bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of transjugular intrahepatic portosystemic shunt implantation on liver perfusion measured by volume perfusion CT
Authors: Preibsch Heike , Spira Daniel , Thaiss Wolfgang M , Syha Roland , Nikolaou Konstantin , Ketelsen Dominik , Lauer Ulrich M , Horger Marius
Published: January 2017

Background

Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) induces changes of liver perfusion.

Purpose

To determine the changes in arterial, portal venous, and total perfusion of the liver parenchyma induced by TIPS using the technique of volume perfusion computed tomography (VPCT) and compare results with invasively measured hepatic intravascular pressure values.

Material and Methods

VPCT quantification of liver perfusion was performed in 23 patients (mean age, 62.5 ± 8.8 years) with portal hypertension in the pre-TIPS and post-TIPS setting, respectively. A commercially available software package was used for post-processing, enabling separate calculation of the dual (arterial [ALP] and portal venous [PVP]) blood supply and additionally of the hepatic perfusion index (HPI) (HPI = ALP/(ALP + PVP)*100%). Invasive pressure measurements were performed during the intervention, before and after TIPS placement. Liver function tests performed before and after the procedure were compared.

Results

Mean decrease of pressure gradient through TIPS was 13.3 mmHg. Mean normal values for ALP, PVP, and total perfusion (ALP + PVP) before TIPS were 15.9, 37.7, and 53.5 mL/100 mL/min, respectively, mean HPI was 35.4%. After TIPS, ALP increased to a mean value of 37.7 mL/100 mL/min, PVP decreased (15.7 mL/100 mL/min, P < 0.05), whereas total perfusion remained unchanged (53.4 mL/100 mL/min, P = 0.97). HPI increased (71.9%; P < 0.05). No correlation between invasive pressure measurement and VPCT parameters was observed. After TIPS, liver function tests were found to worsen with a significant increase of bilirubin ( P < 0.05).

Conclusion

Following TIPS placement, ALP and HPI increased in all patients, whereas PVP markedly decreased. Interestingly, the magnitude of decrease in portosystemic pressure gradients was not found to correlate with VPCT parameters.
Power Doppler signal calibration in the finger joint between two models of ultrasound machine: a pilot study using a phantom and joints in patients with rheumatoid arthritis
Authors: Sakano Ryosuke , Saito Katsumi , Kamishima Tamotsu , Nishida Mutsumi , Horie Tatsunori , Noguchi Atsushi , Kono Michihito , Sutherland Kenneth , Atsumi Tatsuya
Published: January 2017

Background

Despite the advantages of ultrasound (US) in the management of rheumatoid arthritis (RA) patients, power Doppler (PD) US may be highly dependent on the type of US machine used.

Purpose

To present a method to calibrate the PD signal of two models of US machines by use of a flow phantom and finger joints of patients with RA.

Material and Methods

For the phantom study, the PD signal count was measured in the flow phantom perfusing blood mimicking fluid at various injection rates and pulse repetition frequencies (PRFs). The quantitative PD index was calculated with ImageJ. For the clinical study, the second and third metacarpophalangeal joints of five consecutive patients with RA were examined. The quantitative PD index was measured at various PRFs by use of two models of machine (the same models as the phantom study).

Results

For the phantom and clinical studies, negative correlations were found between the PRF and the quantitative PD index when the flow velocity was constant and positive correlations between flow velocity and the quantitative PD index at constant PRF. There was a significant difference in the depiction performance of synovial blood flow between the two models, which can be calibrated by adjusting the PRF values derived from the phantom study in each model.

Conclusion

Signal calibration of pannus vascularity between US machines may be possible by adjusting the PRF value according to flow phantom data. Different US machines can thus provide equivalent examination results concerning the pannus vascularity.
Feasibility of low-dose digital pulsed video-fluoroscopic swallow exams (VFSE): effects on radiation dose and image quality
Authors: Weiss Jakob , Notohamiprodjo Mike , Neumaier Klement , Li Minglun , Flatz Wilhelm , Nikolaou Konstantin , Pomschar Andreas
Published: January 2017

Background

Fluoroscopy is a frequently used examination in clinical routine without appropriate research evaluation latest hardware and software equipment.

Purpose

To evaluate the feasibility of low-dose pulsed video-fluoroscopic swallowing exams (pVFSE) to reduce dose exposure in patients with swallowing disorders compared to high-resolution radiograph examinations (hrVFSE) serving as standard of reference.

Material and Methods

A phantom study (Alderson-Rando Phantom, 60 thermoluminescent dosimeters [TLD]) was performed for dose measurements. Acquisition parameters were as follows: (i) pVFSE: 76.7 kV, 57 mA, 0.9 Cu mm, pulse rate/s 30; (ii) hrVFSE: 68.0 kV, 362 mA, 0.2 Cu mm, pictures 30/s. The dose area product (DAP) indicated by the detector system and the radiation dose derived from the TLD measurements were analyzed. In a patient study, image quality was assessed qualitatively (5-point Likert scale, 5 = hrVFSE; two independent readers) and quantitatively (SNR) in 35 patients who subsequently underwent contrast-enhanced pVFSE and hrVFSE.

