bluuebunny/crossref_metadata_2025 huggingface dataset:
Disability and Recovery of Independent Function in Obstructive Lung Disease: The Cardiovascular Health Study
Authors: Fan Vincent S. , Locke Emily R. , Diehr Paula , Wilsdon Anthony , Enright Paul , Yende Sachin , Avdalovic Mark , Barr Graham , Kapur Vishesh K. , Thomas Rachel , Krishnan Jerry A. , Lovasi Gina , Thielke Stephen
Published: September 2014

Background: Chronic obstructive lung disease frequently leads to disability. Older patients may experience transitions between states of disability and independence over time. Objective: To identify factors associated with transition between states of disability and independent function in obstructive lung disease. Methods: We analyzed data on 4,394 participants in the Cardiovascular Health Study who completed prebronchodilator spirometry. We calculated the 1-year probability of developing and resolving impairment in ≥1 instrumental activity of daily living (IADL) or ≥1 activity of daily living (ADL) using transition probability analysis. We identified factors associated with resolving disability using relative risk (RR) regression. Results: The prevalence of IADL impairment was higher with moderate (23.9%) and severe (36.9%) airflow obstruction compared to normal spirometry (22.5%; p < 0.001). Among participants with severe airflow obstruction, 23.5% recovered independence in IADLs and 40.5% recovered independence in ADLs. In the adjusted analyses, airflow obstruction predicted the development of IADL, but not ADL impairment. Participants with severe airflow obstruction were less likely to resolve IADL impairment [RR 0.67 and 95% confidence interval (CI) 0.49-0.94]. Compared to the most active individuals (i.e. who walked ≥28 blocks per week), walking less was associated with a decreased likelihood of resolving IADL impairment (7-27 blocks: RR 0.81 and 95% CI 0.69-0.86 and <7 blocks: RR 0.73 and 95% CI 0.61-0.86). Increased strength (RR 1.16 and 95% CI 1.05-1.29) was associated with resolving IADL impairment. Conclusions: Disability is common in older people, especially in those with severe airflow obstruction. Increased physical activity and muscle strength are associated with recovery. Research is needed on interventions to improve these factors among patients with obstructive lung disease and disability.
Infarct Pattern and Clinical Outcome in Acute Ischemic Stroke Following Middle Cerebral Artery Occlusion
Authors: Lee Keon-Joo , Jung Keun-Hwa , Byun Jung-Ick , Kim Jeong-Min , Roh Jae-Kyu
Published: September 2014

Background: Cerebral arterial occlusion develops via two distinct mechanisms: thrombosis and embolism. Discrimination between thrombosis and embolism is an important aspect needed for further determining the etiology of stroke in a patient. This study evaluated infarct patterns and outcomes in acute stroke patients with relevant artery occlusions, focusing on features specific to each occlusion mechanism. Methods: Acute ischemic stroke patients who were consecutively registered in a tertiary hospital between 2002 and 2010 with infarctions in the middle cerebral artery territory and a corresponding M1 occlusion confirmed by magnetic resonance angiography, computed tomography angiography, or conventional angiography were enrolled. Patients with a high-risk cardioembolic source, clear recanalization, concurrent infarct in an arterial territory other than the occlusion site, or no prior occlusion in a previous imaging within 1 month were assigned to the embolic occlusion group, and the remaining patients were assigned to the thrombotic occlusion group. The infarct pattern was categorized into seven groups: scattered, territorial, lenticulostriatal, scattered-territorial, scattered-lenticulostriatal, territorial-lenticulostriatal, and scattered-territorial-lenticulostriatal. Data of stroke recurrence and mortality were collected through electronic medical record and the National Vital Statistics System. Results: Of 114 patients, 54 (47.4%) were classified as having an embolic occlusion. When infarct patterns were compared between the groups, any-scattered infarct pattern was more common in the thrombotic occlusion group (71.2% vs. 40.7%, p = 0.002), and any-territorial infarct pattern was more prevalent in the embolic occlusion group (55.6% vs. 28.8%, p = 0.005). In addition, scattered-without-territorial pattern was higher in the thrombotic occlusion group (OR: 0.25; CI: 0.11-0.57; p = 0.001). Any-territorial infarct pattern was also related to initial stroke severity (NIHSS on admission, OR: 400.98; CI: 2.94-54,741.32; p = 0.017) and poor functional outcome (modified Rankin Scale score ≥4) at discharge (OR: 14.40; CI: 1.37-152.00; p = 0.027) independent of other parameters. However, no association was found between stroke recurrence, mortality and occlusion mechanism. Conclusion: This study shows that specific infarct patterns are related to cerebral arterial occlusion mechanisms and are correlated with functional outcome. Otherwise, the results of our study indicates that infarct patterns on DWI might be a clue for determining ischemic stroke etiology on patients with major cerebral artery occlusion.
Recent Approaches in Vaccine Development against Streptococcus pneumoniae
Authors: Tarahomjoo Shirin
Published: September 2014

