bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuroimmunomodulation during Infectious Diseases: Mechanisms, Causes and Consequences for the Host
Authors: Bottasso Oscar , Morales-Montor Jorge
Published: February 2009

In this special issue of Neuroimmunomodulation, the reader will find reviewed some of the hottest topics in the field of neuroendocrine-immune interactions, with emphasis on infectious diseases. For instance, the role that immunoendocrine alterations have during human tuberculosis, a chronic infectious disease, is discussed, and it is concluded that these immunoendocrine interactions may play a detrimental role during the disease, in terms of the development of protective immune responses, control of tissue damage and metabolic disorders. Also, the role that neuroimmunomodulation plays in parasitic diseases is presented, and emphasizes the importance of the host-parasite neuroimmunoendocrine network during helminth infection. Moreover, the influence of β-androstenes on resistance to viral and bacterial infections is discussed, as well as the impact of infectious diseases upon neuroendocrine circuits. Also, the reader will find contributions to the study of sex hormones and modulation of immunity against leishmaniasis, as well as recent work on the immune mechanisms associated with resistance or susceptibility to parasitic diseases during pregnancy. We hope that our readers will find the first ever special issue devoted to neuroimmunomodulation and infectious diseases fascinating and enticing.
Immunoendocrine Mechanisms Associated with Resistance or Susceptibility to Parasitic Diseases during Pregnancy
Authors: Vargas-Villavicencio José Antonio , De León-Nava Marco A. , Morales-Montor Jorge
Published: February 2009

During pregnancy, the mammalian endocrine system plays a leading role in maintaining the fetus, characterized by an increase in the level of hormones such as progesterone, oestradiol and some gonadotropic hormones. The immune system participates during pregnancy by self-regulating to prevent fetus rejection. The distinctive type of immunity during gestation is characterized by an increase in levels of Th2 type cytokines IL-4, IL-6 and IL-10, concomitant with a decrease in IL-2, INF-γ and TNF-α levels. Along pregnancy, sex steroids and factors associated with them regulate the immune response. In this way, endocrine and immunologic factors have an impact on the pregnant female’s susceptibility or resistance to parasitic diseases. There are three main mechanisms proposed to explain this susceptibility or resistance: (1) sex steroids influence the host’s immune system; (2) hormones acting directly on the parasites inhibit or promote their reproduction, or (3) the two effects can occur simultaneously within a network of immuno-endocrine host-parasite interactions, mediated by hormones, cytokines, antibodies and other factors interacting directly and bidirectionally. The present work reviews recent literature concerning the most frequent parasitic infections during pregnancy and discusses the mechanisms implied in the establishment, growth, reproduction or elimination of the parasite.
Neuropsychiatric Disease and Toxoplasma gondii Infection
Authors: Henriquez S.A. , Brett R. , Alexander J. , Pratt J. , Roberts C.W.
Published: February 2009

Toxoplasma gondii infects approximately 30% of the world’s population, but causes overt clinical symptoms in only a small proportion of people. In recent years, the ability of the parasite to manipulate the behaviour of infected mice and rats and alter personality attributes of humans has been reported. Furthermore, a number of studies have now suggested T. gondii infection as a risk factor for the development of schizophrenia and depression in humans. As T. gondii forms cysts that are located in various anatomical sites including the brain during a chronic infection, it is well placed anatomically to mediate these effects directly. The T. gondii genome is known to contain 2 aromatic amino acid hydroxylases that potentially could directly affect dopamine and/or serotonin biosynthesis. However, stimulation of the immune response has also recently been associated with mood and behavioural alterations in humans, and compounds designed to alter mood, such as fluoxetine, have been demonstrated to alter aspects of immune function. Herein, the evidence for T.-gondii-induced behavioural changes relevant to schizophrenia and depression is reviewed. Potential mechanisms responsible for these changes in behaviour including the role of tryptophan metabolism and the hypothalamic-pituitary-adrenal axis are discussed.
Assessing Patient Readiness for the Clinical Adoption of Personalized Medicine
Authors: Issa A.M. , Tufail W. , Hutchinson J. , Tenorio J. , Baliga M. Poonam
Published: February 2009

Background/Aims: Although pharmacogenomics-based diagnostics and therapeutics are increasingly being translated into personalized medicine applications, relatively little evidence exists about how novel pharmacogenomics-based technologies will be accepted and adopted by patients. It is important to understand the characteristics of genomic diagnostics and targeted therapeutics that might impact utilization or serve as barriers to adoption of these novel technologies in order to formulate appropriate policies and procedures. The objective of this study was to investigate patients’ understanding and knowledge of personalized medicine and the process of decision-making regarding pharmacogenomics testing and targeted therapeutics and to better understand how patients value receiving pharmacogenomics-based care. Methods: We conducted 4 focus groups with 8–10 individuals in each group with patients recruited from out-patient clinics at The Methodist Hospital in Houston, Tex., USA. Results: The use of genomic diagnostics and targeted therapeutics to facilitate personalized medicine has considerable support from patients. However, our data revealed that participants were concerned with issues surrounding privacy and confidentiality of genetic test results, particularly with respect to access of information by insurers, with potential costs of testing and issues related to accuracy of test results. Questions regarding willingness to pay revealed that patients would be more willing to pay out-of-pocket if the disease associated with pharmacogenomic testing for treatment was perceived to be high risk (e.g., colorectal cancer) versus a chronic condition that was perceived as lower risk (e.g., high cholesterol). Conclusion: As the personalized medicine approach is increasingly incorporated into health care, understanding patients’ needs and their readiness to adopt these novel technologies will become progressively more important for the development of appropriate health policies.
Which Obesity Index Best Explains the Link between Adipokines, Coronary Heart Disease Risk and Metabolic Abnormalities in Type 2 Diabetes Mellitus?
Authors: Mojiminiyi Olusegun A. , Al Mulla Fahd , Abdella Nabila A.
Published: February 2009

