bluuebunny/crossref_metadata_2025 huggingface dataset:
Herbalists of Today's Switzerland and Their Plant Knowledge. A Preliminary Analysis from an Ethnobotanical Perspective
Authors: Dal Cero Maja , Saller Reinhard , Weckerle Caroline S.
Published: March 2016

Background: Herbal medicine is a popular part of primary health care in Switzerland. Following an ethnobotanical approach, in this study we seek to identify Swiss herbalists with broad, empirical medicinal plant knowledge and use. We aim to consider different areas of the medicinal landscape including biomedicine, complementary and alternative medicine, and self-medication. Material and Methods: A total of 61 expert interviews were conducted from February 2010 to November 2011. The transfer of knowledge was analyzed according to a Switzerland-related selection of historical and recent popular as well as scientific herbal books. Results: A total of 254 medicinal plant species, belonging to 218 genera and 87 families, were recorded in 934 use reports. Predominantly leaves and flowers are used for the treatment of dermatological, respiratory, nervous, and gastrointestinal problems. Recent to historical herbal books are an important source of plant knowledge. Conclusions: Medicinal plants are used for self-medication and professional health care and despite different underlying medicinal concepts and philosophies, herbalists largely agree on the most important medicinal plant species.
Mindfulness-based Stress Reduction (MBSR) as Treatment for Chronic Back Pain - an Observational Study with Assessment of Thalamocortical Dysrhythmia
Authors: Schmidt Stefan , Gmeiner Sophia , Schultz Claudia , Löwer Marc , Kuhn Klaus , Naranjo José Raúl , Brenneisen Christina , Hinterberger Thilo
Published: March 2016

Background: A pilot study of an 8-week mindfulness-based stress reduction (MBSR) program on a sample of low back pain patients was conducted in order to assess the feasibility and effectiveness of the intervention as well as changes in an EEG pattern called thalamocortical dysrhythmia which is associated with chronic pain. Patients and Methods: 22 patients with chronic low back pain participated in an MBSR program. Effect sizes were measured for psychological functioning, pain severity, and quality of life. Furthermore, 4 parameters of the EEG power spectral density were assessed. Results: Medium size effect sizes were found for health-related quality of life (EQ-5D, VAS, d = 0.43, p = 0.02; SF-12, psychological functioning, d = 0.50, p = 0.05), health-related life satisfaction (questions on life satisfaction d = 0.69, p = 0.01), depression (HADS, d = 0.48, p = 0.04, Brief Symptom Inventory d = 0.41, p = 0.04), and affective pain perception (pain perception scale d = 0.50, p = 0.04). The most relevant pain severity measurements improved in the range of d = 0.45-0.75 (p = 0.01-0.24). EEG analyses revealed no differences between the pre- and post-intervention. Conclusion: MBSR is a feasible intervention for patients with low back pain. They benefit from medium size effects which are comparable to similar behavioral interventions. Randomized controlled trials are needed in order to determine the specificity of these benefits.
Das Potenzial der Sauna im Rahmen der Prävention - eine Übersicht neuerer Erkenntnisse
Authors: Brenke Rainer
Published: March 2016

Die Möglichkeiten der Sauna im Rahmen von Präventionsmaßnahmen aber auch der Therapie werden bei Weitem nicht ausgeschöpft. In diesem Beitrag werden neuere Erkenntnisse vorgestellt, die das präventive und therapeutische Potenzial von Sauna bei einer Reihe von Zivilisationserkrankungen aufzeigen. Als Beispiele seien die Abhärtung gegen grippale Infekte und Herz-Kreislauf-Erkrankungen genannt sowie der Einsatz im Rahmen von Schmerztherapie z.B. bei der Fibromyalgie. Sauna ist aber auch eine empfehlenswerte Intervention zur Stressprophylaxe und bei Stoffwechselerkrankungen wie dem Diabetes Typ 2.
Potenzielle Inanspruchnahme von Gesundheitsprofessionen durch privat Versicherte unter Berücksichtigung komplementärmedizinischer Versorgungsleistungen
Authors: Ostermann Thomas , Vollmar Horst Christian , Raak Christa , Jacobi Frank , Büssing Arndt , Matthiessen Peter F.
Published: March 2016