Streptococcus pneumoniae is a major cause of morbidity and mortality among children under 5 years of age worldwide. Vaccines have long been used for protection against pneumococcal infections. Capsular polysaccharides of pneumococci are main antigenic components of these vaccines. However, pneumococcal polysaccharide-based vaccines are not able to elicit appropriate immunological responses in young children and cannot induce the immune memory. Thus, pneumococcal conjugate vaccines were developed through chemical coupling of an immunogenic carrier protein to the capsule. The currently available pneumococcal conjugate vaccines elicited protection against the bacterium efficiently. However, these vaccines are expensive to manufacture and have limited serotype coverage. In this mini-review, therefore, we describe approaches attempted by researchers to circumvent the shortcomings of the conjugate vaccines including specifying appropriate cultivation conditions for the production of S. pneumoniae capsular antigens, development of suitable expression systems for the frequently used carrier protein in the conjugate vaccines (cross-reacting material 197), construction of protein-based vaccines, whole-cell vaccines, DNA vaccines, and using antigen delivery vehicles. Future trends in this field are also discussed.
Understanding Antihypertensive Medication Use after Living Kidney Donation through Linked National Registry and Pharmacy Claims Data
Authors: Lentine Krista L. , Schnitzler Mark A. , Garg Amit X. , Xiao Huiling , Axelrod David , Tuttle-Newhall Janet E. , Brennan Daniel C. , Segev Dorry L.
Published: September 2014

Background: Use of antihypertensive medications (AHM) after living kidney donation is not well described. Methods: We examined a database wherein national transplant registry data for 4,650 living kidney donors in 1987-2007 were linked to pharmacy claims from a US private health insurer (2000-2007 claims) to identify post-donation AHM fills. Cox regression with left- and right-censoring was used to estimate the frequencies and relative likelihood (adjusted hazards ratios, aHR) of post-donation AHM fills according to donor demographic traits. Medication possession ratio (MPRs), defined as (days of AHM dispensed)/(days observed), were also compared among donors and non-donor general beneficiaries. Results: Overall, 17.8% of the sample filled at least one AHM by 5 years post-donation. As compared with White living donors, African-Americans had 37% higher relative likelihood of any AHM use after donation (aHR 1.37, p < 0.0007), including significantly higher likelihoods of filling diuretics (aHR 2.25, p < 0.0001), ACEi/ARBs (aHR 1.46, p < 0.01), calcium channel blockers (aHR 1.56, p = 0.03), and vasodilators/other agents (aHR 2.17, p = 0.03). MPRs for any AHM and subcategories were lower among donors compared with age- and sex-matched non-donors. However, AHM MPRs rose in donors with multiple hypertension diagnoses, and prescription fill exposure for all AHM classes except diuretics was similar among donors and general non-donors with ≥3 hypertension diagnoses. Conclusions: While AHM requirements are lower after kidney donation than among unscreened general persons, racial variation in AHM use occurs in privately insured donors. Demonstration of pharmaceutical care needs of insured donors supports the need for long-term follow-up and healthcare access for all donors.
Identification of Frequent Differentially Methylated Region in Sporadic Bladder Cancers
Authors: Hasegawa Ryo , Fujiwara Kyoko , Obinata Daisuke , Kawashima Hiroyuki , Shinojima Yui , Igarashi Jun , Wang Xiaofei , Ghosh Srimoyee , Nagase Hiroki , Takahashi Satoru
Published: September 2014

Introduction: Aberrant methylation levels in the cytosine-phosphate-guanine island (CpGi) region from exon 1 to intron 1 of the zygote arrest 1 (ZAR1) gene have been reported in several types of human cancers, including melanoma, brain tumor, and hepatocellular carcinoma. In the present study, methylation levels at the CpGi of ZAR1 exon 1/intron 1 in bladder cancer specimens were analyzed using mass spectrometry. Materials and Methods: Genomic DNA was extracted from 20 sporadic bladder cancers, and the methylation levels at ZAR1 CpGi were quantitatively examined by the MassARRAY EpiTYPER method. Result: The methylation levels at specific CpG sites of the ZAR1 CpGi were significantly lower in high-grade bladder cancers than in low-grade tumors. Conclusions: The results of the present study indicated a decreased methylation level at CpG sites of ZAR1 exon 1/intron 1. CpGi could serve as a biomarker for invasive bladder cancer.
Chronic Abdominal Pain in a Patient with Escobar Syndrome
Authors: Mete Ural Ülkü , Bayoğlu Tekın Yeşim , Kir Şahın Figen , Erdıvanli Başar , Kazdal Hızır
Published: September 2014

Escobar syndrome is characterized with multiple pterygia or webs of the skin and multiple congenital anomalies. We present a 15-year-old patient with Escobar syndrome who complained of persistent blunt abdominal pain for 1 year. Preoperative evaluation confirmed the diagnosis of imperforate hymen, and the patient underwent hymenectomy under intravenous sedation. The patient's postoperative course was uneventful and her complaints resolved completely. After a 3-month follow-up, she reported having normal menstrual bleeding intervals each month without any complications. Patients with Escobar syndrome may suffer from abdominal pain due to imperforate hymen. Careful evaluation of these patients must include a complete gynaecological assessment and, if indicated, surgical treatment must be performed without delay.
Coexistence of Atrioventricular Nodal Reentrant Tachycardia with Other Forms of Arrhythmias
Authors: Schernthaner Christiana , Danmayr Franz , Strohmer Bernhard
Published: September 2014