Objective: The aim of this study was to determine, which of: body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist circumference (WC) correlates best with adipokines and is, therefore, the most suitable for the assessment of insulin resistance (IR), metabolic syndrome (MS), type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) risk. Subjects and Methods: We studied 248 T2DM patients classified by gender, IR, MS and CHD. Fasting adiponectin, leptin, resistin, high-sensitivity C-reactive protein (CRP), insulin, glucose, IR (HOMA), and lipid profile were measured. Univariate and multivariate regression analyses were used to find the associations of these variables with each other and with IR, MS and CHD. Receiver operating characteristic (ROC) analyses were used to find the best markers of IR, MS and CHD. Results: There were gender differences in the correlations and associations of BMI, WHR, WHtR and WC with IR, MS and CHD; e.g. in males, WHR showed significant correlation with only resistin (r = 0.30) and leptin (r = 0.39) whereas in females, it showed significant correlations with only adiponectin (r = –0.33). In males and females WHR showed the weakest correlations with CRP and the adipokines and BMI showed the highest correlations. ROC analysis showed that the BMI had the highest diagnostic values for detection of IR, MS and CHD; WHR had the worst diagnostic value. Conclusion: Anthropometric indices show differences in performance and associations with adipokines, CRP, IR, MS and CHD. In patients with T2DM, BMI should be the preferred marker for risk assessment on account of its association with adipokines and diagnostic performance characteristics.
Breast Magnetic Resonance Imaging: Initial Experience in Kuwait
Authors: Al-Khawari Hanaa , Kovacs Agnes , Athyal Reji , Al-Manfouhi Huda , Fayaz Mohammed Salah , Madda John Patrick
Published: February 2009

Objective: To report our initial experience of breast magnetic resonance imaging (MRI) in Kuwait in order to identify and characterize breast lesions. Subjects and Methods: In 58 patients ranging in age from 25 to 64 years, breast MRI was performed as a problem-solving tool (29); for suspicious local relapse of the treated breast (6); to search for a primary breast cancer in patients with metastatic axillary lymph nodes (5); for local staging of breast cancer (5); breast implants (6); screening in high-risk patients (3), and differentiation between inflammation and inflammatory carcinoma (4). Sagittal fat-saturated T2 and axial T1 images were obtained before, and axial fat-saturated T1 and dynamic sagittal fat-saturated T1-weighted images after contrast enhancement in a 1.5-tesla closed magnet. The diagnostic criteria were based on the morphology and kinetics of the lesion. Findings were validated by tissue sampling or radiological follow-up. Results: Seventy breast lesions (25 malignant, 38 benign and 7 lesions detected by MRI only) were identified in the 58 patients. The sensitivity, specificity, and positive and negative predictive values of MRI in diagnosing malignant breast lesions were 96, 67, 71 and 95%, respectively, while the accuracy was 80%. Conclusion: This initial experience is comparable to other published data. Future plans for improving image spatial resolution and MR-guided procedures have been taken into consideration.
Natural Self-Assembly of Allergen-S-Layer Fusion Proteins Is No Prerequisite for Reduced Allergenicity and T Cell Stimulatory Capacity
Authors: Gerstmayr Marianne , Ilk Nicola , Jahn-Schmid Beatrice , Sleytr Uwe B. , Bohle Barbara
Published: February 2009

Background: Recombinant allergen-S-layer fusion proteins display a strongly reduced IgE-binding activity and promote the induction of allergen-specific Th0/1 cells and regulatory T cells. Such fusion proteins show a natural capacity to self-assemble into mono- or double-layer sheets reaching particle-like dimensions of 0.5–2 μm. We were interested in finding out whether self-assembly was crucial for the immunological characteristics of allergen-S-layer fusion proteins. Methods: The IgE-binding and mediator-releasing capacities of nonassembled and self-assembled rSbpA-Bet v 1, consisting of the major birch pollen allergen Bet v 1 and the S-layer protein SbpA, were compared in inhibition ELISA and basophil activation assays using sera from patients allergic to birch pollen. T cell stimulation was evaluated using Bet v 1-specific T cell clones reactive to distinct epitopes of Bet v 1. Autologous B lymphocytes, monocytes and monocyte-derived dendritic cells were employed to evaluate potential differences in uptake and processing by different antigen-presenting cells. Results: Both rSbpA-Bet v 1 variants showed significantly less IgE-binding and mediator-releasing activity than Bet v 1. However, self-assembly further minimized the reduced allergenicity of nonassembled rSbpA-Bet v 1. Both rSbpA-Bet v 1 variants induced comparable proliferation in Bet v 1-specific T cell clones. B cells inappropriately presented either variant of rSbpA-Bet v 1. Self-assembly amplified the T cell stimulatory capacity of monocytes and dendritic cells. Conclusions: The promising characteristics of allergen-S-layer fusion proteins regarding their potential use for allergy treatment do not depend on the formation of particle-like structures.
Allergy Diagnostic Testing in Clindamycin-Induced Skin Reactions
Authors: Seitz Cornelia S. , Bröcker Eva-B. , Trautmann Axel
Published: February 2009

