bluuebunny/crossref_metadata_2025 huggingface dataset:
Should Bone Scan be Performed in Chinese Prostate Cancer Patients at the Time of Diagnosis?
Authors: Wang Yiwei , Guo Jianming , Xu Lei , Zhao Naiqing , Xu Zhibing , Wang Hang , Zhu Yanjun , Jiang Shuai , Yang Nianqin , Yang Yuanfeng , Wang Guomin
Published: April 2013

Background: Prostate cancer (PCa) is increasingly being diagnosed in China. Early detection of bone metastases (BM) is critical in the management of patients with high-risk PCa. The aim of this study is to establish a screening model to determine if bone scan should be performed for BM in Chinese patients at the time when PCa is diagnosed. Materials and Methods: The study included 488 patients who were diagnosed with PCa between 2009 and 2011 at a single center. All patients received bone scans using technetium 99mTc methylene diphosphonate at the initial staging. If the bone scan finding was equivocal, computed tomography or magnetic resonance imaging was performed to confirm the diagnosis. Age, prostate-specific antigen (PSA) at diagnosis, clinical stage assigned according to the TNM 2002 staging system and biopsy Gleason score were collected in all patients. Multivariate logistic regression analysis was performed to identify statistically significant covariates and then receiver operating characteristic (ROC) curves were generated to identify optimal cut-off values. Using these cut-off values, a formula was devised to calculate an index value for BM screening at diagnosis. The model was cross-validated using the leave-one-out method. Results: Of the 488 patients, 65 patients (13.3%) had BM. The area under the ROC curve was 0.87 (95% confidence interval 0.83-0.94). The sensitivity of the cut-off point was 87.7% and the speciﬁcity was 73.1%. Bone scan is needed for all cT4 PCa patients, however, it is also advisable for cT1-T3 PCa patients who have a biopsy Gleason score ≤3 + 4 and a PSA >132.1, and for cT1-T3 patients having a Gleason score of ≥4 + 3 and PSA >44.5. Conclusions: The regression model may help determine if bone scan is needed to detect BM from PCa at the time of diagnosis. The model was generated upon a single center experience. Further validation is needed in future studies.
The Use of the Chronic Kidney Disease Epidemiology Collaboration Equation and Global Cardiovascular Risk Assessment in Patients with Atrial Fibrillation
Authors: Providência Rui , Barra Sérgio , Paiva Luís , Faustino Ana
Published: April 2013

No abstract available
Ameliorative Effects of Caffeic Acid Phenethyl Ester on an Eccentric Exercise-Induced Skeletal Muscle Injury by Down-Regulating NF-kB Mediated Inflammation
Authors: Shen Yuh-Chiang , Yen Jiin-Cherng , Liou Kuo-Tong
Published: April 2013

Background and Purpose: Caffeic acid phenethyl ester (CAPE), a phenolic compound isolated from propolis, displays a variety of biological activities. The aim is to examine the protective effect and mechanisms of CAPE on an eccentric exercise-induced muscle injury model. Experimental Approach: An intermittent downhill eccentric exercise protocol was used. The oxidative tissue injury and expression of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), interleukin-1ß (IL-1ß), monocyte chemotactic protein-1 (MCP-1), and activation of nuclear factor-κB (NF-κB) were examined. CAPE was applied in a dose of 5 and 10 mg/kg/day, p.o. Key Results: The eccentric exercise induced remarkable skeletal muscle damage uncovered by a dramatic elevation of creatine kinase in the serum and severe degenerative myopathy. These pathophysiological changes were accompanied by an upregulation of the inflammatory responses including protein nitrotyrosylation, poly-ADP-ribose-polymerase (PARP) upregulation, lipid peroxidation as measured by malondialdehyde (MDA) formation, and leukocyte infiltration as measured by myeloperoxidase (MPO). The inflammatory responses primarily resulted from enhanced expression of COX2, iNOS, and production of IL-1ß and MCP-1, possibly through activation of NF-κB. All these pathological changes were suppressed by treatment of CAPE. Conclusions and Implications: Our results indicate that CAPE exhibits protective effects against eccentric exercise-induced skeletal muscle damage in rats by blocking the NF-κB-dependent activation of the inflammatory responses.
In vitro Activity of Doripenem plus Fosfomycin against Drug-Resistant Clinical Blood Isolates
Authors: Lingscheid T. , Tobudic S. , Poeppl W. , Mitteregger D. , Burgmann H.
Published: April 2013

The in vitro activity of doripenem in combination with fosfomycin was evaluated against a wide range of clinical blood isolates. Bacterial isolates of methicillin-resistant Staphylococcus aureus (MRSA; n = 39), Pseudomonas aeruginosa (n = 18), multidrug-resistant Escherichia coli (n = 10), Enterobacter cloacae (n = 3) and Klebsiella pneumoniae (n = 5) were investigated. For synergism testing the checkerboard test was applied and determined by calculation of the fractional inhibitory concentration index. Checkerboard results were verified by time-kill curve tests on selected isolates. Among MRSA, E. coli and K. pneumoniae, 94.9, 80 and 100% of isolates demonstrated synergism, respectively. Selected isolates demonstrated synergism in time-kill curve tests. P. aeruginosa isolates demonstrated no interaction in all isolates. Doripenem plus fosfomycin shows high efficacy with promising results in vitro.
Fetoscopic Diagnosis of Congenital Megalourethra at Early Second Trimester
Authors: Yamamoto Ryo , Ishii Keisuke , Ukita Shingo , Hidaka Nobuhiro , Kobayashi Kenichi , Shimada Kenji , Mitsuda Nobuaki
Published: April 2013