Hintergrund: Patientenpräferenzen gewinnen zunehmend an Bedeutung und werden auch in der Versorgungsforschung vermehrt untersucht. Ziel der Arbeit war es, Aufschlüsse über die potenzielle Inanspruchnahme von Gesundheitsprofessionen unter Berücksichtigung komplementärmedizinischer Versorgungsleistungen bei Versicherten einer privaten Krankenkasse zu erhalten. Methodik: Auf der Basis von 7 hypothetischen Beschwerden (Brustdruck, Allergie, Verdauungsbeschwerden, depressive Verstimmung, Knieschwellung, Suchtmittelreduzierung sowie Kind mit fieberhaftem Infekt) sollten die Befragten ihre erste und zweite Wahl des Ansprechpartners nennen. Als Optionen standen zur Wahl: schulmedizinisch orientierter Hausarzt, schulmedizinisch orientierter Facharzt, naturheilkundlich spezialisierter Arzt (NHK-Arzt), Heilpraktiker, Apotheker und sonstige. Übereinstimmungen in Bezug auf die Erstpräferenzen wurden mithilfe des Kappa-Koeffizienten berechnet. Ergebnisse: 1960 Versicherte (74,1% männlich, mittleres Alter 62,4 ± 10,2 Jahre) gaben vollständige Angaben zu ihren Präferenzen an. Bei allen Beschwerden würden die Versicherten primär den schulmedizinisch orientierten Hausarzt und erst im Folgenden einen Facharzt präferieren. Lediglich bei der Behandlung von Allergien (12,5%) und Depressionen (11,8%) oder bei einer Suchtmittelreduzierung (18,6%) würde auch ein NHK-Arzt verstärkt als Erstkontakt zurate gezogen werden. Bei der Suchtmittelentwöhnung spielt auch die Kompetenz des Heilpraktikers in der Zweitwahl eine größere Rolle (15,5%). Vor allem die Angaben zu Konsultationen bei depressiven Verstimmungen, Allergien, Verdauungsbeschwerden und Angina pectoris besaßen mit Kappa-Werten von über 0,5 ein hohes Übereinstimmungspotenzial. Eine Sensitivitätsanalyse in Bezug auf Geschlecht und Bildung zeigte darüber hinaus, dass bei einer Homogenisierung des Kollektivs die Übereinstimmungswerte deutlich höher werden. Diskussion: Ungeachtet der Beschwerdeart scheint für die Mehrheit der Befragten der konventionelle Haus- bzw. Facharzt erster Ansprechpartner bei gesundheitlichen Problemen zu sein, während eine naturheilkundliche Kompetenz nur bei bestimmten Erkrankungen relevant zu sein scheint.
Einfluss des therapeutischen Qi auf die Herzratenvariabilität bei Akupunktur: Eine randomisierte kontrollierte Studie
Authors: Hochstrasser Raphael J. , Endler P. Christian , Klein Sabine D.
Published: March 2016

Hintergrund: In einer kürzlich durchgeführten Studie konnten Probanden bei der Akupunktur eine Stimulation mittels «therapeutischem Qi» wahrnehmen, obwohl mechanische und psychologische Faktoren ausgeschlossen wurden. Nun untersuchten wir, ob das therapeutische Qi auch die Herzratenvariabilität messbar beeinflusst. Methoden: Es handelte sich um eine randomisierte, kontrollierte, einfach verblindete Crossover-Studie mit 30 Probanden. Mithilfe einer Vorrichtung wurde eine Akupunkturnadel in den Akupunkt Pe6 eingeführt. Mit einer weiteren Vorrichtung wurde der herausragende Teil der Nadel so fixiert, dass bei Berührung des Nadelendes die Übertragung von mechanischen Bewegungen auf die Nadelspitze ausgeschlossen werden konnte. Bei der anschließenden Prüfintervention wurde das Nadelende zur Stimulation des Qi durch den Therapeuten berührt, bei der Kontrollintervention wurde die Nadel nicht berührt, sodass das Qi nicht stimuliert wurde. Bei der Nullintervention wurde keine Nadel gesetzt. Bei jeder Intervention wurden jeweils vorher und nachher Parameter der Herzratenvariabilität (HRV) ermittelt. Ergebnisse: Zwischen den drei Interventionen konnten keine signifikanten Unterschiede der HRV-Parameter festgestellt werden. Zwischen Baseline- und Endmessung sank die Herzfrequenz bei der Kontroll- und Prüfintervention (-2 min-1, d = 0,24 bzw. -2 min-1, d = 0,24), die RMSSD stieg mit der Nadelberührung bzw. der Stimulation des Qi signifikant an (+9.7 ms, d = -0.32). Schlussfolgerung: Die zuvor subjektiv wahrgenommene Stimulation mit therapeutischem Qi konnte innerhalb dieses Settings anhand von HRV-Parametern nicht ausreichend bestätigt werden.
A Unifying Concept of Uveal Pigment Cell Distribution and Dissemination Based on an Animal Model: Insights into Ocular Melanogenesis
Authors: Schwab Christoph , Wackernagel Werner , Grinninger Petra , Mayer Christoph , Schwab Katharina , Langmann Gerald , Richtig Erika , Wedrich Andreas , Hofmann-Wellenhof Rainer , Zalaudek Iris
Published: March 2016