Background: In clinical practice, clindamycin is increasingly used because of its good tolerability and high efficacy with excellent tissue penetration. However, with increased application of clindamycin, the frequency of side effects such as skin eruptions rises and the need for diagnostic testing to identify clindamycin allergy increases. The aim of this retrospective analysis was to demonstrate the results of skin and challenge tests in cases of clinically suspected clindamycin allergy. Methods: We evaluated 33 patients with a history of a skin reaction in temporal relation to treatment with clindamycin using standardized patch and prick skin testing. In the case of negative skin tests, oral challenges were performed. Results: Clindamycin hypersensitivity was excluded in 20 patients by negative skin tests and subsequently tolerated oral challenge tests. In 5 patients, positive skin tests strongly suggested delayed-type non-IgE-mediated allergic clindamycin hypersensitivity. In 6 skin test-negative patients (2 patients refused challenge tests), a rash was provoked by controlled challenge tests. Conclusions: The evaluation of patients with clindamycin-associated skin reactions should include appropriate allergologic tests establishing or excluding the diagnosis of clindamycin hypersensitivity. Combined testing, i.e. skin tests and subsequent challenge tests, appears to be necessary to definitely confirm or rule out the presence of allergic clindamycin hypersensitivity.
Selective Immunoglobulin M Deficiency Presenting with Recurrent Impetigo: A Case Report and Review of the Literature
Authors: Belgemen Tugba , Suskan Emine , Dogu Figen , Ikinciogullari Aydan
Published: February 2009

Selective immunoglobulin M (IgM) deficiency is a rare disorder defined by a decreased serum level of IgM and normal levels of other immunoglobulin classes. The disease has not been well described and the cause remains unknown. Patients with IgM deficiency may present with a wide spectrum of clinical manifestations, from asymptomatic to life-threatening infections, including recurrent respiratory and gastrointestinal infections, allergy and autoimmunity. Here, we report a 6.5-year-old otherwise healthy boy with selective IgM deficiency who presented with multiple recurrent impetigo. We reviewed the published data regarding selective deficiency of IgM.
Results of a 1-Year Comparative Study of Zyoptix Tissue-Sparing and Conventional Planoscan LASIK Treatments
Authors: Kirwan Caitriona , O’Keefe Michael
Published: February 2009

Aim: To determine the efficacy, stability and higher order aberrations (HOAs) following Zyoptix Tissue-Sparing (TS) and conventional Planoscan LASIK. Methods: A prospective study was conducted on myopic patients. The Technolas 217z laser and XP microkeratome (Bausch & Lomb) were used. Patients were matched for age, pupil size, optical zone, ablation depth and preoperative HOAs. UCVA, MRSE and HOAs were analysed preoperatively and 3 and 12 months postoperatively. Results: 35 eyes underwent conventional and 31 eyes TS LASIK. 3 months postoperatively, all eyes in the both groups had UCVA ≤20/30 with good stability at 1 year. The mean RMS of total HOA increased significantly 3 months postoperatively in the conventional (1.49 factor increase) and TS LASIK groups (1.84 factor increase) and remained stable at 12 months. Conclusion: TS LASIK induced a greater increase in HOA than conventional Planoscan LASIK. This may be attributable to the smaller blend zone in TS treatments.
Prevalence of Human Papillomavirus and Other Risk Factors in Lithuanian Patients with Head and Neck Cancer
Authors: Gudleviciene Zivile , Smailyte Giedre , Mickonas Alex , Pikelis Arunas
Published: February 2009

Objective: Head and neck squamous cell carcinoma (HNSCC) is a disease attributed to exposure to tobacco and alcohol. However, many epidemiological and molecular data suggest that human papillomavirus (HPV) infection may promote head and neck carcinogenesis. The objective of our study was to evaluate the prevalence of HPV and its various types in fresh HNSCC tumor samples using the polymerase chain reaction (PCR). Methods: 48 patients with primary diagnosed HNSCC carcinoma were investigated. HPV DNA was detected using PCR. HPV-positive samples were additionally tested for HPV16 and 18. Results: Of the 48 patients, 13 (27.1%) had detectable HPV. After HPV typing, HPV16 was found in only 4 cases (30.1%). Conclusions: Our study demonstrated a HPV detection rate of 27.1% in Lithuanian HNSCC patients; 30.1% of them harbored HPV16. There were no differences regarding the other risk factors (smoking, alcohol consumption and occupational history) between HPV-positive and HPV-negative patients with head and neck cancer in our study.
Increase in Prefrontal Cortex Blood Flow during the Computer Version Trail Making Test
Authors: Kubo Masako , Shoshi Chikahumi , Kitawaki Tomoki , Takemoto Rika , Kinugasa Kazushi , Yoshida Hidenori , Honda Chiho , Okamoto Motoi
Published: February 2009

