bluuebunny/crossref_metadata_2025 huggingface dataset:
Muscle bleeds in professional athletes – diagnosis, classification, treatment and potential impact in patients with haemophilia
Authors: BEYER R. , INGERSLEV J. , SØRENSEN B.
Published: May 2010

Summary.  Muscle haematoma represents 10–25% of bleeds in patients with severe haemophilia. There is limited consensus on diagnostic or treatment strategies and little knowledge about the natural history of muscle haematoma and optimal treatment goals. The aim of this review was to perform a systematic description of the natural history of muscle haematoma in healthy athletes, focusing on diagnosis, classification and treatment options. Publications and educational textbooks on management of sports injuries were used as data source. Muscle haematomas occur following contusion, strain, or laceration and can be categorized as mild, moderate, or severe. Muscle haematoma may be inter‐ or intramuscular. In healthy athletes, the healing process takes 20–40 days. Optimal diagnosis includes history, physical examination (inspection, palpation, active and passive range of motion (ROM) test, muscle length test, isometric strength test, biomechanical examination, full spinal examination, peripheral nerve test and slump test), ultrasound, MRI or CT. Treatment is conducted based on: (i) super‐acute stage, control of the bleeding and minimizing the size of the haematoma; (ii) acute stage, restoration of pain‐free ROM; (iii) subacute stage, functional rehabilitation; and (iv) gradual return to normal activity. Treatment and preventive strategies include RICE (rest, ice, compression and elevation), protected mobilization, stretching and strengthening exercises, manual therapy (articular, neural and soft tissue mobilization and massage), correction of movement dysfunction, functional rehabilitation and electro‐therapeutic interventions. The study reviews the natural history of muscle haematoma and state‐of‐the‐art diagnosis and treatment in healthy athletes. Results may be useful to optimize diagnosis and treatment of muscle haematoma in patients with haemophilia.
Nurse‐led self‐management group programme for patients with congestive heart failure: randomized controlled trial
Authors: Smeulders Esther S.T.F. , Van Haastregt Jolanda C.M. , Ambergen Ton , Uszko‐Lencer Nicole H.K.M. , Janssen‐Boyne Josiane J.J. , Gorgels Anton P.M. , Stoffers Henri E.J.H. , Lodewijks‐van der Bolt Cara L.B. , Van Eijk Jacques Th.M. , Kempen Gertrudis I.J.M.
Published: May 2010

smeulders e.s.t.f., van haastregt j.c.m., ambergen t., uszko‐lencer n.h.k.m., janssen‐boyne j.j.j., gorgels a.p.m., stoffers h.e.j.h., lodewijks‐van der bolt c.l.b., van eijk j.th.m. & kempen g.i.j.m. (2010) Nurse‐led self‐management group programme for patients with congestive heart failure: randomized controlled trial. Journal of Advanced Nursing 66(7), 1487–1499.

Title.  Nurse‐led self‐management group programme for patients with congestive heart failure: randomized controlled trial.

Aim.  This paper reports on of the effects of the Chronic Disease Self‐Management Programme on psychosocial attributes, self‐care behaviour and quality of life among congestive heart failure patients who experienced slight to marked limitation of physical activity.

Background.  Most self‐management programmes for congestive heart failure patients emphasize the medical aspects of this chronic condition, without incorporating psychosocial aspects of self‐management. The programme has been used with various patient groups, but its effectiveness with congestive heart failure patients when led by pairs of cardiac nurse specialists and peer leaders is unknown.

Method.  A randomized controlled trial with 12 months of follow‐up from start of the programme was conducted with 317 patients. Control group patients (n = 131) received usual care, consisting of regular outpatient checkups. Intervention group patients (n = 186) received usual care and participated in the six‐week self‐management programme. The programme teaches patients medical, social and emotional self‐management skills. Twenty‐one classes were conducted in six hospitals in the Netherlands, and data were collected between August 2004 and January 2007.

Results.  Directly after the programme, statistically significant effects were found for cognitive symptom management (P < 0·001), self‐care behaviour (P = 0·008) and cardiac‐specific quality of life (P = 0·005). No effects were found at 6‐ and 12‐month follow‐up.

Conclusion.  Further research is necessary to study how long‐term effectiveness of the programme with patients with congestive heart failure can be achieved, and how successful adaptations of the programme can be integrated into standard care.
Unravelling migratory connectivity in marine turtles using multiple methods
Authors: Godley Brendan J. , Barbosa Castro , Bruford Michael , Broderick Annette C. , Catry Paulo , Coyne Michael S. , Formia Angela , Hays Graeme C. , Witt Matthew J.
Published: May 2010

1. Comprehensive knowledge of the fundamental spatial ecology of marine species is critical to allow the identification of key habitats and the likely sources of anthropogenic threats, thus informing effective conservation strategies.

2. Research on migratory marine vertebrates has lagged behind many similar terrestrial animal groups, but studies using electronic tagging systems and molecular techniques offer great insights.

3. Marine turtles have complex life history patterns, spanning wide spatio‐temporal scales. As a result of this multidimensional complexity, and despite extensive effort, there are no populations for which a truly holistic understanding of the spatial aspects of the life history has been attained. There is a particular lack of information regarding the distribution and habitats utilized during the first few years of life.

