bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes Mellitus: Prevalence and Effect of Morbidities in the Oldest Old. The Octabaix Study
Authors: Ferrer Assumpta , Padrós Glòria , Formiga Francesc , Rojas‐Farreras Sònia , Perez Jose‐Manuel , Pujol Ramón
Published: February 2012

Objectives

To describe the prevalence of diabetes mellitus (DM) in community‐dwelling 85‐year‐olds and to study the factors associated.

Design

Cross‐sectional.

Setting

Community‐based survey study of seven primary healthcare centers.

Participants

Three hundred twenty‐eight people born in 1924 and registered with primary healthcare centers.

Measurements

Information on sociodemographic variables, Barthel Index (BI), Spanish version of the Mini‐Mental State Examination (MEC), Mini Nutritional Assessment (MNA), Braden scale for risk of pressure ulcers, Charlson Comorbidity Index, chronic diseases, social risk, quality of life, chronic drug prescriptions, and blood tests was recorded. Participants were defined as having DM according to self‐report, physician diagnosis, antidiabetic prescriptions, or plasma glucose concentration 7 mmol/L or more. A comparative analysis was performed between participants with and without DM.

Results

The prevalence of DM in 328 octogenarians studied was 25.9%. Logistic regression showed an association between DM and BI (odds ratio (OR) = 1.03, 95% confidence interval (CI) = 1.00–1.05, P = .007), Braden risk score (OR = 0.87, 95% CI = 0.79–0.97, P = .01), thyroid disease (OR = 0.23, 95% CI = 0.06–0.92, P = .04), chronic drug prescriptions (OR = 1.28, 95% CI = 1.15–1.42, P < .001), white‐cell count (OR = 1.34, 95% CI = 1.15–1.56, P < .001), low‐density lipoprotein cholesterol (LDL‐C; OR = 0.63, 95% CI = 0.43–0.92, P = .02) and folic acid level (OR = 1.04, 95% CI = 1.01–1.07, P = .005).

Conclusion

There is a high prevalence of DM at 85 years old. The presence of DM was positively associated with disability, drug prescription, white blood cell count, and folic acid level, whereas there was an inverse relationship between DM and Braden scale score, thyroid disease, and LDL‐C. The effect of morbidities on DM may require a multidisciplinary approach to manage its complexity.
High‐Fiber Foods Reduce Periodontal Disease Progression in Men Aged 65 and Older: The Veterans Affairs Normative Aging Study/Dental Longitudinal Study
Authors: Schwartz Natalie , Kaye Elizabeth Krall , Nunn Martha E. , Spiro Avron , Garcia Raul I.
Published: February 2012

Objectives

To determine whether foods that are good to excellent sources of fiber reduce periodontal disease progression in men.

Design

Prospective, observational study.

Setting

Greater Boston, Massachusetts, metropolitan area.

Participants

Six hundred twenty‐five community‐dwelling men participating in the Department of Veterans Affairs Dental Longitudinal Study.

Measurements

Dental and physical examinations were conducted every 3 to 5 years. Diet was assessed using food frequency questionnaires (FFQs). Mean follow‐up was 15 years (range: 2–24 years). Periodontal disease progression on each tooth was defined as alveolar bone loss (ABL) advancement of 40% or more, probing pocket depth (PPD) of 2 mm or more, or tooth loss. Good and excellent fiber sources provided 2.5 g or more of fiber per serving. Multivariate proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of periodontal disease progression and tooth loss in relation to fiber sources, stratified according to age younger than 65 versus 65 and older, and controlled for smoking, body mass index, calculus, baseline periodontal disease level, caries, education, exercise, carotene, thiamin and caffeine intake, and tooth brushing.

Results

In men aged 65 and older, each serving of good to excellent sources of total fiber was associated with lower risk of ABL progression (HR = 0.76, 95% CI = 0.60–0.95) and tooth loss (HR = 0.72, 95% CI = 0.53–0.97). Of the different food groups, only fruits that were good to excellent sources of fiber were associated with lower risk of progression of ABL (HR = 0.86 per serving, 95% CI = 0.78–0.95), PPD (HR = 0.95, 95% CI = 0.91–0.99), and tooth loss (HR = 0.88, 95% CI = 0.78–0.99). No significant associations were seen in men younger than 65.

Conclusion

Benefits of higher intake of high‐fiber foods, especially fruits, on slowing periodontal disease progression are most evident in men aged 65 and older.
The Cholinergic System and Inflammation: Common Pathways in Delirium Pathophysiology
Authors: Cerejeira Joaquim , Nogueira Vasco , Luís Pedro , Vaz‐Serra Adriano , Mukaetova‐Ladinska Elizabeta B.
Published: February 2012

Objectives

To investigate whether delirium is associated with an unbalanced inflammatory response or a dysfunctional interaction between the cholinergic and immune systems.

Design

Cohort observational study.

Setting

General hospital orthopedic ward.

Participants

One hundred one individuals aged 60 and older with no previous cognitive impairment undergoing elective arthroplasty.

Measurements

Incidence of postoperative delirium, plasma cholinesterase activity (acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE)) and inflammatory mediators (C‐reactive protein (CRP), interleukin (IL)‐1 beta, tumor necrosis factor alpha,IL‐6,IL‐8,IL‐10) before and after surgery.

Results

Thirty‐seven participants developed postoperative delirium and had greater production ofCRPand proinflammatory to anti‐inflammatory ratio after surgery. In participants with delirium, but not in controls, preoperative levels of plasma cholinesterase activity correlated with ΔCRP(AChE: ρ = 0.428,P = .008 and BuChE: ρ = 0.423,P = .009), ΔIL‐6 (AChE: ρ = 0.339,P = .04), and ΔP/A ratio (AChE: ρ = 0.346,P = .04).