Background/Aims: Previous studies using near-infrared spectroscopy (NIRS) have reported increases in both oxygenated hemoglobin (oxyHb) and deoxygenated hemoglobin (deoxyHb) during the paper version Trail Making Test (TMT), a neuropsychological test for evaluating cognitive and executive functions. We measured oxyHb and deoxyHb in the prefrontal cortex during the computer version TMT. Methods: Fifteen healthy students first performed TMT-A and then TMT-B; another 7 students first performed TMT-B and then TMT-A. The mean concentrations of Hb (10 s before TMT, during TMT and 30–40 s after TMT) were determined and analyzed by ANOVA. Results: oxyHb increased while deoxyHb decreased during the TMT. There was a significant order effect on the change in deoxyHb, but not in oxyHb. oxyHb significantly increased in the bilateral prefrontal cortices both in TMT-A and TMT-B. The increase tended to be more prominent in TMT-B than in TMT-A. deoxyHb significantly decreased in the bilateral prefrontal cortices, both in TMT-A and TMT-B. Conclusion: The results suggest that blood flow increases in the prefrontal cortex during the performance of TMT, and that the bilateral prefrontal cortices are involved in the performance of the computer version TMT.
Mechanism of Intracellular Signal Transduction during Injury of Renal Tubular Cells Induced by Postasphyxial Serum in Neonates with Asphyxia
Authors: Zhao Jin , Dong Wen-Bin , Li Peng-yun , Deng Chun-liang
Published: February 2009

Background: Renal injury is a severe and extremely common complication that occurs early in neonates with asphyxia. Reperfusion injury has been suggested as the cause of kidney damage during resuscitation of neonatal asphyxia. Previous studies have demonstrated that postasphyxial serum from neonates with asphyxia may result in apoptosis of renal tubular cells. However, the mechanisms that mediate renal tubular cell apoptosis induced by postasphyxial serum remain poorly understood. Objectives: In this report we investigate the intracellular signal transduction mechanisms that operate during injury of renal tubular cells induced by postasphyxial serum in neonates. Methods: Cultured human renal proximal tubular cells HK-2 cell were exposed to 10% fetal calf serum (normal control), 20% postasphyxial serum or 20% postasphyxial serum with pyrrolidine dithiocarbamate (PDTC). The expression of both BAD and BAX in the cytoplasm was detected by immunohistochemistry. The mitochondria membrane potential (Δψm) was examined by confocal microscopy, and the release of the apoptogenic mitochondrial proteins cytochrome C and AIF was assessed by Western blot analysis. Results: Loss of mitochondria membrane potential was detected in HK-2 cells treated with 20% postasphyxial serum as compared to cells in normal serum or PTDC-pretreated cells in 20% postasphyxial serum. A significant increase of Bad and Bax protein expression was also detected, along with the release of cytochrome C and AIF from mitochondria to cytosol in the postasphyxial serum treated cells, but not in the normal or PTDC-pretreated control cells. Conclusions: Our findings suggest that postasphyxial serum may induce renal tubular cell apoptosis through the mitochondrial pathway, and its intracellular signal transduction mechanism includes the activation of nuclear factor-κB.
Quantification of Hox and Surfactant Protein-B Transcription during Murine Lung Development
Authors: Grier David G. , Thompson Alexander , Lappin Terence R.J. , Halliday Henry L.
Published: February 2009

Background: Genetic processes underlying fetal lung development and maturation are incompletely understood. Better knowledge of these processes would provide insights into the causes of lung malformations and prevention of respiratory distress syndrome and the potential adverse effects of glucocorticoids. Hox genes are involved in the lung branching morphogenesis and maturation of respiratory epithelium, but their expression pattern remains to be defined. Objectives: We hypothesized that genes involved in lung branching would be downregulated during early development, whereas those involved in maturation would be unchanged or upregulated. Methods: TaqMan real-time primers and probes were designed for all 39 murine Hox genes, and the murine SP-B gene and transcription profiles of these genes were obtained from whole lungs isolated at e14.5, e16.5, e18.5, e19.5 and postnatal days 1 and 20. Results:Hox genes in clusters A and B, specifically those between paralog groups 3 and 7, were the most represented, with Hoxa4 and Hoxa5 being the most highly transcribed. A wave of reduced transcription in 16 Hox genes, coincident with increased SP-B transcription, was observed with advancing gestation. Consistently high transcription of Hoxa5 from e14.5 to postnatal day 20 may indicate that sustained transcription is required for normal lung maturation. When e15.5 lungs were cultured with dexamethasone, Hoxb6, Hoxb7 and Hoxb8 levels were significantly upregulated, creating the potential for modulation of diverse downstream target genes. Conclusions: Improved understanding of the genetic processes underlying lung development afforded by our Q-PCR platform may allow development of more specific methods for inducing fetal lung maturation.
Temsirolimus-Induced Glomerulopathy
Authors: Izzedine Hassane , Boostandoot Erfaneh , Spano Jean Philippe , Bardier Armelle , Khayat David
Published: February 2009

A 58-year-old man with advanced renal cell carcinoma developed grade 3 proteinuria (8.5 g/24 h) without microscopic hematuria or renal insufficiency five days after temsirolimus infusion. Kidney biopsy revealed ischemic glomeruli and focal segmental glomerulosclerosis lesion. Proteinuria level decreased to 2.80 g per day two weeks after temsirolimus withdrawal. Clinicians should be aware to this complication.
Nimustine (ACNU) Plus Teniposide (VM26) in Recurrent Glioblastoma
Authors: Glas M. , Hundsberger T. , Stuplich M. , Wiewrodt D. , Kurzwelly D. , Nguyen-Huu B. , Rasch K. , Herrlinger U.
Published: February 2009