4. We used satellite tracking technology to track individual turtles following nesting at the green turtle Chelonia mydas nesting colony at Poilão Island, Guinea Bissau; the largest breeding aggregation in the eastern Atlantic.

5. We further contextualize these data with pan‐Atlantic molecular data and oceanographic current modelling to gain insights into likely dispersal patterns of hatchlings and small pelagic juveniles.

6. All adult turtles remained in the waters of West Africa, with strong connectivity demonstrated with Banc D’Arguin, Mauritania.

7. Despite shortcomings in current molecular markers, we demonstrate evidence for profound sub‐structuring of marine turtle stocks across the Atlantic; with a high likelihood based on oceanographic modelling that most turtles from Guinea‐Bissau are found in the eastern Atlantic.

8. Synthesis and applications. There is an increased need for a better understanding of spatial distribution of marine vertebrates demonstrating life histories with spatio‐temporal complexity. We propose the synergistic use of the technologies and modelling used here as a working framework for the future rapid elucidation of the range and likely key habitats used by the different life stages from such species.
Creatine supplementation for patients with COPD receiving pulmonary rehabilitation: A systematic review and meta‐analysis
Authors: AL‐GHIMLAS Fahad , TODD David C.
Published: May 2010

Background and objective:  Creatine improves muscle strength in exercising healthy individuals, and in patients with neuromuscular disease and heart failure. The aim of this study was to assess whether creatine supplementation improves pulmonary rehabilitation (PR) outcomes in patients with COPD.

Methods:  A systematic review and meta‐analysis was performed of randomized controlled trials published between January 1966 and February 2009 that evaluated the effect of creatine compared with placebo on exercise capacity, muscle strength and health‐related quality of life (HR‐QoL) in patients undergoing PR for COPD. The pooled estimates were expressed as mean differences (MD) or standardized mean differences (SMD).

Results:  Four randomized controlled trials that included 151 patients were identified. There was no effect of creatine supplementation on exercise capacity (SMD −0.01, 95% CI: −0.42 to 0.22, n = 151). Creatine supplementation did not improve lower extremity muscle strength (SMD 0.03, 95% CI: −0.55 to 0.61, n = 140) or upper limb muscular strength (SMD 0.02, 95% CI: −0.33 to 0.38, n = 128) compared with placebo. Two studies (n = 48) assessed quality of life using the St. George's Respiratory Disease Questionnaire. There were no differences in HR‐QoL according to domain or total scores. Overall, creatine appeared to be safe and was well tolerated. Quality assessment of the studies showed important limitations.

Conclusions:  Creatine supplementation does not improve exercise capacity, muscle strength or HR‐QoL in patients with COPD receiving PR. However, important limitations were identified in the quality of the available evidence, suggesting that further research is required in this area.
Metabolic abnormalities in adults with cystic fibrosis
Authors: GEORGIOPOULOU Vasiliki V. , DENKER Adam , BISHOP Kathy L. , BROWN Jason M. , HIRSH Benjamin , WOLFENDEN Linda , SPERLING Laurence
Published: May 2010

Background and objective:  Survival of patients with cystic fibrosis (CF) has improved, resulting in increased exposure of patients to cardiovascular risk factors. Diabetes mellitus is common in patients with CF; however, less is known about lipid abnormalities in this population. In this study, the prevalence of lipid abnormalities was investigated in a contemporary population of adults with CF.

Methods:  Clinical and laboratory data on 221 adult patients with CF were collected retrospectively. Fasting serum glucose levels and lipid profiles were recorded. The age‐specific values for healthy individuals, as reported by the National Health and Nutrition Examination Surveys, were used for comparison.

Results:  The mean age of the patients was 30 ± 10 years, 55.1% were men and the mean FEV1% was 68 ± 25%. Sixty‐nine patients (31.2%) had CF‐related diabetes mellitus and 52 (23.5%) were receiving insulin therapy. In addition, 36 patients (16.3%) had impaired glucose tolerance. Triglyceride levels were similar to those of historical control subjects (mean ± SEM, 1.37 ± 0.05 and 1.39 ± 0.02 mmol/L, respectively, P = 0.75). However, in the 30–39 years age group of CF patients, triglyceride levels were increased relative to those of their control counterparts (1.79 ± 0.14 vs 1.38 ± 0.04 mmol/L, P = 0.006). Total cholesterol levels were lower in the CF patients compared with control subjects, across all age groups.

Conclusions:  Abnormalities of glucose metabolism are highly prevalent in CF patients, and are accompanied by hypertriglyceridaemia in the 30–39 years age group. Prospective studies are required to confirm lipid abnormalities and investigate possible cardiovascular complications in patients with CF.
Accruals Quality and Debt Maturity Structure
Authors: GARCÍA‐TERUEL PEDRO J. , MARTÍNEZ‐SOLANO PEDRO , SÁNCHEZ‐BALLESTA JUAN P.
Published: May 2010

In this paper we use panel data and GMM estimation to examine the effect of accounting quality on debt maturity structure in a bank‐based financial system and show that, even after controlling for unobservable heterogeneity, endogeneity, variables reflecting operating volatility and the cost of debt, firms with poor accounting quality face a shorter debt term than firms with higher accounting quality. This association between accounting quality and debt maturity is consistent with accounting quality as a means of reducing information asymmetry problems and improving the monitoring of managers.
Financial Forecasting, Risk and Valuation: Accounting for the Future
Authors: PENMAN STEPHEN H.
Published: May 2010