Congenital megalourethra is a rare urogenital malformation that is usually associated with lower urinary tract obstruction. In association with hypoplasia or deficiency of the corpus spongiosa and/or corpus cavernosum, a cystic dilatation of penile urethra is generally observed. We present a case of congenital megalourethra diagnosed by fetoscopy and ultrasonography at 17 weeks of gestation. Fetoscopic investigation demonstrated a balloon dilatation of the penis with a complete obstruction of the urethral meatus, which could distinguish a fusiform type congenital megalourethra from other disorders. Autopsy subsequent to the termination of pregnancy revealed a complete deficit of both corpus spongiosa and corpus cavernosum.
Laparoscopic Adnexectomy with Peritonectomy for an Ovarian Tumor Adhered to the Pelvic Sidewall
Authors: Kobayashi Eiji , Kanao Hiroyuki , Andou Masaaki
Published: April 2013

Laparoscopic adnexectomy is one of the most commonly used surgical techniques for the treatment of ovarian tumor. However, many physicians find it difficult to conduct the resection without rupturing the ovarian tumor, especially in cases with tumor adhesions. In the case we are presenting, we unexpectedly encountered an ovarian tumor adherent to the pelvic sidewall. Because the possibility of a malignancy could not be completely excluded, we decided to concomitantly resect the ovary and its adherent peritoneum, to avoid any potential tumor rupture due to its manipulation. We were successfully able to laparoscopically retrieve the intact ovarian tumor, without its rupture. The pathological diagnosis was of a Grade 2, FIGO stage IIb endometrioid adenocarcinoma of both ovaries. As a result of this diagnosis, we performed a comprehensive staging laparoscopy. Following the completion of adjuvant chemotherapy, the patient has showed no signs of recurrent malignancy after 3 years. This case report describes our technique for the surgical management of an ovarian tumor adherent to the pelvic wall. To avoid spillage of the tumor contents, the simultaneous resection of the tumor with its adhered peritoneum is a useful method to consider.
The Use of High Dosages of Transdermal Buprenorphine for Pain Management in Palliative Cancer Patients: A Case Study
Authors: Clement Paul M.J. , Beuselinck Benoit , Van Beek Karen , Mertens P. Georgette , Cornelissen Paul , Menten Johan
Published: April 2013

Pain is a prevalent condition in patients with cancer, particularly in advanced stages of cancer. Although strong opioids are the mainstay of cancer pain management protocols, patients are often undertreated. Transdermal buprenorphine is currently available for the treatment of moderate to severe cancer pain and severe pain which does not respond to nonopioid analgesics; patch doses of 35, 52.5 and 70 µg/h are available (applied for up to96 h), with no more than 2 transdermal patches at the same time, regardless of the strength. To date, there are no published reports in the literature of the use of high-dose transdermal buprenorphine (>140 µg/h). Herein, we present 2 cases of palliative cancer patients who received transdermal buprenorphine at doses titrated up to 210 and 175 µg/h, respectively, for the management of pain. Transdermal buprenorphine titrated to doses >140 µg/h provided adequate pain control and was well tolerated. Future studies to confirm these initial observations are warranted.
Metabolic Syndrome, Vitamin D Deficiency and Hypoadiponectinemia among Nondiabetic Patients Early after Kidney Transplantation
Authors: Kulshrestha Satyarth , Ojo Akinlolu O. , Luan Fu L.
Published: April 2013

Background and Aims: Metabolic syndrome (MetS) is common among kidney transplant patients. We studied the relationship between MetS, vitamin D deficiency/insufficiency and hypoadiponectinemia early posttransplantation and their impact on clinical outcomes. Methods: Seventy-four previously nondiabetic kidney transplant patients were enrolled in a prospective cohort study between February and November 2008. Participants underwent a 2-hour oral glucose tolerance test and had their plasma levels of 25-hydroxyvitamin D (25[OH]D), adiponectin, insulin, intact parathyroid hormone and lipids measured at 11 weeks posttransplantation. Clinical events including cardiovascular events, new-onset diabetes after transplantation, acute rejection, graft loss and death were recorded during the follow-up to December 2012. Results: Thirty-four study patients (45.9%) had MetS. Patients with MetS had lower plasma concentrations of 25[OH]D (20.5 ± 7.2 vs. 24.8 ± 11.1 ng/ml, p = 0.049) and adiponectin (8.2 ± 4.5 vs. 14.6 ± 8.0 μg/ml, p < 0.0001) early on, and higher composite clinical event rate (61.8 vs. 27.5%, p = 0.003) during the follow-up. Multivariate analysis showed that the presence of MetS early after transplantation was independently associated with 25[OH]D deficiency/insufficiency (OR: 14.0, 95% CI: 1.8, 107.5; p = 0.011), depressed plasma adiponectin levels (β -6.39, r2 0.195, p < 0.0001) and increased risk for clinical events (OR: 5.6, 95% CI: 1.9, 16.5; p = 0.002). Conclusion: Kidney transplant patients with MetS early after transplantation had lower levels of 25[OH]D and adiponectin, and unfavorable clinical outcomes.
Magnitude of End-Dialysis Overweight is Associated with All-Cause and Cardiovascular Mortality: A 3-Year Prospective Study
Authors: Movilli Ezio , Camerini Corrado , Gaggia Paola , Zubani Roberto , Feller Paolo , Poiatti Patrizia , Pola Alessandra , Carli Orsola , Cancarini Giovanni
Published: April 2013