Background: In a previous trial (NOA-01), the combination of nimustine and teniposide showed efficacy in previously untreated glioblastoma (GBM). After establishing temozolomide as standard first-line therapy in GBM patients, the nimustine (ACNU)/teniposide (VM-26) combination has been employed as salvage chemotherapy for recurrent GBM. However, data on the toxicity and efficacy of this regimen in recurrent GBM are lacking. Patients and Methods: In two neurooncological centers, all patients with recurrent GBM treated with nimustine (90 mg/m2, day 1/42) and teniposide (45–70 mg/m2, days 1–3/42) were analyzed retrospectively for progression-free survival (PFS), overall survival (OS) and toxicity. Results: Thirty-five patients (median age 51 years, range 25–71 years) were identified. Six months after chemotherapy initiation, PFS was 29% and the median OS 6 months; 23% of patients were alive ≥1 year after initiation of nimustine-teniposide chemotherapy. Grade 4 hematotoxicity was observed in 12 of 35 patients (34%) and in 14 of 83 evaluable chemotherapy courses (17%). Conclusions: The benefit of the nimustine-teniposide combination is moderate in patients with recurrent GBM. The data support the efficacy of the nimustine-teniposide chemotherapy, but the rate of high-grade hematotoxicity is increased.
Effects of Chronic Gap Junction Conduction–Enhancing Antiarrhythmic Peptide GAP-134 Administration on Experimental Atrial Fibrillation in Dogs
Authors: Laurent Gabriel , Leong-Poi Howard , Mangat Iqwal , Moe Gordon W. , Hu Xudong , So Petsy Pui-Sze , Tarulli Emidio , Ramadeen Andrew , Rossman Eric I. , Hennan James K. , Dorian Paul
Published: February 2009

Background—

Abnormal intercellular communication caused by connexin dysfunction may contribute to atrial fibrillation (AF). The present study assessed the effect of the gap junction conduction–enhancing antiarrhythmic peptide GAP-134 on AF inducibility and maintenance in a dog model of atrial cardiomyopathy.

Methods and Results—

Twenty-four dogs subject to simultaneous atrioventricular pacing (220 bpm for 14 days) were randomly assigned to placebo treatment (PACED-CTRL; 12 dogs) or oral GAP-134 (2.9 mg/kg BID; PACED-GAP-134; 12 dogs) starting on day 0. UNPACED-CTRL (4 dogs) and UNPACED-GAP-134 (4 dogs) served as additional control groups. Change in left atrial (LA) systolic area from baseline to 14 days was calculated using transoesophageal echocardiography. At 14 days, animals underwent an open-chest electrophysiological study. PACED-CTRL dogs (versus UNPACED-CTRL) had a shorter estimated LA wavelength (8.0�1.4 versus 24.4�2.5 cm,
P
<0.05) and a greater AF vulnerability (mean AF duration, 1588�329 versus 25�34 seconds,
P
<0.05). Oral GAP-134 had no effect on AF vulnerability in UNPACED dogs. Compared with PACED-CTRL dogs, PACED-GAP-134 dogs had a longer estimated LA wavelength (10.2�2.8 versus 8.0�1.4 cm, respectively,
P
<0.05). Oral GAP-134 did not significantly reduce AF inducibility or maintenance in the entire group of 24 PACED dogs; in a subgroup of dogs (n=11) with less than 100% increase in LA systolic area, oral GAP-134 reduced AF induction from 100% to 40% and mean AF duration from 1737�120 to 615�280 seconds (
P
<0.05).

Conclusions—

Oral GAP-134 reduces pacing-induced decrease in LA wavelength and appears to attenuate AF vulnerability in dogs with less atrial mechanical remodeling. Gap junction modulation may affect AF in some circumstances.
A Randomized Study to Compare Ramp Versus Burst Antitachycardia Pacing Therapies to Treat Fast Ventricular Tachyarrhythmias in Patients With Implantable Cardioverter Defibrillators
Authors: Gulizia Michele M. , Piraino Leandro , Scherillo Marino , Puntrello Calogero , Vasco Calogero , Scianaro Maria Carmela , Mascia Franco , Pensabene Orazio , Giglia Salvatore , Chiarandà Giacomo , Vaccaro Ignazio , Mangiameli Salvatore , Corrao Dario , Santi Elisabetta , Grammatico Andrea
Published: February 2009

Background—

In patients with implantable cardioverter-defibrillators (ICDs), antitachycardia pacing (ATP) is highly effective in terminating fast ventricular tachycardias (FVTs) and lowers the use of high-energy shocks, without increasing the risk of arrhythmia acceleration or syncope.

Methods and Results—

The aim of the PITAGORA ICD trial was to randomly compare 2 ATP strategies (88% coupling interval burst versus 91% coupling interval ramp, both 8 pulses) in terms of ATP efficacy, arrhythmia acceleration, and syncope. Two hundred six ICD patients (83% male, 67�11 years) were enrolled. FVT episodes with cycle lengths between 240 and 320 ms were treated by 1 ATP sequence and, in the event of failure, by shocks. Over a median follow-up of 36 months, 829 spontaneous ventricular tachyarrhythmia episodes were detected in 79 patients. Episode review identified 595 episodes as true ventricular arrhythmias in 72 patients; devices classified 111 (18.7%) episodes as VF, 216 (36.3%) as FVT, and 268 (45.0%) as VT. Fifty-six patients had 214 treated FVT episodes—2 FVTs self-terminated before ATP release; 44 (79%) of these had at least 1 effective ATP intervention, and 34 (61%) were spared ICD shocks. Burst terminated 100 of 133 (75.2%) FVT episodes, whereas ramp terminated 44 of 81 (54.3%;
P
=0.015). Acceleration occurred in 9 of 214 (4.2%) FVT episodes treated: 6 episodes in 3 ramp patients and 3 episodes in 3 burst patients. Two patients—1 in each group—suffered 1 syncopal event associated to a nonterminated FVT episode.