Valuation involves forecasting payoffs and discounting expected payoffs for risk. Forecasting is often seen as the province of the statistician, risk determination the province of asset pricing. This paper elaborates on the idea that financial forecasting, risk determination and valuation are a matter of accounting. Accounting not only provides information to forecast payoffs but also specifies the payoffs to be forecasted. Further, accounting determines the transition from the present to the future and thus implicitly the evolutionary parameters that a statistician might estimate for forecasting. Accounting also bears on risk determination in the way it handles uncertainty. Accordingly, accounting is involved in both the numerator and the denominator of a valuation model. Indeed, a valuation model is a model of accounting for the future, and the effectiveness of a valuation model rides on the accounting principles employed.
Building the role of local government authorities towards the achievement of the human right to water in rural Tanzania
Authors: Jiménez Alejandro , Pérez‐Foguet Agustí
Published: May 2010

In recent decades, many changes have occurred in the approach to financing and operating water services in developing countries. The demand‐responsive approach is now adopted in many countries in a context of donor‐supported decentralization processes, which gives more responsibility to end users. However, the government's responsibility at different levels is enforced by the international recognition of the human right to water. This paper examines specific actions that build the role of local government authorities in this scenario. A collaboration between an international NGO and a rural district in Tanzania from 2006 to 2009 is used as an action research case study that is representative of local capacity‐building needs in decentralized contexts and rural areas. Three main challenges were detected: i) lack of reliable information; ii) poor allocation of resources in terms of equity; and iii) lack of long‐term community management support from the district. Two mechanisms were established: i) water point mapping as a tool for information and planning; and ii) a District Water and Sanitation Unit Support (DWUS) for community management. The results show how the framework provided by the goal of human right to water helps to define useful strategies for equity‐oriented planning and post‐project support at the local level.
Shellfish aquaculture and First Nations' sovereignty: The quest for sustainable development in contested sea space
Authors: Joyce Alyssa L. , Satterfield Terre A.
Published: May 2010

Aquaculture tenures or leases have become an increasingly important management tool for regulating access rights to coastal and offshore marine habitat. Tenure, as a form of private property rights to marine space, is generally considered a prerequisite for aquaculture development, as are the associated exclusive access rights which provide necessary incentives for producers to invest in infrastructure. The shellfish industry in British Columbia (BC), Canada, is presented as a case study of a transition from a primarily common property wild fishery to a rights‐based system for aquaculture. In BC, seafood production has grown substantially during the past two decades as a result of aquaculture production. However, despite the inherent economic advantages of the tenuring system for increasing seafood production, rights to aquaculture sites in BC remain highly controversial, particularly in response to environmental concerns and infringements on Aboriginal territorial claims. Shellfish farming has, to‐date, been far less controversial than salmon farming; however, shellfish aquaculture has not been uniformly adopted across the province, and analyses of industry capacity or economic opportunities for coastal communities have failed to adequately explain development patterns. This paper, which identifies perceptions of the risks and benefits of the shellfish aquaculture tenuring system, presents the results of 56 interviews conducted with individuals involved in shellfish production in BC. Results indicate that heightened perceptions of risk about shellfish aquaculture tenuring are related to unresolved Aboriginal territorial claims, economic dependence on wild shellfish resources, as well as place‐based values favouring access to wild resources. Underlying values and cultural understandings also strongly shape public perceptions of the risks of aquaculture, and as such, influence local decisions to either accept or resist industry growth. In this case, interviewees' risk perceptions were found to be more important indicators of the potential for industry expansion than studies of capacity or economic cost‐benefit analyses.
In Vitro and Computational Thrombosis on Artificial Surfaces With Shear Stress
Authors: Corbett Scott C. , Ajdari Amin , Coskun Ahmet U. , N‐Hashemi Hamid
Published: May 2010

Implantable devices in direct contact with flowing blood are associated with the risk of thromboembolic events. This study addresses the need to improve our understanding of the thrombosis mechanism and to identify areas on artificial surfaces susceptible to thrombus deposition. Thrombus deposits on artificial blood step transitions are quantified experimentally and compared with shear stress and shear rate distributions using computational fluid dynamics (CFD) models. Larger steps, and negative (expanding) steps result in larger thrombus deposits. Fitting CFD results to experimental deposit locations reveals a specific shear stress threshold of 0.41 Pa or a shear rate threshold of 54 s−1 using a shear thinning blood viscosity model. Thrombosis will occur below this threshold, which is specific to solvent‐polished polycarbonate surfaces under in vitro coagulation conditions with activated clotting time levels of 200–220 s. The experimental and computational models are valuable tools for thrombosis prediction and assessment that may be used before proceeding to clinical trials and to better understand existing clinical problems with thrombosis.
Physiologic Benefits of Pulsatile Perfusion During Mechanical Circulatory Support for the Treatment of Acute and Chronic Heart Failure in Adults
Authors: Guan Yulong , Karkhanis Tushar , Wang Shigang , Rider Alan , Koenig Steven C. , Slaughter Mark S. , El Banayosy Aly , Ündar Akif
Published: May 2010