Objective: The aim of this retrospective study was to investigate the association of atrioventricular nodal reentrant tachycardia (AVNRT) with other forms of arrhythmia in individual patients and its consequences for treatment. Subjects and Methods: This study comprised 493 consecutive patients aged 16-88 years (296 women and 197 men) who were diagnosed with a form of AVNRT via a standard 4-catheter electrophysiological study (EPS). Patients were clinically followed (range 0.5-12 years) at a single center. Results: Coexistence of AVNRT with other types of tachycardias was observed in 197 (40%) patients. Atrial fibrillation was found most frequently in 94 (19%) patients as follows: focal atrial tachycardia, n = 40 (8%); atrial flutter, n = 32 (6%), and AV reentrant tachycardia, n = 22 (4%). Double tachycardia was present in 140 (30%) patients, and more than 2 different types of tachycardias were present in 57 (12%) patients. Transitions between AVNRT and other tachycardias occurred in 25 (5%) patients. Two or more tachycardias were ablated in 42 (9%) patients. The majority of patients were free of symptoms at the first follow-up, whereas 130 (26%) patients reported a variety of symptoms. Conclusion: Coexistence of AVNRT with other types of arrhythmias was a common finding among these patients. The most frequently observed double tachycardia was the combination of AVNRT with atrial tachyarrhythmias, such as atrial fibrillation, with a potential significance for further patient management.
Effects of Lying Position on P-Wave Dispersion in Patients with Heart Failure
Authors: Oylumlu Muhammed , Dogan Adnan , Ozer Orhan , Yuce Murat , Ercan Suleyman , Davutoglu Vedat
Published: September 2014

Objective: It was the aim of this study to investigate the effects of the right lateral decubitus, left lateral decubitus and supine lying position on P-wave dispersion (PWD) in patients with heart failure (HF). Subjects and Methods: Seventeen patients with HF whose ejection fraction was <35% were included in the study. Right lateral decubitus, left lateral decubitus and supine electrocardiogram (ECG) recordings were obtained. The recordings for each of the three positions were taken after the patients had maintained each position for 30 min to ensure a stabilized hemodynamic position. For the baseline recording, in supine position, there was no 30-min waiting period before the ECG. Results: After the right lateral decubitus position, there was a statistically significant reduction in the longest P-wave duration (100.0 ± 14.5 and 84.7 ± 16.2 ms; p = 0.001) and a significant decrease in PWD (41.7 ± 8.0 and 24.1 ± 7.1 ms; p < 0.0001). After the left lateral decubitus position, there was no significant change between the baseline PWD values (41.7 ± 8.0 and 40.2 ± 9.7 ms; p = 0.606). After the supine position, there was no significant change between the baseline PWD values (41.7 ± 8.0 and 39.7 ± 9.4 ms; p = 0.427). Conclusion: Our study revealed that patients' PWDs and maximum P-wave durations were lower in the right lateral decubitus lying position than in other positions. The clinical implication of this study needs to be further explored.
Oxidative Stress Status Increase in Patients with Nonischemic Heart Failure
Authors: Karabacak Mustafa , Dogan Abdullah , Tayyar Senol , Bas Hasan Aydın
Published: September 2014

Objective: It was the aim of this study to investigate the serum oxidative stress level in nonischemic patients with heart failure (HF). Subjects and Methods: The study included 37 patients who presented to the Department of Cardiology, Suleyman Demirel University, Isparta, Turkey, with a diagnosis of asymptomatic HF (New York Heart Association class I-II). The patients had a left ventricular (LV) ejection fraction (EF) of ≤40% and normal coronary arteries or nonsignificant stenosis (stenosis <40%). In addition, 30 age- and sex-matched normal patients were selected as the control group. Clinical and laboratory characteristics presumed to be associated with oxidative stress were evaluated. Results: Demographic characteristics were comparable. However, creatinine and potassium levels were higher in the HF than in the control group. Total oxidative status [2.42 μmol H2O2 Eq/l (range 0.74-5.86) vs. 1.81 μmol H2O2 Eq/l (range 0.42-3.45); p < 0.01], oxidative stress index [2.24 (range 0.63-5.33) vs. 1.53 (range 0.28-2.51); p < 0.01] and uric acid (6.1 ± 1.8 vs. 4.4 ± 1.1 mg/dl; p < 0.01) levels were significantly higher in the HF than in the control group. The total antioxidant capacity was similar in both groups [1.22 mmol Trolox Eq/l (range 0.61-1.99) vs. 1.18 mmol Trolox Eq/l (range 0.82-1.80); p = 0.77]. The γ-glutamyltransferase levels were also comparable in both groups [32 U/l (range 11-106) vs. 23 U/l (range 11-72); p = 0.10]. Conclusion: The oxidative stress levels were higher in HF patients, and hence, oxidative stress may play an important role in poor prognosis of HF. Therefore, antioxidant treatment might be reasonable.
Standard of Care and Controversies in the Adjuvant Endocrine Treatment of Hormone-Responsive Early Breast Cancer
Authors: Bauerschlag Dirk O. , Maass Nicolai , Schem Christian
Published: September 2014

Hormone-responsive early breast cancer is a highly curable disease. In premenopausal women, tamoxifen (TAM) is still the standard treatment. Nowadays, up to 10 years of TAM can be safely administered, especially in women who remain premenopausal. Patients who are considered to be perimenopausal should be initially treated like premenopausal patients. Depending on their serum hormone levels, these patients can be safely switched to an aromatase inhibitor (AI) therapy once the estradiol (E2) and follicle-stimulating hormone (FSH) levels prove the established postmenopausal status. In postmenopausal women, several sequences of endocrine treatment are available. The AI therapy can be induced upfront or sequentially by switching from Tam to AI and vice versa. Extended endocrine therapy, by adding up to 5 years of letrozole after 5 years of TAM, has also been proven to be beneficial in certain patient subgroups. Genotyping of cytochromes such as CYP2D6 did not have any added value in identifying patients who are at higher risk of recurrence. Nevertheless, in all patients the side effects need to be given high consideration. New strategies developed to overcome endocrine resistance are tested in clinical studies. New co-administered drugs such as specific inhibitors of mammalian target of rapamycin (mTOR), Src, or phosphatidylinositol 3-kinase (PI3K) do improve endocrine responsiveness in meta-static disease and will eventually be introduced in the treatment of early breast cancer.
Association of U.S. Dialysis Facility Neighborhood Characteristics with Facility-Level Kidney Transplantation
Authors: Plantinga Laura , Pastan Stephen , Kramer Michael , McClellan Ann , Krisher Jenna , Patzer Rachel E.
Published: September 2014

