular biology of asthma in different age groups is presented with special emphasis on the abnormal immune response, cellular activation and lymphokine production. Different age groups of asthmatics have important similarities in clinical presentation, lung physiology and histopathology. Eosinophilia and increased immunoglobulin (Ig) E levels are present at every age except in young infants. Signs of cellular activation and increased production of lymphokines of the type 2 helper T lymphocyte, which can increase IgE levels and affect eosinophils, are also found in every age group. These abnormalities have been shown in animal models to cause airway inflammation and physiological changes comparable with those encountered in asthma. In conclusion, future studies should try to identify the specific characteristics of the population at risk for asthma, emphasizing not only primary prevention but also the use of inhibitors or modulators of the inflammatory reaction that is present in the airways or asthmatics.
NSAIDs in the Treatment of Adult Asthma: Sodium Cromoglycate and Nedocromil Sodium
Authors: Rouleau Michel-Y
Published: May 2016

Among nonsteroidal anti‐inflammatory drugs used in the treatment of adult asthma, sodium cromoglycate and nedocromil sodium are the most frequently prescribed. These medications have a similar efficacy profile in asthma although it has been suggested that nedocromil is more powerful than cromoglycate, particularly in its steroid sparing effects. Both drugs have been recommended as alternatives to steroids in the treatment of mild asthma. They are useful in the prevention of bronchospasm induced by exposure to allergens or to a variety of other stimuli. In comparison with theophylline or low dose inhaled steroids, cromoglycate and nedocromil have shown a similar antiasthmatic efficacy, although this is variable among patients.
Frequency Analysis of Functionally Graded Curved Pipes Conveying Fluid
Authors: Liang Feng , Yang Xiao-Dong , Bao Ri-Dong , Zhang Wei
Published: May 2016

The curved pipe made of functionally graded material conveying fluid is considered and the in-plane free vibration frequency of the resulting composite pipe is investigated. The material properties are assumed to distribute continuously along the pipe wall thickness according to a power law and the effective mass, flexural rigidity, and mass ratio are used in the governing equations. The natural frequencies are derived numerically by applying the modified inextensible theory. The lowest four natural frequencies are studied via the complex mode method, the validity of which is demonstrated by comparing the results with those in available literatures. A parametric sensitivity study is conducted by numerical examples and the results obtained reveal the significant effects of material distribution gradient index, flow velocity, fluid density, and opening angle on the natural frequencies of the FGM curved pipes conveying fluid.
Development of Eosinophilic Fasciitis during Infliximab Therapy for Psoriatic Arthritis
Authors: Hariman Richard , Patel Payal , Strouse Jennifer , Collins Michael P. , Rosenthal Ann
Published: May 2016

Eosinophilic fasciitis (EF) is a rare disorder involving chronic inflammation of the fascia and connective tissue surrounding muscles, nerves, and blood vessels. While its pathogenesis is not entirely understood, this disorder is thought to be autoimmune or allergic in nature. We present here a case of a 59-year-old male who developed peripheral eosinophilia and subsequent eosinophilic fasciitis during treatment with infliximab. To our knowledge, eosinophilic fasciitis has not been previously described in patients during treatment with an inhibitor of tumor necrosis factorα.
Adaptation of Opossum Kidney Cells to Luminal Phosphate: Effects of Phosphonoformic Acid and Kinase Inhibitors
Authors: Thomas Linto , Wagner Carsten A. , Biber Jürg , Hernando Nati
Published: May 2016

Background/Aims: Renal reabsorption of inorganic phosphate (Pi) is mediated by SLC34 and SLC20 Na+/Pi-cotransporters the abundance of which is under hormonal control. Extracellular Pi itself also regulates the expression of cotransporters and the concentration of Pi-regulating hormones, though the signaling pathways are largely unknown. Here, we explored the mechanisms that allow renal proximal cells to adapt to changes in the concentration of Pi. Methods: opossum kidney (OK) cells, a model of proximal epithelia, were incubated with different concentrations of Pi in the absence/presence of phosphonoformic acid (PFA), a Pi-analogue and SLC34-inhibitor, and of inhibitors of kinases involved in hormonal control of Pi-homeostasis; cells cultured in normal media were treated with uncouplers of oxidative phosphorylation. Then, the intracellular concentration of ATP and/or the Pi-transport capacity of the cultures were analyzed. Results: luminal Pi regulates the Pi-transport and the intracellular ATP levels. Changes in ATP seem secondary to alterations in Pi-transport, rather than ATP acting as a signal. Adaptation of Pi-transport to high Pi was not mimicked by PFA. Transport adaptation was blocked by PFA but not by kinase inhibitors. Conclusions: in OK cells, adaptation of Pi-transport to luminal Pi does not depend on the same signaling pathways involved in hormonal regulation.
Variant Syndromes of Autoimmune Liver Diseases: Classification, Diagnosis and Management
Authors: Weiler-Normann Christina , Lohse Ansgar W.
Published: May 2016