A growing population experiencing heart failure (100 000 patients/year), combined with a shortage of donor organs (less than 2200 hearts/year), has led to increased and expanded use of mechanical circulatory support (MCS) devices. MCS devices have successfully improved clinical outcomes, which are comparable with heart transplantation and result in better 1‐year survival than optimal medical management therapies. The quality of perfusion provided during MCS therapy may play an important role in patient outcomes. Despite demonstrated physiologic benefits of pulsatile perfusion, continued use or development of pulsatile MCS devices has been widely abandoned in favor of continuous flow pumps owing to the large size and adverse risks events in the former class, which pose issues of thrombogenic surfaces, percutaneous lead infection, and durability. Next‐generation MCS device development should ideally implement designs that offer the benefits of rotary pump technology while providing the physiologic benefits of pulsatile end‐organ perfusion.
Antibacterial Nitric Oxide‐Releasing Polyester for the Coating of Blood‐Contacting Artificial Materials
Authors: Seabra Amedea B. , Martins Dorival , Simões Maíra M.S.G. , Da Silva Regiane , Brocchi Marcelo , De Oliveira Marcelo G.
Published: May 2010

The emergence of multidrug‐resistant bacteria associated with blood‐contacting artificial materials is a growing health problem, which demands new approaches in the field of biomaterials research. In this study, a poly(sulfhydrylated polyester) (PSPE) was synthesized by the polyesterification reaction of mercaptosuccinic acid with 3‐mercapto‐1,2‐propanediol and blended with poly(methyl methacrylate) (PMMA) from solution, leading to solid PSPE/PMMA films, with three different PSPE : PMMMA mass ratios. These films were subsequently S‐nitrosated through the immersion in acidified nitrite solution, yielding poly(nitrosated)polyester/PMMA (PNPE/PMMA) films. A polyurethane intravascular catheter coated with PNPE/PMMA was shown to release nitric oxide (NO) in phosphate buffered saline solution (pH 7.4) at 37°C at rates of 4.6 nmol/cm2/h in the first 6 h and 0.8 nmol/cm2/h in the next 12 h. When used to coat the bottom of culture plates, NO released from these films exerted a potent dose‐ and time‐dependent antimicrobial activity against Staphylococcus aureus and a multidrug‐resistant Pseudomonas aeruginosa strains. This antibacterial effect of PSPE/PMMA films opens a new perspective for the coating of blood‐contacting artificial materials, for avoiding their colonization with highly resistant bacteria.
The Influence of Translocation Strategy and Management Practices on the Genetic Variability of a Reestablished Elk (Cervus elaphus) Population
Authors: Conard Jonathan M. , Statham Mark J. , Gipson Philip S. , Wisely Samantha M.
Published: May 2010

Reintroduction of terrestrial vertebrates with the goal of ecosystem restoration typically establishes small and isolated populations that may experience reduced genetic variability due to founder effects and genetic drift. Understanding the genetic structure of these populations and maintaining adequate genetic diversity is important for long‐term restoration success. We quantified genetic variability at six microsatellite loci for a reintroduced population ofCervus elaphus(elk) restored to the tallgrass prairie ecosystem of northeastern Kansas. Allelic richness, observed and expected heterozygosity were intermediate to levels reported in other North American elk populations. Current levels of genetic variability in restored North American elk populations were not well explained by founding population size, number of founding populations, or number of years since the last translocation. Simulation results suggest that the retention of genetic variability in isolated populations is strongly influenced by mating system while also being impacted by temporal variability in population size and population growth rate. Our results have implications for understanding how translocation strategies and post‐reintroduction management may influence genetic variability in restored populations.
Addressing inadequacies in Victoria's trauma system: Responses of the Consultative Committee on Road Traffic Fatalities and Victorian trauma services
Authors: McDermott Francis , Cordner Stephen , Winship Victoria
Published: May 2010

Objectives:  Victoria's new trauma care system has been followed by reductions in preventable and potentially preventable deaths and in deficiencies contributing to death. This improvement has followed triaging more patients to expanded major trauma services where mortality was already lower rather than to improved results within the major trauma services, metropolitan or rural trauma services or ambulance services, Victoria. The objective of the present study was to identify continuing inadequacies within the individual trauma services and in association with representatives of these services to develop appropriate countermeasures.

Methods:  Initially, presentations were made to each trauma service of their fatalities evaluated after introduction of the new trauma system. At separate working party meetings with each service consensus recommendations were finalized and these disseminated to stakeholders.

Results:  Recommendations related to the need for Trauma Director/Coordinator appointments at all designated hospitals receiving major trauma, improved facilities and equipment, the trauma team, referral, communications, protocols, a prompting system, education, audit and feedback, infrastructure, staffing, documentation and inter‐hospital patient transfer.