Pigmented cells are derived from neural crest cells, which migrate along the peripheral nerve sheets into their specific final region. During their migration, cells progressively acquire pigment-producing capabilities, maturation, and the shape of melanocytes. These insights, along with specific clinical characteristics of melanocytic nevi, have led to new concepts of cutaneous, periocular, and iris nevogenesis. To further elucidate the specific ocular embryogenic melanoblast distribution and dissemination - that could explain the distinct distribution of uveal melanocytic neoplasms - we investigated the ocular pigmentation of dogs affected by a specific mutation called Merle, which results in either pigment- (wild type) or non-pigment- (mutated type) producing cells. Based on our observations, we propose a unifying concept of uveal pigment cell distribution and dissemination, which postulates melanoblast migration and maturation following the trigeminal V1 branch and, later, their entrance into the eye along the ciliary nerves and their finest iris branches. Our concept provides an explanation not only for the specific distribution of ocular melanocytic lesions, including uveal and iris nevi, but also for the different locations depending on the metastatic potential of the ocular melanoma. Though speculative, the higher metastatic potential of posterior uveal melanomas compared to iris melanomas may be related to a less differentiated stage in the maturation of migrating melanocytes in the posterior segment compared to the anterior segment of the eye. However, there is a need of further studies focusing on cell differentiation markers of melanocytes at different locations in the eye.
Verification of the Inactivation of Melanocytic Nevus in vitro Using a Newly Developed Portable High Hydrostatic Pressure Device
Authors: Morimoto Naoki , Jinno Chizuru , Mahara Atsushi , Kakudo Natsuko , Fujisato Toshia , Kusumoto Kenji , Suzuki Shigehiko , Yamaoka Tetsuji
Published: March 2016

High hydrostatic pressure (HHP) technology is a physical method for inactivating tissue. We reported that nevus specimens were inactivated after HHP at 200 MPa and that the inactivated nevus could be used as autologous dermis for covering skin defects. In this study, we verified the inactivation of nevus specimens using a newly developed portable HHP device which will be used in a clinical trial. Nevus tissue specimens were obtained from 5 patients (mean age 7.2 years, range 1-19). We cultured fibroblasts and nevus cells from the tissue specimens and then evaluated their inactivation after HHP at 200 MPa by confirming the attachment of the suspensions and by the live/dead staining of the suspensions, through the dissociation of the cells on chamber slides and by the live/dead staining of the remaining cells. The cells were also quantitatively evaluated by WST-8 assay. We then confirmed the inactivation of the nevus specimens after HHP using explant culture. Our results indicated that fibroblasts and nevus cells were inactivated after HHP at 200 MPa, with the exception of a small percentage of green-colored cells, which reflected the remaining activity of the cellular esterases after HHP. No cells migrated from the nevus specimens after HHP at 200 MPa. We verified the inactivation of fibroblasts and nevus cells cultured from nevus specimens, and in the nevus samples themselves after pressurization at 200 MPa using this device. This device could be used in clinical trials for giant congenital melanocytic nevi and may thus become useful in various medical fields.
Bilateral Ventral Intermediate Nucleus Thalamic Deep Brain Stimulation in Orthostatic Tremor
Authors: Coleman Robert R. , Starr Philip A. , Katz Maya , Glass Graham A. , Volz Monica , Khandhar Suketu M. , Ostrem Jill L.
Published: March 2016

Background: Orthostatic tremor (OT) is characterized by high-frequency leg tremor when standing still, resulting in a sense of imbalance, with limited treatment options. Ventral intermediate (Vim) nucleus thalamic deep brain stimulation (DBS) has been reported as beneficial in a few cases. Objective: To report clinical outcomes, lead locations, and stimulation parameters in 2 patients with severe medication-refractory OT treated with Vim DBS. Methods: The patients underwent surface electromyography (EMG) to confirm the OT diagnosis. Outcomes were measured as change in tolerated standing time at the last follow-up. Lead locations were quantified using postoperative MRI. Results: Vim DBS was well tolerated and resulted in improvement in standing time (patient 1: 50 s at baseline to 15 min 16 months after surgery; patient 2: 34 s at baseline to 4.2 min 7 months after surgery). Postoperative surface EMG for patient 1 demonstrated a delayed onset of tremor, lower-amplitude tremor, and periods of quiescence, but an unchanged tremor frequency. Conclusion: These cases provide further support for Vim DBS to improve standing time in severe medication-refractory OT. The location of the effective thalamic target for OT does not differ from the effective target for essential tremor.
Variability in Motor and Language Recovery during the Acute Stroke Period
Authors: Dunn Lauren E. , Schweber Adam B. , Manson Daniel K. , Lendaris Andrea , Herber Charlotte , Marshall Randolph S. , Lazar Ronald M.
Published: March 2016

