bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical Distraction for the Treatment of Posttraumatic Stiffness of the Elbow in Children and Adolescents
Authors: Mader Konrad , Koslowsky Thomas Christian , Gausepohl Thomas , Pennig Dietmar
Published: March 2007

BACKGROUND:

Elbow contracture is a recognized sequela of elbow injuries in children and adolescents, but previous studies of operative treatment with formal capsular release have demonstrated unpredictable outcomes and unfavorable results.

METHODS:

Over a period of five years, fourteen children and adolescents with a mean age of fourteen years who had posttraumatic stiffness of the elbow were managed according to a prospective protocol. Eleven patients had undergone a mean of three previous operative procedures before the index operation. After intraoperative distraction with an external fixator, there was a relaxation phase for six days followed by mobilization of the elbow joint under distraction in the fixator for a mean of seven weeks. Intraoperative range of motion under distraction reached a mean of 100°. Open arthrolysis was not performed, but in four children impinging heterotopic bone was removed through a limited approach. Decompression of the ulnar nerve was performed in seven patients.

RESULTS:

The mean preoperative arc of total elbow motion was 37°. The mean pronation was 46°, and the mean supination was 56°. After a mean duration of follow-up of thirty-four months, all patients but two had achieved an arc of motion of 100°. The mean arc of flexion-extension was 108° (range, 75° to 130°). The mean range of pronation was 73° (range, 20° to 90°), and the mean range of supination was 75° (range, 10° to 90°). There were no pin-track infections or deep infections, and all elbows were stable. At the time of follow-up, three patients had radiographic evidence of humeroulnar degeneration.

CONCLUSIONS:

Closed distraction of the elbow joint with use of a monolateral external fixation frame with motion capacity yields more favorable results than other previously reported options for the treatment of posttraumatic elbow contractures in children and adolescents.
Solid Phosphorus Phase in Aluminum‐ and Iron‐Treated Biosolids
Authors: Huang Xiao‐Lan , Chen Yona , Shenker Moshe
Published: March 2007

Stabilization of phosphorus (P) in sewage sludge (biosolids) to reduce water‐soluble P concentrations is essential for minimizing P loss from amended soils and maximizing the capacity of the soil to safely serve as an outlet for this waste material. The chemical form at which P is retained in biosolids stabilized by Al2(SO4)3·18H2O (alum) or FeSO4·7H2O (FeSul) was investigated by scanning electron microscopy (SEM) equipped with energy‐dispersive X‐ray elemental spectrometry (EDXS) and by X‐ray diffraction (XRD). Both treatments resulted in the formation of a Ca‐P phase, probably brushite. Phosphorus was further retained in the alum‐treated biosolids by precipitation of an Al‐P phase with an Al/P molar ratio of about 1:1, while in the FeSul‐treated biosolids, P was retained by both precipitation with Fe/P molar ratios of 1:1 or 1.5:1, and by adsorption onto newly formed Fe hydroxides exhibiting an Fe/P molar ratio of up to 11:1. All of these mechanisms efficiently reduced P solubility and are crucial in biosolids environmentally safe agronomic beneficial use for this waste product; however, each P phase formed may react differently in the amended soil, depending on soil properties. Thus, the proper P stabilization method would depend on the target soil.
Sources of Sediment and Phosphorus in Stream Flow of a Highly Productive Dairy Farmed Catchment
Authors: McDowell R. W. , Wilcock R. J.
Published: March 2007

Both sediment and phosphorus (P) are important contaminants for surface water quality. Knowing the main sources of sediment and P loss within agricultural catchments enables mitigation practices to be better targeted. With this in mind seasonal loads of suspended sediment (SS), dissolved reactive P (DRP), total P (TP), and bioavailable P (BAP) were measured in a low gradient stream draining an intensively farmed New Zealand dairying catchment. Integrating in situ samplers were deployed to collect samples and the results merged with continuous flow data to calculate seasonal loads during 2005 through 2006. Flow rate, SS, and TP concentrations peaked in winter‐spring and were lowest in summer‐autumn. Concentrations of BAP in trapped sediment were greatest in autumn, contrasting with winter and spring when greater amounts of sediment were trapped, but with lower P enrichment. Analysis of 137Cs and mixing model output showed that a major source of sediment and associated P in winter and spring was stream banks. Possible causes for this include trampling and destabilization by stock, channel straightening and sediment removal, and removal of riparian trees that stabilize banks. Modelling indicated that overland flow probably from topsoil (but could include sediment from lanes) contributed most sediment during summer and autumn. Remediation aimed at decreasing particulate P inputs to streams should focus on riparian protection measures, such as permanent stock exclusion and planting with shrubs and trees, ensuring runoff from lanes is minimized, and decreasing Olsen P to nearer optimum agronomic levels.
Making a Difference With Interactive Technology: Considerations in Using and Evaluating Computerized Aids for Diabetes Self-Management Education
Authors: Glasgow Russell E. , Bull Sheana S.
Published: March 2007