Background: Improving access to optimal healthcare may depend on the attributes of neighborhoods where patients receive healthcare services. We investigated whether the characteristics of dialysis facility neighborhoods - where most patients with end-stage renal disease are treated - were associated with facility-level kidney transplantation. Methods: We examined the association between census tract (neighborhood)-level sociodemographic factors and facility-level kidney transplantation rate in 3,983 U.S. dialysis facilities where kidney transplantation rates were high. Number of kidney transplants and total person-years contributed at the facility level in 2007-2010 were obtained from the Dialysis Facility Report and linked to the census tract data on sociodemographic characteristics from the American Community Survey 2006-2010 by dialysis facility location. We used multivariable Poisson models with generalized estimating equations to estimate the link between the neighborhood characteristics and transplant incidence. Results: Dialysis facilities in the United States were located in neighborhoods with substantially greater proportions of black and poor residents, relative to the national average. Most facility neighborhood characteristics were associated with transplant, with incidence rate ratios (95% CI) for standardized increments (in percentage) of neighborhood exposures of: living in poverty, 0.88 (0.84-0.92), black race, 0.83 (0.78-0.89); high school graduates, 1.22 (1.17-1.26); and unemployed, 0.90 (0.85-0.95). Conclusion: Dialysis facility neighborhood characteristics may be modestly associated with facility rates of kidney transplantation. The success of dialysis facility interventions to improve access to kidney transplantation may partially depend on reducing neighborhood-level barriers.
Bifunctional T-Cell-Derived Cytokines for the Diagnosis of Tuberculosis and Treatment Monitoring
Authors: Essone Paulin N. , Kalsdorf Barbara , Chegou Novel N. , Loxton André G. , Kriel Magdalena , Preyer Rosemarie , Ernst Martin , Walzl Gerhard , Lange Christoph
Published: September 2014

Background: Diagnosis and treatment monitoring of patients with tuberculosis remain challenging. Objective: We have evaluated whether Mycobacterium-specific interferon (IFN)-γ and interleukin (IL)-2 bifunctional cytokine immune response assays improve the diagnosis of and correlate to treatment response in pulmonary tuberculosis. Methods: Early secretory antigenic target (ESAT)6/culture filtrate protein 10 (CFP10), microsomal triglyceride transfer protein 65 (MTP65) and the purified protein derivative (PPD) tuberculin-specific immune profiles were investigated in peripheral blood mononuclear cells from 19 patients with culture-confirmed tuberculosis and 23 healthy community controls (HCCs; 82.6% with latent M. tuberculosis infection) using a novel fluorescence-based dual-colour enzyme-linked immunospot (EliSpot) technology (FluoroSpot). Results: The frequency of ESAT6/CFP10-induced IFN-γ+IL-2- producing cells was elevated (p < 0.001), whereas the percentages of specific IFN-γ-IL-2+ (p = 0.002) and IFN-γ+IL-2+ double producing cells (p = 0.037) were diminished in tuberculosis patients in comparison to HCCs. A 3-host marker model using a combination of those IFN-γ and IL-2 single-cell responses showed 93.8% sensitivity and 77.8% specificity for tuberculosis. During tuberculosis treatment, the PPD-induced immune responses shifted from an IFN-γ+IL-2- dominated profile towards a balance of IFN-γ-IL-2+ and IFN-γ+IL-2+ double producing cells (all p ≤ 0.05). Conclusions: The addition of antigen-specific IL-2 production to IFN-γ responses by EliSpot in IFN-γ release assays increases diagnostic sensitivity for active tuberculosis.
SNOT-22 Validation in Greek Patients
Authors: Seferlis Fokion , Proimos Efklidis , Chimona Theognosia S. , Asimakopoulou Panagiota , Papadakis Chariton E.
Published: September 2014

Background: Chronic rhinosinusitis (CRS) with or without nasal polyps is a frequent and significant health problem. The 22-item Sinonasal Outcome Test (SNOT-22) is a valid, disease-specific health status instrument translated into several languages. The translation into Greek has been considered essential for the individual assessment of the patients' symptoms and a reliable tool for quality of life evaluation. Methods: Our study included 40 patients with CRS without nasal polyps and 40 healthy individuals as control group recruited from the ENT Allergy and Endoscopy Clinic of Chania General Hospital. Assessment included full ENT examination and nasal endoscopy. In the study, we compared the patients' examination and reexamination results with the results of the control group, and thus estimated test-retest reliability, internal consistency (determined by Cronbach's alpha) and validity. Results: The statistical significance level calculated by the paired t test was p < 0.05 for all questions, which proves the questionnaire's consistency. The kappa value was estimated for each symptom, with an average value of 0.94. Cronbach's alpha was 0.934 in the test and 0.856 in the retest. The p value was <0.05 between both the control group and the test group and between the control group and the retest group. Conclusion: Our study certifies the existence of a valid, reproducible Greek version of SNOT-22, which overcomes limitations of use, allows to answer the questionnaire in Greek, and thus makes it highly recommended for Greek clinicians.
Aerosolized Antibiotics for Non-Cystic Fibrosis Bronchiectasis
Authors: Rubin Bruce K. , Williams Ronald W.
Published: September 2014