Results

Phantom measurements showed a dose reduction per picture of factor 25 for pVFSE versus hrVFSE images (0.0025 mGy versus 0.062 mGy). The DAP (µGym2) was 28.0 versus 810.5 (pVFSE versus hrVFSE) for an average examination time of 30 s. Direct and scattered organ doses were significantly lower for pVFSE as compared to hrVFSE ( P < 0.05). Image quality was rated 3.9 ± 0.5 for pVFSE versus the hrVFSE standard; depiction of the contrast agent 4.8 ± 0.3; noise 3.6 ± 0.5 ( P < 0.05); SNR calculations revealed a relative decreased of 43.9% for pVFSE as compared to hrVFSE.

Conclusion

Pulsed VFSE is feasible, providing diagnostic image quality at a significant dose reduction as compared to hrVFSE.
MRI diagnosis of carpal boss and comparison with radiography
Authors: Mespreuve Marc , De Smet Luc , De Cuyper Kristof , Waked Karl , Vanhoenacker Filip
Published: January 2017

Background

A carpal boss is a potentially painful bony mass in the region of the second or third carpometacarpal joint. The combination of clinical examination and radiography is usually sufficient for the diagnosis.

Purpose

To determine whether magnetic resonance imaging (MRI) examination of the quadrangular joint can assist the diagnosis of persistent pain near a carpal boss.

Material and Methods

Fifty-seven patients with a carpal boss were retrospectively reviewed using MRI and conventional radiographs and compared to an asymptomatic control group.

Results

MRI demonstrated a variable morphology and a variety of bone and soft tissue abnormalities associated with carpal boss. Bone marrow edema around the quadrangular joint shows a significant correlation (Fisher's exact test: P < 0.001) and a positive correlation (Pearson's test r = 0.632, significant at the 0.01 level [two-tailed]) with a painful carpal boss.

Conclusion

MRI offers detailed examination of bone and soft tissue abnormalities associated with a carpal boss. Local bone marrow edema strongly correlates with a painful carpal boss.
Alcohol Withdrawal Syndrome: Treatment and Assessment of Therapeutic Efficacy
Authors: Jänne Juhani , Malinen Laila
Published: January 2017

The acute alcohol withdrawal syndrome is a disease of many different symptoms. Although the metabolism of ethanol is well-known, no specific treatment of the withdrawal syndrome has been developed. When assessing the therapeutic efficacy of drugs in this syndrome one of the main symptoms to be followed is sleep disturbances, because inability to sleep often maintains the drinking cycle. Besides different target symptoms, the visual analogue scale and the ability to work are useful parameters. The assessment of the efficacy relies mainly on subjective parameters and comparisons with placebo are needed.
Clinical Use of Rifampicin in Combination for Non-Mycobacterial Infections: A Survey of Published Evidence
Authors: Nessi Renato , Fowst Giovanni
Published: January 2017

The literature on the clinical use of rifampicin in combination for the treatment of non-mycobacterial diseases is reviewed. From the published evidence, the most promising associations are, for staphylococcal infections, gentamicin, erythromycin, kanamycin and fusidic acid. In the field of Gram-negative infections, Pseudomonas-induced sepsis in particular, data are not so impressive but promising results have been obtained with the associated use of rifampicin and gentamicin or colistin.

Some systemic fungal diseases may be successfully treated with rifampicin in combination with amphotericin-B. Although only few reports are available on this subject, the importance of such an application is stressed in view of the severity of these diseases and of the lack of appropriate treatments.
Comparison of Clinical Effects of Propranolol (Inderal ®) with Once Daily Slow-Release Oxprenolol (Slow Trasicor®) in Angina Pectoris
Authors: Majid P A , de Feijter P J , Wardeh R , van der Wall E E , Roos J P
Published: January 2017

In a double-blind, crossover, randomized study, the therapeutic effectiveness of a single daily dose of slow-release oxprenolol (160 mg/day) was compared with a conventional dosage schedule of propranolol (40 mg three times daily) in eighteen patients with uncomplicated, stable exercise-induced angina pectoris. Compared to control values both drugs produced equipotent reduction in the frequency and severity of anginal attacks accompanied by a significant increase in exercise tolerance, a significant suppression of exercising heart rate and an appreciable reduction in the electrocardiographic evidence of myocardial ischaemia when tested on a treadmill. The possible advantages offered by a single dose treatment with slow-release oxprenolol are discussed.
Comparison of a Once Daily Long-Acting Formulation of Propranolol with Conventional Propranolol Given Twice Daily in Patients with Mild to Moderate Hypertension
Authors: Douglas-Jones A P
Published: January 2017

The effect of conventional propranolol tablets given twice daily has been compared with an equivalent dosage of a long-acting formulation of propranolol ('Inderal’ LA)p given once daily in twenty-nine patients with mild to moderate hypertension. The study lasted 10 weeks. There was no significant difference in clinical response to the two treatments which were equally effective and well tolerated. A once daily dosage schedule should greatly aid patient compliance.
Double-Blind Comparison of Maternal Analgesia and Neonatal Neurobehaviour following Intravenous Butorphanol and Meperidine
Authors: Hodgkinson Robert , Huff Robert W , Hayashi Robert H , Husain Farkhanda J
Published: January 2017