This article provides a discussion of the strengths and limitations of interactive technologies (e.g., Internet, CD-ROM) as supplements to and extensions of diabetes self-management education. Examples are provided, and the RE-AIM framework is used to consider how different interactive technologies have been used to enhance the Reach, Effectiveness, Adoption, Implementation, and Maintenance of interventions. Appropriate use of these technologies (e.g., computer administration, scoring, and feedback on assessment instruments; modeling optional coping strategies) should help diabetes educators reach and support more people in a more tailored manner and should free up educators’ time to focus on the creative problem identification and problem-solving that humans do best.
Traditional Chinese Medicine in the Treatment of Diabetes
Authors: Covington Maggie B.
Published: March 2007

In Brief

Traditional Chinese medicine (TCM) is a system of healing that is thousands of years old. It has long been utilized in the Chinese culture to treat the complex of symptoms that Western medicine terms diabetes mellitus. This article will outline the key concepts and therapies of TCM that play a role in the evaluation and treatment of diabetic patients.
Blood Pressure and the U.K. Prospective Diabetes Study
Authors: Burden Mary , Burden A.C.
Published: March 2007

Control of blood pressure is important to people with diabetes. This article provides background information on the design and results of the U.K. Prospective Diabetes Study blood pressure study and the potential difficulties of translating this landmark study into practice. The article addresses the practical and quality assurance issues surrounding blood pressure and offers information about potential pitfalls that can lead to errors of measurement. The article also explores methods of patient participation in the measurement of blood pressure and in decision making about control of high blood pressure and explains why a participatory approach is needed.
Case Study: Infections in Diabetes Mellitus
Authors: Schaberg Dennis S. , Norwood John M.
Published: March 2007

In Brief

Acute care for patients with diabetes varies greatly depending on the nature of the patients’ primary illness and physical condition during hospitalization. The following two case studies review common considerations when treating 1) diabetic patients who develop infections; and 2) hyperglycemic inpatients who have had an acute myocardial infarction or cerebrovascular accident.
Management of Diabetes Mellitus in Surgical Patients
Authors: Dagogo-Jack Samuel , Alberti K. George M.M.
Published: March 2007

In Brief

Diabetes is associated with increased requirement for surgical procedures and increased postoperative morbidity and mortality. The stress response to surgery and the resultant hyperglycemia, osmotic diuresis, and hypoinsulinemia can lead to perioperative ketoacidosis or hyperosmolar syndrome. Hyperglycemia impairs leukocyte function and wound healing. The management goal is to optimize metabolic control through close monitoring, adequate fluid and caloric repletion, and judicious use of insulin.
Cognitive Functioning and Self-Management in Older People With Diabetes
Authors: Asimakopoulou Koula , Hampson Sarah E.
Published: March 2007

The extent to which diabetes is responsible for cognitive dysfunction in older people continues to be investigated. Research is also being conducted to better understand why people with diabetes find self-management of their illness a challenge and to develop behavioral interventions to help older people improve their diabetes self-management. There is little research combining these two issues, that is, whether the level and type of cognitive impairment associated with diabetes affects people’s self-management. In this article, we review the evidence for deficits in cognitive functioning in older people with diabetes (predominantly type 2) and consider the implications for diabetes self-management.

Case-control and epidemiological studies comparing cognitive functioning of older people with and without diabetes have yielded inconsistent findings. However, one may draw the broad conclusion that there is some evidence of decline in more complex aspects of cognitive function, such as verbal memory, learning, and psychomotor efficiency. Cognitive functioning is probably also adversely affected by age, illness duration, glycemic control, and the presence of other co-morbid conditions. People with diabetes are at increased risk for dementia. This research is limited by lack of consensus on cognitive measures across studies and small sample sizes limiting power to detect differences. We summarize the findings from our study relating cognitive functioning to self-management behaviors for older people with type 2 diabetes, in which we found only a few associations.

On the basis of the available evidence, we conclude that the cognitive impairment associated with relatively uncomplicated type 2 diabetes in older adults is unlikely to adversely affect self-management of the illness.
Evidence-Based Trends for Achieving Weight Loss and Increased Physical Activity: Applications for Diabetes Prevention and Treatment
Authors: Delahanty Linda M.
Published: March 2007

In Brief

The prevalence of overweight and obesity is increasing dramatically and so is the incidence of type 2 diabetes. Evidence-based treatment recommendations for overweight and obesity have been published, and recent research has demonstrated that lifestyle interventions, primarily weight loss and increased activity, are very effective in preventing diabetes. It is time to critically evaluate evidence-based treatment trends in these areas and reassess our clinical practice guidelines. Emerging evidence on the effectiveness of meal replacements for weight loss, for example, is impressive and warrants attention. Evidence-based research trends suggest that we should include the use of meal replacements in our repertoire of weight-loss strategies to help people prevent and treat type 2 diabetes.
Polypharmacy in Elderly Patients With Diabetes
Authors: Good Chester B.
Published: March 2007

In Brief

Elderly diabetic patients often require multiple medications to adequately and appropriately treat their diabetes and associated comorbidities. Careful attention to avoiding drug interactions, limiting unnecessary medications, and choosing drugs most appropriate for elderly patients will lead to optimal outcomes.
Interactions Between Complementary Therapies or Nutrition Supplements and Conventional Medications
Authors: Shane-McWhorter Laura , Geil Patti
Published: March 2007

In Brief

Although there are many effective diabetes medications, patients with diabetes may decide to use complementary therapies or nutrition supplements in addition to their conventional medications. The two case studies presented in this article review drug interactions and other issues that must be considered when patients decide to combine traditional medications with other therapies.
Familial Clustering of Diabetic Nephropathy: Perceptions and Risk Recognition Among Mexican-American Patients With a Family History of Diabetes
Authors: Arar Nedal H. , Hazuda Helen P. , Plaetke Rosemarie , Sartorio Valeria , Arar Mazen Y. , Abboud Hanna E.
Published: March 2007

Abstract

Objective. Diabetic nephropathy (DN) clusters in families with type 2 diabetes, suggesting a genetic susceptibility for its development and progression. We investigated DN probands’ and relatives’: 1) perceptions of the causes and clustering of DN and 2) recognition of their genetic susceptibility and of other selected risk factors.