The term ‘overlap syndrome' has been used to describe the presence of both autoimmune hepatitis and primary biliary cholangitis or primary sclerosing cholangitis in the past. As this term is misleading, the term ‘variant syndrome' should be used preferably. Laboratory features, serology, histology and bile duct imaging contribute to the diagnosis of ‘variant syndromes'. Patients with a suspected variant syndrome should receive a complete work-up with liver histology, serology and - if not conclusive, bile duct imaging. Liver histology is usually reliable to recognize secondary autoimmune hepatitis in patients with primary cholestatic disease. An histological activitiy index of >4 usually is commonly seen in patients with variant syndrome. Identification of variant syndrome is very important, as appropriate - in most cases additional - immunosuppressive treatment is necessary and most patients will respond promptly.
Novel Aspects in the Management of Cholestatic Liver Diseases
Authors: Chazouillères Olivier
Published: May 2016

Background: There is a great need for risk stratification in patients with chronic cholestatic diseases in order to allow for more personalized care and adapted management as well as for well-designed therapeutic trials. Novel tools for monitoring primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) patients have been recently proposed. In addition, major insight has been gained into bile acid (BA) physiology during the last decade including the role of BAs as metabolic modulators and the gut-liver axis. As a consequence, alongside drugs targeting immune response or fibrotic processes, a number of novel anti-cholestatic agents have undergone pre-clinical and clinical evaluation and have shown promising results although none has been approved yet. Key Messages: Biochemical non-response to ursodeoxycholic acid (UDCA) (mainly defined by bilirubin and alkaline phosphatase levels at 1 year) is a strong prognostic factor in PBC whereas present biochemical surrogates are far from robust in PSC. By contrast, liver stiffness measurement by vibration-controlled transient elastography (VCTE) is a very promising tool in both PBC and PSC. Novel therapeutic approaches include (i) agonists of nuclear receptors, especially farnesoid X receptor (FXR), pregnane X receptor (PXR), glucocorticoid receptor (GR) and peroxisome proliferator-activated receptor α (PPARα) that are transcriptional modifiers of bile formation; (ii) agonists of TGR5, a BA membrane receptor expressed in various tissues; (iii) inhibitors of the ileal apical sodium BA transporter; (iv) derivatives of the FXR-induced fibroblast growth factor 19 from the ileum that suppresses hepatic BA synthesis and (v) norUDCA, a side chain shortened UDCA derivative with specific physicochemical and therapeutic properties. The most advanced clinical evaluation (PBC patients) relates to agonists for PPARα, FXR and GR/PXR most often in combination with UDCA, namely fibrates, obeticholic acid (OCA) and budesonide, respectively. Existing results look promising even though some side effects are worrisome such as pruritus in OCA-treated patients. Results of large well-designed studies are eagerly awaited. Conclusions: Major advances in the management of cholestatic liver diseases are in progress and promising times for these patients seem likely in the near future.
Current Management of the Complications of Cirrhosis and Portal Hypertension: Variceal Hemorrhage, Ascites, and Spontaneous Bacterial Peritonitis
Authors: Garcia-Tsao Guadalupe
Published: May 2016

Cirrhosis is not a single entity but represents a disease progression across different prognostic stages, with the compensated and decompensated stages being the most important. Variceal hemorrhage (VH) and ascites are complications of cirrhosis that denote the presence of a decompensated stage. Spontaneous bacterial peritonitis (SBP) is a common bacterial infection unique to patients with cirrhosis that can precipitate the development of recurrent VH and hepatorenal syndrome (HRS), complications that denote the presence of a ‘further decompensated' stage of cirrhosis. Main current issues in the management of VH include identification of different prognostic stages that allow for individualized patient care. Management of VH cannot be performed in an isolated manner, and the presence of other complications of cirrhosis (ascites, encephalopathy) should be taken into account both in the management and in the design of clinical trials. Because management of ascites per se has not resulted in significant changes in mortality, main management issues consist of preventing further decompensating events by preventing factors that will lead to worsening vasodilatation and hemodynamic status (infections, vasodilators), preventing volume depletion (overdiuresis, GI hemorrhage) and preventing structural kidney injury (nephrotoxins). Prophylaxis of bacterial infections such as SBP currently consists of the administration of antibiotics. By preventing infections, there is evidence that recurrent VH and HRS can also be prevented. However, response to recommended empirical antibiotics in patients with suspected infection, such as SBP, is currently significantly lower than in the past because of an increase in infections secondary to multidrug resistant (MDR) organisms. One of the main predictors of the development of MDR organisms is antibiotic prophylaxis and unnecessary and prolonged use of antibiotics in hospital. Therefore, appropriate antibiotics should be used in patients with a high suspicion of infection, and antibiotic prophylaxis should be restricted to patients with the highest risk of infection.
Liver Cirrhosis and Kidney
Authors: Gerbes Alexander L.
Published: May 2016