Background: We hypothesized that the difference between the prescribed end-dialysis body weight, defined end-dialysis over-weight (edOW; kg), and the body weight which is actually attained could impact survival in hemodialysis (HD) patients. The aim of this prospective observational study was to evaluate if edOW could influence survival in a cohort of prevalent HD patients, controlled for multiple dialysis and clinical risk factors and followed for 3 years. Methods: One hundred and eighty-two patients (117 men, age 65 ± 13 years) on regular HD treatment for at least 6 months [median 48 months (range: 6-366)] were followed from January 1, 2008 to December 31, 2010. Eighty-four patients (46%) did not achieve their prescribed dry body weight (dBW); their median edOW was 0.4 kg (range: 0.1-1.4). Ninety-eight died during observation, mainly from cardiovascular reasons (69%). Multivariate Cox regression analysis was utilized to evaluate the effect edOW, ultrafiltration rate (UFR), interdialytic weight gain (IDWG), age, sex, dialytic vintage, cardiovascular disease, antihypertensive therapy, diabetes, duration of HD, dBW, BMI, mean arterial blood pressure, Kt/V, and protein catabolic rate (PCRn) had on mortality. Results: Age (HR: 1.04; CI: 1.03-1.05; p <0.0001), IDWG (HR: 2.62; CI: 2.06-3.34; p < 0.01), UFR (HR: 1.13; CI: 1.09-1.16; p< 0.01), PCRn (HR: 0.02; CI: 0.01-0.04; p <0.001), and edOW (HR: 2.71; CI: 1.95-3.75; p < 0.02) were independently correlated to survival. The relative receiver operating characteristic curve identified a cutoff value of 0.3 kg for edOW in predicting death. Conclusions: High edOW is independently associated with an increased long-term risk of all-cause and cardiovascular mortality in HD patients. Better survival was observed in patients with edOW <0.3 kg. For patients with higher edOW, longer or more frequent dialysis sessions should be considered in order to prevent the deleterious consequences of excessive body fluid expansion.
The Calcimimetic Calindol Prevents High Phosphate-Induced Vascular Calcification by Upregulating Matrix GLA Protein
Authors: Ciceri Paola , Elli Francesca , Brenna Irene , Volpi Elisa , Brancaccio Diego , Cozzolino Mario
Published: April 2013

Background: High serum phosphate (Pi) levels represent a major issue in dialysis patients, because associate with secondary hyperparathyroidism, vascular calcification (VC), and cardiovascular outcomes. In this population, calcimimetics are used to control secondary hyperparathyroidism, hyperphosphatemia, and, more recently, to delay the progression of VC. The aim of this in vitro study was to investigate the direct effects of the calcimimetic calindol on the progression of high Pi-induced VC. Methods: Rat vascular smooth muscle cells (VSMCs) were incubated with high Pi concentrations, and the effects of calindol were investigated on vascular calcium deposition and VSMC osteoblastic differentiation. Results: Calindol inhibited calcium deposition concentration-dependently with a maximal inhibition of 64.0 ± 5.2% achieved at 100 nM. Furthermore, calindol was able to partially prevent the high Pi-induced bone morphogenic protein 2 (BMP-2) expression upregulation (32.4 ± 4.6% of inhibition; p < 0.01). Interestingly, the pretreatment with calindol enhanced the matrix Gla protein (MGP) gene expression significantly, compared to high Pi-treated cells (40.2 ± 6.6% of increase, p < 0.01). Conclusions: In conclusion, we demonstrated that the calcimimetic calindol prevents high Pi-induced VC by affecting osteoblastic differentiation in vitro. In particular, the inhibitory effect of calindol on VC is probably due to its stimulatory role on the calcium-sensing receptor, leading to an increase in the synthesis of MGP by VSMCs.
Are the Current Treatment Strategies for Facial Nerve Schwannoma Appropriate Also for Complex Cases?
Authors: Bacciu Andrea , Nusier Amjad , Lauda Lorenzo , Falcioni Maurizio , Russo Alessandra , Sanna Mario
Published: April 2013

Objectives: To describe the decision-making strategies for complex facial nerve schwannomas (FNSs). Materials and Methods: Charts belonging to 103 consecutive patients with facial nerve tumors managed between 1990 and 2011 were examined retrospectively to identify complex FNSs. To be classified as complex, at least one of the following criteria had to be met: (1) FNS with large intraparotid tumor component and preoperative good facial nerve function (3 cases); (2) multiple-segment FNSs with extension to both the cerebellopontine angle and the middle cranial fossa in patients with preoperative good hearing (5 cases); (3) fast-growing FNS with preoperative good facial nerve function (4 cases), and (4) large FNS compressing the temporal lobe with preoperative normal facial nerve function (1 case). Results: Thirteen patients were classified as complex; 12 patients had total tumor removal with sural nerve grafting and 1 patient had partial tumor removal. Two patients with intratemporal-intraparotid FNS underwent a transmastoid-transparotid approach. One patient with a tumor extending from the geniculate ganglion to the parotid portion of the facial nerve underwent a combined middle fossa transmastoid-transparotid approach. A transcochlear approach with temporal craniotomy was performed in all the patients with multiple-segment FNS as well as in patients with fast-growing tumors extending both in the cerebellopontine angle and middle cranial fossa. A partial tumor removal through the middle fossa approach was performed in 1 patient with a large tumor compressing the temporal lobe. Conclusions: Therapeutic options for patients with FNS include surgical intervention, observation and radiotherapy. Nowadays, surgical resection with facial nerve repair is usually the standard management for patients with poor facial function (House-Brackmann grade III or worse). In patients presenting with normal or near-normal facial nerve function, initial observation with periodic examination and imaging is usually recommended. However, on rare occasions surgeons can be faced with a situation in which the management decision-making process is particularly challenging. In these complex cases treatment should be individualized. We recommend early surgical intervention regardless of the preoperative facial and hearing functions in the following cases: intratemporal FNSs extending with a large tumor component into the parotid, multiple-segment FNSs extending in both the cerebellopontine angle and the middle cranial fossa, fast-growing FNSs, and large FNSs with temporal lobe compression.
Reduced-Fluence Photodynamic Therapy Combined with Ranibizumab for Nonproliferative Macular Telangiectasia Type 2
Authors: Zehetner Claus , Haas Gertrud , Treiblmayr Bernhard , Kieselbach Gerhard F. , Kralinger Martina T.
Published: April 2013