Butorphanol (1 mg and 2 mg) and meperidine (40 mg and 80 mg), given intravenously, were evaluated for analgesic efficacy and safety in a double-blind randomized study employing 200 consenting pre-partum patients in moderate to severe pain during the late first stage of labour. Both drugs provided adequate relief of pain to the mothers. There was no significant difference in the rate of cervical dilation, the foetal heart rate, the Apgar score, pain relief or neonatal neurobehavioural scores between those receiving butorphanol and those receiving meperidine. Twenty-two mothers who received butorphanol and eleven who received meperidine nursed their infants with no adverse effects observed. Side-effects were generally infrequent in this study; however, more side-effects were reported by the patients and observed by the investigator in the meperidine-treated cases (13%) than in the cases treated with butorphanol (2%).
A Clinical Trial of Trimebutine (Mebutin) in Spastic Colon
Authors: Moshal M G , Herron M
Published: January 2017

Twenty adult Indian patients suffering from the spastic form of irritable colon, i.e. abdominal pain and constipation, were given trimebutine (Mebutin), 2-phenyl, 2-dimethylamino-n-butyl 3, 4, 5-trimethoxybenzoate. Patients were given treatment with 200 mg trimebutine three times daily, or placebo for 4 weeks, and then crossed over. In addition, stool transit times were assessed by the single stool transit time (SST) method of Cummings. Results showed a statistical improvement in abdominal pain and constipation with both trimebutine and placebo after 4 weeks, but only with trimebutine after 8 weeks. Single stool transit time was significantly reduced after trimebutine.
A Double-Blind Clinical Study with Monydrin Tablets in Patients with Non-Allergic Chronic Rhinitis
Authors: Renvall U , Lindqvist N
Published: January 2017

Oral combination preparations (antihistamine + sympathomimetic) are widely used for nasal and sinus congestion without the presence of allergy. The use of antihistamine in these cases may be questioned. Evaluation of the clinical effect of only a sympathomimetic agent on patients with non-allergic rhinitis is performed in a double-blind clinical study on seventy patients. Phenylpropanolamine (50 mg and 100 mg) was compared with placebo. It was found that 100 mg phenylpropanolamine was significantly more active than 50 mg or placebo administered orally as a sustained-release tablet twice daily. No side-effects such as CNS stimulation and influence on blood pressure were seen at any of the dose levels.
Analgesic Combinations with Orphenadrine in Oral Post-Surgical Pain
Authors: Winter Leo , Post Arthur
Published: January 2017

Two hundred male and female patients underwent a variety of oral surgical procedures and were treated qfterwards in four test groups. They took a combination of orphenadrine (25 mg) and acetaminophen (325 mg), either drug alone, or placebo. A double-blind study design was used. All patients had moderately severe baseline pain intensity; post-treatment pain relief was recorded at 30 minutes, one, two, four and six hours. A back-up analgesic (codeine-ASA) was made available if needed. Pain intensity difference (PID) and sums of pain intensity difference (SPID) were calculated using established analgesic study techniques.

Statistical analyses indicated better analgesic efficacy in both PID and SPID scores for the orphenadrine-acetaminophen combination over the three other treatments. This was evident at 30 minutes and continued through the sixth hour. Each active drug, in turn, was also significantly better throughout than placebo for pain relief. Sub-groups in each treatment regimen required additional pain relief prior to six hours, with significantly more placebo than orphenadrine-acetaminophen patients needing remedication. Side-effect incidence was very low and randomly distributed among the four groups-
Anxiolytic Efficacy of Alprazolam Compared to Diazepam and Placebo
Authors: Maletzky Barry M
Published: January 2017

The anxiolytic effects of alpraxolam (0.5–3.0 mg), diazepam (5–60 mg) and placebo were evaluated in eighty-six out-patients suffering from moderate to severe psychoneurotic anxiety in this 28-day, double-blind study.

Efficacy was evaluated using five rating instruments, three rated by the physician (Hamilton Anxiety Rating Scale, Physician's Global Impressions and Target Symptoms) and two by the patients (Self-Rating Symptom Scale and Patient's Global Impressions). Alprazolam was more effective than placebo on all five measures of efficacy and, on several parameters, more effective than diazepam as well.

The incidence of side-effects was lowest in the alprazolam group and decreased steadily over the course of the study, whereas the incidence in the diazepam and placebo groups remained relatively unchanged.
Comparison of a Paper Pill with a Conventional Oral Contraceptive Tablet
Authors: Basu H K , Edwards C
Published: January 2017

A multicentre clinical trial comparing a novel formulation (the Paper Pill) of a combined oral contraceptive containing 30 μg ethinyloestradiol and 150 μg levonorgestrel with a conventional tablet formulation (Microgynon 30) has been carried out in 336 women over 6 cycles. There were no pill failures in women taking either preparation with one exception in the Microgynon 30 group which was due to poor patient compliance. Cycle control judged by cycle length, duration and amount of withdrawal bleeding and the incidence of intermenstrual bleeding was good in both groups. The number of adverse effects was slightly less in the Paper Pill group and fewer withdrawals for medical reasons were noted than in the Microgynon 30 group. A questionnaire showed that the Paper Pill was accepted well by the majority of women in the trial.
Induction of Labour with Oral Prostaglandin E2: A Canadian Multicentre Study
Authors: Squires D J P , Masson E L
Published: January 2017