Conclusion

Delirium was associated not only with an unbalanced inflammatory response, but also with a dysfunctional interaction between the cholinergic and immune systems. Comprehensive understanding of the relationship between the cholinergic and immune systems is crucial to developing new insights into delirium pathophysiology and novel therapeutic interventions.
Short‐Term Oral Nutritional Intervention with Protein and Vitamin D Decreases Falls in Malnourished Older Adults
Authors: Neelemaat Floor , Lips Paul , Bosmans Judith E. , Thijs Abel , Seidell Jaap C. , van Bokhorst‐de van der Schueren Marian A. E.
Published: February 2012

Objectives

To evaluate the effects of a short‐term nutritional intervention with protein and vitamin D on falls in malnourished older adults.

Design

Randomized controlled trial.

Setting

From hospital admission until 3 months after discharge.

Participants

Malnourished older adults (≥60) newly admitted to an acute hospital (n = 210).

Intervention

Participants were randomized to receive nutritional intervention (energy‐ and protein‐enriched diet, oral nutritional supplements, calcium‐vitamin D supplement, telephone counseling by a dietitian) for 3 months after discharge or usual care.

Measurements

Number of participants who fell, fall incidents, serum 25‐hydroxyvitamin D, and dietary intake. Measurements were performed on admission to hospital and 3 months after discharge.

Results

Three months after discharge, 10 participants (10%) in the intervention group had fallen at least once, compared with 24 (23%) in the control group (hazard ratio = 0.41, 95% confidence interval (CI) = 0.19–0.86). There were 57 fall incidents (16 in the intervention group; 41 in the control group). A significantly higher intake of energy (280 kcal, 95% CI = 37–524 kcal) and protein (11 g, 95% CI = 1–25 g) and significantly higher serum 25‐hydroxyvitamin D levels (10.9 nmol/L, 95% CI = 2.9–18.9 nmol/L) were found in participants in the intervention group than in controls.

Conclusion

A short‐term nutritional intervention consisting of oral nutritional supplements and calcium and vitamin D supplementation and supported by dietetic counseling in malnourished older adults decreases the number of patients who fall and fall incidents.
Laparoscopic‐Assisted Cystotomy and Cystostomy for Treatment of Cystic Calculus in a Gelding
Authors: Straticò Paola , Suriano Riccardo , Sciarrini Chiara , Varasano Vincenzo , Petrizzi Lucio
Published: February 2012

Objective

To report laparoscopic‐assisted cystotomy and inguinal cystostomy for treating bladder urolithiasis in a gelding.

Study Design

Clinical report.

Animals

Twelve‐year‐oldAppaloosa gelding.

Methods

A laparoscopic approach was used to locate and grasp the bladder, which was exteriorized through an enlarged instrument portal for cystotomy to remove the calculus. During withdrawal, the calculus fragmented into multiple pieces. To avoid urethral occlusion and facilitate elimination of these fragments, an inguinal cystostomy was created. The seromuscular layer of the bladder was circumferentially secured to the abdominal fascia and bladder mucosa margins were sutured to the skin.

Results

At 2‐year follow‐up, the gelding was in good condition with mild urine scald of the left ventral abdomen.

Conclusion

Laparoscopic‐assisted cystotomy was used for calculus removal and inguinal cystostomy for successful fragment elimination.
The cost of blood transfusion in Western Europe as estimated from six studies
Authors: Abraham Ivo , Sun Diana
Published: February 2012

BACKGROUND: Blood is a costly and scarce resource. We report on a systematic review of the literature to estimate the cost of a 2‐unit red blood cell (RBC) transfusion in Western Europe.

STUDY DESIGN AND METHODS: Medline was searched for studies about the cost of RBC transfusion in Europe. Data extracted included authors, country, year of data, cost perspective, cost types, cost elements, units examined, study design, study population, and cost of a 2‐unit blood transfusion. The population‐weighted mean cost per 2 units of transfused blood was calculated.

RESULTS: Six studies met inclusion and exclusion criteria and reported data from the United Kingdom, Sweden, Switzerland, Austria, and France. Methodology used to derive cost estimates differed across the studies. The population‐weighted mean cost of transfusing 2 units of blood was €877.69.

CONCLUSION: The estimated cost of transfusing 2 units of RBCs in Western Europe is significant. Differences in methodology were partially diffused by aggregation of prior estimates into a population‐weighted mean. Future cost studies should follow the Cost of Blood Consensus Conference (COBCON) recommendation to apply activity‐based costing methods.
Effect of increasing hemoglobin cutoff in male donors and increasing interdonation interval in whole blood donors at a hospital‐based blood donor center
Authors: Gandhi Manish J. , Duffy Kimberly , Benike Mary , Jenkins Sarah , Stubbs James R.
Published: February 2012

BACKGROUND: The NHANES‐III survey found hemoglobin (Hb) concentrations of more than 13.5 g/dL and more than 12.0 g/dL in normal Caucasian males and females. In the United States, a Hb of least 12.5 g/dL is required for blood donation, which allows “anemic” males to donate while excluding “normal” females. Low Hb is the major cause of deferral in donors and deferrals are associated with decreased donor return rates. Additionally, frequent blood donations are associated with depletion of body iron stores. Analysis of the effect of various Hb cutoffs and interdonation intervals on our center's blood supply is presented.