Patients with non-cystic fibrosis bronchiectasis (NCFB) share many of the respiratory symptoms and the disease progression of cystic fibrosis (CF). As there are no approved therapies for the management of NCFB, an approach has been to use therapies similar to those used to treat CF. In many cases, however, this is ineffective or detrimental. The reason for this has not been determined, but it may be due to key differences in pathogenesis. The questions arising from this have spurred dedicated investigation into the effective management of NCFB. Patients with NCFB have chronic bacterial infection, and bacterial load correlates with symptoms and quality of life. Treatment with systemic antibiotics decreases bacterial load and can have a favorable effect on outcomes. Chronic or frequent use of systemic antibiotics, however, is impractical and sometimes unsafe, so aerosol as a means of delivery is seen as an attractive alternative. The clinical response to and tolerability of inhaled antibiotics have differed significantly between NCFB and CF. New delivery technology, novel antibiotic formulations and a better understanding of the bacterial burden of NCFB are now changing the approach to disease management.
Tyrosine Kinase Inhibitors Enhance Ciprofloxacin-Induced Phototoxicity by Inhibiting ABCG2
Authors: Mealey Katrina L. , Dassanayake Sandamali , Burke Neal S.
Published: September 2014

The tyrosine kinase inhibitor (TKI) class of anticancer agents inhibits ABCG2-mediated drug efflux. ABCG2 is an important component of the blood-retinal barrier, where it limits retinal exposure to phototoxic compounds such as fluoroquinolone antibiotics. Patients treated with TKIs would be expected to be at greater risk for retinal phototoxicity. Using an in vitro system, our results indicate that the TKIs gefitinib and imatinib abrogate the ability of ABCG2 to protect cells against ciprofloxacin-induced phototoxicity. We conclude that the concurrent administration of ABCG2 inhibitors with photoreactive fluoroquinolone antibiotics may result in retinal damage.
Cytopathologic Characteristics of Epithelioid Vascular Malignancies
Authors: VandenBussche Christopher J. , Wakely Jr. Paul E. , Siddiqui Momin T. , Maleki Zahra , Ali Syed Z.
Published: September 2014

Objectives: Epithelioid hemangioendothelioma (EHE) and epithelioid angiosarcoma (EAS) are rare vascular neoplasms that share many morphological characteristics on histology but demonstrate different clinical behavior. Given the many reported clinical and morphological features shared between EAS and EHE, we examined all cases of EAS and EHE diagnosed primarily on fine needle aspiration (FNA) at our three institutions that were confirmed by a tissue diagnosis. Study Design: A total of 29 cases from 25 patients were identified: 15 EHE from 11 patients and 14 EAS from 14 patients. Results: Many cytomorphological features existed on a spectrum that overlapped considerably between EAS and EHE cases. Common features between the two entities include epithelioid morphology and eccentrically placed nucleus. Intracytoplasmic lumens (ICL), a morphological feature that may suggest vascular origin, can be found in both entities but are not always present. Conclusions: Given the general absence of vascular cytomorphological features, such as ICL, the proper classification of these tumors depends on the successful use of immunoperoxidase markers such as factor VIII-related antigen, ERG, or CD31 as well as a high index of suspicion. The distinction between EAS and EHE on FNA alone is treacherous at best.
Usefulness of Rehabilitation in Patients with Rotator Cuff Calcific Tendinopathy after Ultrasound-Guided Percutaneous Treatment
Authors: Abate Michele , Schiavone Cosima , Salini Vincenzo
Published: September 2014

Objective: To evaluate the efficacy of a specific rehabilitation program for patients in whom ultrasound-guided percutaneous treatment (UGPT) was performed for rotator cuff calcific tendinopathy (RCCT). Subjects and Methods: In this prospective observational study, 86 patients (22 males and 64 females) with shoulder calcific tendinopathy treated with UGPT were enrolled. At the end of the procedure, a corticosteroid injection into the subacromial-subdeltoid bursa was performed. The patients were then asked to follow a specific rehabilitation protocol (2 times/week for 5 weeks) that focused on mobility, strength and function. At baseline and after 6 weeks, clinical parameters, visual analog scale (VAS) and Constant-Murley scale (CMS) scores and ultrasound (US) features were collected. Results: The mean age of the patients was 48.9 ± 8.4 years and their mean BMI was 22.7 ± 2.1. Considering the whole cohort, the treatment was effective, with a significant decrease in the VAS score and an improvement in the CMS score. Thereafter, on the basis of the compliance to the rehabilitation program (by self-report), 53 and 33 patients were included in the rehabilitation group (Rehab group; performed exercises ≥2 times/week) and the No Rehab group (performed exercises <2 times/week), respectively. The comparison between the groups showed that the subjects who performed the exercises regularly had better results in terms of pain and functional recovery, and less associated diseases (e.g. adhesive bursitis and tenosynovitis of the long head of the biceps) than those who were less compliant with the program. Conclusions: UGPT, followed by a specific postprocedure rehabilitation program, was an effective treatment for RCCT.
Very Fast Recovery of Acute Disseminated Intravascular Coagulation with Abiraterone Acetate in a Patient with Bone Metastases from Castrate-Resistant Prostate Cancer
Authors: Gauthier Hélène , Serrate Camille , Pouessel Damien , le Maignan Christine , Teixeira Luis , Culine Stéphane
Published: September 2014