Purpose: To report the efficacy of reduced-fluence photodynamic therapy (PDT) combined with intravitreal ranibizumab for the treatment of nonproliferative macular telangiectasia (MacTel) type 2. Methods: Noncomparative, interventional, retrospective case series; 5 eyes of 4 patients were studied. Patients were treated with reduced-fluence PDT and intravitreal ranibizumab within 24 h. After initial treatment, follow-up was at least 12 months in all patients. Results: At baseline median logMAR (logarithm of the minimal angle of resolution) best-corrected visual acuity (BCVA) was 1.0 (range, 1.0-0.3). At 3 months of follow-up vision increased in 3 out of 5 eyes and median BCVA was 0.4 (range, 1.0-0.2). The gain of BCVA ranged from 6 lines to 1 line. Visual acuity remained stable in the other 2 study eyes. No eyes lost vision at 3 months of follow-up. At 12 months of follow-up median logMAR BCVA was 0.7 (range, 1.3-0.3). Two eyes had maintained their gain in BCVA compared to baseline. Two eyes lost vision compared to baseline and 1 eye showed unchanged visual acuity at 12 months of follow-up. Conclusion: A combination therapy with reduced-fluence PDT and intravitreal ranibizumab might be a valuable treatment option for eyes with progressive vision loss due to nonproliferative MacTel type 2.
A Rapid Association Test Procedure Robust under Different Genetic Models Accounting for Population Stratification
Authors: Chen Wenan , Chen Xiangning , Archer Kellie J. , Liu Nianjun , Li Qizhai , Zhao Zhongming , Sun Shumei , Gao Guimin
Published: April 2013

Objective: For genome-wide association studies (GWAS) using case-control data with stratification, a commonly used association test is the generalized Armitage (GA) trend test implemented in the software EIGENSTRAT. The GA trend test uses principal component analysis to correct for population stratification. It usually assumes an additive disease model and can have high power when the underlying disease model is additive or multiplicative, but may have relatively low power when the underlying disease model is recessive or dominant. The purpose of this paper is to provide a test procedure for GWAS with increased power over the GA trend test under the recessive and dominant models, while maintaining the power of the GA trend test under the additive and multiplicative models. Methods: We extend a Hardy-Weinberg disequilibrium (HWD) trend test for a homogeneous population to account for population stratification, and then propose a robust association test procedure for GWAS that incorporates information from the extended HWD trend test into the GA trend test. Results and Conclusions: Our simulation studies and application of our method to a GWAS data set indicate that our proposed method can achieve the purpose described above.
Solifenacin Succinate versus Percutaneous Tibial Nerve Stimulation in Women with Overactive Bladder Syndrome: Results of a Randomized Controlled Crossover Study
Authors: Vecchioli-Scaldazza Carlo , Morosetti Carolina , Berouz Azizi , Giannubilo Willy , Ferrara Vincenzo
Published: April 2013

Aims: This study compared the effectiveness of solifenacin succinate (SS) versus percutaneous tibial nerve stimulation (PTNS) in women with overactive bladder syndrome (OABS). Methods: A randomized controlled crossover study of 40 women with OABS was performed. Patients were randomized into two groups. In group A, patients received SS and then PTNS. In group B, patients underwent PTNS and then SS. Voiding diaries, quality of life surveys and patient perception of intensity of urgency questionnaire were performed before and after each treatment. The global impression of improvement questionnaire was performed at the end of the study. Results: A reduction in the number of daily micturitions, episodes of nocturia and urge incontinence were found with both SS and PTNS in all groups, but PTNS showed a greater effectiveness than SS. There was an increase in voided volume in all groups with both SS and PTNS, but patients treated with PTNS had a greater increase. PTNS showed greater effectiveness in patient perception of urgency and quality of life. Conclusion: This study demonstrates the effectiveness of SS and PTNS In women with overactive bladder symptoms. However, greater improvements were found with PTNS.
Online Information on Complementary and Alternative Medicine for Cancer Patients: Evidence-Based Recommendations
Authors: Huebner Jutta , Senf Bianca , Micke Oliver , Muecke Ralph , Stoll Christoph , Prott Franz J. , Muenstedt Karsten , Dennert Gabriele ,   on behalf of the working group Prevention and Integrative Oncology(PRIO)of the German Cancer Society
Published: April 2013