Prostaglandin E2 (PgE2) tablets were administered orally for the induction of labour at or near term to 680 patients. Successful vaginal delivery occurred in 81.8% of patients with a mean total dose of 3.7 mg and a mean induction-delivery interval of 7.1 hours. PgE2 was most efficacious in parous patients and in those with high Bishop scores. The most common maternal side-effects were gastro-intestinal in nature and uterine hypertonus was observed in six patients. Foetal heart rate changes occurred in fifty patients.
Carteolol Treatment of Essential Hypertension: A Long-Term Study of Safety and Efficacy
Authors: Luther Robert R , Maurath Clemeth J , Klepper Michael J , Peckinpaugh Robert O , Ringham Gary L ,   The Carteolol Long-Term Hypertension Investigators
Published: January 2017

The long-term safety and antihypertensive efficacy of carteolol were evaluated in an open-label, multicenter trial of 245 hypertensive patients. For those patients maintained on carteolol monotherapy, three months of treatment with once-daily oral doses of carteolol ranging from 2.5 to 60 mg reduced the mean recumbent blood pressure by 12/14 mm Hg from baseline values of 151/100. Blood pressure reductions observed at three months were maintained throughout the study. The final daily dose of carteolol for most patients was 10 mg or less. Carteolol was shown to be safe and well tolerated by most patients.
Resistance to Beta-Lactams in Enterobacteriaceae: Distribution of Phenotypes Related to Beta-Lactamase Production
Authors: Sirot D , Sirot J , Saulnier P , Joly B , Chanal M , Cluzel M , Cluzel R
Published: January 2017

Phenotypes of susceptibility to amoxycillin (Amo), ticarcillin (Tic), cephalothin (Ctn) were determined in 1366 isolates of Enterobacteriaceae by disk method and beta-lactamases were identified in 243 strains belonging to different phenotypes of amoxycillin-resistant strains.

AmoR TicR Ctns strains (25%) were penicillinase producers and all of them were susceptible to the combination amoxicillin/clavulanic acid (Amo/CA) and ticarcillin/clavulanic acid (Tic/CA). AmoI/R Tics CtnR strains (12%) were cephalosporinase producers and resistance to Amo/CA was observed, except for Proteus vulgaris. AmoR TicR CtnR strains (18%) often produced two beta-lactamases (penicillinase and cephalosporinase) and they were resistant to Amo/CA; in this group, susceptibility to Tic/CA depends on the nature and the amount of the beta-lactamase produced, except for Serratia marcescens for which antibiotic resistance is probably due to other mechanisms. Tic/CA resistance was mainly found in Serratia marcescens (41%) and Enterobacter cloacae (36%).
Comparison of in vivo Antibacterial Activity of Hydro-Alcoholic Solutions of Hexamidine and of Chlorhexidine
Authors: Michel G , Truquet M , Mondain J , Poitou P
Published: January 2017

Samples of cutaneous flora were obtained from the antecubital fossa of 20 healthy volunteers before and after treatment with hydro-alcoholic solutions of chlorhexidine (CHX) and of hexamidine (HXM). Percentage reductions in bacterial flora were statistically greater (p <0.001) after CHX (99 to 100%) than after HXM (about 70 to 90%). Furthermore, CHX had a smaller disturbing effect upon the natural balance of the bacterial population than HXM with a more rapid return towards the initial proportions of the different organisms one hr after treatment.
Multicentre Double-Blind Clinical Trials of Ciclopirox Olamine Cream 1% in the Treatment of Tinea Corporis and Tinea Cruris
Authors: Bogaert Huberto , Cordero Carlos , Ollague Wenceslao , Savin Ronald C , Shalita Alan R , Zaias Nardo
Published: January 2017

In separate multicentre, randomized, double-blind clinical trials, 1% ciclopirox olamine cream was compared with its cream vehicle and with 1% clotrimazole cream as treatment for tinea corporis and tinea cruris. Patients who demonstrated clinical and mycological findings consistent with the diagnoses of tinea corporis or tinea cruris were included in the study. Clinical and mycological evaluations were made pretreatment, at the end of each of the four, weeks of treatment, and weekly for the two weeks immediately following cessation of treatment.

In both studies, use of ciclopirox olamine cream resulted in demonstrable improvements after the first week of therapy and in complete clinical and mycological clearing in two thirds of the patients at the end of the treatment period. These results were maintained through the two-week drug-free observation period that followed the end of treatment. Statistically, the results with ciclopirox olamine cream were significantly better than those with the vehicle and were equivalent to those with clotrimazole cream. All treatments were well tolerated.
Pirenzepine in Non-Ulcer Dyspepsia: A Double-Blind Multicentre Trial
Authors: Smith P.M. , Troughton A.H. , Gleeson F. , Walters J. , McCarthy C.F.
Published: January 2017

In a double-blind multicentre study to compare pirenzepine with placebo in non-ulcer dyspepsia, 71 patients were randomized to receive 50 mg pirenzepine or placebo given orally twice daily for 4 weeks. The trial was not completed by five patients in the pirenzepine group and six in the placebo group. There were no significant differences between the groups in respect to changes in total symptoms (upper abdominal pain, nausea and vomiting, early satiety and postprandial bloating, eructation and pyrosis) scores and outcome, although 27/35 (77%) patients receiving pirenzepine were cured or improved compared with 22/36 (61%) receiving the placebo. Adverse effects were reported by 13 (37%) patients treated with pirenzepine and by six (17%) treated with placebo, seven withdrawing due to adverse effects.
Double-Blind, Placebo-Controlled Multicentre Trial of the Efficacy and Tolerance of Morniflumate Suppositories in the Treatment of Tonsillitis in Children
Authors: Manach Y. , Ditisheim A.
Published: January 2017