Conclusion:  Interaction between the Consultative Committee on Road Traffic Fatalities and Victorian trauma services identified continuing deficiencies in the new trauma care system and developed consensus recommendations to target these problems. These require implementation through the State Trauma Committee.
Access Versus Incentives: Analysing Intellectual Property Policies in Four UN Specialized Agencies by Emphasizing the Role of the World Intellectual Property Organization and Human Rights
Authors: Haugen Hans Morten
Published: May 2010

Concerns have been expressed over the role of the World Intellectual Property Organization (WIPO) in influencing the intellectual property policies of other specialized agencies of the United Nations. This article reviews the policies of the Food and Agricultural Organization (FAO), World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO), in addition to WIPO itself, and finds very interesting patterns of cooperation. While intellectual property law is primarily concerned with providing incentives for the production of new, creative and applicable arts and knowledge, human rights law is primarily concerned with providing improved access to goods crucial for human well‐being and survival. While UNESCO has paid less attention to intellectual property rights over the last decades, rather emphasizing cultural preservation, both FAO and WHO have increased their focus on intellectual property rights. The latter two have increased their cooperation with WIPO, but without a formal agreement with WIPO. The article finds that WIPO, as a specialized agency, has to cooperate with specialized agencies, and there is no reason to believe that the cooperation will be in the form of a “one‐way” process in which WIPO instructs the other agencies. At the same time, it must be acknowledged that intellectual property rights can also hamper research, in addition to impacting on the access to the crucial goods.
Policy Framework for Transition to a Low‐Carbon World Economy
Authors: GARNAUT Ross
Published: May 2010

Climate change mitigation policy is the most difficult to come before our polity in living memory. There can be no solution without international agreement involving all substantial economies, and yet each country has an incentive to free ride on others. The international agreement must have five parts: agreement on the objective in terms of concentrations of greenhouse gases in the atmosphere, agreement on allocation of an emissions entitlements budget among countries, agreement on rules for international trade in entitlements, agreement on developed countries taking the lead on development of low‐emissions technologies, and agreement on assistance from developed countries for climate change mitigation in developing countries. Two sources of market failure must be corrected to achieve emissions reduction targets efficiently: the external costs of emitting greenhouse gases and the external benefits of private investment in innovation in relation to low‐emissions technologies.
Reaching a Global Agreement on Climate Change: What are the Obstacles?
Authors: HUFBAUER Gary Clyde , KIM Jisun
Published: May 2010

A successor accord to the Kyoto Protocol was supposed to be wrapped up in Copenhagen in December 2009, but negotiations are now expected to extend through the South African UNFCCC conference in 2011 since the Copenhagen talks failed to yield a binding agreement. To reach a comprehensive deal, major gaps between developing and developed countries must be narrowed. The gaps include the character of common but differentiated responsibilities, financial support, technology transfer, and trade subsidies and sanctions. The paper concludes with some options and recommendations.
Climate Change Policy Options for Asian Economies: Findings from an Integrated Assessment Model
Authors: VAN DER MENSBRUGGHE Dominique
Published: May 2010

This study outlines potential futures for the global economy through the 2050 with a specific focus on the countries of Asia. With underlying assumptions about population and output growth, a baseline scenario assesses the growth of greenhouse gas emissions and the ensuing impacts on the climate. Under the baseline scenario, Asia's high growth leads to a strong rotation in global output and emissions by the year 2050. The analytical framework traces back the changes in temperature to economic damages – limited to the agricultural sectors. Parts of Asia are likely to see much higher dependence on food imports as a consequence of these damages. Various carbon tax scenarios are implemented to assess the potential for reducing carbon emissions. Because of the structure of their economies, Asian countries are likely to bear the greatest burden in reducing emissions in an efficient global tax scheme, but there is significant scope to ease this burden through financial transfers.
The BTNL2 A allele variant is frequent in Danish patients with sarcoidosis
Authors: Milman Nils , Svendsen Claus Bo , Nielsen Finn Cilius , van Overeem Hansen Thomas
Published: May 2010

Background:  The butyrophilin‐like 2 (BTNL2) gene is located on chromosome 6p21.3 close to the HLA‐class II genes. An association has been reported between sarcoidosis and a single nucleotide polymorphism in BTNL2, rs2076530, also termed the A allele.

Objectives:  To evaluate whether patients with sarcoidosis carry the A allele more frequently than healthy subjects.

Methods:  The series comprised 87 ethnic Danes with sarcoidosis and 113 healthy control subjects. Analysis of rs2076530 was performed by Taqman assay, polymerase chain reaction and sequencing of genomic DNA.

Results:  Sarcoidosis patients had a higher frequency of the A allele than controls (73.9% vs 55.8%) (P < 0.025). The frequency of GG, GA and AA genotype was 5.7%, 40.2% and 54.0% in patients vs 16.0%, 56.6% and 27.4% in controls (P < 0.001). The AA genotype was associated with increased risk of sarcoidosis in both a dominant [odds ratio (OR) 3.1; 95% confidence interval (CI) 1.1–8.7; P < 0.03] and a recessive model (OR 3.1; 95% CI 1.72–5.61; P < 0.001). Population attributable fraction for disease was 50% in a dominant model and 25% in a recessive model.

Conclusions:  The BTNL2 A allele variant occurs with a high frequency in Danish patients with sarcoidosis and the AA genotype is associated with a ∼threefold higher risk of sarcoidosis than the GG genotype. Our results should encourage future studies on the interrelationship between the BTNL2 protein and granuloma formation in sarcoidosis.