STUDY DESIGN AND METHODS: Whole blood donor data for a 12‐month period were studied. Potential effects on the blood supply by increasing male Hb eligibility levels and/or increasing the interdonation interval were analyzed.

RESULTS: A total of 13,519 individuals (females, 56%) donated 30,678 units (mean frequency, male 2.7 and females 2.1) with the majority (42%) donating once. Increasing the male Hb eligibility to at least 13.5 g/dL will decrease collections by 1457 (5%) units. In addition, decreasing the female Hb eligibility to at least 12.0 g/dL will result in total gain of 307 (1%) units. Considering 12‐week interdonation interval and Hb eligibility of at least 13.5 g/dL (male) and at least 12.5 g/dL (female) results in decrease of 11% (3352) units.

CONCLUSIONS: Increasing the Hb cutoff for male donors and/or interdonation interval for all donors will decrease available blood, some of which may be reduced by decreasing the Hb cutoff for females to at least 12.0 g/dL. As a majority of the donors donate only once with mean donation frequency being 2.4, it may be possible to overcome this shortfall by targeted recruitment of donors donating once.
Outpatient transfusions and occurrence of serious noninfectious transfusion‐related complications among US elderly, 2007‐2008: utility of large administrative databases in blood safety research
Authors: Menis Mikhail , Izurieta Hector S. , Anderson Steven A. , Kropp Garner , Holness Leslie , Gibbs Jonathan , Erten Tugce , Worrall Christopher M. , MaCurdy Thomas E. , Kelman Jeffrey A. , Ball Robert
Published: February 2012

BACKGROUND: Transfusion‐related acute lung injury (TRALI) and hemolytic transfusion reactions account for significant transfusion‐related morbidity and mortality in the United States. Our study evaluated types and quantities of transfused components as well as occurrence of TRALI, ABO, and Rh incompatibilities among the US elderly in the institutional outpatient setting during 2007 to 2008.

STUDY DESIGN AND METHODS: This retrospective claims‐based study utilized the Centers for Medicare & Medicaid Services' large administrative databases. Transfusions were identified by recorded procedure and revenue center codes, while complications were ascertained via ICD‐9‐CM diagnosis codes. The study quantified blood use based on revenue center units.

RESULTS: Among 26,054,242 and 25,662,864 Medicare elderly in 2007 and 2008, a total of 241,055 (0.9%) and 251,284 (1.0%) had outpatient transfusions. Leukoreduced red blood cells (LR‐RBCs) was the most frequently transfused single blood component (60.1 and 61.3%, respectively) each year. Likewise, LR‐RBCs and LR pheresis platelets (LR‐PLTs) was the most frequent component combination (2.4 and 2.6%, respectively). TRALI rate comparison for RBCs and PLTs versus RBCs only showed higher rate for RBCs and PLTs (p = 0.033). In 2007 and 2008, ABO incompatibility rate comparison for irradiated (IR) LR‐RBCs versus LR‐RBCs showed higher rates for IR LR‐RBCs (rate ratio [RR] 37.4, 95% confidence interval [CI] 10.6‐132.6; and RR 31.3, 95% CI 11.6‐84.4, respectively).

CONCLUSION: This study shows potential usefulness of Medicare databases in assessment of blood utilization, transfusion‐related complications, and risk factors among US elderly in the outpatient setting. It suggests limitations (e.g., need for several years of data to better assess rare complications) and importance of databases as hypothesis‐generating tool to supplement blood safety research.
Longevity/Mortality Risk Modeling and Securities Pricing
Authors: Deng Yinglu , Brockett Patrick L. , MacMinn Richard D.
Published: February 2012

Abstract

Securitizing longevity/mortality risk can transfer longevity/mortality risk to capital markets. Modeling and forecasting mortality rate is key to pricing mortality‐linked securities. Catastrophic mortality and longevity jumps occur in historical data and have an important impact on security pricing. This article introduces a stochastic diffusion model with a double‐exponential jump diffusion process that captures both asymmetric rate jumps up and down and also cohort effect in mortality trends. The model exhibits calibration advantages and mathematical tractability while better fitting the data. The model provides a closed‐form pricing solution for J.P. Morgan’s q‐forward contract usable as a building block for hedging.
Hedonic Models with Redevelopment Options under Uncertainty
Authors: Clapp John M. , Jou Jyh‐Bang , (Charlene) Lee Tan
Published: February 2012

In the hedonic model, implicit market prices can be interpreted as the present values of rents per unit of each hedonic characteristic. But when rents rise, there may be substantial value associated with the option to redevelop to higher intensity per unit land value. In the presence of option value, we first demonstrate that hedonic linear regressions should include an additive nonnegative term for the value of the option. This term increases in the variance of the underlying stochastic process. If this term is omitted, then estimates of implicit market prices for desirable (undesirable) characteristics will be biased downward (upward). This prediction is supported by recent empirical studies. We further suggest that future empirical work can employ the nonlinear functional form derived from our theory.
Regulation of Cerebral Vascular Function by Sirtuin 1
Authors: TAJBAKHSH NEGARA , SOKOYA ELKE M.
Published: February 2012

Please cite this paper as: Tajbakhsh N, Sokoya EM. Regulation of cerebral vascular function by sirtuin 1. Microcirculation 19: 336–342, 2012.

Objective:  Endothelial dysfunction, associated with reduced nitric oxide bioavailability and oxidative stress, is a common feature of vascular‐related diseases. Sirtuin 1 (SIRT1) is a protein deacetylase that has been shown to target endothelial nitric oxide synthase in large arteries and is protective during oxidative stress. However, within resistance‐sized vessels, the expression and functional effects of SIRT1 remain unknown.