Background: Most stroke recovery occurs by 90 days after onset, with proportional recovery models showing an achievement of about 70% of the maximal remaining recovery. Little is known about recovery during the acute stroke period. Moreover, data are described for groups, not for individuals. In this observational cohort study, we describe for the first time the daily changes of acute stroke patients with motor and/or language deficits over the first week after stroke onset. Methods: Patients were enrolled within 24-72 h after stroke onset with upper extremity hemiparesis, aphasia, or both, and were tested daily until day 7 or discharge with the upper-extremity Fugl-Meyer Assessment of Motor Recovery after Stroke, the Boston Naming Test, and the comprehension domain from the Western Aphasia Battery. Discharge scores, and absolute and proportional changes were examined using t-tests for pairwise comparisons and linear regression to determine relative contributions of initial impairment, lesion volume, and age to recovery over this period. Results: Thirty-four patients were enrolled: 19 had motor deficits alone, 8 had aphasia alone, and 7 had motor and language deficits. In a group analysis, statistically significant changes in absolute scores were found in the motor (p < 0.001) and comprehension (p < 0.001) domains but not in naming. Day-by-day recovery curves for individual patients displayed wide variation with comparable initial impairment. Proportional recovery calculations revealed that, on average, patients achieved less than 1/3 of their potential recovery by the time of discharge. Multivariate regression showed that the amount of variance accounted for by initial severity, age, and lesion volume in this early time period was not significant for motor or language domains. Conclusions: Over the first week after stroke onset, recovery of upper extremity hemiparesis and aphasia were not predictable on the basis of initial impairment, lesion volume, or age. In addition, patients only achieved about 1/3 of their remaining possible recovery based on the anticipated 70% proportion found at 90 days. These findings suggest that the complex interaction between poststroke structural repair, regeneration, and functional reorganization during the first week after stroke has yet to be elucidated.
Cognitive Health Assessment and Establishment of a Virtual Cohort of Dementia Caregivers
Authors: Lathan Corinna , Wallace Angela S. , Shewbridge Rita , Ng Nicole , Morrison Glenn , Resnick Helaine E.
Published: March 2016

Background: Many factors impact caregivers' cognitive health and, by extension, their ability to provide care. This study examined the relationship between psychosocial factors and cognitive performance among dementia caregivers and established a virtual cohort of caregivers for future research. Methods: Data on 527 caregivers were collected via a Web-based survey that assessed cognitive performance. Caregiver data were compared to corresponding data from 527 age-, race-, gender-, and education-matched controls from a normative database. Caregiver self-reported sleep, stress, health, and social support were also assessed. Results: Caregivers performed significantly worse than controls on 3 of 5 cognitive subtests. Stress, sleep, perceived support, self-rated health, years of caregiving, race, and gender were significant predictors of cognitive performance. Conclusion: In this sample of dementia caregivers, psychosocial factors interacted in complex ways to impact cognitive performance. Further investigation is needed to better understand how these factors affect cognitive performance among caregivers. This could be accomplished by the establishment of a virtual cohort that facilitates the development of digital tools to support the evaluation and management of caregiver needs in a manner that helps them remain effective in their caregiving roles.
Developmental Age Differentially Mediates the Calcium-Binding Protein Parvalbumin in the Rat: Evidence for a Selective Decrease in Hippocampal Parvalbumin Cell Counts
Authors: Honeycutt Jennifer A. , Keary III Kevin M. , Kania Vanessa M. , Chrobak James J.
Published: March 2016

Local circuit GABAergic neurons, including parvalbumin (PV)-containing basket cells, likely play a key role in the development, physiology, and pathology of neocortical circuits. Regionally selective and well-defined decreases in PV have been described in human postmortem schizophrenic brain tissue in both the hippocampus and prefrontal cortex. Animal models of schizophreniform dysfunction following acute and/or chronic ketamine treatment have also demonstrated decreases in PV expression. Conflicting reports with respect to PV immunoreactivity following acute and chronic ketamine treatments in rodents question the utility of using PV as a biological marker of pathology-related dysfunction. The current literature lacks sufficient and systematic characterization of normative PV expression in pharmacologically and behaviorally naïve rodent tissue. In order to understand developmental changes in PV and its putative role in neuropathology, we examined the baseline distribution of the number of cells expressing this protein at distinct developmental ages. The present study examined PV cell counts across the septotemporal axis of the CA1, CA3, and dentate gyrus (DG) regions of the hippocampus, as well as within the retrosplenial, somatosensory, and prefrontal cortices, in 1-, 6-, and 12-month-old naïve rats. Our findings suggest that the hippocampal PV+ cell number significantly decreases as a function of age with considerable regional (CA1, CA3, and DG) and septotemporal variation, a finding that was specific to the hippocampus. Additionally, we observed a modest increase in PV cell number within the prefrontal (anterior cingulate) cortex, which is in line with findings indicating a delayed developmental maturation of this region. The present work highlights decreases in PV+ cell counts within the hippocampus across development, and points to the need for a greater understanding of the role of PV and local circuit developmental changes, as well as consideration of their development when modeling developmentally related neuropathological disorders (e.g. schizophrenia, autism).
Oxidative Stress and DNA Damage in Untreated First-Episode Psychosis in Adolescents
Authors: Şimşek Şeref , Gençoğlan Salih , Yüksel Tuğba , Kaplan İbrahim , Alaca Rümeysa , Aktaş Hüseyin
Published: March 2016