Please cite this paper as: Milman N, Svendsen CB, Nielsen FC and Hansen TvO. The BTNL2 A allele variant is frequent in Danish patients with sarcoidosis. Clin Respir J 2011; 5: 105–111.
Clinical, radiological and pathological study of 88 cases of typical and complicated scleroma
Authors: Fawaz Samia , Tiba Medhat , Salman Manal , Othman Hala
Published: May 2010

Background:  Scleroma is a chronic specific granulomatous disease. It is considered endemic in Central America, Egypt, tropical Africa, India, and Indonesia. The most common complaint is nasal obstruction, other symptoms include; rhinorrhea, epistaxis, dysphagia, stridor, and dysphonia.

Aim:  So our objective was to focus on the various clinical and radiological manifestations of scleroma in an endemic area, with some atypical symptoms and signs, and to alert physicians to suspect scleroma or its complications in any case of unexplained nasal lesion.

Material and methodology:  Our study included 88 cases who were admitted in our otorhinolaryngology department. They presented with various manifestations of Rhino‐pharyngo‐laryngo scleroma, out of these patients 16 cases showed atypical presentations. Our diagnosis was based on clinical and radiological examination, aided by bacteriological and pathological examination.

Results:  Patients with typical rhinoscleroma (72 patients) presented with various nasal and laryngo‐tracheal symptoms. 16 patients (18%) presented complaining of various nasal symptoms and signs, which were not suspected to be rhinoscleroma, so our workup was directed to diagnose those patients, and their final diagnosis was reached to be rhinoscleroma, we sub classified those patients according to their presentation.

Conclusion:  Rhinoscleroma can present clinically with atypical features, so in order to avoid misdiagnosis, it is important to keep in mind these atypical manifestations.

Please cite this paper as: Fawaz S, Tiba M, Salman M, and Othman H. Clinical, radiological and pathological study of 88 cases of typical and complicated scleroma. Clin Respir J 2011; 5: 112–121.
The patient with recurrent oral ulceration
Authors: Talacko AA , Gordon AK , Aldred MJ
Published: May 2010

This paper discusses the range of recurrent oral ulceration which affects the oral mucosa. Types of ulceration covered in this paper include traumatic, infective, aphthous, ulceration related to the oral dermatoses, drug‐induced, ulceration as a manifestation of systemic disease and ulceration indicating malignancy. Aspects of the aetiology, diagnosis and management of common oral recurrent ulcerative conditions are reviewed from a clinical perspective as an aid to practising dentists.
Oral mucosal diseases: the inflammatory dermatoses
Authors: Schifter M , Yeoh S‐C , Coleman H , Georgiou A
Published: May 2010

The oral inflammatory dermatoses is a term used to describe a number of predominantly immune‐mediated disorders: lichen planus (LP), erythema multiforme (EM), the vesiculobullous diseases pemphigoid (MMP), pemphigus (PV) and epidermolysis bullosa acquisita (EBA). These conditions are characterized by frequent involvement of the oral mucosa and often associated with extraoral manifestations, particularly of the skin, but can involve the eyes, both the conjunctiva and sclera, the nasal and pharyngeal mucosa, as well as the genitals. Given their frequent, and sometimes initial involvement of the oral mucosa, oral health professionals need to be both familiar with the clinical features and presentations of these conditions, and appreciate their critical role in management.

This paper reviews the clinical features and presentation of the oral dermatoses, provides guidance as to the appropriate investigations needed to differentiate and correctly diagnose these conditions, details the aetio‐pathology of these diseases and discusses their management.
Sjögren’s syndrome: a review of aetiology, pathogenesis, diagnosis and management
Authors: Bayetto K , Logan RM
Published: May 2010

Sjögren’s syndrome is a chronic autoimmune disease that affects many individuals within the community. Despite this, its exact aetiology and pathogenesis is still unclear. Sjögren’s syndrome affects many organ systems in the body. However, for dental practitioners it is important to recognize the many oral and dental manifestations that are associated with the syndrome. In addition to these oral manifestations, this review will discuss the systemic manifestations of Sjögren’s syndrome as well as the current understanding of factors that have a role in its aetiology and pathogenesis. Furthermore, this review will highlight the difficulties and complexities that are inherent in the diagnosis of Sjögren’s syndrome and the important role that dental practitioners can play in the management of its oral manifestations. The effective management of oral manifestations and minimization of oral disease in patients with Sjögren’s syndrome can result in improved quality of life for these patients.
Oral mucosal malignancy and potentially malignant lesions: an update on the epidemiology, risk factors, diagnosis and management
Authors: McCullough MJ , Prasad G , Farah CS
Published: May 2010

An oral examination for the assessment for malignant and potentially malignant oral mucosal lesions is routine in general dental practice. It may be uncommon for general dental practitioners to encounter oral cancer, with anecdotal reports suggesting that this occurs about once every 10 years in a busy general dental practice. However, potentially malignant oral mucosal lesions are relatively common, occurring in about 2.5% of the population. This update highlights the epidemiology, risk factors, diagnosis and management of these oral mucosal lesions.
Clinical assessment and management of the oral environment in the oncology patient
Authors: Walsh LJ
Published: May 2010