Methods:  Immunoblotting and immunohistochemistry were used to determine SIRT1 expression and localization in cultured brain endothelial cells and intact rat middle cerebral artery. The influence of SIRT1 on vascular function was then studied in intact middle cerebral arteries using pressure myography.

Results:  We report for the first time that SIRT1 is expressed in the resistance‐sized vessels in the brain and is present in both the endothelium and smooth muscle. Pharmacological inhibition of SIRT1 demonstrated reduced endothelium‐dependent dilation mediated by nitric oxide. However, endothelium‐independent dilations were comparable in the presence and absence of SIRT1 block.

Conclusions:  Our results support a role for SIRT1 in endothelium‐dependent relaxation in the cerebral vasculature and reveal a potential for SIRT1 as a therapeutic target in vascular‐related diseases by restoring endothelial function.
Increasing Population and the Environment: How Do the Numbers Stack Up?
Authors: Scott Marian
Published: February 2012

The UK population has risen by at least 10% since 1971. Our impact on the environment has increased by much more. Marian Scott explains why.
Acute ST‐elevation myocardial infarction in a 24‐year‐old woman with atheromatous coronary artery disease
Authors: McIver Lachlan , Liebenberg Paul , Scott Ashleigh , Sutcliffe Steven
Published: February 2012

We report the case of a 24‐year‐old Torres Strait Islander woman who presented to a rural hospital ED with chest pain suspicious for myocardial ischaemia and was found to have an anterior ST‐elevation myocardial infarction. She was thrombolysed and transferred to a tertiary centre where subsequent angiography revealed atheromatous disease of the left anterior descending coronary artery. We believe this to be one of the youngest reported cases of myocardial infarction due to atheromatous coronary artery disease, and demonstrates important learning points regarding the demographics and risk factors of indigenous patients with chest pain.
Imbalanced Matrix Metalloproteinases in Cardiovascular Complications of End‐Stage Kidney Disease: A Potential Pharmacological Target
Authors: Marson Bernardo P. , Poli de Figueiredo Carlos E. , Tanus‐Santos Jose E.
Published: February 2012

End‐stage kidney disease (ESKD) is a major health problem associated with very high morbidity and mortality secondary to cardiovascular complications, especially in ESKD patients on dialysis. Therefore, exploring key mechanisms underlying cardiovascular alterations associated with ESKD may offer reasonable pharmacological targets that may benefit these patients. Imbalanced matrix metalloproteinases (MMP) activities have been implicated in many cardiovascular diseases, and growing evidence now indicates that excessive MMP activities contribute to cardiovascular complications in ESKD patients. However, there is no study on the effects of MMP inhibitors (MMPIs) in such patients. MMPIs may prevent against the vascular and cardiac changes associated with ESKD. In this MiniReview, we aimed at reviewing current evidence supporting the idea that pharmacological inhibition of imbalanced MMP activities in ESKD may decrease the morbidity and mortality associated with cardiovascular complications in ESKD patients. However, MMPs have variable effects during different phases of kidney disease, and therefore optimal timing for MMP inhibition during a disease process may vary significantly and is largely undetermined. While current research shows that MMPs play a role in the pathogenesis of the cardiovascular alterations found in ESKD patients, clinical studies are required to validate the idea of using MMPIs in ESKD.
Aggressiveness and diversity of Phytophthora capsici on vegetable crops in Georgia
Authors: Yin J. , Jackson K.L. , Candole B. L. , Csinos A.S. , Langston D.B. , Ji P.
Published: February 2012

Phytophthora blight induced by Phytophthora capsici causes significant yield loss in a number of vegetable crops. It is imperative to understand the diversity and aggressiveness of the pathogen to design more efficient disease management programs. A collection of P. capsici strains isolated from different vegetable crops in Georgia, USA, were characterised in this study. Of the 49 isolates tested, 24 were A1 and 25 were A2 mating type, respectively, with both mating types found in the same fields. Variability of the isolates was assessed in terms of their aggressiveness on six pepper genotypes. The isolates differed in their aggressiveness on different pepper cultivars with 10 pathotypes identified. No correlation between aggressiveness of the isolates and their host origin or geographical location of isolation was observed. Randomly amplified polymorphic DNA (RAPD) analysis was used to evaluate genetic variability among P. capsici populations. RAPD analysis using 15 random primers resulted in 133 reproducible bands and cluster analysis separated the isolates into 5 groups. Analysis of molecular variance showed that there was moderate genetic differentiation associated with host origin and geographical location of the isolates. No correlation was found between RAPD groups and pathotypes or mating types. These results indicate that P. capsici populations infecting vegetable crops in Georgia were genetically diverse, which should be taken into account in developing resistant cultivars or other disease management programmes.
DICER‐like Proteins and Their Role in Plant‐herbivore Interactions in Nicotiana attenuata
Authors: Ahmadovich Bozorov Tohir , Prakash Pandey Shree , Dinh Son Truong , Kim Sang‐Gyu , Heinrich Maria , Gase Klaus , Baldwin Ian T.
Published: February 2012