Objective: Oxidative stress has been reported to play a role in the psychopathology of schizophrenia, though only a few studies have investigated the relationship between early-onset schizophrenia and oxidative stress. The aim of the present study is to evaluate the level of oxidative stress and the presence of DNA damage in first-episode psychosis (FEP) in adolescents. Methods: This study was conducted in the Department of Child Psychiatry of the Dicle University Hospital. It included 20 adolescent patients (age 11-17 years) with psychosis (acute psychosis, schizophreniform disorder, or schizophrenia) according to DSM-IV criteria who had received no previous psychiatric therapy (patient group) and 20 age/gender-matched healthy adolescents (control group). Structured psychiatric interviews [Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS-PL) and Positive and Negative Symptom Scale (PANSS)] were conducted on the patients, and the Clinical Global Impressions (CGI) scale was used to evaluate the severity of disease. Glutathione peroxidase (GPx), superoxide dismutase (SOD), coenzyme Q (CoQ), and 8-hydroxy-2-deoxyguanosine (8-OHdG) levels were determined using the ELISA method and commercial ELISA kits. Results: The mean age was 14.5 ± 1.6 years in the FEP group (male-to-female ratio: 8/12) and 14.4 ± 1.5 years in the control group (male-to-female ratio: 8/12). There were no differences between the patient and control groups in terms of SOD, GPx, or 8-OHdG values (p > 0.05). Conclusions: This study on DNA damage and oxidative stress in FEP in adolescents had a small sample size, and our data suggest that oxidative stress is associated with a chronic disease course rather than being an early sign of early-onset schizophrenia.
Consecutive Endovascular Treatment of 20 Ruptured Very Small (<3 mm) Anterior Communicating Artery Aneurysms
Authors: Asif Kaiz S. , Sattar Ahsan , Lazzaro Marc A. , Fitzsimmons Brian-Fred , Lynch John R. , Zaidat Osama O.
Published: March 2016

Background: Small aneurysms located at the anterior communicating artery carry significant procedural challenges due to a complex anatomy. Recent advances in endovascular technologies have expanded the use of coil embolization for small aneurysm treatment. However, limited reports describe their safety and efficacy profiles in very small anterior communicating artery aneurysms. Objective: We sought to review and report the immediate and long-term clinical as well as radiographic outcomes of consecutive patients with ruptured very small anterior communicating artery aneurysms treated with current endovascular coil embolization techniques. Methods: A prospectively maintained single-institution neuroendovascular database was accessed to identify consecutive cases of very small (<3 mm) ruptured anterior communicating artery aneurysms treated endovascularly between 2006 and 2013. Results: A total of 20 patients with ruptured very small (<3 mm) anterior communicating artery aneurysms were consecutively treated with coil embolization. The average maximum diameter was 2.66 ± 0.41 mm. Complete aneurysm occlusion was achieved for 17 (85%) aneurysms and near-complete aneurysm occlusion for 3 (15%) aneurysms. Intraoperative perforation was seen in 2 (10%) patients without any clinical worsening or need for an external ventricular drain. A thromboembolic event occurred in 1 (5 %) patient without clinical worsening or radiologic infarct. Median clinical follow-up was 12 (±14.1) months and median imaging follow-up was 12 (±18.4) months. Conclusion: This report describes the largest series of consecutive endovascular treatments of ruptured very small anterior communicating artery aneurysms. These findings suggest that coil embolization of very small aneurysms in this location can be performed with acceptable rates of complications and recanalization.
Prolonged Duration of Renal Recovery Following ANCA-Associated Glomerulonephritis
Authors: Oomatia Amin , Moran Sarah M. , Kennedy Claire , Sequeira Rachel , Hamour Sally , Burns Aine , Little Mark A. , Salama Alan D.
Published: March 2016

Background: As renal biopsies are not routinely repeated to monitor treatment response in anti-neutrophil cytoplasm antibody (ANCA)-associated glomerulonephritis, serum creatinine (SC) and proteinuria assessed by urine protein:creatinine ratio (UPCR) measurements are relied upon to provide a non-invasive estimate of disease activity within the kidney. However, sparse information exists about the time to achieve maximal improvement in these parameters, which has important implications for treatment decisions and disease-scoring systems. Methods: We analysed patients with ANCA-associated glomerulonephritis and renal impairment from cohorts in the United Kingdom and Ireland, with the primary objective of determining actuarial time to nadir SC and UPCR. Time to disappearance of haematuria was analysed as a secondary objective. Results: Ninety-four patients fulfilled our selection criteria, with 94 (100%) and 66 (70%) having reached their nadir SC and UPCR respectively during the follow-up period. Nadir SC was achieved after a median of 88 days (95% CI 74-102), UPCR at 346 days (95% CI 205-487). Those of Indo-Asian ethnic origin reached their nadir SC faster (34 days) than other ethnicities (p < 0.01). There were no significant differences in time to nadir SC or UPCR on the basis of gender, clinical diagnosis, ANCA positivity or renal biopsy findings. Conclusion: In this retrospective study, nadir creatinine and proteinuria occur later than other signs of clinical remission, suggesting that ongoing renal recovery continues for a significant time after diagnosis. It may benefit disease-scoring systems to take into account SC levels beyond the initial assessment.
Low-Risk Prostate Cancer and Tumor Upgrading to Higher Patterns in the Surgical Specimen. Analysis of Clinical Factors Predicting Tumor Upgrading to Higher Gleason Patterns in a Contemporary Series of Patients Who Have Been Evaluated According to the Modified Gleason Score Grading System
Authors: Porcaro Antonio Benito , Siracusano Salvatore , De Luyk Nicolò , Corsi Paolo , Sebben Marco , Tafuri Alessandro , Bizzotto Leonardo , Tamanini Irene , Inverardi Davide , Cerruto Maria Angela , Martignoni Guido , Brunelli Matteo , Artibani Walter
Published: March 2016