Background: Renal failure in cirrhosis may be due to various causes. While treatment for patients with ascites and hepatorenal syndrome is established, recent attention has been focused on acute kidney injury (AKI) in cirrhosis. Key Messages: The reduction of centrally effective blood volume is the key to the pathophysiology of renal failure and ascites formation in cirrhosis. Therefore, albumin infusion following large volume paracentesis is recommended by all guidelines. In selected patients, transjugular intrahepatic portosystemic shunt provides good control of ascites and improves survival. The role of non-selective beta-blockers in patients with cirrhosis and ascites is being controversially discussed. AKI in cirrhosis has been redefined and has prognostic importance. Conclusions: The role of kidney function in patients with liver cirrhosis is receiving increasing attention. In particular, the use of beta-blockers and novel definitions of AKI seem to be of clinical relevance.
Liver Fibrosis: From Pathogenesis to Novel Therapies
Authors: Weiskirchen Ralf , Tacke Frank
Published: May 2016

Chronic liver injury is accompanied by a dysbalanced scarring process, termed fibrosis. This process is mainly driven by chronic inflammation and an altered activity of a multitude of different chemokines and cytokines, resulting in the infiltration by immune cells (especially macrophages) and increase of matrix-expressing cell types. These processes might lead to cirrhosis representing the end-stage of fibrosis. Recent clinical studies comprising patients successfully treated for viral hepatitis showed that liver fibrogenesis and even cirrhosis may be reverted. The hepatic capacity to remodel scar tissue and to revert into a normal liver follows specific mechanistic principles that include the termination of chronic tissue damage, shifting the cellular bias from inflammation to resolution, initiation of myofibroblast apoptosis or senescence and, finally, fibrinolysis of excess scar tissue. The plurality of molecular and cellular triggers involved in initiation, progression and resolution of hepatic fibrogenesis offers an infinite number of therapeutic possibilities. For instance, inflammatory macrophages can be targeted via inhibition of chemokine CCL2 or its receptor CCR2 (e.g., by cenicriviroc) as well as by transfer of restorative macrophage subsets. Another target is galectin-3 that acts at various stages along the continuum from acute to chronic inflammation. Profibrogenic cytokines (e.g., transforming growth factor-β), matricellular proteins (e.g., CCN1/CYR61) or signaling pathways involved in fibrogenesis offer further possible targets. Other options are the application of therapeutic antibodies directed against components involved in biogenesis or remodeling of connective tissue such as lysyl oxidase-like-2 or synthetic bile acids like obeticholic acid that activate the farnesoid X receptor and was antifibrotic in a phase 2 study (FLINT trial). Factors affecting the gut barrier function or the intestinal microbiome further expanded the repertoire of drug targets. In this review, we discuss novel concepts in resolution of hepatic fibrosis and focus on drug targets that might be suitable to trigger resolution of fibrosis.
Severe Prolonged Cough as Presenting Manifestation of FIP1L1-PDGFRA+ Chronic Eosinophilic Leukaemia: A Widely Ignored Association
Authors: Roufosse Florence , Heimann Pierre , Lambert Frédéric , Sidon Pierre , Bron Dominique , Cottin Vincent , Cordier Jean-François
Published: May 2016

Chronic eosinophilic leukaemia associated with the FIP1L1-PDGFRA fusion gene (F/P+ CEL) is a rare cause of marked persistent hypereosinophilia, arising almost exclusively in male patients. Clinical presentations are heterogeneous with a higher incidence of eosinophil-mediated cardiomyopathy than in other hypereosinophilic syndrome variants. Features of chronic myeloproliferative disease are often present, including splenomegaly and elevated serum vitamin B12 levels. The diagnosis is made by fluorescence in situ hybridization (FISH) showing the deletion of the CHIC2 locus and/or RT-PCR showing the FIP1L1-PDGFRA fusion transcript. Treatment with imatinib mesylate, a tyrosine kinase inhibitor, results in rapid and complete resolution of hypereosinophilia and associated symptoms, except for those related to sub-endocardial fibrosis that may be irreversible. We report the case of a male patient in whom isolated intractable cough remained the only clinical manifestation of F/P+ CEL for 4 years. Furthermore, eosinophil autofluorescence, an as yet unreported artefact in this setting, precluded the detection of the CHIC2 deletion and further delayed diagnosis, underlining that both FISH and RT-PCR should be performed when this disease is suspected.
Revascularization Trends in Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease Presenting With Non–ST Elevation Myocardial Infarction
Authors: Pandey Ambarish , McGuire Darren K. , de Lemos James A. , Das Sandeep R. , Berry Jarett D. , Brilakis Emmanouil S. , Banerjee Subhash , Marso Steven P. , Barsness Gregory W. , Simon DaJuanicia N. , Roe Matthew , Goyal Abhinav , Kosiborod Mikhail , Amsterdam Ezra A. , Kumbhani Dharam J.
Published: May 2016

Background—

Current guidelines recommend surgical revascularization (coronary artery bypass graft [CABG]) over percutaneous coronary intervention (PCI) in patients with diabetes mellitus and multivessel coronary artery disease. Few data are available describing revascularization patterns among these patients in the setting of non–ST-segment–elevation myocardial infarction.