Research methods. Structured interviews were conducted with 246 Mexican-American participants in the Family Investigation of Nephropathy and Diabetes (FIND) study using the Contextual Assessment Approach Questionnaire (CAA-Q). A total of 105 (43%) DN probands and 141 (57%) first-degree relatives were enrolled. Subjects averaged 56 years of age (range: 33–76; SD: 9.04); 62% were females. Data analysis included both qualitative and quantitative methods using Atlas.ti and SPSS 9.0 software packages.

Results. Eighty-three percent of subjects recognized that type 2 diabetes clusters in their family, while 63% asserted that DN did not. Fifty-three percent of diabetic relatives presented with a high urinary albumin/creatinine ratio (≥0.03) and were unaware of having DN (P ≤0.05). All subjects viewed DN as a component of type 2 diabetes and not a separate disease entity. More than 80% of the subjects considered ethnicity but not age of onset or sex as risk factors for developing type 2 diabetes or DN.

Conclusion. Participants viewed type 2 diabetes and DN in the context of health behaviors related to their everyday activities. They considered DN to be part of diabetes with no direct genetic predisposition and not a separate entity. Diabetic relatives under-estimated their risks for developing DN and were not engaged in preventive measures to reduce these risks. We recommend that health professionals consider these findings when interacting with high-risk diabetic patients. DN is a serious complication of diabetes that requires special care, education, prevention, and management.
Psychological Functioning of Obese Individuals
Authors: Fabricatore Anthony N. , Wadden Thomas A.
Published: March 2007

In Brief

This review found that obese individuals in the general population have essentially normal psychological functioning. Obese women, however, are at greater risk than obese men of depression and related complications. Binge eating and extreme obesity further increase the likelihood of patients reporting emotional complications. Pharmacotherapy and psychotherapy may be of benefit in this subset of individuals.
Development and Validation of the Diabetes Quality of Life Brief Clinical Inventory
Authors: Burroughs Thomas E. , Desikan Radhika , Waterman Brian M. , Gilin Debra , McGill Janet
Published: March 2007

Objective. To design and test the reliability and validity of a brief, treatment-focused version of the Diabetes Quality of Life (DQOL) questionnaire for use with both type 1 and type 2 diabetes.

Research design and methods. Questionnaire packets including the DQOL, measures of current diabetes self-care behaviors, and demographic and health characteristics were mailed to 1,080 adults with type 1 or type 2 diabetes. A total of 498 patients returned completed packets. A three-stage statistical process was used to understand the underlying structure of the DQOL and to identify items most predictive of self-care behaviors and satisfaction with diabetes control.

Results. Principal components analysis, conducted on 26 items predictive of the main criteria, identified five key underlying factors. For each component, best subset regression analysis was conducted to identify nonredundant questions that best explained self-care behaviors and satisfaction with diabetes control.

A combined set of 15 questions was reliable (alpha = 0.85) and valid, though several questions were more relevant to type 1 or type 2 diabetes. For patients with type 1 diabetes, the 15-item brief inventory was equally or more effective at predicting self-care behaviors (shortened scale R2 = 0.360; full scale R2 = 0.254) and satisfaction with diabetes control (shortened scale R2 = 0.562; full scale R2 = 0.580) than the original 60-item DQOL. For type 2 diabetic patients, only satisfaction with diabetes control was well-predicted, but the 15-item inventory accounted for as much variance as the original 60-item DQOL (shortened scale R2 = 0.513; full scale R2 = 0.492).

Conclusions. The 15-item DQOL Brief Clinical Inventory provides a total health–related quality of life score that predicts self-reported diabetes care behaviors and satisfaction with diabetes control as effectively as the full version of the instrument. In addition, it provides a vehicle for quickly screening patients for readiness and specific treatment-related concerns. It takes about 10 minutes to administer and can be used to identify quality of life issues that might not arise during the typical patient-provider encounter.
Identifying and Prioritizing Diabetes Care Issues Among Mental Health Professionals of a Multi-Ethnic, State Psychiatric Hospital
Authors: Kaholokula Joseph Keawe’aimoku , Schirmer Todd N. , Elting Dirk
Published: March 2007

Objective. The purpose of this study was to identify and prioritize diabetes care issues in a multi-ethnic, state psychiatric hospital.

Research design and methods. The nominal group technique (NGT) was used to gather qualitative and quantitative data. Three NGT groups were conducted with various mental health professionals from the hospital.