Disseminated intravascular coagulation (DIC) is a rare, potentially life-threatening complication of advanced prostate carcinoma. We report the successful treatment with abiraterone acetate of acute DIC related to a progressive bone metastatic disease in a chemotherapy-naïve patient with castrate-resistant prostate cancer.
Correspondence of Plasma and Salivary Cortisol Patterns in Women with Breast Cancer
Authors: Zeitzer Jamie M. , Nouriani Bita , Neri Eric , Spiegel David
Published: September 2014

Introduction: The ‘diurnal slope' of salivary cortisol has been used as a measure of stress and circadian function in a variety of reports with several detailing its association with cancer progression. The relationship of this slope, typically a negative value from high morning concentrations to low evening concentrations, to the underlying daily variation in total plasma cortisol throughout the 24-hour cycle, however, has never been reported. Methods: To examine the relationship between the diurnal salivary cortisol slope and the underlying pattern of plasma cortisol in individuals with cancer, we examined a cohort of women with advanced breast cancer (n = 97) who had saliva and plasma collected during a modified 24-hour, constant posture protocol. Results: We found that the steepness of the diurnal slope of salivary cortisol was correlated with the amplitude of plasma cortisol rhythm when the slope was calculated from samples taken at wake + 30 min and 9 PM (r = -0.29, p > 0.05). Other variants of salivary slope calculations were not significantly correlated with the amplitude of the plasma cortisol rhythm. Diurnal salivary cortisol slope steepness was not correlated with the time between habitual waking and the computed circadian peak of cortisol, but there was a correlation between diurnal slope steepness and the time between habitual waking and the time of the awakening spike of morning cortisol (r values <-0.23, p values <0.05). Conclusion: It therefore appears that in women with advanced breast cancer, diurnal salivary cortisol slope primarily represents aspects of the cortisol awakening response in relation to evening levels more than the circadian rhythm of total plasma cortisol.
Cardiac Evaluation of Pediatric Relatives in Sudden Arrhythmic Death Syndrome
Authors: Wong Leonie C.H. , Roses-Noguer Ferran , Till Janice A. , Behr Elijah R.
Published: September 2014

Background—

Sudden arrhythmic death syndrome defines a sudden unexpected and unexplained death despite comprehensive pathological and toxicological investigation. Previous studies have focused on evaluation of adult relatives. There is, however, a lack of data in children, leading to highly variable management. We sought to determine the clinical utility of cardiac evaluation in pediatric relatives of sudden arrhythmic death syndrome probands.

Methods and Results—

Retrospective review was undertaken of pediatric patients with a family history of sudden arrhythmic death syndrome assessed from 2010 to 2013 in 2 centers. Clinical history, cardiac, and genetic investigations were assessed, including diagnoses made after evaluation of adult relatives. A total of 112 pediatric relatives from 61 families were evaluated (median age at presentation, 8 years; range, 0.5–16 years). A probable diagnosis was made in 18 (29.5%) families: Brugada syndrome, 13/18 (72%); long QT syndrome, 3/18 (17%); and catecholaminergic polymorphic ventricular tachycardia, 2/18 (11%). Genetic testing identified mutations in 20% of Brugada syndrome (2/10) and 50% of long QT syndrome (1/2) and catecholaminergic polymorphic ventricular tachycardia families (1/2) who were tested. Pediatric evaluation diagnosed 6/112 relatives (5.4%), increasing to 7% (6/85) if only first-degree relatives were assessed. The only useful diagnostic tests were the 12-lead and exercise electrocardiograms and ajmaline provocation test. The median duration of follow-up was 2.1 years (range, 0.2–8.2 years) with no cardiac events.

Conclusions—

The yield of evaluating pediatric relatives is significant and higher when focused on first-degree relatives and on conditions usually expressed in childhood. We propose a management pathway for these children.
Prognostic Significance of Left Atrial Enlargement in a General Population
Authors: Bombelli Michele , Facchetti Rita , Cuspidi Cesare , Villa Paolo , Dozio Dario , Brambilla Gianmaria , Grassi Guido , Mancia Giuseppe
Published: September 2014

We estimated the risk of cardiovascular events, cardiovascular mortality, and all-cause mortality associated with left atrium (LA) enlargement alone or combined with echocardiographic left ventricular hypertrophy (LVH) in 1785 representatives of the general population of Monza recruited for the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study. LA enlargement was assessed by measuring LA diameter via echocardiography. LA enlargement was defined as a LA diameter >2.3 cm/m
2
, whereas LVH was defined as a left ventricular mass index ≥114 g/m
2
and 99 g/m
2
in men and women, respectively. Death certificates and hospital diagnoses were collected over an average 148 months follow-up. During follow-up, there were 175 deaths (of which 59 for cardiovascular causes) and 139 cardiovascular fatal and nonfatal events. Compared with subjects with neither LA enlargement nor LVH, subjects with isolated LA enlargement exhibited a significant increase in the adjusted risk of combined fatal and nonfatal cardiovascular events (hazard ratio, 2.0; confidence interval, 1–4.1;
P
=0.04), although not of cardiovascular death or all-cause death. The adjusted (for baseline covariates, including ambulatory blood pressure) risk of fatal and nonfatal cardiovascular events, cardiovascular death, and all-cause death was significantly increased also in subjects with isolated LVH (hazard ratio, 2.2, 3.4, 2.1, respectively;
P
=0.001 for all), whereas no further increase was seen in subjects with both LA and left ventricular abnormalities. Thus, like LVH, LA enlargement is an independent long-term predictor of cardiovascular events. The cardiovascular risk, however, is not further increased when LA enlargement is superimposed on an increase of LV mass.
Comparatism in the Neoplatonic Pantheon of Late Antiquity: Damascius, De Princ. III 159.6–167.25
Authors: Mihai Adrian
Published: September 2014