Objective: To identify clinical factors associated with prostate cancer (PCA) upgrading to higher patterns of the surgical specimen in low-risk PCA. Materials and Methods: We evaluated the records of 438 patients. The multinomial logistic regression model was used. Results: Low-risk PCA included 170 cases (38.8%) and tumor upgrading was detected in 111 patients (65.3%) of whom 72 (42.4%) had pathological Gleason patterns (pGP) = 3 + 4 and 39 (22.9%) pGP >3 + 4. Prostate-specific antigen (PSA) and proportion of positive cores (P+) were independent predictors of tumor upgrading to higher patterns. The main difference between upgraded cancers related to PSA and to P+ >0.20. The population was stratified into risk classes by PSA ≤5 μg/l and P+ ≤0.20 (class A), PSA >5 μg/l and P+ ≤0.20 (class B), PSA ≤5 μg/l and P+ >0.20 (class C) and PSA >5 μg/l and P+ 0.20 (class D). Upgrading rates to pGP >3 + 4 were extremely low in class A (5.1%), extremely high in D (53.8%). Conclusions: Low-risk PCA is a heterogeneous population with significant rates of undetected high-grade disease. Significant clinical predictors of upgrading to higher patterns include PSA and P+, which identify a very high-risk class that needs repeat biopsies in order to reclassify tumor grade.
Pure Lymphoepithelioma-Like Carcinoma Originating from the Urinary Bladder
Authors: Nagai Takashi , Naiki Taku , Kawai Noriyasu , Iida Keitaro , Etani Toshiki , Ando Ryosuke , Hamamoto Shuzo , Sugiyama Yosuke , Okada Atsushi , Mizuno Kentaro , Umemoto Yukihiro , Yasui Takahiro
Published: March 2016

Lymphoepithelioma-like carcinoma of the urinary bladder (LELCB) is a rare variant of infiltrating urothelial carcinoma. We report a case of LELCB in a 43-year-old man. Ultrasonography and cystoscopy revealed two bladder tumors, one on the left side of the trigone and the other on the right side of the trigone. Transurethral resection of the bladder tumors was performed and pathological analysis revealed undifferentiated carcinoma. We therefore performed radical cystectomy and urinary diversion. Immunohistochemically the tumor cells were positive for cytokeratin, but negative for Epstein-Barr virus-encoded small RNA in situ hybridization as found for previous cases of LELCB. The final pathological diagnosis was a lymphoepithelioma-like variant of urothelial carcinoma with perivesical soft tissue invasion. For adjuvant systemic chemotherapy, three courses of cisplatin were administered. The patient subsequently became free of cancer 72 months postoperatively. Based on the literature, pure or predominant LELCB types show favorable prognoses due to their sensitivity to chemotherapy or radiotherapy. An analysis of the apparent diffusion coefficient (ADC) values of bladder tumors examined in our institution revealed that the ADC value measured for this LELCB was relatively low compared to conventional urothelial carcinomas. This suggests that measuring the ADC value of a lymphoepithelioma-like carcinoma prior to operation may be helpful in predicting LELCB.
Cytokines of Cervical Mucosa and Human Papilloma Virus Infection of the Cervix: A Descriptive Study
Authors: Daniilidis Angelos , Koutsos John , Oikonomou Zinon , Nasioutziki Maria , Hatziparadisi Katerina , Tantanasis Theocharis
Published: March 2016

Objective: The production of cytokines by various cervical cells can be triggered by antigenic stimuli, including human papilloma virus (HPV) infection. The aim of the present study was to evaluate differences in cytokine levels between various intraepithelial cervical lesions. Study Design: A total of 97 women participated in this descriptive study. Within our study population, 27 subjects presented with high-grade squamous intraepithelial lesions (HSIL), 48 with low-grade squamous intraepithelial lesion (LSIL) and 22 with a normal smear. Colposcopy and directed biopsy were performed as needed. To confirm the presence of HPV, an HPV-DNA test was performed using polymerase chain reaction. Using flow cytometry to ThinPrep cervical samples, we assessed the family of interleukins (ILs), including IL-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor (TNF)-α and TNF-β and transforming growth factor-β1. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS for Windows; version 20.0). Results: Significantly lower levels of IL-1α, IL-2, IL-4 and TNF-α were detected in cervical samples obtained from the LSIL group when compared to samples obtained from the HSIL group. Conclusion: Significant differences in tissue cytokine levels exist between intraepithelial cervical lesions obtained from patients presenting with HSIL versus LSIL.
Introducing Hyperthermic Intraperitoneal Chemotherapy into Gynecological Oncology Practice - Feasibility and Safety Considerations: Single-Center Experience
Authors: Abramian Alina , Zivanovic Oliver , Kuhn Walther , Weber Stefan , Schaefer Nico , Keyver-Paik Mignon-Denise , Kiefer Nicholas
Published: March 2016