Results and conclusions. The overall results indicated that the primary concerns relating to diabetes care among hospital staff included 1) lack of knowledge of diabetes care by both patients and staff; 2) lack of proper training in diabetes care among staff; 3) poor communication between hospital units and mental health disciplines; and 4) need for a multi-modal and cross-cultural approach to diabetes care.
The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement
Authors:   Institute for Healthcare Improvement
Published: March 2007

In Brief

Based on a collaborative approach, the Breakthrough Series model described in this article is reaping results worldwide, as organizations use it to improve how they deliver care to patients.
A Gym-Based Wellness Challenge for People With Type 2 Diabetes: Effect on Weight Loss, Body Composition, and Glycemic Control
Authors: Tucker Richard M. , May Casey , Bennett Richard , Hymer Jenny , McHaney Blair
Published: March 2007

Context. Modification of diet and exercise is known to be effective in treating diabetes and obesity, but options for practical, effective interventions are few.

Objective. To assess the effectiveness of a gym-based fitness competition with financial incentives in weight loss and diabetes control in adults with type 2 diabetes.

Design. Retrospective analysis of outcomes of a quality improvement initiative in diabetes care. Analysis was made from comparisons of measurements made of participants before enrollment to those of the subset of enrolling participants who finished the challenge.

Setting. Outpatient multispecialty group practice clinic and private gym in rural eastern Washington State.

Participants. Sixty-nine adults with type 2 diabetes who were followed by the participating clinic. Participants were recruited from diabetes disease management registries and from newspaper and posted advertisements.

Interventions. Participants competed in a 5.5-month, gym-based structured exercise and diet program with close clinical monitoring. Substantial financial awards were made at the end of the program based on a point system that included credits for diet tracking, gym attendance, body composition improvement, participation in patient education sessions, and adherence to the diabetes care regimen.

Main outcome measures. The primary outcomes were weight loss and body composition improvement. Secondary outcomes included quality of life assessment and improvements in hemoglobin A1c (A1C) and lipid levels.

Results. Thirty participants (45%) finished the program and could be evaluated. Significant (P < 0.05) improvements were seen for A1C results; weight loss; decrease in body fat; inches lost from abdomen, thigh,and hips; and physical component score from a quality-of-life scale (the Short-Form 8 [SF-8] health survey). Weight loss was seen in 28 of the 30 patients who completed the program (mean loss = 15.9 lb; median = 14.5 lb;range = 4.5–49.7 lb). A1C reductions were seen in 86% of these participants (mean = –1.52%; median = –1.6%; range = +0.8 to–5.0%). Physician-directed reduction of one or more diabetes,lipid-lowering, or anti-hypertensive medications occurred in 28%, and discontinuation of one more medications occurred in 28%.

Conclusion. Structured financial incentives are highly effective in achieving weight loss and improved clinical outcomes in some adults with type 2 diabetes.
Glucose Metabolism and Regulation: Beyond Insulin and Glucagon
Authors: Aronoff Stephen L. , Berkowitz Kathy , Shreiner Barb , Want Laura
Published: March 2007

Insulin and glucagon are potent regulators of glucose metabolism. For decades, we have viewed diabetes from a bi-hormonal perspective of glucose regulation. This perspective is incomplete and inadequate in explaining some of the difficulties that patients and practitioners face when attempting to tightly control blood glucose concentrations. Intensively managing diabetes with insulin is fraught with frustration and risk. Despite our best efforts,glucose fluctuations are unpredictable, and hypoglycemia and weight gain are common. These challenges may be a result of deficiencies or abnormalities in other glucoregulatory hormones. New understanding of the roles of other pancreatic and incretin hormones has led to a multi-hormonal view of glucose homeostasis.
Point-of-Care Testing in Diabetes Management: What Role Does It Play?
Authors: Brown Judith Belle , Harris Stewart B. , Webster-Bogaert Susan , Porter Sheila
Published: March 2007

Diabetes is a multisystem disease requiring complex management provided by a variety health care professionals (HCPs). Comprehensive care of patients with diabetes requires frequent testing of hemoglobin A1c (A1C),and research indicates that use of point-of-care testing (POCT) can affect patients' A1C results in the shortterm. The purpose of this qualitative study was to explore the ideas, opinions, and expectations of HCPs and patients with diabetes about the potential role of POCT, including its impact on patient-provider interactions, patient care, and issues of implementation.

In-depth interviews, which were audiotaped and transcribed verbatim, were conducted with key stakeholders. The analysis used immersion and crystalization strategies. Thirty-seven interviews were conducted: seven with endocrinologists and internists, seven with family physicians, eight with diabetes educators, seven with family practice nurses, and eight with patients with diabetes.

Two major themes emerged from the data analysis: 1) the impact of POCT on the clinical encounter and the care of patients, and 2) the POCT machine, including accuracy and the cost of incorporating the machine into clinical practice. The analysis revealed strong similarities across all groups of HCPs, and patients also expressed similar concerns.