Background: Many cancer patients use complementary and alternative medicine (CAM). Most websites offering online information on CAM are not helpful for them. Methods: We extracted decisive elements for online information on CAM by analyzing the literature on the information needs of cancer patients and on counseling cancer patients on CAM. Results: Key issues for online information on CAM are the qualification of the authors, transparency and accountability of the information, description of the aims, a scientific approach, description of treatment alternatives, support for the patient-physician relationship, individualized information, a summary of the information, disclosure of funding, and the privacy policy. Conclusions: The communicative challenge will be to convey information without destroying hope and motivation. We suggest that CAM topics should be integrated into broader information provided on cancer (etiology, conventional treatment). By also providing information for physicians, such a website could promote shared decision-making. Online information will gain the status of independent expert knowledge if provided by a well-known scientific organization as, e.g., a national cancer society.
Relationship between White Matter Lesions and Progression of Cognitive Decline in Alzheimer's Disease
Authors: Kimura Noriyuki , Nakama Hiroshi , Nakamura Kenichiro , Aso Yasuhiro , Kumamoto Toshihide
Published: April 2013

Background: This study examined the relationship between baseline white matter lesions (WMLs) and the progression of cognitive decline in patients with late-onset Alzheimer's disease (AD). Methods: Fifty-six patients with AD were included in the study (23 men, 33 women; mean age, 77.8 years). All subjects were treated with acetylcholinesterase inhibitors and followed up for approximately 1 year. The Mini-Mental State Examination (MMSE) score was assessed at least twice to evaluate the progressive cognitive impairment. All subjects underwent brain MRI at baseline and were divided into WMLs(-), mild WMLs(+), and moderate WMLs(+) groups based on WML severity. Changes in MMSE scores between baseline and follow-up were analyzed using the Wilcoxon signed-rank test. Results: MMSE scores at baseline did not differ significantly among the three groups (p = 0.1658), whereas MMSE scores at the follow-up evaluation were significantly lower in the moderate WMLs(+) group than in the WMLs(-) group (p = 0.0257). The mean MMSE scores remained above baseline values during the approximately 1-year follow-up in the WMLs(-) group, whereas they were decreased in the mild and moderate WMLs(+) groups. Moreover, the frequency of improvement in patients from the WMLs(-) group tended to be higher than that in patients from the WMLs(+) groups. Conclusion: Baseline WMLs may be associated with the heterogeneous progression of cognitive decline in patients with AD.
Characterization of Platelet Concentrates Using Dynamic Light Scattering
Authors: Labrie Audrey , Marshall Andrea , Bedi Harjot , Maurer-Spurej Elisabeth
Published: April 2013

Background: Each year, millions of platelet transfusions save the lives of cancer patients and patients with bleeding complications. However, between 10 and 30% of all platelet transfusions are clinically ineffective as measured by corrected count increments, but no test is currently used to identify and avoid these transfusions. ThromboLUX® is the first platelet test intended to routinely characterize platelet concentrates prior to transfusion. Methods: ThromboLUX is a non-invasive, optical test utilizing dynamic light scattering to characterize a platelet sample by the relative quantity of platelets, microparticles, and other particles present in the sample. ThromboLUX also determines the response of platelets to temperature changes. From this information the ThromboLUX score is calculated. Increasing scores indicate increasing numbers of discoid platelets and fewer microparticles. ThromboLUX uses calibrated polystyrene beads as a quality control standard, and accurately measures the size of the beads at multiple temperatures. Results: Results from apheresis concentrates showed that ThromboLUX can determine the microparticle content in unmodified samples of platelet concentrates which correlates well with the enumeration by flow cytometry. ThromboLUX detection of microparticles and microaggregates was confirmed by microscopy. Conclusion: ThromboLUX provides a comprehensive and novel analysis of platelet samples and has potential as a non-invasive routine test to characterize platelet products to identify and prevent ineffective transfusions.
State of the Art in Platelet Function Testing
Authors: Kehrel Beate E. , Brodde Martin F.
Published: April 2013

Platelets perform many functions in hemostasis but also in other areas of physiology and pathology. Therefore, it is obvious that many different function tests have been developed, each one conceived and standardized for a special purpose. This review will summarize the different fields in which platelet function testing is currently in use; diagnostics of patients with bleeding disorders, monitoring patients' response to anti-platelet therapy, monitoring in transfusion medicine (blood donors, platelet concentrates, and after transfusion), and monitoring in perioperative medicine to predict bleeding tendency. The second part of the review outlines different methods for platelet function testing, spanning bleeding time, and platelet counting as well as determining platelet adhesion, platelet secretion, platelet aggregation, platelet morphology, platelet signal transduction, platelet procoagulant activity, platelet apoptosis, platelet proteomics, and molecular biology.
Erythema a computatro
Authors: Gauglitz G.G. , Ruzicka T. , Herzinger T.
Published: April 2013

Historically, erythema ab igne (EAI) was commonly seen on the shins of individuals working in front of coal stoves or sitting close to a fireplace. In the more recent past, this condition has been primarily observed after repeated application of heating pads. Today, unintentional and unperceived exposure to heat from laptop computers needs to be considered as a potential trigger. A rising number of laptop-induced cases of EAI have been reported recently. For this modern-age version of classic EAI, we propose thus the more accurate neo-Latin term erythema a computatro.
Systemic Mastocytosis Presenting as Acute Appendicitis: A Case Report and Review of the Literature
Authors: Akbar Syed A. , Raza Shahzad , Denney Jason E. , Johannesen Eric J. , Doll Donald C.
Published: April 2013