Methods and Results—

Using Acute Coronary Treatment and Intervention Outcomes Network Registry–Get with the Guidelines (ACTION Registry–GWTG), we compared the in-hospital use of different revascularization strategies (PCI versus CABG versus no revascularization) in diabetes mellitus patients with non–ST-segment–elevation myocardial infarction who had angiography, demonstrating multivessel coronary artery disease between July 2008 and December 2014. Factors associated with use of CABG versus PCI were identified using logistic multivariable regression analyses. A total of 29 769 patients from 539 hospitals were included in the study, of which 10 852 (36.4%) were treated with CABG, 13 760 (46.2%) were treated with PCI, and 5157 (17.3%) were treated without revascularization. The overall use of revascularization increased over the study period with an increase in the proportion undergoing PCI (45% to 48.9%;
P
trend
=0.0002) and no change in the proportion undergoing CABG (36.1% to 34.7%; p
trend
=0.88). There was significant variability between participating hospitals in the use of PCI and CABG (range: 22%–100%; 0%–78%, respectively;
P
value <0.0001 for both). Patient-level, but not hospital-level, characteristics were statistically associated with the use of PCI versus CABG, including anatomic severity of the disease, early treatment of adenosine diphosphate receptor antagonists at presentation, older age, female sex, and history of heart failure.

Conclusions—

Among patients with diabetes mellitus and multivessel coronary artery disease presenting with non–ST-segment–elevation myocardial infarction, only one third undergo CABG during the index admission. Furthermore, the use of PCI, but not CABG, increased modestly over the past 6 years.
Introduction to Henryk Grossman, ‘The Value-Price Transformation in Marx and the Problem of Crisis’
Authors: Kuhn Rick
Published: May 2016

Whereas most previous and later discussions of Marx’s transformation of values into prices of production have focused on his mathematical procedure, Henryk Grossman addressed the logic of its place in the structure ofCapital. On this basis he criticised underconsumptionist and disproportionality theorists of economic crises for inappropriately basing their accounts on the level of analysis of the value schemas in the second volume ofCapital. Such a criticism cannot be made of Grossman’s and Marx’s explanation of systemic crises in terms of the tendency for the rate of profit to fall. Grossman’s article still provides insights into Marx’s analysis of capitalism and his theory of economic crises, unsurpassed in the subsequent literature.
Alain Testart (1945–2013): An Evolutionist in the Land of the Anthropologists
Authors: Darmangeat Christophe
Published: May 2016

Alain Testart (1945–2013) was one of the major social anthropologists of his time. He left behind a considerable and original body of work dealing with social structures and their evolution which afforded keys to the reinterpretation of archaeological material. A one-time self-professed Marxist, he had abandoned this theoretical framework many years ago. Nevertheless, since they tackle questions that are crucial to those who want to understand the past in order to change the present, his writings are a precious source of information and of thought-provoking reasoning.
Scattered Letters
Authors: Allan Michael
Published: May 2016

In Assia Djebar’s L’amour, la fantasia, the narrator describes the linguistic resonance of her mother’s claim that her daughter “reads”—by which she implies, via Arabic, that her daughter studies. The circularity of an Arabic expression spoken in French makes the scene both descriptive and performative of the sorts of migrations, displacements and appropriations at play in this Algerian novel. In what language ought such multilingual work be read? By looking at inter and intra-lingual travels, this article emphasizes slippages between texts and readers, French and Arabic, and postcolonial and world literature. We encounter here less a lingua franca—that is, a global French or francophone framework—than we do the fundamental instability of any particular language in this internally translating text that travels from French to Arabic and ultimately into a market for readers in other languages.
MicoRNA-425-5p is a potential prognostic biomarker for cervical cancer
Authors: Sun Liwei , Jiang Rong , Li Jinduo , Wang Bin , Ma Chunhua , Lv Yuan , Mu Ning
Published: May 2016

Background

MicroRNAs have been implicated in many biological pathways involved in tumourigenesis and can serve as prognostic biomarkers in many cancer types. The present study aims at evaluating the prognostic significance of miR-425-5p in cervical cancer.

Methods

Real-time polymerase chain reaction was performed to assess the expression levels of miR-425-5p in 35 pairs of cervical cancer tissues and their matched normal tissues as well as serum samples from 40 cervical cancer patients, 13 benign cervical disease patients and 32 healthy controls. The association between miR-425-5p expression levels in tissue and serum, and clinicopathological factors was examined. The correlation between serum miR-425-5p expression levels and overall survival of cervical cancer patients was assessed by Kaplan–Meier analysis and Cox proportional hazards model.

Results

MiR-425-5p expression levels were significantly increased in cervical cancer tissues compared with matched non-cancerous tissues. Higher expression of miR-425-5p was positively associated with high tumour stage ( P = 0.0003) and positive lymph node metastasis ( P = 0.0107). Serum concentrations of miR-425-5p in cervical cancer patients were significantly higher compared with benign cervical disease and healthy controls. Moreover, the up-regulation of serum miR-425-5p occurred more frequently in cervical cancer patients with high TNM stage ( P = 0.0003) and positive lymph node metastasis ( P = 0.0037). Kaplan–Meier analysis showed that high serum miR-425-5p expression levels predicted poor survival ( P = 0.0571). Cox proportional hazards risk analysis demonstrated that miR-425-5p was an independent prognostic factor for cervical cancer.