This study illuminates perceptions of HCPs and patients regarding the impact of POCT on diabetes management. POCT was viewed as having many benefits in the clinical care of patients with diabetes, including face-to-face encounters that offer immediate feedback, proactive patient education,increased collaboration between patients and providers, and improved patient adherence. However, logistical issues, such as the machine's accuracy and cost factors, could be significant barriers to implementation
Management of Competitive Athletes With Diabetes
Authors: Hornsby W. Guyton , Chetlin Robert D.
Published: March 2007

In Brief An effective management plan for an athlete with type 1 diabetes must consider the energy demands of intense competition and training,the athlete's goals, factors related to competitive sports that may affect glucose homeostasis, and strategies that may be employed to allow safe,effective sports participation. Athletes should be appropriately screened,counseled to avoid risky behaviors, and provided with specific recommendations for glucose monitoring and insulin and diet adjustments so that they may anticipate and compensate for glucose responses during sports competition.
Diabetes Educators and the Exercise Prescription
Authors: Mullooly Catherine A. , Kemmis Karen L.
Published: March 2007

In Brief Physical activity and the exercise prescription is an integral component of the diabetes self-management training (DSMT) plan for any patient with diabetes or anyone at risk for developing type 2 diabetes. Diabetes educators from a variety of health care professions are responsible for the successful inclusion of this component into lifestyle behaviors. Current recommendations describe the multidisciplinary team approach as the preferred delivery system for DSMT.
Physical Activity/Exercise and Type 2 Diabetes
Authors: Sigal Ronald J. , Kenny Glen P. , Wasserman David H. , Castaneda-Sceppa Carmen
Published: March 2007

In Brief This is an abridged reprint of a technical review on exercise and type 2 diabetes, which was originally published in the journal Diabetes Care in October 2004. Full text of this article, as well as its accompanying references, is available on the American Diabetes Association website at http://care.diabetesjournals.org/cgi/content/full/27/10/2518. Reprinted with permission from Diabetes Care 27:2518–2539,2004.
Diabetes Care in the Veterans Health Administration
Authors: Haas Linda B. , Watts Sharon A.
Published: March 2007

In Brief Veterans who use the Veterans Health Administration (VHA)are more likely to be nonwhite, be unemployed, have lower income, have lower health status, and have more activity limitations than male veterans not using the VHA. Veterans using the VHA also show a higher concurrent comorbidity status. Despite this high-risk population, the VHA health care system provides an exemplary model of high quality diabetes care for the nation's veterans.
Identifying Children at Risk for Obesity, Type 2 Diabetes, and Cardiovascular Disease
Authors: Velasquez-Mieyer Pedro , Perez-Faustinelli Sylvia , Cowan Patricia A.
Published: March 2007

In Brief Critical periods for the development of childhood obesity have been established. Health care providers should recognize these periods for initiation of interventions to prevent obesity because treatment options once obesity occurs are limited. Greater body weight predisposes children to many of the medical complications of obesity found in adults, including hypertension, dyslipidemia, impaired glucose metabolism, and hyperinsulinemia. Race, genetic predisposition, sedentary lifestyle, duration of overweight, and underlying conditions are major determinants of risk for type 2 diabetes and cardiovascular disease (CVD). However, not all adolescents with these characteristics share a similar risk for developing these conditions. The appropriate risk stratification for adolescents could guide clinicians in recognizing overweight youth who are at higher risk of developing pre-diabetes, diabetes, or CVD and lead to a prompt intervention.
Field testing of an enhanced direct-fecal polymerase chain reaction procedure, bacterial culture of feces, and a serum enzyme-linked immunosorbent assay for detecting Mycobacterium avium subsp paratuberculosis infection in adult dairy cattle
Authors: Scott H. Morgan , Fosgate Geoffrey T. , Libal Melissa C. , Sneed Lloyd W. , Erol Erdal , Angulo Arthur B. , Jordan Ellen R.
Published: March 2007

Objective—To estimate the sensitivity (Se) and specificity (Sp) for an enhanced direct-fecal PCR procedure, bacterial culture of feces (BCF), and a serum ELISA for detecting Mycobacterium avium subsp paratuberculosis (MAP) infection in adult dairy cattle.

Sample Population—Fecal and serum samples were collected from 669 adult cattle randomly selected from a 4,000-cow dairy herd known to contain animals infected with MAP.

Procedures—Serum samples were evaluated for MAP-specific antibodies via ELISA. Fecal samples were evaluated by BCF and enhanced PCR methods (both gel-based [GB]-PCR and quantitative real-time [qRT]-PCR assays). Fecal samples also were pooled (5:1) and then subjected to GB-PCR assay. Bayesian statistical methods were used to estimate Se and Sp for each diagnostic test without knowledge concerning true MAP infection status.

Results—Adjusting for Se conditional dependence between serum ELISA and BCR, overall Se and Sp were estimated at 33.7% and 95.9%, 51.3% and 99.0%, and 32.2% and 100% for serum ELISA, qRT-PCR, and BCF, respectively.The GB-PCR assay yielded positive results for 38.3% of the pools known to contain feces from at least 1 cow that had positive GBPCR results.

Conclusions and Clinical Relevance—Estimated Se values for the serum ELISA and BCF were slightly lower than those reported elsewhere. The enhanced qRT-PCR method offered relative improvements in Se of 52% and 59% over serum ELISA and microbial culture, respectively. Pooling of fecal samples and testing with the GB-PCR assay are not recommended. Additional studies with qRT-PCR and fecal pools are required.
Changes in platelet function, hemostasis, and prostaglandin expression after treatment with nonsteroidal anti-inflammatory drugs with various cyclooxygenase selectivities in dogs
Authors: Brainard Benjamin M. , Meredith Craig P. , Callan Mary Beth , Budsberg Steven C. , Shofer Francis S. , Driessen Bernd , Otto Cynthia M.
Published: March 2007

Objective—To determine the effects of nonsteroidal anti-inflammatory drugs of various cyclooxygenase selectivities on hemostasis and prostaglandin expression in dogs.