In the following paper, we will look at the Neoplatonic pantheon as found in Damascius and at his comparatist method, which is centered on the principle ofsumphōnia. This hermeneutical tool is used to reconcile or harmonize the doctrines of Plato sand Aristotle with other Greek and foreign theological traditions. We will see this at play in a passage from the last part of Damascius’ treatise onProblems and Solutions Concerning First Principles(III 159.6–167.25). In this section, Damascius, the last diadoch of the Platonic school of Athens, is trying to show that his ‘Platonic’ theology is in accordance not only with Greek wisdom (as represented by theChaldean Oracles, Orphism, Homer, Hesiod and Pythagoreanism), but also with the oldest traditions of inspired religion, such as the Babylonian, Persian, Sidonian, Phoenician and Egyptian traditions. We will try to show that Damascius is establishing here a one-to-one correspondence between these Oriental and Hellenic theologies.
The Youth-Crisis Model of Conversion: An Idea Whose Time Has Passed?
Authors: Lewis James R.
Published: September 2014

Initially formulated in the 1970s when large numbers of former counterculturists were joining alternative religions, the youth-crisis model of conversion posited that new recruits were predominantly young people whose involvement could be explained as a function of their youth (e.g., as an adolescent developmental crisis). The present study presents statistics on recruits to seven different contemporary new religions that fundamentally challenge this item of conventional wisdom. Six out of seven data sets also embody a striking pattern of gradually increasing age across time for new converts. In addition to uncovering the growing age-at-recruitment pattern — which I designate the E-correlation — I argue that: (1) With the exception of efforts to understand true youth movements such as Internet Satanism, attempts to interpret conversions to contemporary emergent religions as being a function of the imputed youthfulness of recruits is no longer in touch with the reality on the ground. (2) The persistence of the characterization of converts as youthful reflects a failure to build a strong empirical base for such generalizations. Instead, we have relied upon quantitative work carried out over a quarter of a century ago for much of what passes as conventional wisdom in the study of recruitment to alternative religions.
Redefinition of the genus Typhlocypris Vejdovský, 1882 (Ostracoda, Candonidae)
Authors: Namiotko Tadeusz , Danielopol Dan L. , Meisch Claude , Gross Martin , Mori Nataša
Published: September 2014

The taxonomy of the genusTyphlocyprisVejdovský, 1882 is reviewed. New morphological information onTyphlocypris eremita(Vejdovský, 1882), the type species of the genus, is provided, and a new reference material is presented. The generic diagnosis is emended with details derived from the developmental trajectory of the valves, from the juvenile stage A-3 to the adult. Those criteria clearly differentiateTyphlocyprisfrom the related genusPseudocandonaKaufmann, 1900. As here redefined,Typhlocyprisis a phylogentic lineage of the subfamily Candoninae containing extant species presently living in aquatic subterranean habitats and fossil species recovered from non-marine Late Palaeogene to Neogene and Quaternary deposits in Europe and western Asia. The type species ofTyphlocyprisis considered a metaspecies, taxonomically treated asT. eremita(sensu lato), which includes populations resembling the newly designated reference material. The homeomorphic triangular valve shape of the Candoninae is discussed. Careful examination of the valve morphology ofTyphlocypriscombined with the analysis of limb traits helps to distinguish representatives of this genus from unrelated phylogenetic groups presenting similar triangularly shaped valves. It is emphasised that for a useful description ofTyphlocypristaxa both transmitted light and scanning electron microscopy are necessary.
Comments on Larry May’s Limiting Leviathan, Hobbes on Law and International Affairs
Authors: Curran Eleanor
Published: September 2014

Larry May makes some important arguments about Hobbes on law and particularly about the significance of the notion of equity for Hobbes, both as a moral law and as a (possibly limiting) requirement of a sovereign’s lawmaking authority. I am generally supportive of May’s project while remaining sceptical about the conclusion that a self-restraining sovereign is a genuinely limited sovereign.
Article 9 of the eu Water Framework Directive
Authors: Gawel Erik
Published: September 2014

Article 9 of the eu Water Framework Directive (wfd) requires Member States to take account of the principle of recovery of the costs of water services, including environmental and resource costs (ercs). Whilst legally the Member States have broad scope for discretion when applying Article 9, the idea that the eu legislator has effectively assigned the Member States a mathematical task to determine the level of cost recovery achieved for environmental and resource costs is increasingly gaining ground in the Common Implementation Strategy (cis) process. The present paper shows that this strict interpretation of taking account of environmental and resource costs has no basis in Article 9, is conceptually misleading, and could even prove counter-productive for the practical application of water protection.
A new combination in Alkekengi (Solanaceae) for the Flora of China
Authors: Wang Ruijiang
Published: September 2014