The efficacy and tolerability of morniflumate suppositories used together with phenoxymethylpenicillin were studied in a placebo-controlled, double-blind trial in 101 children with acute tonsillitis. Patients received a suppository containing 400 mg morniflumate or placebo twice daily for 4 days; all patients also received 1 500 000 IU/day phenoxymethylpenicillin. Response to treatment was assessed by clinical examination before and after 2 and 4 days' treatment. Efficacy was evaluated by resolution of oropharyngeal pain, congestion, fever, size and sensitivity of adenopathies, quality of life and duration of sleep. Body temperature fell rapidly after the start of treatment. There was also resolution of pharyngeal pain, earache, dysphagia and adenopathy. Spontaneous pharyngeal pain was present after 4 days in significantly ( P = 0.03) fewer patients receiving morniflumate than receiving placebo. It is suggested that morniflumate combined with antibiotic therapy is an effective and well-tolerated treatment for tonsillitis in children.
Recurrent Respiratory Infections in Childhood: Experience with a Bacterial Extract plus Bacterial Ribosomes (Immucytal®)
Authors: Fiocchi A. , Arancio R. , Cinquepalmi P. , Sala M. , Zuccotti G.V. , Riva E. , Giovannini M.
Published: January 2017

A total of 60 children (mean age ± SD 7.6 ± 3.5 years, range 2 − 14.2 years) with recurrent respiratory infections were treated with bacterial wall extract plus bacterial ribosomes (Immucytal) or placebo sprayed into the nostrils and oropharynx three times a day for 1 or 2-week periods over 3.5 months. The treatment was completed by 58 subjects; two patients in the placebo-treated group were withdrawn, one for poor compliance and the other because of headaches. Respiratory symptoms improved from the first month in the Immucytal treated children, but not in the placebo group, with a reduction in the incidence of infections in the upper and lower airways. No changes were noted in respiratory function parameters. Treatment with Immucytal significantly increased serum immunoglobulin A ( P < 0.02) and immunoglobulin M ( P < 0.01) and enhanced skin response to the in vivo lymphocyte blastization test, but there was no significant change in the circulating lymphocyte subpopulations. Both physicians and the patients' parents judged the bacterial extract to be clinically better than the placebo. Immucytal, therefore, may provide a useful alternative therapy for recurrent respiratory infections in infancy.
Bovine Aspergillosis Produced by the Inoculation of Conidiospores of Aspergillus fumigatus into a Mesenteric or Jugular Vein
Authors: Whiteman C. E. , Benjamin Maxine M. , Ball Leslie , Hill M. W. M.
Published: January 2017

Conidiospores of Aspergillus fumigatus were inoculated during the second trimester of pregnancy into a mesenteric vein of 14 heifers and into a jugular vein of three additional heifers. Heifers were killed at intervals after inoculation. Lesions were confined largely to the placentas, livers, and lungs. Placental infection was present in seven of 14 heifers inoculated via a mesenteric vein and in the three heifers inoculated via a jugularvein. Fetal mycotic infection or lesions were not established. Two heifers inoculated via a mesenteric vein aborted. Mycotic granulomas developed in the livers and lungs.
Malignant Hemangioendothelioma in an Irradiated Rat
Authors: Talerman A.
Published: January 2017

A male hybrid F1 rat developed a tumor on the lateral side of the right thigh, which had been exposed to a high dose of external radiation (3,500 rads), administered as a single dose by an X-ray machine 16 months previously. The tumor grew rapidly and showed extensive local spread, but there were no metastases at autopsy. The tumor was ulcerated, dark red and hemorrhagic. It was not encapsulated and invaded the surrounding muscles extensively. Microscopically the tumor was composed of anastomozing channels lined by swollen anaplastic endothelial cells that were either heaped up and projected into the lumen or were free within the lumen. Mitotic activity was evident. There were also more solid areas as well as large cavities containing blood cells. The tumor was diagnosed as a malignant hemangioendothelioma. Seven other rats exposed at the same time to various doses of external radiation developed tumors at the site of exposure. There were four fibrosarcomas, one anaplastic, poorly differentiated connective tissue tumor, one squamous cell carcinoma, and one adnexal tumor of skin.
Congenital Encephalitozoonosis in a Squirrel Monkey (Saimiri sciureus)
Authors: Anver Miriam R. , King N. W. , Hunt R. D.
Published: January 2017

Multifocal granulomatous encephalitis associated with invasion of the brain by Encephalitozoon cuniculi was present in a squirrel monkey less than 24 h old. This appeared to be a congenital infection. The infant's dam was clinically normal.
Hemorrhagic Necrosis of the Central Nervous System
Authors: Margolis G. , Kilham L.
Published: January 2017

During studies of transplacental virus infections in random bred hamsters purchased with timed pregnancies from three commercial dealers, spontaneous hemorrhagic necrosis of the central nervous system was seen in fetuses harvested near term. Ninety-seven pregnant hamsters from three colonies were examined during a 6-month period; this condition was seen in 25 of 41, 19 of 36, and five of 20 litters. Hamsters from another commercial colony were received, housed, and fed under the same conditions, but remained free of the disease. The pathological process was characterized by multiple spreading zones of edema, malacia, and hemorrhage. Lesions were restricted to neural tissues, including the retina and internal ear. Neuroepithelial proliferation with rosette formation, accompanying the destructive process, constituted a striking reparative response. No inflammatory reaction or cytopathic effects suggestive of virus-induced disease were seen. Studies on the cause of this condition were negative at the time when the disease disappeared spontaneously.
A modification to the cross slitting method for measuring two components of residual stresses
Authors: Mahmoudi AH , Hasani AR
Published: January 2017