Animals—8 client-owned dogs with clinical signs of osteoarthritis.

Procedures—Dogs received aspirin (5 mg/kg, PO, q 12 h), carprofen (4 mg/kg, PO, q 24 h), deracoxib (2 mg/kg, PO, q 24 h), and meloxicam (0.1 mg/kg, PO, q 24 h) for 10 days each, with an interval of at least 14 days between treatments. On days 0 and 10, blood was collected for platelet aggregation assays, thrombelastography, and measurement of lipopolysaccharide-stimulated prostaglandin E2, platelet thromboxane B2 (TXB2), and free serum TXB2 and 6-keto-prostaglandin F (PGF)-1α concentrations.

Results—Platelet aggregation decreased after treatment with aspirin and carprofen, whereas significant changes from baseline were not detected for the other drugs tested. Thrombelastograms obtained after treatment with carprofen revealed decreased maximum amplitude and α-angle, suggesting hypocoagulability. Maximum amplitude and coagulation index increased after treatment with deracoxib. Plasma concentrations of prostaglandin E2 decreased after treatment with carprofen or deracoxib, and platelet TXB2 production increased after treatment with aspirin. Serum concentrations of the prostacyclin metabolite 6-keto-PGF-1α did not change significantly after treatment with any of the drugs, although the ratio of free TXB2 to 6-keto-PGF-1α decreased slightly after treatment with carprofen and increased slightly after treatment with deracoxib.

Conclusions and Clinical Relevance—At the dosages tested, treatment with meloxicam affected platelet function minimally in dogs with osteoarthritis. Treatment with carprofen decreased clot strength and platelet aggregation. Clot strength was increased after treatment with deracoxib.
Clinical, biochemical, and histologic effects of intra-articular administration of autologous conditioned serum in horses with experimentally induced osteoarthritis
Authors: Frisbie David D. , Kawcak Christopher E. , Werpy Natasha M. , Park Richard D. , McIlwraith C. Wayne
Published: March 2007

Objective—To assess the clinical, biochemical, and histologic effects of intra-articular administration of autologous conditioned serum (ACS) in the treatment of experimentally induced osteoarthritis in horses.

Animals—16 horses.

Procedures—Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. In 8 placebo- and 8 ACS-treated horses, 6 mL of PBS solution or 6 mL of ACS was injected into the osteoarthritis-affected joint on days 14, 21, 28, and 35, respectively; PBS solution was administered in the other sham-operated joints. Evaluations included clinical assessment of lameness and synovial fluid analysis (performed biweekly); gross pathologic and histologic examinations of cartilage and synovial membrane samples were performed at necropsy.

Results—No adverse treatment-related events were detected. Horses that were treated with ACS had significant clinical improvement in lameness, unlike the placebo-treated horses. Among the osteoarthritis-affected joints, ACS treatment significantly decreased synovial membrane hyperplasia, compared with placebo-treated joints; although not significant, the ACS-treated joints also appeared to have less gross cartilage fibrillation and synovial membrane hemorrhage. The synovial fluid concentration of interleukin-1 receptor antagonist (assessed by use of mouse anti–interleukin-1 receptor antagonist antibody) was increased following treatment with ACS.

Conclusions and Clinical Relevance—Results of this controlled study indicated that there was significant clinical and histologic improvement in osteoarthritis-affected joints of horses following treatment with ACS, compared with placebo treatment. On the basis of these findings, further controlled clinical trials to assess this treatment are warranted, and investigation of the mechanisms of action of ACS should be pursued concurrently.
Correlation of ultrasonographic appearance of lesions and cytologic and histologic diagnoses in splenic aspirates from dogs and cats: 32 cases (2002–2005)
Authors: Ballegeer Elizabeth A. , Forrest Lisa J. , Dickinson Ryan M. , Schutten Melissa M. , Delaney Fern A. , Young Karen M.
Published: March 2007

Objective—To determine the accuracy of cytologic diagnosis, compared with histologic diagnosis, in determination of disease in ultrasound-guided fine-needle aspirates of splenic lesions.

Design—Retrospective study.

Sample Population—Splenic specimens from 29 dogs and 3 cats.

Procedures—Records were searched for dogs and cats that had undergone ultrasound-guided splenic aspiration. Criteria for inclusion were ultrasonographic identification of splenic lesions and cytologic and histologic evaluation of tissue from the same lesion. Cytologic samples were obtained by fine-needle aspiration, and histologic specimens were obtained via surgical biopsy, ultrasound-guided biopsy, or necropsy.

Results—Cytologic diagnoses corresponded with histologic diagnoses in 19 of 31 (61.3%) cases and differed in 5 of 31(16.1%) cases, and 1 aspirate was inadequate for evaluation. In 7 of 31 (22.6%) cases, histologic evaluation of tissue architecture was required to distinguish between reactive and neoplastic conditions. On the basis of histologic diagnosis in 14 animals with nonneoplastic conditions, the cytologic diagnosis was correct in 11 cases, not definitive in 2 cases, and incorrect in 1 case. In 17 animals with malignant neoplastic diseases, the cytologic diagnosis was correct in 8 cases, not definitive but consistent with possible neoplasia in 5 cases, and incorrect in 4 cases. Multiple similar-appearing nodules were significantly associated with malignancy, whereas single lesions were more often benign.