Conclusion

Our study suggests that miR-425-5p is up-regulated in cervical cancer and serum miR-425-5p may serve as a potential prognostic biomarker for cervical cancer.
Analysis of legal high materials by ultra-performance liquid chromatography with time of flight mass spectrometry as part of a toxicology vigilance system: what are the most popular novel psychoactive substances in the UK?
Authors: Ford Loretta T , Berg Jonathan D
Published: May 2016

Introduction

Legal highs also known as novel psychoactive substances mimic the effects of classic drugs of abuse. Challenges to developing screening services for novel psychoactive substances include identifying which novel psychoactive substances are available to target. Using new techniques such as exact mass time of flight can help identify common novel psychoactive substances to target for screening patient samples by routine methods such as tandem mass spectrometry. We demonstrate this strategy working in our own clinical toxicology laboratory after qualitative analysis of 98 suspect materials for novel psychoactive substances by ultra-performance liquid chromatography with time of flight mass spectrometry.

Results

From July 2014 to July 2015 we received 98 requests to test a range of different suspect materials for novel psychoactive substances including herbs, tobacco, liquids, pills and powders. Overall, 87% of the suspect materials tested positive for novel psychoactive substances, and 15% for controlled drugs. Three common novel psychoactive substances were present in 74% of the suspect materials: methiopropamine, a methamphetamine analogue; ethylphenidate, a cocaine mimic; and the third generation synthetic cannabinoid 5F-AKB-48. For the 55 branded products we tested only 24% of the stated contents matched exactly the compounds we detected.

Conclusion

Testing suspect materials using ultra-performance liquid chromatography with time of flight mass spectrometry has identified three common novel psychoactive substances in use in the UK, simplifying the development of a relevant novel psychoactive substances screening service to our population. By incorporating this into our routine liquid chromatography tandem mass spectrometry drugs of abuse screen, then offers a clinically relevant novel psychoactive substances service to our users. This strategy ensures our clinical toxicology service continues to remain effective to meet the challenges of the changing drug use in the UK.
I Ain’t Gonna Make It. Comparing Job Demands-Resources and Attrition Intention Between Senior Teachers and Senior Employees of Six Other Occupational Categories in Flanders
Authors: Van Droogenbroeck Filip , Spruyt Bram
Published: May 2016

Teachers are often thought to retire early and have more stress and burnout than other human service professionals. In this article, we investigate attrition intention amongst senior teachers and senior employees of six other blue- and white-collar occupational categories using the Job Demands-Resources (JD-R) model. We followed a two-step approach. First, analysis of variance and logistic regression analysis was used to assess differences in the level of job demands, resources, and attrition intention between occupations for male and female employees separately. Subsequently, multiple group path analysis was used to assess the invariance of the JD-R model across occupational groups and genders. We used representative data gathered in Flanders among 6,810 senior employees (45 years or older). Results indicate that there are differences in the determinants of attrition intention between men and women. The differences in attrition intention are minimal between occupations once controlled for job demands and resources. In addition, the JD-R model is largely invariant across white-collar occupations and gender. We provide support for both the energetic and motivational process of the JD-R model.
High precise tracking control for a chain of integrator systems with modelling uncertainties
Authors: Yang Guichao , Yao Jianyong , Le Guigao , Ma Dawei
Published: May 2016

In this paper, adaptive compensation with a robust integral of the sign of the extended error (RISEE) feedback is developed for high precise tracking control of systems in the presence of simultaneous structured and unstructured uncertainties. To handle various uncertainties existing in the system in one controller, we propose an adaptive RISEE controller (ARISEE), in which an adaptive law based on the improved discontinuous projection method is synthesized to handle parametric uncertainties and the RISEE robust term to attenuate unmodelled disturbances. Moreover, the present controller does not need a priori knowledge on the bounds of the lumped disturbances and the gain of the designed robust control law can itself be tuned. The major feature of the proposed controller is that it can theoretically guarantee global asymptotic tracking performance with a continuous control input, in the presence of parametric uncertainties and unmodelled disturbances via Lyapunov analysis. Comparative numerical results verify the effectiveness of the proposed non-linear controller.
Efficacy of Elective Neck Dissection in T1/T2N0M0 Oral Tongue Squamous Cell Carcinoma
Authors: Patel Tapan D. , Vázquez Alejandro , Marchiano Emily , Sanghvi Saurin , Eloy Jean Anderson , Baredes Soly , Park Richard Chan Woo
Published: May 2016

Objective/Hypothesis

The aim of this population‐based study is to analyze the survival benefits of elective neck dissection (END) over neck observation in T1/T2N0M0 oral tongue squamous cell carcinoma (OT‐SCC) cases.

Study Design

Retrospective administrative database analysis.

Subjects and Methods

The SEER database (Surveillance, Epidemiology, and End Results) was queried for patients diagnosed with T1/T2N0M0 OT‐SCC from 1998 to 2011. Data included patient demographics, initial treatment, and survival outcomes. The Kaplan‐Meier model and the Cox proportional hazards model were utilized for survival analysis.