Conclusions—

Burst is significantly more efficacious than ramp in terminating FVT episodes. As the first therapy for FVT episodes, ATP carries a low risk of acceleration or syncopal events.
Risk Factors for Mortality in Patients With Cardiac Device-Related Infection
Authors: Baman Timir S. , Gupta Sanjaya K. , Valle Javier A. , Yamada Elina
Published: February 2009

Background—

Because of the increased use of pacemakers and implantable cardioverter defibrillators, infection has become a complication with significant morbidity and mortality. Data on risk factors for mortality in patients with cardiac-device related infection are limited. We evaluated the prognostic significance of key clinical and echocardiographic variables in a large retrospective population of patients with cardiac-device related infection.

Methods and Results—

Two hundred ten patients with cardiac-device related infection were identified at the University of Michigan between 1995 and 2006. Data were abstracted on key clinical and echocardiographic variables, treatment strategy, and 6-month outcomes. We used multivariable Cox proportional hazards models to examine clinical and echocardiographic variables that were associated with 6-month mortality. Mean age for our study population was 63�17 years, and 72 (44%) were women. All-cause 6-month mortality was 18% (n=37). Independent variables associated with death were systemic embolization (hazard ratio 7.11; 95% CI 2.74 to 18.48), moderate or severe tricuspid regurgitation (hazard ratio 4.24; 95% CI 1.84 to 9.75), abnormal right ventricular function (hazard ratio 3.59; 95% CI 1.57 to 8.24), and abnormal renal function (hazard ratio 2.98; 95% CI 1.17 to 7.59). Size and mobility of cardiac device vegetations were not independently associated with mortality.

Conclusions—

We identified several clinical and echocardiographic variables that identify patients with cardiac-device related infection who are at high-risk for mortality and may benefit from more aggressive evaluation.
Remote Robotic Navigation and Electroanatomical Mapping for Ablation of Atrial Fibrillation
Authors: Schmidt Boris , Tilz Roland R. , Neven Kars , Julian Chun K.R. , Fürnkranz Alexander , Ouyang Feifan
Published: February 2009

Background—

Radiofrequency current ablation of atrial fibrillation (AF) requires high technical skills to achieve optimal catheter stability and is associated with an individually high x-ray exposure to both the patient and the operator. To facilitate catheter navigation and to reduce the operator’s x-ray burden, remote navigation (RN) systems have been developed. Considerations for navigation of a novel remote robotic navigation system in pulmonary vein isolation (PVI) procedures are reported.

Methods and Results—

In 65 patients with drug-refractory AF (43 paroxysmal, 22 persistent), complete circumferential PVI was performed using RN in conjunction with different electroanatomic mapping systems. Acute complete PVI using exclusively RN was achieved in 95%. The procedure time was 195�40 minutes. The operator’s x-ray exposure time was reduced by 6�4 minutes (35%) using RN. In 7 of 14 patients with persistent AF, conversion to sinus rhythm was achieved by radiofrequency current ablation. During a median follow-up period of 239 days (range, 184 to 314 days), 47 of 65 patients (73%) remained free of any documented atrial tachyarrhythmia recurrences after a single procedure. The relative proportion of patients remaining free of AF was 76% and 68% for paroxysmal and persistent AF, respectively.

Conclusions—

PVI using the novel RN system can be performed safely and effectively. One third of the operator’s fluoroscopy exposure time might be saved using RN. However, the questions of whether the overall fluoroscopy exposure is reduced by RN and whether RN improves PVI procedures needs to be assessed during a comparative trial between man and machine.
Asymptomatic Ventricular Preexcitation
Authors: Santinelli Vincenzo , Radinovic Andrea , Manguso Francesco , Vicedomini Gabriele , Ciconte Giuseppe , Gulletta Simone , Paglino Gabriele , Sacchi Stefania , Sala Simone , Ciaccio Cristiano , Pappone Carlo
Published: February 2009

Background—

Sudden cardiac death can be the first clinical presentation of asymptomatic ventricular preexcitation.

Methods and Results—

From 1995 to 2005, we prospectively collected clinical and electrophysiological data among 293 adults with asymptomatic ventricular preexcitation (61.4% males; median age, 36 years; interquartile range [IQR], 28 to 47.5). After electrophysiological testing, patients were prospectively followed, taking no drugs. The primary end point of the study was the occurrence of a first arrhythmic event. Predictors of arrhythmic events were analyzed by univariate and multivariate Cox models. Over a median follow-up of 67 months (minimum to maximum, 8 to 90), after electrophysiological testing, 262 patients (median age, 37 years; IQR, 30 to 48) did not experience arrhythmic events, remaining totally asymptomatic, whereas 31 patients (median age, 25 years; IQR, 22 to 29; median follow-up, 27 months; minimum to maximum, 8 to 55) had a first arrhythmic event, which was potentially life-threatening in 17 of them (median age, 24 years; IQR, 20 to 28.5; median follow-up, 25 months; minimum to maximum, 9 to 55). Potentially life-threatening tachyarrhythmias resulted in resuscitated cardiac arrest (1 patient), presyncope (7 patients) syncope (4 patients), or dizziness (5 patients). In multivariate analysis age (
P
=0.004), inducibility (
P
=0.001) and anterograde effective refractory period of the accessory pathway ≤250 ms (
P
=0.001) predicted potentially life-threatening arrhythmias.