Conclusions and Clinical Relevance—Ultrasound-guided aspiration of splenic lesions is a minimally invasive tool for obtaining specimens for cytologic evaluation. Although cytologic diagnoses often reflect histologic results, if missampling or incomplete sampling occurs or tissue architecture is required to distinguish between reactive and neoplastic conditions, accurate diagnosis with fine-needle aspiration may not be possible.
Estrogen regulation and ion dependence of taurine uptake by MCF-7 human breast cancer cells
Authors: Shennan David , Thomson Jean
Published: March 2007

It has been reported that estrogen receptor-positive MCF-7 cells express TauT, a Na+-dependent taurine transporter. However, there is a paucity of information relating to the characteristics of taurine transport in this human breast cancer cell line. Therefore, we have examined the characteristics and regulation of taurine uptake by MCF-7 cells. Taurine uptake by MCF-7 cells showed an absolute dependence upon extracellular Na+. Although taurine uptake was reduced in Cl- free medium a significant portion of taurine uptake persisted in the presence of NO3 -. Taurine uptake by MCF-7 cells was inhibited by extracellular β-alanine but not by L-alanine or L-leucine. 17β-estadiol increased taurine uptake by MCF-7 cells: the Vmax of influx was increased without affecting the Km. The effect of 17β-estradiol on taurine uptake by MCF-7 cells was dependent upon the presence of extracellular Na+. In contrast, 17β-estradiol had no significant effect on the kinetic parameters of taurine uptake by estrogen receptor-negative MDA-MB-231 cells. It appears that estrogen regulates taurine uptake by MCF-7 cells via TauT. In addition, Na+-dependent taurine uptake may not be strictly dependent upon extracellular Cl-.
Soup or Sparks: The History of Drugs and Synapses
Authors: Van der Kloot William
Published: March 2007

The 130 years between Claude Bernard's demonstration that curare blocks neuromuscular transmission, but not nerve conduction or muscular contraction, and the cloning of receptor that binds the drug saw the emergence of neuropharmacology. Propelled by the staggering economic growth of the 19thCentury and public support, the number of scientists and scientific institutions expanded enormously. It became clear that excitable cells interact though one‐way junctions without cytoplasmic continuity: synapses. Drugs were discovered that block transmission at specific synapses or mimic the effects of nerve stimulation. Some thought that drugs bound to specific receptor sites, perhaps on arms of the huge molecule then believed to make up the protoplasm. The crucial step in elucidating the mechanism of transmission and revealing how the drugs act was Loewi's demonstration, in 1921, that stimulated nerves release a chemical that acts on the effector like nerve stimulation. Many concluded that synaptic transmission is chemical. Others argued that this could not be because transmission is so fast—it must be electrical. The argument was finally resolved in the 1950's when it was shown that the potential changes produced by presynaptic nerve stimulation reverse in sign at a set level of postsynaptic potential, demonstrating that the released transmitters open ion channels in the postsynaptic membrane. Transmission is fast because the transmitters bind, open an ion channel, and then are promptly released so the channel closes. These receptors are operated by the high local concentrations of transmitter produced by quanta1 release. Understanding how drugs work at synapses led to new drugs and advances in health care—a stunning record of achievement.
Muscarinic Acetylcholine Receptors
Authors: Wess Jürgen
Published: March 2007

The five muscarinic acetylcholine receptors (M1–M5mAChRs) are prototypical members of the superfamily of G protein‐coupled receptors. The M1–M5mAChRs regulate an extraordinarily large number of central and peripheral functions. The first part of this chapter primarily focuses on how mAChRs function at a molecular level, the diversity of cellular responses following mAChR activation, and the mechanisms that are involved in regulating mAChR activity. The second part of this chapter summarizes recent results obtained with mutant mouse strains deficient in specific mAChR subtypes. These studies have led to a wealth of novel information about the physiological and pathophysiological roles of the individual mAChRs which may pave the way toward the development of novel, clinically useful muscarinic drugs.
Neuropharmacology of Histamine in Brain
Authors: Faucard Raphaël , Schwartz Jean‐Charles
Published: March 2007

Histamine is an important neurotransmitter in brain. Histaminergic neurons emanating from the tuberomamillary nucleus in the hypothalamus project diffusely to the whole brain. Histamine acts via stimulation of three receptor subtypes and exerts essentially excitatory effects upon target neurons. The main function of histaminergic neurons is to trigger and maintain wakefulness and pro cognitive responses. Activation of histaminergic neurotransmission in brain is achieved via blockade of H3 receptors, and is currently explored as a treatment of wakefulness and cognitive deficits in several neurological and psychiatric diseases.
Neuropeptides
Authors: Strand Fleur L.
Published: March 2007