Results

Out of 7010 T1/T2N0M0 cases, END was performed in 1770 T1 and 950 T2 cases, and the neck was observed in 3278 T1 and 1001 T2 cases. Significantly poorer 5‐year disease‐specific survival (DSS) rates were noted for the neck observation group when compared with the END group for tumors with moderately differentiated (72.1% vs 86%, P <. 0001) and poorly differentiated or undifferentiated (55.6% vs 71.5%, P =. 0001) histologic grades. No significant survival benefit was seen between the END group and the neck observation group when tumor size was <1 cm, regardless of histology grade. However, those with tumors >1 cm had a significantly better 5‐year DSS with END, except for the well‐differentiated tumor cohort, which showed improved survival only when the tumors were >2 cm (5‐year DSS: END vs neck observation, 83.5% vs 65.7%, P =. 0002).

Conclusion

END improves DSS versus neck observation in T1/T2N0M0 OT‐SCC patients with moderately differentiated, poorly differentiated, or undifferentiated histologic grade tumors >1 cm. Those with well‐differentiated tumors benefited from END only when tumor size was >2 cm.
Racial Differences of Pigmentation in the Human Vestibular Organs
Authors: Erbele Isaac D. , Lin Frank R. , Agrawal Yuri , Francis Howard W. , Carey John P. , Chien Wade W.
Published: May 2016

Objectives

Melanin pigmentation is present in the human inner ear. In this study, we quantify the melanin pigmentation in the vestibular system and examine racial differences of vestibular melanin pigmentation using human cadaveric temporal bone specimens.

Study Design

Basic research.

Setting

Laboratory.

Subjects and Methods

Light microscopy was used to examine specimens from 40 left temporal bones from the Johns Hopkins Human Temporal Bone Collection. Color images of (1) ampulla of the horizontal canal, (2) utricular wall, (3) endolymphatic duct, and (4) posterior ampullary nerve as it enters the posterior canal were acquired with a digital camera attached to the microscope and image acquisition software. Acquired images of each anatomic area of interest were processed offline through ImageJ. Melanin content was then compared according to ethnicity, age, sex, and location.

Results

Fifteen African American and 25 Caucasian specimens were analyzed. Mean age was 68.8 years. African American specimens had a significantly greater amount of pigment at all 4 sampled locations as compared with Caucasian specimens (P <. 01). Between sexes, there was a statistically significant difference (P <. 05) at the posterior ampullary nerve, with males having more than females. Melanin content was not associated with age.

Conclusions

There is greater melanin pigmentation within the vestibular system of African Americans than in Caucasians, similar to what has been described in the cochlea. Racial differences in vestibular physiologic function have been observed in the literature and may be explained by differences in melanin pigmentation.
High leptin levels are associated with migraine with aura
Authors: Pisanu Claudia , Preisig Martin , Castelao Enrique , Glaus Jennifer , Cunningham Janet L , Del Zompo Maria , Merikangas Kathleen R , Schiöth Helgi B , Mwinyi Jessica
Published: May 2016

Background

Migraine is a prevalent disorder characterised by recurrent headache attacks preceded or accompanied by aura in a subgroup of patients. Migraine often occurs together with major depressive disorder (MDD). Alterations of adipokine levels have been reported both in migraine and in MDD. In this cross-sectional study, we aimed to assess the associations between serum leptin and adiponectin levels and migraine or migraine subtypes. Analyses were adjusted for a lifetime history of MDD in order to investigate the association between adipokines and migraine under consideration of depression status.

Methods

We included 3025 participants from the CoLaus/PsyCoLaus study. The impact of leptin and adiponectin levels on a diagnosis of migraine was analysed by binary regression analyses, adjusting for variables known to influence adipokine levels. Subgroup analyses were conducted based on the presence of aura.

Results

Crude leptin levels were significantly higher in subjects with migraine than controls (Mann–Whitney U = 515,102, p = 6 × 10−7). When performing adjusted analyses, leptin levels were found to be significantly higher in subjects with migraine (odds ratio = 1.22, p = 0.024) and migraine with aura (odds ratio = 1.34, p = 0.004).

Conclusion

High leptin levels might play a role in the pathogenesis of migraine and migraine with aura.
Examining Preservice Teachers’ Criteria for Evaluating Educational Mobile Apps
Authors: Baran Evrim , Uygun Erdem , Altan Tugba
Published: May 2016

Recent interest in integrating mobile apps into teaching will continue growing. There remains, however, a pressing need to develop methods and resources to support and educate preservice teachers about the use of these technologies. This case study aimed to examine preservice teachers’ criteria for evaluating educational mobile apps. Nineteen fourth-year preservice teachers, who studied math, science, English, and computer education at a public university, participated in the research. During the usability tests, the preservice teachers were asked to evaluate the affordances and limitations of selected educational mobile apps from their particular subject domains. Their interactions with and evaluations of the mobile apps were collected through think-aloud sessions and interviews. Qualitative analysis revealed preservice teachers’ evaluation criteria in five categories such as pedagogy, technical usability, content, connectivity, and contextuality. The results point to recommendations for future research on evaluating the capabilities of existing mobile apps with key players such as in-service and preservice teachers.
Use of Computer Drug-Drug Interaction Program for Detection of Adverse Drug Reactions and Related Therapeutic Problems
Authors: Hood Jerry C. , Miller Jon R.
Published: May 2016

Pharmacies currently using computers to detect drug-drug interactions may not be fully utilizing the computers' programs. Potential drug-disease interactions and some potential adverse drug reactions not traditionally defined as interactions can be detected by extending the basic concept of cross-referencing. For example, certain clinically important ADRs are readily detected by cross-referencing drugs which are often used to treat the results of specific ADRs with certain causative agents.