DICER‐like (DCL) proteins produce small RNAs that silence genes involved in development and defenses against viruses and pathogens. Which DCLs participate in plant‐herbivore interactions remains unstudied. We identified and stably silenced four distinct DCL genes by RNAi in Nicotiana attenuata (Torrey ex. Watson), a model for the study of plant‐herbivore interactions. Silencing DCL1 expression was lethal. Manduca sexta larvae performed significantly better on ir‐dcl3 and ir‐dcl4 plants, but not on ir‐dcl2 plants compared to wild type plants. Phytohormones, defense metabolites and microarray analyses revealed that when DCL3 and DCL4 were silenced separately, herbivore resistance traits were regulated in distinctly different ways. Crossing of the lines revealed complex interactions in the patterns of regulation. Single ir‐dcl4 and double ir‐dcl2 ir‐dcl3 plants were impaired in JA accumulation, while JA‐Ile was increased in ir‐dcl3 plants. Ir‐dcl3 and ir‐dcl4 plants were impaired in nicotine accumulation; silencing DCL2 in combination with either DCL3 or DCL4 restored nicotine levels to those of WT. Trypsin proteinase inhibitor activity and transcripts were only silenced in ir‐dcl3 plants. We conclude that DCL2/3/4 interact in a complex manner to regulate anti‐herbivore defenses and that these interactions significantly complicate the already challenging task of understanding smRNA function in the regulation of biotic interactions.
Washing and filtering of cell‐salvaged blood – does it make autotransfusion safer?
Authors: KONIG GERHARDT , WATERS JONATHAN H.
Published: February 2012

Autologous transfusion was first performed in the late 1800s, but it was not until the 1970s that devices were developed that enabled widespread adoption of the practice. Unwashed salvaged blood contains thrombogenic products, cell breakdown products and plasma proteins, and gross chemical, cellular and physical contaminants. Washing and filtering of salvaged blood is routinely performed to remove or reduce these elements. In this paper we review the clinical data supporting the need for washing and filtering of salvaged blood.
Development and validation of Hong Kong Rapid Estimate of Adult Literacy in Dentistry
Authors: Wong Hai Ming , Bridges Susan M. , Yiu Cynthia K.Y. , McGrath Colman P.J. , Au Terry K. , Parthasarathy Divya S.
Published: February 2012

Aim:  To develop and validate an instrument, the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREALD‐30).

Methods:  The Rapid Estimate of Adult Literacy in Dentistry (REALD‐99) was translated into Chinese and modified in the pretest. A total of 200 parents of pediatric dental patients were interviewed using this modified scale and administered additional three sets of self‐reported questionnaires. The 99 items of the scale were reduced to 30 (HKREALD‐30). Concurrent validity was tested by comparing the HKREALD‐30 scores with the participants’ educational level, pattern of dental visits and reading habits. Convergent validity was tested by examining the association between HKREALD‐30 and the Test of Functional Health Literacy in Dentistry (TOFHLiD). The test–retest reliability and internal consistency of HKREALD‐30 were also evaluated.

Results:  A significant correlation (P < 0.01) was found between HKREALD‐30 and participants’ reading habits. HKREALD‐30 was also highly correlated with TOFHLiD (Spearman’s rho = 0.693, P < 0.01). In the regression model, HKREALD‐30 was positively associated with TOFHLiD (P < 0.05) after controlling for participants’ characteristics. The intra‐class correlation coefficient of HKREALD‐30 was 0.78 and the Cronbach’s alpha was 0.84.

Conclusion:  Initial testing of HKREALD‐30 suggested that it is a valid and reliable instrument for the basic screening of oral health literacy among Chinese people in Hong Kong.
Minimal intervention concept: a new paradigm for operative dentistry
Authors: Dallı Mehmet , Çolak Hakan , Mustafa Hamidi M.
Published: February 2012

The current treatment philosophy is to prevent and detect dental disease at the earliest stage in order to avoid invasive treatment. With the current understanding of the nature of dental disease and its process, the treatment philosophy is now changing to a more conservative approach and the concept of minimal intervention is gaining popularity in modern dentistry throughout the world. It is now established that demineralized but non‐cavitated enamel and dentine can be healed and traditional surgical approach of drilling and filling may no longer be necessary as this only treats the symptoms of the disease and not the cause. However, when surgical intervention is indicated, the least invasive techniques such as preventive resin restoration and minimal cavity preparation are utilized. The aim of this article is to give dental professionals an overview of the concepts of minimal intervention dentistry and recent innovations in dental technology in both the diagnosis and treatment of dental caries.
Acute pancreatitis in two five‐day‐old Appaloosa foals
Authors: OLLIVETT T. L. , DIVERS T. J. , CUSHING T. , PRIEST H. , DAWSON D. R. , PETERS R. , STOKOL T.
Published: February 2012

Severe acute pancreatitis (SAP) in foals is rare and treatment has not been documented. This paper describes the clinical, haematological and ultrasonographic findings as well as attempted treatment of SAP in two 5‐day‐old Appaloosa fillies. Clinical signs, including colic, diarrhoea and coma, may be mistaken for sepsis or neonatal encephalopathy. Hyperlipaemic serum and peritoneal fluid, and elevated serum and peritoneal fluid amylase and lipase activities aided the diagnosis. Severe acute pancreatitis should be included as a differential in an acutely ill foal with diarrhoea, colic, cerebral cortical dysfunction and hyperlipaemia.
Pancreatic endocrine function in newborn pony foals after induced or spontaneous delivery at term
Authors: HOLDSTOCK N. B. , ALLEN V. L. , FOWDEN A. L.
Published: February 2012

Reasons for performing study:During the switch from parenteral to enteral nutrition at birth, endocrine glands such as the pancreas must assume a glucoregulatory role for the first time if the neonate is to survive the transition to extrauterine life.

Objectives:To determine the adaptations in pancreatic endocrine function during the neonatal period in term pony foals delivered by different methods.