The genus Physalis Linnaeus (1753: 182) is a medium-sized genus in the family Solanaceae Jussieu (1789: 124). It includes about 75 New World species and one Eurasian species, P. alkekengi Linnaeus (1753: 183), the generic lectotype (Britton & Brown 1913). Recently, several phylogenetic analyses focusing on Physalis and related taxa strongly supported the monophyly of the morphologically typical New World species, characterized by unlobed and yellow flowers. Physalis alkekengi represents a divergent clade characterized by somewhat lobed, white corollas and brilliant red-orange fruiting calyces (Whitson & Manos 2005; Olmstead et al. 2008). In order to emphasize the monophyly and morphological homogeneity of the New World species and decrease nomenclatural disruption, the genus Physalis was proposed for conservation with a conserved type, P. pubescens Linneaus, to represent the New World species (Whitson 2011). The Eurasian P. alkekengi was suggested to be placed in a monotypic genus Alkekengi Miller (1754: AL) typified with A. officinarum Moench (1802: 177). This proposal was subsequently recommended for acceptance by the Nomenclature Committee for Vascular Plants (Applequist 2012).
The impact of direct speech framing expressions on the narrative: a contrastive case study of Gabriel García Márquez’s Buen viaje, señor Presidente and its English translation
Authors: Linde-Usiekniewicz Jadwiga , Nalewajko Paulina
Published: September 2014

The impact of direct speech framing expressions on the narrative: a contrastive case study of Gabriel García Márquez’s Buen viaje, señor Presidente and its English translationThis paper discusses an application of Relevance Theory methodology to an analysis of a literary text: a short story of Gabriel García Márquez “Buen viaje, señor Presidente” and its English translation. “Close reading” technique carried out on rather linguistic than literary basis allows for adding yet another layer of interpretation to this complex story. The analysis concentrates on the representation of direct speech and particularly on the impact of direct speech framing clauses on the reading of dialogic turns. Specifically, it is argued that the explicit mention of the addressee by indirect object pronouns (which are optional in direct speech framing turns) in Spanish makes the tension between the two protagonists even more palpable, therefore apparently courteous turns can be interpreted as defiant or otherwise antagonistic. In English similar role is played by the contrast between the absence of quotative inversion with subject pronouns and its presence when speakers are identified by full nominals. The parallel effect in both linguistic versions is traced to the distinction between linguistic items carrying mainly conceptual meaning (nominals) and carrying mainly procedural meaning (pronouns) and to the different ways these two kind of elements are processed in comprehension. The paper also provides some arguments for leaving aside literary considerations and treating a literary text as an act of ostensive communication.
Curiosity and Critical Thinking
Authors: Jackson Allison M. , Deye Katherine P. , Halley Tina , Hinds Tanya , Rosenthal Eric , Shalaby-Rana Eglal , Goldman Ellen F.
Published: September 2014

Objective. We reviewed medical records to identify factors contributing to not recognizing child abuse in cases where it was subsequently identified. Design/Methods. Eighteen cases of delayed diagnosis of physical abuse were reviewed for qualitative themes. Missed abuse was defined by prior medical encounters that revealed findings concerning for physical abuse that were not recognized. Results. Clinical limitations contributing to a delay in diagnosis included inattention to skin and subconjunctival findings, acceptance of inadequate explanations for injuries, no history obtained from verbal children, insufficient exploration of signs and symptoms, nonadherence to the maltreatment pathway, and incorrect diagnoses from radiologic examinations. System-based limitations included limited medical record access or completeness and admission to less-than-optimal settings. Conclusions. Having a greater index of suspicion for abuse may mitigate missed opportunities. With variability of medical training in child abuse, the factors we identified can be used as learning objectives for continuing medical education.
Tourette Syndrome
Authors: Byler Debra L. , Chan Lisa , Lehman Erik , Brown Ashley D. , Ahmad Syeda , Berlin Cheston
Published: September 2014

A retrospective analysis of a 35-year single-center experience with pediatric tics and Tourette syndrome was conducted. 482 charts from 1972 to 2007 were reviewed. Follow-up surveys were mailed to last known address and 83 patients responded (17%). Response rate was affected by long interval from last visit; contact information was often incorrect as it was the address of the patient as a child. Males constituted 84%. Mean tic onset was 6.6 years. At first visit, 83% had multiple motor tics and >50% had comorbidities. 44% required only 1 visit and 90% less than 12 visits. Follow-up showed positive clinical and social outcomes in 73/83 survey responses. Of those indicating a poor outcome, mean educational level was lower and attention deficit/hyperactivity disorder and learning disabilities were significantly higher. Access to knowledgeable caregivers was a problem for adult patients. A shortage of specialists may in part be addressed by interested general pediatricians.
The State of African Cities 2014
Authors: Obeng-Odoom Franklin
Published: September 2014

After an unprecedented and notable delay, the State of African Cities Report 2014 has been published. It makes a bold claim for re-imagining urban sustainability in Africa, continuing two earlier attempts at shaping the nature of urban discussion among scholars, students, and practitioners interested in cities located in Africa. A systematic content analysis shows that although, as in previous attempts, the report is a major success in highlighting developments in African cities, this year’s attempt is undermined by severe drawbacks, among which are conceptual challenges, a failure to achieve agreement between the report’s claims and research findings, and a bias in focus against smaller African countries and their cities. In turn, there are many dark clouds hanging over this otherwise successful report.
Act Like a Lady, Think Like a Patriarch
Authors: Charleston Kayla
Published: September 2014

The purpose of this study was to examine how Black men and women understand masculine performances in romantic relationships and to do so using Steve Harvey’s book Act Like A Lady, Think Like A Man as a point of reference. This book was chosen specifically for its success and because of its patriarchal implications. Data from six focus groups revealed that participants viewed masculinity as dynamic both over time and within an individual. Participants also emphasized the reciprocity involved in masculine performances. Last, the Black men and women in this study were aware of the potential impact of larger society on their relationships but expressed the importance of eschewing societal norms as a tactic to maintain the integrity of their relationships.