Conclusions—

These results indicate that prognosis of adults who present with asymptomatic ventricular preexcitation is good, and the risk of a significant event is small. Short anterograde effective refractory period of the accessory pathway and inducibility at baseline are independent predictors of potentially life-threatening arrhythmic events, and the risk decreases with increasing age.
Resistance Training Effects on Arterial Compliance in Premenopausal Women
Authors: Fjeldstad Anette S. , Bemben Michael G. , Bemben Debra A.
Published: February 2009

Endurance training has been shown to increase arterial compliance; however, the effect of resistance training is unclear. Purpose: The purpose of this study was to examine the effect lower body resistance training on arterial compliance in healthy premenopausal women. Methods: Thirty-two women were assigned to a resistance training group (n = 21) or a control group (n = 11). Large (C1) and small (C2) arterial compliance (Pulse Contour Analysis) were measured at baseline and after twelve weeks of training. Results: Two-way (group × time) repeated measured ANOVA did not detect significant group, time effects or group × time interactions for small arterial compliance (P > 0.05). There was a significant time effect for large arterial compliance (P < 0.05), which increased in both groups. Conclusions: In contrast to previous studies in men, which found decrease in arterial compliance with resistance training, no decrease in arterial compliance was observed.
Transformation in Reverse
Authors: Hagiwara Sumi , Wray Susan
Published: February 2009

The complexity of urban contexts is often subsumed into generalizations and deficit assumptions of urban communities and its members by those unfamiliar with urban culture. This is especially true for teachers seeking work in urban schools. This article addresses the complex interpretations of urban through the lens of a White male graduate student teacher, Nathan, as he contemplates his experiences in urban school settings. The trajectory of his understanding of the complex nature of urban realities that influence the work of urban teachers and the lives of their students is discussed. The article concludes with implications for urban teacher education programs and teacher educators.
Literacy for Playwriting or Playwriting for Literacy
Authors: Chizhik Alexander Williams
Published: February 2009

The article reports an empirical research study documenting how an integrated playwriting program within an urban, low—socioeconomic status middle school with a majority Latino/a population facilitates increased students' confidence regarding writing in addition to helping students learn transferable writing skills as measured by a districtwide writing sample. Students in the playwriting program with variable levels of writing skills are quantitatively compared with similar students in traditional language arts classrooms of the same urban school. In addition, qualitative methods are used to explore quantitative findings. To delve into possible reasons for these findings that are based on quantitative and qualitative research methods, the discussion of the results is informed by sociocultural learning theory with an emphasis on communities of practice and the motivational theory of self-determination.
Exploring Superintendent Leadership in Smaller Urban Districts
Authors: Hentschke Guilbert C. , Nayfack Michelle B. , Wohlstetter Priscilla
Published: February 2009

Much of the existing literature on urban school reform focuses on how the relatively small number of our nation's largest urban districts are approaching school reform with these objectives in mind. However, does smaller district size have any bearing, direct or indirect, on the nature of superintendent leadership? The authors' exploratory research investigates the interplay between superintendent leadership strategies and behaviors, and district reform initiatives in a sample of relatively well-performing, smaller urban districts in California. The authors conducted interviews with superintendents and members of their leadership teams in four urban districts to examine how district size might influence superintendent leadership strategies, reform initiatives, and personal behaviors. The authors found that the personal leadership behaviors and associated operating processes (strategies and tactics for execution) appeared remarkably distinct from what superintendents do (or are expected to do) in very large urban school districts. The implications of these tentative findings are discussed in the conclusion.
Migration of Fibers in Air-jet Yarn
Authors: Pradyumkumar Vasant Kadole  , Chandrakant Dattatraya Kane  , Satish Shankar Aparaj  , Manjunath Chandrashekar Burji
Published: February 2009

The air-jet spun yarn consists of a core of parallel fibers wrapped by surface fibers. Many research workers have carried out a wealth of work on fiber migration of yarn, an important structural characteristic. Fiber integration and nature of twisting determine to a large extent the structure of a spun yarn, therefore the research work presented here aimed to analyze fiber migration in air-jet spun yarn by varying process parameters of air-jet spinning machine. The measurement of fiber migration in air-jet spun yarn was performed with the help of the tracer fiber technique. Our study revealed that two process parameters, namely main draft and N1 pressure, had an influence on root mean square deviation. Other migratory parameters were not affected by any other process parameters.
Fabrics Made from Non-conventional Blends: What Can We Expect from them Related to Frictional Properties?
Authors: Lima Mário , Vasconcelos Rosa M. , Silva Luís F , Cunha Joana
Published: February 2009

This paper briefly describes a novel patented laboratory equipment, which was studied, designed, and manufactured at the University of Minho, Portugal, based on a new method of accessing friction coefficient of fabrics and other two-dimensional non-rigid surfaces, as well as its fundamentals and working principle. An experimental study was carried out in order to compare fabrics produced with a new generation of fibers, namely polylatic acid (PLA) fiber and soya protein fiber (SPF). A 5- satin structure weave was used in the double-faced fabrics' construction in both sides, allowing us to test the influence of each fiber in the friction properties. The results of the experimental work were analyzed using various tools, including SPSS 15.0® statistical package and commented in the light of the influence of the raw material in the friction properties of the fabrics. The soft felling of the SPF was confirmed as expected, as well as the roughness of the PLA fiber.
Navigating the “New” Marriage Market
Authors: Goldscheider Frances , Kaufman Gayle , Sassler Sharon
Published: February 2009