Background: Within the surgical oncology community interest is increasingly focusing on combining surgical cytoreduction and regional chemotherapeutic drug delivery to manage solid abdominal tumors. In particular, the role of hyperthermic intraperitoneal chemotherapy (HIPEC) is evolving for treating epithelial ovarian carcinomas (EOCs), as EOCs remain confined to the peritoneal cavity for most of their natural history. Currently there is no evidence from prospective trials to confirm an overall survival benefit associated with HIPEC. In addition, there are no generally accepted regimens, which results in heterogeneous clinical procedures. Methods: We have initiated a HIPEC program at our institution and completed a phase I study of HIPEC with cisplatin in patients with platinum-sensitive recurrent EOC. The data have been published and prove the feasibility of this approach. In the process of introducing HIPEC, several safety measures had to be taken into consideration. Results: We present the implications and requirements of introducing HIPEC in clinical practice and discuss our proposed procedure referring to the recent literature. Conclusion: HIPEC is feasible and can be performed safely in daily gynecological oncology routine provided that certain considerations and precautions are taken into account during its introduction to guarantee a proper and safe operating sequence.
Patients with Advanced Ovarian Cancer Administered Oral Etoposide following Taxane as Maintenance Chemotherapy
Authors: Nagano Hiroaki , Tachibana Yasunari , Kawakami Megumi , Ueno Mariko , Morita Yoshihiro , Muraoka Mitsue , Takagi Koichiro
Published: March 2016

Introduction: The concept of maintenance therapy is one of the highly relevant approaches in the management of advanced ovarian cancer. The fundamental goal of maintenance therapy is to improve survival outcomes. We attempted to reinforce maintenance chemotherapy by adding oral etoposide following taxane administration. Cases: We retrospectively evaluated 14 patients with advanced ovarian cancer who had achieved clinically defined complete response to a primary platinum/taxane chemotherapy regimen and who were administered oral etoposide (50 mg/day × 21 days per cycle monthly for 3-5 cycles) following paclitaxel or docetaxel administration as maintenance chemotherapy. With regard to oral etoposide toxicity, grade 2 oral mucositis and grade 3 anemia were observed in 1 patient each. Three to five cycles of etoposide were administered to all patients, though daily dosage was reduced to 25 mg in 2 patients due to toxicity. The median progression-free survival was 43.5 months, the median overall survival was 86 months, and 5-year overall survival was 77.1%. Conclusion: The results from this ovarian cancer treatment evaluation suggest that oral etoposide may be administered safely following paclitaxel or docetaxel as maintenance chemotherapy. We expect this regimen to contribute to the improvement in the survival outcomes of patients with advanced ovarian cancer.
Arquitetura em Antonioni
Authors: Furtado Cláudio
Published: March 2016

A análise aproxima a filmografia de Michelangelo Antonioni, principalmente os filmes Blow-up e Profissão repórter, com a arquitetura contemporânea através do pensamento do diretor e dos arquitetos do Team 10. O tratamento cromático dos filmes, assim como o despregamento das imagens com o enredo são similares às posturas do grupo de arquitetos que procuram uma nova linguagem para arquitetura. O estudo visa ampliar a abrangência da visão do arquiteto através da apropriação de processos de produção cultural de outras áreas.
Odiléa Toscano: design visual, espaços públicos e ensino
Authors: Goldchmit Sara Miriam , Santos Maria Cecília Loschiavo dos , Santos Luciene Ribeiro dos
Published: March 2016

Representante da geração pioneira de arquitetos graduados na Faculdade de Arquitetura e Urbanismo da Universidade de São Paulo, Odiléa Helena Setti Toscano (1934-2015) foi também docente da FAUUSP entre meados dos anos 1970 e o fim dos anos 1990, integrando o grupo de disciplinas de Programação Visual. Com senso estético apurado e traço de delicadeza inconfundível,Odiléa teve uma atuação marcante como artista gráfica, ainda pouco divulgada. Produziu desenhos, serigrafias, capas de livros, ilustrações para jornais e revistas e também projetos de painéis destinados a espaços arquitetônicos privados e públicos. Suas obras de maior visibilidade são os murais que realizou para diversas estações do Metrô de São Paulo. O objetivo deste artigo é apresentar um panorama de sua biografia e de sua trajetória profissional, acadêmica e docente, de forma a colaborar com o registro e divulgação da obra desta arquiteta que ofereceu grande contribuição ao campo do design visual. O presente artigo visa também homenagear a atuação pioneira da arquiteta.
Enhancing Cardiac Rehabilitation With Stress Management Training
Authors: Blumenthal James A. , Sherwood Andrew , Smith Patrick J. , Watkins Lana , Mabe Stephanie , Kraus William E. , Ingle Krista , Miller Paula , Hinderliter Alan
Published: March 2016

Background—

Cardiac rehabilitation (CR) is the standard of care for patients with coronary heart disease. Despite considerable epidemiological evidence that high stress is associated with worse health outcomes, stress management training (SMT) is not included routinely as a component of CR.