Methods:By measuring insulin and glucagon concentrations, pancreatic α and β cell responses to exogenous glucose (0.5 g/kg bwt) and arginine (100 mg/kg bwt) and to endogenous muzzling for 90 min were determined periodically over the first 10 post natal days in foals born spontaneously (n = 8) or by induction of labour with oxytocin at term (n = 7).

Results:Pancreatic α and β cell function changed with post natal age in a manner related to the method of delivery. Induced foals had 2–3 fold greater β cell responses to exogenous glucose and arginine, despite similar glucose and α‐amino nitrogen clearances compared with spontaneously delivered foals. Pancreatic β cell responses to glucose decreased by 50% while those to arginine doubled with increasing age in induced but not spontaneously delivered foals. In contrast, pancreatic α cell responses to arginine doubled with increasing age in foals born spontaneously but not by induction. These differences in pancreatic endocrine cell function with delivery method were associated with 2–3 fold higher cortisol levels in the induced foals and with differences in the absolute and age‐related changes in basal concentrations of glucose, α‐amino nitrogen and insulin.

Conclusions:Induced delivery leads to changes in pancreatic β cell sensitivity to glucose and/or tissue insulin resistance in association with persistent neonatal hypercortisolaemia.

Potential relevance:The altered post natal development of pancreatic endocrine function with induced delivery may compromise glucoregulation and adaptation to enteral nutrition in neonatal foals with potential consequences long after birth.
Hypothalamic–pituitary–adrenal axis function in pony foals after neonatal ACTH‐induced glucocorticoid overexposure
Authors: JELLYMAN J. K. , ALLEN V. L. , FORHEAD A. J. , HOLDSTOCK N. B. , FOWDEN A. L.
Published: February 2012

Reasons for performing the study: The effects of overexposure to glucocorticoids during early life of the foal on the subsequent HPA programming of the hypothalamic–pituitary–adrenal axis are unknown.

Objectives: To test the hypotheses that excess glucocorticoid exposure in early life subsequently increases both basal plasma concentrations of cortisol and the adrenocortical responsiveness to exogenous adrenocorticotropic hormone (ACTH).

Methods: Foals received either saline (0.9% NaCl, n = 9) or long‐acting ACTH (0.125 mg i.m. b.i.d., n = 6) for 5 days from Day 1 to increase endogenous cortisol concentrations. Long‐term indwelling catheters were inserted under local anaesthesia into the jugular veins of foals aged 2 and 12 weeks. After recovery, short‐acting ACTH1‐24 was given as a single i.v. injection (2 µg/kg bwt) and blood samples were taken at 5–30 min intervals before and after ACTH administration to measure plasma cortisol concentrations.

Results: Basal plasma cortisol concentrations were higher in ACTH‐ than in saline‐treated foals at age 3 weeks, but not at 13 weeks. There were no significant differences in either the time profile or the area under the cortisol curve in response to ACTH between the 2 groups.

Conclusions: These data suggest that ACTH‐induced overexposure to glucocorticoids during early post natal life of the foal does not have a programming effect on HPA axis function at 13 weeks. In foals, the effects of ACTH‐induced overexposure to glucocorticoids, if any, may not become apparent until much later in life in a long‐lived species such as the horse.

Potential relevance: These studies suggest that clinical and other stressful conditions that raise plasma cortisol concentrations during early life are unlikely to programme cardiovascular and metabolic function in horses in the short term.
Parturition, dystocia and foal survival: A retrospective study of 1047 births
Authors: McCUE P. M. , FERRIS R. A.
Published: February 2012

Reason for performing study:An understanding of the normal events of foaling, causes of dystocia and clinical outcomes is important for equine practitioners.

Objectives:The goals of the present study were to: 1) evaluate factors that influence gestation length; 2) report duration of Stage II labour; 3) determine the frequency of dystocia and premature placental separation; and 4) determine the relationship between problems at foaling and foal survival.

Materials and methods:Foaling records of 1047 mare births were evaluated.

Results:The average gestation length was 341 ± 0.3 days, with no effect of mare age or breed observed. Mares carrying male fetuses had a longer gestation (P≤0.001) than mares carrying female fetuses. A majority (52.8%) of mares foaled at night between 2000 h and 0200 h when the facility was quiet. Dystocia occurred in 10.1% of all births and the incidence rate was higher in Thoroughbred mares than in Quarter Horse mares. The most common cause of dystocia was abnormalities of fetal posture. A delay in foal delivery beyond 40 min of Stage II of labour was associated with a significant increase in foal mortality. In addition, an increase in foal morbidity and mortality was noted when the interval from birth to standing or birth to nursing was prolonged.

Conclusion:Early detection and rapid appropriate intervention are critical to foal survival in an equine dystocia.

Potential relevance:Equine veterinarians should counsel horse owners that early recognition of a foaling problem and rapid, appropriate intervention are critical to the survival of a foal.
The impact of birthweight on mare health and reproductive efficiency, and foal health and subsequent racing performance
Authors: WHITTAKER S. , SULLIVAN S. , AUEN S. , PARKIN T. D. H. , MARR C. M.
Published: February 2012

Reasons for performing study:Although low birthweight is a risk factor for neonatal illness, the impact of high birthweight on the health of foals and mares, and on the foals' long‐term athletic capability, is unknown.

Objectives:To investigate whether: 1) foals that are excessively heavy are associated with an increased prevalence of maternal illness in the first monthpost partumand reproductive dysfunction in the following season; 2) excessively light or heavy foals are at an increased risk of illness in the first month of life; and 3) birthweight is associated with racing success.