The dental care of oncology patients is an important component of general dental practice. Oncology patients have additional requirements for their outpatient care in the dental office. Intense involvement of the general dental practitioner in the patient’s overall plan of care is essential so that appropriate preventive and therapeutic strategies are followed prior to chemotherapy, radiation and other medical treatments. This paper provides an overview of the role of the dental practitioner in the pre‐treatment workup and post‐treatment maintenance of oncology patients, and discusses the complications which occur during the intensive and in‐hospital phases of care, in the context of approaches that show promise for reducing or preventing these. The role of the general dental practitioner in the maintenance of oral health for the remainder of the patient’s life is stressed, with evidence‐based recommendations given for optimal use of home care products which support oral health and improve quality‐of‐life.
Actinic cheilitis in dental practice
Authors: Savage NW , McKay C , Faulkner C
Published: May 2010

Actinic cheilitis is a potentially premalignant condition involving predominantly the vermilion of the lower lip. The aim of the current paper was to review the clinical presentation of actinic cheilitis and demonstrate the development of management plans using a series of cases. These are designed to provide immediate treatment where required but also to address the medium and long‐term requirements of the patient. The authors suggest that the clinical examination of lips and the assessment of actinic cheilitis and other lip pathology become a regular part of the routine soft tissue examination undertaken as a part of the periodic examination of dental patients. Early recognition of actinic cheilitis can allow the development of strategies for individual patients that prevent progression. These are based on past sun exposure, future lifestyle changes and the daily use of emollient sunscreens, broad‐brimmed hats and avoidance of sun exposure during the middle of the day. This is a service that is not undertaken as a matter of routine in general medical practice as patients are not seen with the regularity of dental patients and generally not under the ideal examination conditions available in the dental surgery.
The mouth in HIV/AIDS: markers of disease status and management challenges for the dental profession
Authors: Johnson NW
Published: May 2010

There are over 30 million people in the world with HIV infection and, whilst the rate of new infections is slowing, this number continues to grow. Although in Australia the overall prevalence of HIV infection in adults aged 15–49 is officially estimated at only 0.2%, representing less than 20 000 people living with HIV and AIDS, our geographical area contains populations with prevalences exceeding 10 times this. Oral health professionals must therefore practise safe, standard infection control at all times and be aware of the oral manifestations of HIV disease. These are predominantly opportunistic infections with fungi such asCandida albicansor with viruses of the herpes family, particularly herpes simplex, herpes zoster and Epstein‐Barr virus infections. Warts or papillomas may arise due to human papilloma viruses – even in individuals on effective antiretroviral therapy. Rare types of fungal infection can occur, and severe bacterial infections, notably tuberculosis, are an ever‐present risk. Susceptibility to periodontal breakdown is somewhat enhanced by the effects of HIV disease itself, and caries activity may increase because the patient neglects attention to diet and oral hygiene. Restorative and periodontal care need, therefore, to be maintained at a high level. Oral opportunistic infections cause much distress and the diagnosis and management of these is the responsibility of our profession.
Non‐carious cervical lesions: a scanning electron microscopic study
Authors: Michael JA , Kaidonis JA , Townsend GC
Published: May 2010

Background:  Examining non‐carious cervical lesions using scanning electron microscopy (SEM) provides an opportunity to clarify their complex aetiology. This study aimed to examine the morphological forms of non‐carious cervical lesions found within a sample of extracted human permanent anterior teeth using scanning electron microscopy.

Methods:  Five examples of non‐carious cervical lesions from each of eight different morphologic categories were replicated and examined using scanning electron microscopy.

Results:  In total, 40 non‐carious cervical lesions were examined at magnifications ranging from 10× to 2605× magnification. Qualitative ultrastructural features evident in the lesions were described and classified according to their appearance. A total of 13 different qualitative features were observed throughout the sample of NCCLs.

Conclusions:  SEM highlighted a broad range of microscopic features of NCCLs, providing valuable insights into their complex, multifactorial aetiology.
The all‐ceramic, inlay supported fixed partial denture. Part 1. Ceramic inlay preparation design: a literature review
Authors: Thompson MC , Thompson KM , Swain M
Published: May 2010

The effect of cavity design is a controversial and underrated factor in the clinical success of ceramic inlays and inlay supported prosthesis. Many articles and studies have been conducted into the advantages and disadvantages of isolated aspects of preparation design, but lacking is a review of the most relevant papers which bring together a consensus on all the critical features. Hence, a review and analysis of cavity depth, width, preparation taper and internal line angles is warranted in our attempts to formulate preparation guidelines that will lead to clinically successful, all‐ceramic inlay restorations and ceramic inlay supported prosthesis.
One‐year clinical evaluation of a two‐step self‐etch adhesive with and without additional enamel etching technique in cervical lesions
Authors: Ozel E , Say EC , Yurdaguven H , Soyman M
Published: May 2010

Background:  The aim of this study was to determine the clinical performance of a two‐step self‐etch adhesive with and without additional enamel etching technique to advanced non‐carious cervical sclerotic lesions.