Trends in divorce and nonmarital childbearing suggest that the marriage market is increasingly filled with people who have been married and/or have children. This study examines the effect of personal attitudes on entrance into a union with a partner who has been previously married or has children. Using data from two waves of the National Survey of Families and Households, the authors find that men who hold more positive attitudes about marrying someone who already has children are more likely to enter a union with a single mother. Willingness to marry someone with children also has a positive impact on women's entry into a union with a man who has children, though only if he has not been married before. Men who express greater acceptance about marriage to someone who has been married are more likely to enter a union with a previously married woman, though only if she is childless. There is no parallel effect for women.
Decentralized, Adaptive Coverage Control for Networked Robots
Authors: Schwager Mac , Rus Daniela , Slotine Jean-Jacques
Published: February 2009

A decentralized, adaptive control law is presented to drive a network of mobile robots to an optimal sensing configuration. The control law is adaptive in that it uses sensor measurements to learn the distribution of sensory information in the environment. It is decentralized in that it requires only information local to each robot. The controller is then improved by introducing a consensus algorithm to propagate sensory information from every robot throughout the network. Convergence and consensus of parameters is proven with a Lyapunovtype proof. The controller with and without consensus is demonstrated in numerical simulations. These techniques are suggestive of broader applications of adaptive control methodologies to decentralized control problems in unknown dynamic environments.
Open Wedge High Tibial Osteotomy
Authors: Matar Wadih Y. , Boscariol Rya , Dervin Geoffrey F.
Published: February 2009

Background

In patients with unicompartmental medial knee arthritis, medial opening wedge high tibial osteotomy is used to shift the mechanical weightbearing line laterally to reduce pain and improve function. There have been concerns that opening wedge high tibial osteotomy is associated with a reduction of patellar height and increase in the sagittal posterior tibial slope, both of which can adversely affect the final result.

Hypothesis

A more distal oblique osteotomy at the level of insertion of the patellar tendon should decrease these effects when compared with a horizontal osteotomy made proximal to the patellar tendon insertion.

Study Design

Cohort study; Level of evidence, 3.

Methods

Review of 22 horizontal and 19 oblique high tibial osteotomies with a mean follow-up of 4.2 ± 1.8 years (mean ± SD) was performed. Anatomic tibiofemoral angle, mechanical weightbearing line, medial coronal tibial plateau angle, patellar height (Blackburne and Peel ratio), and sagittal tibial slope were measured.

Results

In both groups, the weightbearing line was equally shifted toward the center of the plateau. In the horizontal group, the Blackburne and Peel ratio decreased from 0.85 ± 0.16 to 0.67 ± 0.12, and the sagittal tibial slope was increased from 7.7° ± 4.6° to 10.7° ± 3.8° ( P < .001). In comparison, the oblique group did not show any significant postoperative changes for these 2 parameters. In the oblique group, 2 patients sustained loss of correction and early failure when the osteotomy remained below the metaphyseal flare on the lateral cortex.

Conclusion

The oblique osteotomy group showed more normalized postoperative sagittal tibial slope and patellar height. Caution should be exercised not to osteotomize too distally.
Long-term Follow-up of Acute Arthroscopic Bankart Repair for Initial Anterior Shoulder Dislocations in Young Athletes
Authors: Owens Brett D. , DeBerardino Thomas M. , Nelson Bradley J. , Thurman John , Cameron Kenneth L. , Taylor Dean C. , Uhorchak John M. , Arciero Robert A.
Published: February 2009

Background

Little is known of the long-term results of acute arthroscopic Bankart repair for first-time traumatic anterior glenohumeral dislocations.

Hypothesis

Acute arthroscopic Bankart repair for first-time traumatic anterior glenohumeral dislocations will provide good results at long-term follow-up.

Study Design

Case series; Level of evidence, 4.

Methods

The authors evaluated a cohort of young patients who sustained first-time anterior glenohumeral dislocations and were acutely treated with arthroscopic Bankart repair using bioabsorbable tacks. Subjective outcome measures were obtained at a mean follow-up of 11.7 years (range, 9.1-13.9 years).

Results

Thirty-nine patients (40 shoulders) were available of the original cohort of 49 shoulders (82%). Two of the 9 who were lost to follow-up had revision surgery before being lost and are carried forward in the calculations of recurrent instability and revision surgery but are not included in the calculation of the functional scores. The mean Single Assessment Numeric Evaluation was 91.7, the mean Western Ontario Shoulder Instability score was 371.7, the mean subjective Rowe score was 25.3, the mean Simple Shoulder Test was 11.1, the mean American Shoulder and Elbow Society score was 90.9, the mean Short Form-36 Physical Component score was 94.4, and the mean Tegner score was 6.5. Six patients sustained recurrent dislocations for a redislocation rate of 14.3%. Nine patients (21.4%) reported experiencing subluxation events. Six patients (14.3%) underwent revision stabilization surgery.

Conclusion

At long-term follow-up, acute arthroscopic Bankart repair for first-time traumatic anterior glenohumeral dislocations resulted in excellent subjective function and return to athletics in young, active patients with an acceptable rate of recurrence and reoperation.