Residual stresses measurement techniques are constantly modified and progressed. There have been many residual stresses measurement methods developed and practiced by researchers. Slitting method is one of the destructive techniques that can measure residual stresses deep within the components. However, the conventional slitting method can only measure the component of residual stress normal to the cut plane. Furthermore, the cross slitting has been developed to measure two components of residual stresses simultaneously. In the current research, a modification to the cross slitting method is proposed to enhance the accuracy of the technique. The samples were prepared exactly similar to previous study and were quenched at different temperatures to create different levels of residual stresses in order to compare the outcomes. The proposed modification was examined both numerically and experimentally. The results confirmed the success of the modification in reducing the errors. Results from experiments and predictions agreed well.
Coupon specimen–based approach for the simulation of crossbore stress and strain state
Authors: Kiani Mahdi , Forest Rayford , Tipton Steven M , Keller Michael W
Published: January 2017

Direct investigation of the stress and strain state of structures with crossbore geometries is typically complex to achieve. Crossbores are often located at the center of reciprocating machinery with few options for access. Thus, the number of studies that have directly characterized these structures is limited and continues to be an experimental challenge. In order to provide an alternative approach for the investigation of material performance in these structures, a coupon specimen is presented as an alternative to direct measurement. A notched tensile specimen geometry is adopted in this study and is designed to match the stress gradient in a representative crossbore intersection. An approach for specimen design is presented and the design is validated using digital image correlation to measure the full-field stress gradient. The proposed design is shown to match the stress gradient to within 10% for the first 50% of the specimen. In addition to the validation of the gradient, an initial set of fatigue experiments is also conducted in order to compare to the modified Smith–Watson–Topper fatigue life approach. Finally, a simulated autofrettage cycle is completed and the resulting residual stress is analyzed by digital image correlation.
p53 and BCL-2 Over-Expression Inversely Correlates with Histological Differentiation in Occupational Ethmoidal Intestinal-Type Sinonasal Adenocarcinoma
Authors: Re M. , Magliulo G. , Tarchini P. , Mallardi V. , Rubini C. , Santarelli A. , Muzio L. Lo
Published: January 2017

Despite their histological resemblance to colorectal adenocarcinoma, there is little information on the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinoma (ITACs). The aim of this paper is to evaluate the possible role of TP53 and Bcl-2 gene defects in ITAC by investigating the immunohistochemical expression of TP53 and Bcl-2 gene products in a group of ethmoidal ITACs associated with occupational exposure. A retrospective study on 15 patients with pathological diagnosis of primary ethmoidal ITAC was conducted. Representative formalin-fixed, paraffin wax-embedded block from each case was selected for immunohistochemical studies using the antibodies against p53 and Bcl-2. Clinical-pathological data were also correlated with the staining results. The results of immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of p53 and Bcl-2 expressing cells in comparison to well-differentiated cases. No correlation was found with other clinico-pathological parameters, including T, stage and relapses. The relationship between up-regulation of p53 and Bcl-2 and poorly differentiated ethmoidal adenocarcinoma suggests a role of these genes, in combination with additional genetic events, in the pathogenesis of ITAC.
Validation of a Diagnostic Score for the Diagnosis of Autoinflammatory Diseases in Adults
Authors: Cantarini L. , Iacoponi F. , Lucherini O.M. , Obici L. , Brizi M.G. , Cimaz R. , Rigante D. , Benucci M. , Sebastiani G.D. , Brucato A. , Sabadini L. , Simonini G. , Giani T. , Pasini F. Laghi , Baldari C.T. , Bellisai F. , Valentini G. , Bombardieri S. , Paolazzi G , Galeazzi M.
Published: January 2017

Most autoinflammatory disorders typically come out in the pediatric population, although a limited number of patients may experience disease onset during adulthood. To date, a late disease onset has been described only in familial Mediterranean fever, caused by mutations in the MEFV gene, and in tumor necrosis factor receptor-associated periodic syndrome, caused by mutations in the TNFRSF1A gene. The relative rarity and lack of information on adult-onset autoinflammatory diseases make it likely that mutations will be found in an even smaller percentage of cases. With the aim of improving the genetic diagnosis in adults with suspected autoinflammatory disorders, we recently identified a set of variables related to the probability of detecting gene mutations in MEFV and TNFRSF1A and, in addition, we have also proposed a diagnostic score for identifying those patients at high risk of carrying mutations in these genes. In the present study we evaluated the preliminary score sensitivity and specificity on a wider number of patients in order to validate the goodness of fit of the model. Two hundred and nineteen consecutive patients with a clinical history of periodic fever attacks were screened for mutations in MEFV and TNFRSF1A genes; detailed information about family/personal history and clinical manifestations were also collected. For the validation of the score we considered data both from the 110 patients used to build the preliminary diagnostic score and from the additional 219 patients enrolled in the present study, for a total number of 329 patients. Early age at disease onset, positive family history for recurrent fever episodes, thoracic pain, abdominal pain and skin rash, which are the variables that had previously been shown to be significantly associated with a positive genetic test result (12), were used for validation. On univariate analysis the associations with a positive genetic test were: age at onset (odds ratio [OR] 0.43, p=0.003), positive family history for recurrent fever episodes (OR 5.81, p<0.001), thoracic pain (OR 3.17, p<0.001), abdominal pain (OR 3.80, p<0.001) and skin rash (OR 1.58, p=0.103). The diagnostic score was calculated using the linear combination of the estimated coefficients of the logistic multivariate model (cut-off equals to 0.24) revealing good sensitivity (0.778) and good specificity (0.718). In conclusion, our score may serve in the diagnostic evaluation of adult patients presenting with recurrent fever episodes suspected of having an autoinflammatory disorder, helping identify the few subjects among them who may be carriers of mutations in MEFV and TNFRSF1A genes.
Metallosis following Knee Arthroplasty: A Histological and Immunohistochemical Study
Authors: Panni A. Schiavone , Vasso M. , Cerciello S. , Maccauro G.
Published: January 2017