The identification, characterization, and evolution of neuropeptides, neuropeptide families, and their receptors are discussed, including new information gleaned by genetic manipulations, peptidomics, and genomics. The flexibility of neuropeptides to act as neurohormones, neurotransmitters, and/or neuromodulators in regulating and modifying synatic events is emphasized. Neuropeptide processing and inactivation are considered and the phenomenon of tissue‐specific processing of prohormones is introduced as an efficient method to achieve diversity in the nervous system. The role of the hypothalamic–pituitary–adrenal system in stress is discussed, as is the importance of the blood–brain barrier, neuropeptide redundancy, and routes of administration.
Antidepressant Treatment and Hippocampal Neurogenesis: Monoamine and Stress Hypotheses of Depression Converge
Authors: Dranovsky Alex , Hen René
Published: March 2007

There are multiple highly effective treatments for depression. Psychosocial treatments focus on the perceptions of stress, stress prevention, and coping mechanisms, whereas most effective pharmacological treatments modulate monoamines in the brain. Numerous research efforts to understand the mechanisms by which psychotherapy and pharmacotherapy treat depression have resulted in the respective “stress” and “monoamine” hypotheses of depression. This chapter will focus on recent findings that stress and monoamine hypotheses of depression converge in their opposing impact on adult hippocampal neurogenesis.
Neuroendocrine Abnormalities in Women with Depression Linked to the Reproductive Cycle
Authors: Parry Barbara L. , Meliska Charles J. , Fernando Martinez L. , Maurer Eva L. , Lopez Ana M. , Sorenson Diane L.
Published: March 2007

In this chapter, the authors focus on reviewing studies that measure the circadian profile of hormonal changes in relation to baseline changes in the reproductive hormones of estradiol, progesterone, follicle‐stimulating hormone (FSH), and luteinizing hormone (LH), comparing DPs with NCs during the menstrual cycle, pregnancy, postpartum, and menopause and across each of these reproductive epochs. Elevated prolactin levels characterize DPs at each reproductive epoch. Increased melatonin levels characterize menopausal and postpartum DPs, whereas decreased melatonin levels characterize premenstrual dysphoric disorder (PMDD) and DPs during pregnancy. Decreased cortisol levels distinguish menopausal DPs from healthy controls. Using circadian measures in well‐defined diagnostic groups, further work is needed in order to identify common versus distinctive neuroendocrine profiles for DPs during each reproductive epoch. This information then could serve as a basis for developing more specific treatment modalities.
Phenomenology and Clinical Science of Schizophrenia
Authors: Ghose Subroto , Tamminga Carol
Published: March 2007

Schizophrenia is a clinically well‐characterized illness but of obscure pathophysiology. A shift in conceptual framework from searching for a specific protein defect in schizophrenia to a search for a defect in neural systems is a biologically plausible approach to investigating the pathophysiology of schizophrenia.
Molecular Genetics of Schizophrenia
Authors: Carroll Liam , O'Donovan Michael C. , Owen Michael J.
Published: March 2007

Molecular genetic studies of schizophrenia are built upon the firm foundations of reliable diagnostic methodology and a wealth of genetic epidemiological data. The fact that most, if not all, disease genes apparently have only moderate or small effect sizes on the risk of developing the disorder has proved a challenge to their discovery, as it has in the study of other common diseases. However, the sample and technological resources combined with the reagents generated by the human genome project have begun to make complex disease gene discovery studies feasible. This chapter discusses the potential regions of linkage and two associated chromosomal abnormalities that have been identified for schizophrenia, and debates the accumulating evidence favoring several positional candidate genes. Although in no case has the causative variant(s) been identified, the current findings suggest that the positional genetic approach to schizophrenia is at last bearing fruit, and offer grounds for considerable optimism.
Prokineticins: New Pair of Regulatory Peptides
Authors: Cheng Michelle Y. , Zhou Qun‐Yong
Published: March 2007

Prokineticins are newly discovered regulatory proteins that contain five disulfide bonds. Prokineticins activate a pair of closely related G protein‐coupled receptors. In the last five years, multiple biological functions have been identified for prokineticins. These include functions in peripheral organs such as gastrointestinal motility, pain perception, angiogenesis and hematopoiesis and brain functions such as circadian rhythms and neurogenesis. This chapter gives an overview on the short history of prokineticins, their receptors, followed by discussions of the currently known biological functions of prokineticins.
Pharmacotherapy for Traumatic Brain Injury
Authors: Stein Donald G. , Hoffman Stuart W.
Published: March 2007

Currently there are no clinically approved, safe and effective treatments for traumatic brain injury (TBI) that can rescue damaged nerve cells and enhance functional recovery. This chapter shows that TBI is a complex cascade of events that unfolds over time and no single pharmacological agent has been found to block all the processes that comprise the injury. Here we review the categories of candidate agents and approaches that have been examined for their potential benefits in the treatment of TBI.
Pharmacological Treatment of Multiple Sclerosis
Authors: Keegan B. Mark
Published: March 2007

Pharmacological therapy for multiple sclerosis includes those aimed at resolution of acute inflammatory relapses of MS, and those for chronic prevention of relapses and new inflammatory MRI lesions. High doses of corticosteroids are the gold standard treatment for resolving acute relapses but, occasionally, therapeutic plasma exchange is used for severe, corticosteroid‐resistant relapses. Type one beta interferons and glatiramer acetate are the standard chronic immunomodulatory treatments for relapse prevention. Mitoxantrone is a chemotherapy agent used mainly in treatment resistant cases and novel monoclonal antibodies such as natalizumab is now reapproved for MS treatment. Innovative uses of medications currently approved for other medical indications are being also pursued as potential MS treatments.