Systemic mastocytosis is characterized by abnormal growth and accumulation of mast cells in various organs. Gastrointestinal (GI) symptoms are common disease manifestations in this disease and can significantly impair the quality of life. Signs of GI systemic mastocytosis include steatorrhea, malabsorption, hepatomegaly, splenomegaly, portal hypertension, and ascites. Acute appendicitis as a presenting feature in systemic mastocytosis has not been reported in the literature previously. In this report, we discuss the case of a female patient with systemic mastocytosis (c-KIT D816V (+)) who was admitted for right-sided acute abdominal pain. Laboratory study revealed an normal white blood cell count with eosinophilia and an elevated serum tryptase level of 23 μg/l. CT of the abdomen and pelvis showed an enlarged appendix of 12 mm in diameter, with minimal wall enhancement. Laparoscopic appendectomy was performed. The appendix was found to be hyperemic and firm, and it was densely adherent to the posterior cecum, the surrounding peritoneal wall, and the overlying mesenteric fat. Pathology revealed acute appendicitis with greater than 30 mast cells per high-power field by immunoperoxidase studies with mast cell tryptase and CD117. The patient subsequently improved and was discharged home. This case is the first reported case with a histological diagnosis of acute appendicitis resulting from mast cell infiltration. Physicians should be aware of acute appendicitis as a manifestation of systemic mastocytosis. Prompt diagnosis and management may prevent potentially fatal complications of appendiceal perforation and peritonitis.
Long-Term Treatment with Erlotinib for EGFR Wild-Type Non-Small Cell Lung Cancer: A Case Report
Authors: Polychronidou Genovefa , Papakotoulas Pavlos
Published: April 2013

The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib are known to have greater efficacy in EGFR mutation-positive non-small cell lung cancer (NSCLC), although erlotinib also has activity in wild-type disease. We report the successful long-term maintenance treatment of a patient with EGFR wild-type NSCLC with gefitinib and later erlotinib. The patient (male; 44 years old; smoker) was diagnosed with EGFR wild-type NSCLC after computer tomography had revealed a mediastinal mass, and histology and mutation testing had identified the tumor as an EGFR wild-type grade 3 adenocarcinoma. The patient received multiple rounds of chemotherapy, followed by gefitinib maintenance (3 years). Later on, he received erlotinib maintenance and developed a persistent rash (grade 1/2) that lasted throughout the treatment. The patient's condition has remained stable on erlotinib for more than 5 years, with no evidence of progression. We describe the patient's disease course and treatment in the context of EGFR TKI therapy and the prognostic factors for long-term clinical outcomes of NSCLC, including the development of erlotinib-induced rash.
Spontaneous Regression of Hepatocellular Carcinoma due to Disruption of the Feeding Artery
Authors: Okano Akihiro , Ohana Masaya , Kusumi Fusako , Nabeshima Motoshige
Published: April 2013

We present an unusual case of spontaneous regression of hepatocellular carcinoma (HCC). A 77-year-old man with alcoholic liver cirrhosis presented with a 50-mm tumor in the Couinaud's segment 8 (S8) of the liver, a 15-mm tumor in the S8-7 and 10-mm tumors in the other segments (S4, S6). The tumors were diagnosed as HCC by typical imaging findings and elevated serum alpha-fetoprotein (AFP, 1,825.0 ng/ml) and protein induced by vitamin K absence II (PIVKA II, 3,043 mAU/ml). One month later, AFP and PIVKA II decreased to 51.1 ng/ml and 411 mAU/ml, respectively, and the 50-mm tumor in the S8 became small and completely necrotic on angiography and computed tomography arteriography without any treatment. On the other hand, the 15-mm tumor in the S8-7 decreased in size to 10 mm and received blood supply from the right posterior superior arteries (A7). The other 10-mm tumors remained. Ischemia of the tumors due to disruption of the feeding artery (A8) might have induced tumor regression in the present case.
Adenocarcinoma in Colonic Interposition
Authors: Grunner Shahar , Gilshtein Hayim , Kakiashvili Eliahu , Kluger Yoram
Published: April 2013

A 59-year-old female with dysphagia presented to our clinic. In childhood, she underwent colonic interposition due to anastomotic stricture after a previous proximal gastrectomy for gastric ulcer perforation. Imaging studies revealed a space-occupying lesion obstructing the distal interposed colon. At surgery, completion gastrectomy with segmental colectomy was carried out, and Roux-en-Y coloenterostomy and enteroenterostomy were performed.
Fractional Flow Reserve Assessment of Left Main Stenosis in the Presence of Downstream Coronary Stenoses
Authors: Yong Andy S.C. , Daniels David , De Bruyne Bernard , Kim Hyun-Sook , Ikeno Fumiaki , Lyons Jennifer , Pijls Nico H.J. , Fearon William F.
Published: April 2013

Background—

Several studies have shown that fractional flow reserve (FFR) measurement can aid in the assessment of left main coronary stenosis. However, the impact of downstream epicardial stenosis on left main FFR assessment with the pressure wire in the nonstenosed downstream vessel remains unknown.

Methods and Results—

Variable stenoses were created in the left main coronary arteries and downstream epicardial vessels in 6 anaesthetized male sheep using balloon catheters. A total of 220 pairs of FFR assessments of the left main stenosis were obtained, before and after creation of a stenosis in a downstream epicardial vessel, by having a pressure-sensor wire in the other nonstenosed downstream vessel. The apparent left main FFR in the presence of downstream stenosis (FFR
app
) was significantly higher compared with the true FFR in the absence of downstream stenosis (FFR
true
; 0.80±0.05 versus 0.76±0.05; estimate of the mean difference, 0.035;
P
<0.001). The difference between FFR
true
and FFR
app
correlated with composite FFR of the left main plus stenosed artery (
r
=−0.31;
P
<0.001) indicating that this difference was greater with increasing epicardial stenosis severity. Among measurements with FFR
app
>0.80, 9% were associated with an FFR
true
of <0.75. In all instances, the epicardial lesion was in the proximal portion of the stenosed vessel, and the epicardial FFR (combined FFR of the left main and downstream stenosed vessel) was ≤0.50.