Methods:Veterinary records from 230 Thoroughbred mares and 409 foalings were reviewed. Data relating to foaling, foal and mare health during the first monthpost partumand subsequent breeding efficiency were extracted. Foals' racing records were obtained and the association between birthweight and these outcomes examined.

Results:Mares with heavy foals had a higher prevalence of minor nonreproductive problems than those with light and average foals. Compared to average foals, placental weight was lower in the light group and higher in the heavy group. Light foals took longer to stand, nurse and pass meconium, whereas gestation period and duration of Stage 2 parturition were longer in heavy foals. Heavy foals were at increased risk of nonseptic musculoskeletal conditions and conformational defects. Birthweight was not associated with racing outcomes.

Conclusions:High birthweight was associated with increased prevalence of neonatal musculoskeletal conditions but birthweight did not have a major impact on mares' health and reproductive efficiency, or foals' racing success.

Potential relevance:These data add to the understanding of the impact of birthweight on short‐ and long‐term health outcomes in mares and foals.
Relationship between infection, inflammation and premature parturition in mares with experimentally induced placentitis
Authors: LEBLANC M. M. , GIGUÈRE S. , LESTER G. D. , BRAUER K. , PACCAMONTI D. L.
Published: February 2012

Reasons for performing the study:Ascending placentitis results in premature birth and high foal mortality. By understanding how placentitis induces premature delivery, it may be possible to develop diagnostic markers and to delay premature delivery pharmacologically, thereby decreasing perinatal foal mortality.

Objective:To identify relationships between bacterial infection, inflammation and premature parturition in mares with experimentally induced placentitis.

Materials and methods:Experiment 1: Concentrations of allantoic fluid prostaglandins (PGs) F2αand E2were measured in 8 mares after intracervical inoculation withStreptococcus equissp.zooepidemicus(at Days 285–291 of gestation) until parturition and compared with controls (n = 4).Experiment 2: mRNA expression of interleukin (IL)‐1β, IL‐6, tumour necrosis factor (TNF)‐α and IL‐8 in the chorioallantois from inoculated mares inExperiment 1were compared with 7 mares that foaled normally.

Results:Bacterial inoculation resulted in 7 aborted fetuses and birth of one premature, viable foal. Infection was associated with inflammation of the chorioallantois in the region of the cervical star, isolation of bacteria and high concentrations of PGE2and PGF2αin allantoic fluid obtained within 48 h of delivery (P = 0.04). Chorioallantois from all mares expressed mRNA for IL‐8, TNF‐α, IL‐6 and IL‐1β. Experimentally infected mares expressed more mRNA for IL‐6 (P = 0.003) and IL‐8 (P = 0.009) in the cervical star region and more mRNA for IL‐6 (P = 0.004) in tissues from placental horns than control mares.

Conclusions and clinical relevance:Bacterial placentitis may result in liberation of cytokines from the chorioallantois and prostaglandin formation leading to abortion or birth of a precociously mature foal.
Intraoperator, intraobserver and interoperator variability of echocardiographic measurements in healthy foals
Authors: SLACK J. , DURANDO M. M. , BELCHER C. N. , COLLINS N. , PALMER L. , OUSEY J. , BIRKS E. K. , MARR C. M.
Published: February 2012

Reason for performing study:The repeatability of various echocardiographic measurements is unknown.

Objectives:To determine the intraoperator, intraobserver and interoperator variability of echocardiographic measures in healthy foals.

Methods:Echocardiographic examinations were carried out on 6 healthy foals by 3 experienced echocardiographers. Intraoperator variability was determined by having a single echocardiographer obtain and measure images from 6 foals scanned on 3 consecutive days. Interoperator and intraobserver variability were determined by having 3 echocardiographers each obtain images from an additional 6 sedated foals. Within‐day interoperator variability was determined by having each echocardiographer measure their own images. Intraobserver variability was determined by having a single echocardiographer measure images obtained by all 3 echocardiographers. The coefficient of variation (CV) and standard error were calculated for each measure.

Results:The variability for most measurements was either very low (CV<5%) or low (CV = 5–15%). Measurements of right ventricular internal diameter (RVID) in systole and E‐point to septal separation (EPSS) showed moderate (CV 15–25%) to high variability (CV>25%) in all 3 categories. Measurements of the left ventricular ejection time (LVET) and velocity time integral from the right parasternal long axis view of right outflow tract in the fourth intercostal space showed moderate intraoperator variability. Measurements of the LVET, RVID in diastole and left atrial appendage (LAA) showed moderate interoperator variability and measurements of the RVID in diastole and acceleration time from the short axis view of the right outflow tract in the right third intercostal space showed moderate interobserver variability.

Conclusion:The intraoperator, intraobserver and interoperator variabilities for most echocardiographic measurements in foals are low.

Potential relevance:Most standard transthoracic echocardiographic measurements in foals have a low enough variability to warrant their use in serial clinical evaluations or experimental studies. Repeated measurements of RVID, EPSS, LVET and LAA should be interpreted with caution.
Allopregnanolone infusion induced neurobehavioural alterations in a neonatal foal: Is this a clue to the pathogenesis of neonatal maladjustment syndrome?
Authors: MADIGAN J. E. , HAGGETT E. F. , PICKLES K. J. , CONLEY A. , STANLEY S. , MOELLER B. , TOTH B. , ALEMAN M.
Published: February 2012

Reasons for performing the study: Increased plasma progestagen concentrations have been reported in foals with neonatal maladjustment syndrome (NMS). These steroids may cross the blood–brain barrier and have dampening effects in the central nervous system.

Objectives: To evaluate if the infusion of a progesterone derivative (allopregnanolone) in a healthy neonatal foal would induce clinical signs compatible with NMS.