Metallosis represents a rare and severe complication of knee replacement surgery. It is caused by the infiltration and accumulation of metallic debris into the peri-prosthetic structures, deriving from friction between metallic prosthetic components. In knee arthroplasty, this event generally occurs as a result of polyethylene wear of the tibial or metal-back patellar component. The real incidence of metallosis is still unknown, although it seems to be more frequent in hip than in knee arthroplasty. The metallic debris induces a massive release of cytokines from inflammatory cells, making a revision necessary whenever osteolysis and loosening of the prosthesis occur. We report four patients who underwent revision of their knee arthroplasty because of severe metallosis. In one of these patients, polyethylene wear had determined friction between the metal-back patellar component and the anterior portion of the femoral component. In the remaining three cases, metallosis was caused by friction between the femoral and tibial prosthetic metal surfaces, resulting from full-thickness wear of the tibial polyethylene. T lymphocytes were activated by metal particles present in periprosthetic membranes. In all patients, one-stage revision was necessary, with rapid pain disappearance and a complete functional recovery of the knee joint.
Evolution of Hypogammaglobulinemia in Premature and Full-Term Infants
Authors: Ricci G. , Piccinno V. , Giannetti A. , Miniaci A. , Specchia F. , Masi M.
Published: January 2017

There are few data in the literature reporting the evolution of hypogammaglobulinemia in premature and full-term infants during the first years of life. The aim of this study was to assess the clinical and immunological evolution of premature and full-term infants with hypogammaglobulinemia. We included 24 children (11 premature and 13 full-term infants), aged 0–36 months, with hypogammaglobulinemia. Fifteen (62.5%) children had an isolated reduction in IgG, 7 (29.2%) had a decrease in both IgG and IgA and 2 (8.3%) a reduction in IgG and IgM. Normalization of IgG serum levels occurred in the premature infants at a mean age of 7.2 months. Full-term infants were divided into 3 groups based on age at normalization of IgG serum level: A) hypogammaglobulinemia with normalization within 12 months of life; B) with normalization within 36 months of life; C) normalization after 36 months. All the premature infants with hypogammaglobulinemia recovered, even though in the lower limits for age in the first years, while transient hypogammaglobulinemia observed in full-term infants has a different age of recovery.
NARES Patients Have More Respiratory Infections than Allergic Subjects
Authors: Cassano M. , Cassano P. , Mora F. , Ciprandi G.
Published: January 2017

Respiratory infections (RI) represent a frequent challenge for physicians. Allergic patients could present higher susceptibility to contract RI than non-allergic subjects. Non-allergic rhinitis with eosinophils (NARES) has been little investigated. This preliminary study was performed to evaluate the number and duration of RI and their sequelae in NARES and allergic patients, and non-allergic healthy subjects. Forty healthy non-allergic subjects (22 males, mean age 29 years), 40 patients with allergic rhinitis (AR) (19 males, mean age 35), and 40 NARES patients (18 males, mean age 34) were evaluated. The considered parameters were: nasal eosinophils, total number, duration in days of RI, and RI severity. NARES patients had more eosinophils than AR patients and normal controls (p<0.01); RI duration was longer in NARES patients than in AR ones (p<0.05) and controls (p<0.01); RI were more severe in NARES patients than in AR ones (p<0.05) and controls (p<0.01); pneumonia and asthma were more frequent in both NARES and AR patients than controls (p<0.05 and p<0.01). In conclusion, this preliminary study shows that NARES may induce more severe respiratory infections than allergic rhinitis.
Economic Impacts of Supported Employment for Persons with Severe Mental Illness
Authors: Latimer Eric A
Published: January 2017

Background:

Most persons with severe mental illness prefer competitive to sheltered vocational settings. Supported employment (SE) has become a clearly defined model for helping people with severe mental illness to find and maintain competitive jobs. It involves individualized and rapid placement, ongoing support and assessment, and integration of vocational and mental health staff within a single clinical team. Previous studies show that SE secures competitive employment much more effectively than do other approaches. This review focuses on its economic impacts.

Methods:

Studies reporting some service use or monetary outcomes of adding SE programs were identified. These outcomes were tabulated and are discussed in narrative form.