Conclusions—

A clinically relevant effect on the FFR assessment of left main disease with the pressure wire in a nonstenosed downstream vessel occurs only when the stenosis in the other vessel is proximal and very severe.
Stroke After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Guptill Jeffrey T. , Mehta Rajendra H. , Armstrong Paul W. , Horton John , Laskowitz Daniel , James Stefan , Granger Christopher B. , Lopes Renato D.
Published: April 2013

Background—

Stroke is a rare but potentially devastating complication of acute myocardial infarction. Little is known about stroke timing, characteristics, and clinical outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI).

Methods and Results—

We studied 5372 patients enrolled in the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial. We analyzed stroke incidence, type, timing, and association with the prespecified 90-day clinical outcomes. Cox proportional hazards modeling was performed to assess the relationship between stroke and outcomes, after adjusting baseline characteristics and analyzing stroke as a time-dependent covariate. Stroke occurred in 69 primary patients with PCI (1.3%). A third of strokes were ischemic (n=23; 33%), 12% (n=8) were hemorrhagic, and the remaining 55% (n=38) were of uncertain type. The median (25th, 75th percentile) time of stroke occurrence was 6 (3, 14) days. Overall, 43% of strokes occurred within 48 hours of PCI, and all hemorrhagic strokes occurred within 48 hours. Stroke was associated with an increased risk of 90-day death (unadjusted hazard ratio [HR], 8.0; 95% confidence interval [CI], 4.8–13.5), congestive heart failure (unadjusted HR, 3.2; 95% CI, 1.3–7.8), and 30-day hospital readmission (unadjusted HR, 3.2; 95% CI, 2.0–5.1). After adjustment, stroke was still strongly associated with 90-day death (adjusted HR, 5.6; 95% CI, 3.2–9.8) and the combination end point of death, congestive heart failure, or cardiogenic shock at 90 days (adjusted HR, 2.4; 95% CI, 1.2–4.7).

Conclusions—

Stroke is an infrequent complication in the setting of ST-segment elevation myocardial infarction treated with primary PCI but is associated with increased morbidity and mortality. Studies to determine mechanisms that may be responsible for strokes that occur >48 hours from primary PCI are warranted.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00091637.
Thrombolysis Despite Recent Stroke
Authors: Alhazzaa Mohammed , Sharma Mukul , Blacquiere Dylan , Stotts Grant , Hogan Matthew , Dowlatshahi Dar
Published: April 2013

Background and Purpose—

Thrombolysis in ischemic stroke is contraindicated in patients who have had a stroke within 3 months. However, it is unclear whether thrombolytic therapy is associated with adverse outcomes in this population. We report the characteristics and outcomes of patients treated with systemic recombinant tissue-type plasminogen activator in the context of known or unknown recent stroke.

Methods—

We identified patients who received recombinant tissue-type plasminogen activator despite recent stroke (within 3 months of acute thrombolysis). Clinical and radiological findings were collected, including early neurological worsening and hemorrhagic transformation on unenhanced computed tomography at 24 hours. Clinical outcome measured by modified Rankin Scale was determined at 3 months from onset.

Results—

Six patients presenting with acute stroke within 3 months of previous stroke were identified (median age, 76 years; median National Institutes of Health Stroke Scale, 8.5). Hemorrhagic transformation was seen in the follow-up computed tomography scan in 3 of 6 cases: all were hemorrhagic transformation 1 (petechial hemorrhage), asymptomatic, and mostly located within the area of subacute infarction. There was no early neurological deterioration, and 3 patients had modified Rankin Scale ≤2 after 3 months.

Conclusions—

In our center, we thrombolysed 6 patients despite recent stroke. Three patients had asymptomatic petechial hemorrhagic transformation within the area of subacute infarct, without apparent neurological worsening. Prospective studies are needed to explore the possible safety of tissue-type plasminogen activator in the context of previous subacute stroke in otherwise eligible patients.
Minority ethnic adolescents’ wellbeing: Child rearing practices and positive family influences
Authors: Ochieng Bertha MN
Published: April 2013

Objective:

This paper examines Black adolescents’ experiences and views on the interrelationships between their families’ parenting practices and their wellbeing.

Method:

The material is drawn from a community-based qualitative study on the health and wellbeing experiences of Black African families and adolescents. A total of 53 adolescents of Black African origin residing in a county in the north of England participated in the study. Data were collected by means of semi-structured in-depth interviews conducted in participants’ homes and youth clubs. Data were subjected to thematic analysis with the aid of a qualitative data analysis software package.

Results:

While the adolescents acknowledged receiving health-promotion messages from sources such as their peers and the media, they also identified the continued significance of their parents and family network in shaping their behaviours and facilitating their wellbeing. These included specific health-promotion messages such as not to use illegal drugs and cigarettes, and on the dangers and effects of excessive alcohol. In addition, the adolescents believed that their parents’ values, beliefs and child-rearing practices had helped them to cope with social discrimination.