Methods:  Twenty‐two patients (mean age = 51.5) having at least two pairs of non‐carious cervical erosion/attrition/abfraction lesions with incisal or occlusal margins in enamel and gingival margins in dentine/cementum were included in the study. The two‐step self‐etch adhesive (AdheSE; Ivoclar‐Vivadent) was either applied following the self‐etch approach on both enamel and dentine (AdheSE non‐etch), or a similar application including additional acid‐etching of the enamel cavity margins with 37% phosphoric acid (AdheSE etch). Resin composite Point 4 was used for all 104 restorations. Restorations were evaluated at baseline and at one year according to the modified United States Public Health Service (USPHS) criteria. Data were analysed by using McNemar’s test (p <0.05).

Results:  There were no significant differences in the marginal adaptation both at the cervical and enamel margins between AdheSE non‐etch and AdheSE etch groups (p >0.05). At one year, marginal discolouration was evident in the AdheSE non‐etch group but it was not statistically significant from the AdheSE etch group (p = 0.12). Postoperative sensitivity was 5% at baseline and reduced to 2% at one year.

Conclusions:  At one year, the two‐step self‐etch adhesive with and without additional enamel etching technique showed excellent clinical results to advanced non‐carious cervical sclerotic lesions.
Preventive effect of iron gel with or without fluoride on bovine enamel erosion in vitro
Authors: Bueno MG , Marsicano JA , Sales‐Peres SHC
Published: May 2010

Background:  The aim of this study was to evaluate the preventive effect in vitro of experimental gel containing iron and/or fluoride on the erosion of bovine enamel.

Methods:  To standardize the blocks (n = 80), specimens (4 × 4 mm) were previously selected to measure the initial microhardness. The blocks were randomly allocated into four groups of 20 samples each: C (control, placebo gel); F (fluoride gel, 1.23% NaF); Fe (iron gel, 10 mmol/L FeSO4) and F + Fe (fluoride + iron gel). The gels were applied and removed after 1 minute. The blocks were then submitted to six alternating remineralization and demineralization cycles. The beverage Coca‐Cola® (10 minutes, 30 mL) was used for demineralization, and artificial saliva (1 hour) for remineralization. The effect of erosion was measured by wear analysis (profilometry). Data were analysed by ANOVA and the Tukey test for individual comparisons (p <0.05).

Results:  The mean wear (± SD, μm) was C: 0.94 ± 0.22; F: 0.55 ± 0.12; Fe: 0.49 ± 0.11 and F + Fe: 0.55 ± 0.13. When the experimental gels were used, there was statistically significant reduction in enamel wear in comparison with the control (p <0.001). However, the experimental gels did not differ significantly among them.

Conclusions:  The gels containing iron with or without fluoride are capable of interfering with the dissolution dental enamel in the presence of erosive challenge.
Laser explantation of a failing endosseous dental implant
Authors: Smith LP , Rose T
Published: May 2010

Explantation of failed dental implants has traditionally been performed by mechanical bone removal techniques. The advent of intraoral laser surgery has seen increasing numbers of applications in oral implantology. The technique demonstrates safe and efficient explantation of a failed dental implant using Er,Cr:YSGG laser. Laser assisted explantation of dental implants is a minimally invasive technique providing an alternative to conventional mechanical explantation techniques.
Asthma and oral health: a review
Authors: Thomas MS , Parolia A , Kundabala M , Vikram M
Published: May 2010

Asthma is a chronic inflammatory condition that causes the airways to constrict and produce excess mucus, making breathing difficult. It is characterized by the obstruction of airflow which is variable over a short period of time. This condition is reversible, either spontaneously or can be controlled with the help of drugs. Asthma medication comprises bronchodilators, corticosteroids and anticholinergic drugs. Most of these drugs are inhaled using various forms of inhalers or nebulizers. The effect of these drugs on oral health is the subject of debate among dental practitioners. Patients taking asthma medication may be at risk of dental caries, dental erosion, periodontal diseases and oral candidiasis. Hence, patients with bronchial asthma on medication should receive special prophylactic attention. This article reviews the correlation between asthma and oral health, and suggests various measures to counter possible oral health problems related to asthma.
Damage engineering of boron-based low energy ion implantations on ultrashallow junction fabrications
Authors: Qin Shu , Hu Y. Jeff , McTeer Allen
Published: May 2010

Combination of transmission electron microscopy and secondary ion mass spectrometry methods and device characteristics are used to successfully study damage engineering of the B-based low energy ion implants. The depths and densities of the amorphizing (a-Si) layer (surface lattice damage) and the end of range (EOR) damage are found to correlate to ion mass (amu) and implant energy, which are scalable to the molecular ion implants and ultralow energy) implants. The B11 beam-line implant shows thinner both a-Si and EOR depths due to its smaller amu and lower energy, and the damage are well annealed under the current annealing conditions. The BF2 beam-line implant shows severe surface lattice damage by more amorphizing due to its larger amu and higher energy, and needs more thermal budget to annealing (recrystallizing). The B2H6 plasma doping (PLAD) shows moderate a-Si layer and less EOR damage than beam-line ones which attributes to B deposition as a screen so that there are no direct ion bombardments on Si wafer substrate. The BF3 PLAD shows similar damage behavior to the BF2 beam-line implant but with less lattice damage. The device performance evaluation confirms that the device processed by B2H6 PLAD shows better ION versus IOFF characteristics than those processed by BF2 and C2B10H12 molecular beam-line implants due to less damage and more complete annealing.