Results:

Five nonrandomized and 3 randomized studies compare SE programs with day treatment or transitional employment programs. The introduction of SE services can result in anything from an increase to a decrease in vocational service costs, depending on the extent to which they substitute for previous vocational or day treatment services. Overall service costs tend to be lower, but differences are not significant. Earnings increase only slightly on average.

Conclusions:

Converting day treatment or other less effective vocational programs into SE programs can be cost-saving or cost-neutral from the hospital, community centre, and government points of view. Investments of new money into SE programs are unlikely to be materially offset by reductions in other health care costs, by reductions in government benefit payments, or by increased tax revenues. Such investments must be motivated by the value of increasing the community integration of persons with severe mental illness.
Schizophrénie et psychothérapies cognitivo-comportementales
Authors: Abdel-Baki Amal , Nicole Luc
Published: January 2017

Objectif:

Différencier les approches de psychothérapie cognitivo-comportementale pour la schizophrénie selon leurs buts, objectifs et techniques, puis exposer les études d'efficacité.

Méthode:

Synthèse de l'information recueillie au moyen de recherches électroniques (MEDLINE, PSYchlit) et bibliographiques.

Résultats:

Les thérapies cognitivo-comportementales ont pour objectif global une meilleure adaptation à l'expérience psychotique au point de vue cognitif, comportemental et affectif, en proposant au patient un nouveau modèle explicatif de la psychose, soit le modèle vulnérabilité-stress. Ces approches comportent différents niveaux et visent différents buts. Certaines sont axées sur la correction des déficits cognitifs de base ou sur la modification des symptômes psychotiques ou de la détresse associée. À l'autre extrémité, les approches métacognitives visent la modification et la restructuration des schèmes du soi et de l'environnement dysfonctionnels pour faciliter l'acquisition de stratégies cognitives plus adaptées et généralisables. L'efficacité de ces thérapies a été démontrée par quelques études dont la puissance et la méthodologie sont limitées.

Conclusion:

Les thérapies cognitivo-comportementales se révèlent un traitement adjuvant prometteur dont l'efficacité a été démontrée en ce qui concerne l'amélioration de l'ajustement social, la qualité de vie ainsi que la diminution des symptômes psychotiques et de la détresse entraînée par l'expérience de la psychose. Elles visent à la fois les symptômes positifs, négatifs, cognitifs, comportementaux, et affectifs en tenant compte de la phase de la maladie et des besoins particuliers du patient. Des recherches futures devront permettre de préciser la durée, la fréquence idéale d'administration et la spécificité de ces approches.
Risperidone Treatment of Outpatients with Schizophrenia: No Evidence of Sex Differences in Treatment Response
Authors: Labelle Alain , Light Margaret , Dunbar Fiona
Published: January 2017

Objective:

Given the renewed interest in the role of sex differences in schizophrenia, we undertook a post hoc analysis to determine whether sex differences in treatment response were present among outpatients with schizophrenia who received risperidone in an 8-week, open-label, Phase IV clinical study.

Method:

We evaluated 330 adult patients (232 men, 98 women) with a DSM-III-R diagnosis of schizophrenia for safety and 292 (206 men, 86 women) for efficacy. Antipsychotic and antiparkinsonian medications were discontinued at study entry. Treatment with risperidone was initiated at a dosage of 2 mg daily, increased to the target dosage of 6 mg daily by day 3, and maintained at 6 mg daily until day 14. The dosage was then maintained at 6 mg daily, increased or decreased by 2 mg daily each week, based on the patient's response. Risperidone treatment was given for 8 weeks; the permitted dosage range was 4 mg to 10 mg daily.

Results:

Both male and female participants responded well to risperidone treatment; by the final assessment day, they had experienced decreases from baseline in their total Positive and Negative Syndrome Scale (PANSS) scores of 41.0% and 36.5%, respectively. Most male (77%) and female (78%) participants were considered to be PANSS responders: risperidone was effective against both the positive and negative symptoms of schizophrenia. Both sexes showed improvements over baseline in the incidence and severity of parkinsonism, dystonia, and dyskinesia. No significant (P > 0.05) sex differences in treatment response were observed for any of the efficacy outcomes or in the incidence and severity of extrapyramidal symptoms (EPS).

Conclusions:

In this population of outpatients with chronic schizophrenia, both men and women responded well to flexible doses of risperidone. No significant sex differences were evident either in treatment response or in neurological side effects. The absence of sex differences in response to risperidone treatment may obviate the need for a sex-based differential dosing in schizophrenia management.
Pre-, Peri-, and Postnatal Trauma in Subjects with Attention-Deficit Hyperactivity Disorder
Authors: Zappitelli Michael , Pinto Teresa , Grizenko Natalie
Published: January 2017

Objective:

To review research on pre-, peri-, and postnatal stress and their potential relation to attention-deficit hyperactivity disorder (ADHD).

Method:

We selected and critically reviewed 51 research reports from the medical and psychology literature, between January 1, 1976 and May 1, 2001, based on the subjects of pre-, peri-, or postnatal stress and ADHD.

Results:

Children with ADHD show higher percentages of pre-, peri-, or postnatal insult, compared with unaffected children; however, the relative influence of various factors is still controversial.

Conclusions:

The etiology of ADHD encompasses genetic and environmental factors. Pre-, peri-, and postnatal stressors are environmental factors that may play a role in its etiology. Future research should carefully examine interactions between genetic predisposition and environmental factors as etiologies of ADHD.