Conclusion:

Knowledge and understanding of Black families’ child-rearing practices, socio-economic circumstances and life experiences can provide health-promotion practitioners with sound background information for the design and implementation of specific effective health-promotion strategies directed at adolescents.
Establishment of Absolute Measurement Standards for In-Situ Calibration of Acoustic Emission Energy
Authors: Yan T. , Jones B. E.
Published: April 2013

To date acoustic emission (AE) monitoring has been undertaken without proper means of calibration and the actual AE measurement results are significantly affected by the experimental layout. As the use of AE monitoring increases, the need for more meaningful measurement to reflect the AE physical process becomes urgent and necessary, and this ultimately requires an absolute calibration for AE measurement systems in-situ. This paper outlines a possible hierarchy of measurement standards for AE energy calibration using artificial standard AE energy sources generated by the elastic impact of a bouncing-ball, the thermoelastic irradiation of a pulsed-laser, and the excitation of a conical piezoelectric transducer. The basic idea is to provide absolute standard AE energy sources for calibration of AE measurement systems in-situ.
Er-Doped Sapphire Fibre Temperature Sensors Using Upconversion Emission
Authors: Sharp J.H. , Shi C.W.P. , Seat H.C.
Published: April 2013

We report the production of Er:Al2O3 and Er:Yb:Al2O3 fibres using the LHPG method for application as fibre temperature sensors. Intense upconversion emission in the blue, green and red was observed from these fibres when pumped with a laser diode at 965nm. The lifetime and the integrated intensity of the upconversion signal was characterised as function of laser power and temperature. Results indicate the ratiometric analysis of the integrated intensities provides a suitable transduction mechanism for temperatures up to 1000K.
Simultaneous Measurement of Temperature and Strain by Combining Active Fibre with Fibre Gratings
Authors: Lai Y. C. , Qiu G. F. , Zhang W. , Zhang L. , Bennion I. , Grattan K. T. V.
Published: April 2013

This paper reports on a novel optical fiber-based sensing system for conducting simultaneous measurement of temperature and strain. The sensor design is based on the combination of active fibre and fibre gratings. Addressing smart structure applications erbium/ytterbium co-doped fibre is used to meet the requirements for both high temperature responsivity and small sensor size. The temperature dependence of ASE power under different pump wavelengths is investigated. An optical reference is induced to enhance the measurement resolution. The feasibility of this technique for simultaneous measurement of temperature and strain is demonstrated.
Simulation Software Accelerates Development of Neural Network Control Applications in the Water Industry
Authors: Adgar Adam , Fletcher Ian
Published: April 2013

Artificial neural network (ANN) applications have become popular in the field of water treatment process for modelling and control purposes. This is due to the fact that the processes are not well understood and also due to the large amounts of data available which are recorded for regulatory purposes. Development of such ANN applications are made more difficult by the data handling issues. It is often advantageous to try techniques developed on different plant data sets, under different operating conditions etc, but this is difficult to achieve efficiently in software. In this research, however, we have described several different applications of ANNs to demonstrate the significant results which may be achieved. But more importantly we have shown how the ANN application development, modification, comprehensive testing and benchmarking can be efficiently completed.

To simplify the presentation, we have omitted a section on neural network architectures and learning processes since this is adequately covered in the paper by Renotte et al included as part of this Special Feature.
Mathematical Modelling in Measurement and Instrumentation
Authors: Khan S.H. , Finkelstein L.
Published: April 2013

This paper presents a brief outline of the use of mathematical modelling techniques in measurement and instrumentation systems and sub-systems. Following an overview of various models, it illustrates some of the recent advances in mathematical modelling of sensors and instrument transducers. This is illustrated in two case studies describing the use of numerical finite element (FE) modelling techniques for CAD and performance modelling of capacitive sensors and torque motor actuators.
Ultrasonic Flow Measurement Using Two Asymmetric ‘Sing-Around’ Paths
Authors: Kakolaki J. B. , Henry R. M.
Published: April 2013

A novel approach to non-invasive ultrasonic flow-metering is described. The use of two asymmetric ‘sing-around’ (or frequency difference) paths avoids the problem of temperature dependence inherent in conventional flowmeters. The new system transmits two beams of ultrasound in bursts of 0.5 to 1.5μs duration at 2 MHz through the metered medium to two receiver transducers, one upstream and one downstream. The flow velocity is derived from the measured ‘sing-along’ frequencies of the two paths of different lengths and distance between the two receivers; the frequencies are independent of the temperature-dependent velocity of sound. The accuracy for water flow at 2 m/s was about 2%. The pipe material must be ultrasonically conducting and the fluid must be sonically homogeneous. Flow direction can be identified easily. The high frequency used gives shorter counting intervals, so better response. Less beam divergence also results. Good matching of transducers to the fluid was needed to allow high frequency operation.
Net-Based SCADA with Ethernet I/O — The State of the Art
Authors: Williams R
Published: April 2013

This paper considers the implementation of SCADA over a more widely distributed system and with a far higher level of integration into management information networks. Having reviewed the traditional approach to distributed measurement and control, it is proposed that use of presently available internet, cellular telephone and other enabling (network) technologies will offer business a far more competitive edge. The requisite technologies are discussed and the business advantages presented.
Increasing Control and Accuracy in the Separation Process by Density Profiling
Authors: Lees Raymond Paul
Published: April 2013

Three-phase, horizontal, gravity separation vessels are the principal method of extracting oil and gas from unwanted produced water and solids prior to transportation. Traditionally, oil production separators have used separate single-point transmitters for interface and bulk level measurement. This paper shows how a profile of the different layers as opposed to single-point measurement can enable oil production and chemical usage to be optimised.