The potential therapeutic implications of such a system when restricted to clinically significant ADRs can be readily appreciated, especially in situations where the pharmacist's time in patient-care areas is limited. This concept is currently being practiced at Bayfront Medical Center, and has added a new dimension to the clinical services provided by the pharmacy. It seems likely that detection of therapeutic situations in this manner may be appropriate in other hospital settings.
Legal and Ethical Issues in Clinical Pharmacy Research — Informed Consent, Part II
Authors: Pathak Dev S. , Foster Thomas S. , Raehl Cynthia L.
Published: May 2016

Preparation of an effective informed consent document presents significant problems to those investigators not familiar with federal and institutional requirements. This article examines a detailed format for preparation of an informed consent instrument. Prepared by the authors and supplied to potential clinical investigators by a university institutional review committee, the guidelines incorporate Department of Health, Education, and Welfare regulations. An example consent form is provided.
Use of Cefamandole in the Treatment of Soft Tissue and Skeletal Infections
Authors: LeFrock Jack L. , Paparone Philip , Kowalsky Steven F. , Schell Ronald F. , Jacobs Richard L. , Wirth Carl R. , Tillotson James R.
Published: May 2016

Thirty-eight patients were treated with cefamandole 6–12 g/d. These included 24 patients with cellulitis and/or abscess and 14 with osteomyelitis or septic arthritis. Two patients were bacteremic. Of the patients treated, 26 had an underlying disease; 27 required some surgical procedure. Staphylococcus aureus was the most frequent bacteria isolated. Of 38 patients treated, 31 had a clinical cure, six were unevaluable, and one failed on therapy. Twelve patients developed a reaction to the drug. Average peak serum level after cefamandole 1 g iv was 30.6 μg/ml (range, 10–67 μg/ml); average peak serum level after 2 g iv was 39.9 μg/ml (range, 6.6–110 μg/ml). Cancellous bone concentrations in two patients ranged from 6 to 7 μg/ml, and cortical bone concentrations in five patients ranged from 10 to 28 μg/ml.
Receipt of Prescription Drug Information by the Elderly
Authors: Moore Steven R. , Kalu Mma , Yavaprabbas Supachai
Published: May 2016

Analysis of responses of 267 elderly subjects to a telephone survey dealing with communications between patients and health professionals about prescribed medications indicated several age-related differences. Results showed that elderly patients received less general information and less drug-specific information than younger patients did. This occurred in both pharmacist and physician encounters.
Colloids Vs. Crystalloids—A Continuing Controversy
Authors: Dasta Joseph F. , Ross Adrienne D. , Angaran David M.
Published: May 2016

The crystalloid vs. colloid controversy is based on a disagreement as to the most effective, safest, and most economical method of maintaining an effective plasma volume in shock patients.

This review discusses Starling's law of fluid movement, with a definition of each term in the normal physiological state, and presents examples of how each component of Starling's law differs in the two major types of pulmonary edema: (1) cardiogenic and (2) noncardiogenic.

The colloid-crystalloid literature is reviewed briefly with an emphasis on the major studies that support each side, and the deficiencies in each study. The arguments supporting each side of the crystalloid-colloid debate are then listed, with a summary that demonstrates the areas of agreement between the two schools of thought on fluid resuscitation.

Each major colloid (albumin, dextran, hetastarch) and a representative crystalloid (lactated Ringer's) are discussed in terms of their chemistry; pharmacology and indications; and precautions, adverse reactions, and side effects.

A table is included that summarizes the available products' data regarding composition, volume expansion, duration of expansion, half-life, metabolism, elimination, precautions, adverse reactions, and dose.
Hospital Pharmacy Practice in India
Authors: Nahata Milap C.
Published: May 2016

The status of pharmacy practice was evaluated at six hospitals in India. Common drugs were available at private hospitals but the pharmacies at government hospitals had fewer than half of the needed drugs. Selection of the best generic drug appeared difficult because the bioavailability and pharmacokinetic data generally were not available. The hospitals did not have formularies. No unit dose and intravenous admixture services had been implemented. The patient profiles were not maintained. The pharmacists did not appear to provide any professional, educational, or clinical services to patients or physicians. Serum concentrations of drugs were not measured for monitoring therapy. A lack of clinical education and training of pharmacists, lower status and salaries in the hospital pharmacy compared with industry and government, and overall limited resources appear to be the important reasons for the present status of pharmacy practice.
Pharmacists' Perceptions of Consumer Demand for Patient-Oriented Pharmacy Services
Authors: Carroll Norman V. , Gagnon Jean Paul
Published: May 2016