Methods: A healthy neonatal foal from a healthy mare with a normal gestation (length, no complications), birth and placenta was infused with allopregnanolone to observe its neurobehavioural effects. Heparinised blood samples were collected pre‐ and post infusion to determine various progestagen concentrations using liquid chromatography mass spectrometry. A second healthy neonatal foal was infused with ethanol and saline for comparison of clinical observations.

Results: Infusion of allopregnanolone resulted in obtundation, lack of affinity for the mare and decreased response to external stimuli. These effects were short‐lasting and associated with measurable concentrations of progestagens.

Conclusions and potential relevance: Infusion of a steroid metabolite to a healthy neonatal foal resulted in neurobehavioural alterations compatible with those observed in foals with NMS. These findings suggest that increased progestagen concentrations may be responsible for some of the behavioural changes observed in foals with NMS.
Association of admission L‐lactate concentration in hospitalised equine neonates with presenting complaint, periparturient events, clinical diagnosis and outcome: A prospective multicentre study
Authors: BORCHERS A. , WILKINS P. A. , MARSH P. M. , AXON J. E. , READ J. , CASTAGNETTI C. , PANTALEON L. , CLARK C. , QURA'N L. , BELGRAVE R. , TRACHSEL D. , LEVY M. , BEDENICE D. , SAULEZ M. N. , BOSTON R. C.
Published: February 2012

Reasons for performing the study: Admission L‐lactate concentration is a useful and commonly measured biomarker not previously prospectively evaluated in a large multicentre study of critically ill neonatal foals.

Objectives: To evaluate overall outcome and the association of survival and L‐lactate concentration at admission ([LAC]ADMIT) by periparturient history, presenting complaint and clinicians' major diagnosis for ill neonatal foals.

Methods: Thirteen university and private equine referral hospitals enrolled 643 foals over the 2008 foaling season. Case details, historical, clinical and clinicopathological data were entered into standardised spreadsheets then unified for analysis.

Results: Overall survival was 79% (505/643). Risk of nonsurvival increased with each 1 mmol/l increase in [LAC]ADMIT (odds ratio 1.14, P<0.001). Mean arterial pressure had a small (r2= 19.1) but significant (P<0.001) association with [LAC]ADMIT. Foals experiencing known dystocia or premature placental separation had increased [LAC]ADMIT (P<0.001). Single umbilical problems (excluding uroperitoneum), meconium impaction only and failure of passive transfer of immunity only had 100% survival. Six clinicians' major diagnoses had increased odds of nonsurvival for each 1 mmol/l increase in [LAC]ADMIT: ‘sepsis’; ‘unspecified enterocolitis’; ‘unspecified colic’; ‘unspecified trauma’; ‘immune related (not failure of passive transfer of immunity)’ and ‘respiratory only’.

Conclusions and potential relevance: Survival of critically ill foals is good but varies with peripartum history, presenting complaint and clinicians' major diagnosis. L‐lactate concentration at admission proves its utility as a valuable prognostic biomarker in neonatal foals and its utility appears to vary with peripartum history and clinicians' major diagnosis.
Feeding the foal for immediate and long‐term health
Authors: BECVAROVA I. , BUECHNER‐MAXWELL V.
Published: February 2012

The nutrition and nutritional status of the mare, as well as foal's nutrient intake from colostrum, milk and creep feed, are critical factors that are known to influence the growth period of the foal. Long‐term effects of mare and foal nutrition are not well recognised or understood in the horse but may have the greatest impact on the animal's health and use when mature. Both under‐ and overfeeding can negatively influence important characteristics such as bone development and neurological function. The risk of developing debilitating diseases such as metabolic syndrome may also be increased by mare, fetal and early foal feeding, supporting the importance of providing a balanced diet to mare and foal throughout gestation and beyond.
Selective inhibitory action of Biginelli-type dihydropyrimidines on depolarization-induced arterial smooth muscle contraction
Authors: Cernecka Hana , Veizerova Lucia , Mensikova Lucia , Svetlik Jan , Krenek Peter
Published: February 2012

Objectives

Dihydropyridine calcium channel blockers have some disadvantages such as light sensitivity and relatively short plasma half-lives. Stability of dihydropyrimidines analogues could be of advantage, yet they remain less well characterized. We aimed to test four newly synthesized Biginelli-type dihydropyrimidines for their calcium channel blocking activity on rat isolated aorta.

Methods

Dihydropyrimidines (compounds A–D) were prepared by the Biginelli-like three-component condensation of benzaldehydes with urea/thiourea and dimethyl or diethyl acetone-1,3-dicarboxylate, and their physicochemical properties and effects on depolarization-induced and noradrenaline-induced contractions of rat isolated aorta were evaluated.

Key findings

Dihydropyrimidines A and C blocked KCl-induced contraction only weakly (−log(IC50) = 5.03 and 3.73, respectively), while dihydropyrimidine D (−log(IC50) = 7.03) was almost as potent as nifedipine (−log(IC50) = 8.14). Washout experiments revealed that dihydropyrimidine D may bind strongly to the L-type calcium channel or remains bound to membrane. All tested dihydropyrimidines only marginally inhibited noradrenaline-induced contractions of rat isolated aorta (20% reduction of noradrenaline Emax), indicating a more selective action on L-type calcium channel than nifedipine with 75% inhibition of noradrenaline Emax at 10−4m nifedipine).

Conclusions

Compounds A and, particularly, D are potent calcium channel blockers in vitro, with a better selectivity in inhibiting depolarization-induced arterial smooth muscle contraction than nifedipine.