This study examined pharmacists' perceptions of consumer demand for various patient-oriented pharmacy services. Data on pharmacists' perceptions were gathered by a mail questionnaire of pharmacist-managers in Raleigh, NC. Conjoint and regression analyses indicate that pharmacists perceive little demand either for voluntary provision of advisory services or for patient medication records, and that pharmacists' perceptions of the demand for patient medication records relate significantly to their provision of this service. Comparison of pharmacists' perceptions of demand with previously collected consumer data indicates that pharmacists underestimate the demand for patient medication records but not for voluntary provision of advisory services. These findings suggest that pharmacists' perception of consumer demand is as important as actual consumer demand in explaining why pharmacists do not provide patient-oriented pharmacy services more frequently.
PharmaCE Test Questions
Authors: Lopez Larry M. , Gefter Monica L. , Hemmes Robert J.
Published: May 2016

Twenty patients with essential hypertension, who were receiving a diuretic plus propranolol qid, were instructed to take their entire daily requirement of propranolol as a single morning dose. Blood pressure was measured in standing and supine positions at the end of a dosing interval. Patients were questioned about the occurrence of specific propranolol side effects during each of four bi-weekly evaluations. Mean blood pressure on once-daily propranolol did not differ significantly from that observed on propranolol qid. Daily doses of propranolol ranged from 80–320 mg. Side effects were infrequent and mild. We conclude that propranolol may be administered as a single daily dose to patients with hypertension whose blood pressure already has been controlled on a qid regimen.
New Drug Therapy for Kidney Stones: A Review of Cellulose Sodium Phosphate, Acetohydroxamic Acid, and Potassium Citrate
Authors: Lake Kathleen D. , Brown David C. , McLeod Donald C.
Published: May 2016

Kidney stones have an overall incidence of two to three percent in western countries. In many patients, the disease process is difficult to control and recurrence rates are high: 20 to 50 percent over the subsequent ten years. The pathogenesis and standard methods of treatment for the five major types of stones (i.e., calcium oxalate, struvite, calcium phosphate, uric acid, and cystine) are reviewed. Three new drugs are reviewed in the context of their roles in the selective treatment of kidney stones. Cellulose sodium phosphate (Calcibind) is a nonabsorbable ion-exchange resin with a limited indication for the treatment of calcium stones associated with absorptive hypercalciuria Type I. Acetohydroxamic acid (Lithostat) is an urease-inhibitor that is indicated as adjunctive therapy in patients with chronic urea-splitting urinary tract infections and struvite stones. Potassium citrate (Urocit) is an investigational agent that has clinical efficacy in patients with calcium oxalate and calcium phosphate stones who are hypocitraturic. In addition, potassium citrate is an alkalinizing agent that can be used in patients with uric acid stones.
Pharmacotherapy of Eating Disorders: A Critical Review
Authors: Bond William S. , Crabbe Sarah , Sanders Michael C.
Published: May 2016

The pharmacotherapy of anorexia nervosa and bulimia are critically reviewed. No chemical treatment has been shown effective for anorexia nervosa. Antidepressants with a low incidence of annoying adverse reactions (e.g., desipramine) may be used as initial drug therapy in patients with concomitant depression. Cyproheptadine also is an attractive agent for initial therapy consideration in anorectics because of its relative safety.

Both uncontrolled and controlled trials have found antidepressant drugs effective in bulimia, and they represent the pharmacotherapy of first choice. Alternative drug therapies include anticonvulsants (phenytoin and carbamazepine) and lithium. However, these agents need further controlled trials to substantiate their efficacy.
Allele‐specific transcriptional activity of the variable number of tandem repeats of the inducible nitric oxide synthase gene is associated with idiopathic achalasia
Authors: Sarnelli Giovanni , Grosso Michela , Palumbo Ilaria , Pesce Marcella , D’Alessandro Alessandra , Zaninotto Giovanni , Annese Vito , Petruzzelli Raffaella , Izzo Paola , Sepulveres Rossana , Bruzzese Dario , Esposito Giuseppe , Cuomo Rosario
Published: May 2016

Background

Polymorphisms of genes involved in the regulation of the immune response are risk factors for achalasia, but their contribution to disease pathogenesis is unknown. Nitric oxide is involved both in immune function and inhibitory neurotransmission.

Objective

The objective of this article is to assess the association and the functional relevance of the CCTTT‐inducible nitric oxide synthase (NOS2 ) gene promoter polymorphism in achalasia.

Methods

Genomic DNA was isolated from 181 achalasia patients and 220 controls. Genotyping of the (CCTTT)n repeats was performed by PCR and capillary electrophoresis, and data analyzed by considering the frequency of the different alleles. HT29 cells were transfected with iNOS luciferase promoter‐reporter plasmids containing different (CCTTT)n.

Results

The alleles’ distribution ranged from 7 to 18, with a peak frequency at 12 repeats. Analysis of the allele frequencies revealed that individuals carrying 10 and 13 CCTTT repeats were respectively less and more frequent in achalasia (OR 0.5, 95% CI 0.3–0.5 and OR 1.6, 95% CI 1–2.4, all p  < 0.05). Long repeats were also significantly associated with an earlier onset of the disease (OR 1.69, 95% CI 1.13–2.53, p  = 0.01). Transfection experiments revealed a similar allele‐specific iNOS transcriptional activity.

Conclusion

The functional polymorphism (CCTTT) of NOS2 promoter is associated with achalasia, likely by an allele‐specific modulation of nitric oxide production.