Methods and Results—

One hundred fifty-one outpatients with coronary heart disease who were 36 to 84 years of age were randomized to 12 weeks of comprehensive CR or comprehensive CR combined with SMT (CR+SMT), with assessments of stress and coronary heart disease biomarkers obtained before and after treatment. A matched sample of CR-eligible patients who did not receive CR made up the no-CR comparison group. All participants were followed up for up to 5.3 years (median, 3.2 years) for clinical events. Patients randomized to CR+SMT exhibited greater reductions in composite stress levels compared with those randomized to CR alone (
P
=0.022), an effect that was driven primarily by improvements in anxiety, distress, and perceived stress. Both CR groups achieved significant, and comparable, improvements in coronary heart disease biomarkers. Participants in the CR+SMT group exhibited lower rates of clinical events compared with those in the CR-alone group (18% versus 33%; hazard ratio=0.49; 95% confidence interval, 0.25–0.95;
P
=0.035), and both CR groups had lower event rates compared with the no-CR group (47%; hazard ratio=0.44; 95% confidence interval, 0.27–0.71;
P
<0.001).

Conclusions—

CR enhanced by SMT produced significant reductions in stress and greater improvements in medical outcomes compared with standard CR. Our findings indicate that SMT may provide incremental benefit when combined with comprehensive CR and suggest that SMT should be incorporated routinely into CR.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00981253.
Excessive Adventitial Remodeling Leads to Early Aortic Maladaptation in Angiotensin-Induced Hypertension
Authors: Bersi Matthew R. , Bellini Chiara , Wu Jing , Montaniel Kim R.C. , Harrison David G. , Humphrey Jay D.
Published: March 2016

The primary function of central arteries is to store elastic energy during systole and to use it to sustain blood flow during diastole. Arterial stiffening compromises this normal mechanical function and adversely affects end organs, such as the brain, heart, and kidneys. Using an angiotensin II infusion model of hypertension in wild-type mice, we show that the thoracic aorta exhibits a dramatic loss of energy storage within 2 weeks that persists for at least 4 weeks. This diminished mechanical functionality results from increased structural stiffening as a result of an excessive accumulation of adventitial collagen, not a change in the intrinsic stiffness of the wall. A detailed analysis of the transmural biaxial wall stress suggests that the exuberant production of collagen results more from an inflammatory response than from a mechano-adaptation, hence reinforcing the need to control inflammation, not just blood pressure. Although most clinical assessments of arterial stiffening focus on intimal–medial thickening, these results suggest a need to measure and control the highly active and important adventitia.
Tetrahydrobiopterin Protects Against Hypertrophic Heart Disease Independent of Myocardial Nitric Oxide Synthase Coupling
Authors: Hashimoto Toru , Sivakumaran Vidhya , Carnicer Ricardo , Zhu Guangshuo , Hahn Virginia S. , Bedja Djahida , Recalde Alice , Duglan Drew , Channon Keith M. , Casadei Barbara , Kass David A.
Published: March 2016

Background

Nitric oxide synthase uncoupling occurs under conditions of oxidative stress modifying the enzyme's function so it generates superoxide rather than nitric oxide. Nitric oxide synthase uncoupling occurs with chronic pressure overload, and both are ameliorated by exogenous tetrahydrobiopterin (
BH
4)—a cofactor required for normal nitric oxide synthase function—supporting a pathophysiological link. Genetically augmenting
BH
4 synthesis in endothelial cells fails to replicate this benefit, indicating that other cell types dominate the effects of exogenous
BH
4 administration. We tested whether the primary cellular target of
BH
4 is the cardiomyocyte or whether other novel mechanisms are invoked.

Methods and Results

Mice with cardiomyocyte‐specific overexpression of
GTP
cyclohydrolase 1 (
mGCH
1) and wild‐type littermates underwent transverse aortic constriction. The
mGCH
1 mice had markedly increased myocardial
BH
4 and, unlike wild type, maintained nitric oxide synthase coupling after transverse aortic constriction; however, the transverse aortic constriction–induced abnormalities in cardiac morphology and function were similar in both groups. In contrast, exogenous
BH
4 supplementation improved transverse aortic constricted hearts in both groups, suppressed multiple inflammatory cytokines, and attenuated infiltration of inflammatory macrophages into the heart early after transverse aortic constriction.

Conclusions

BH
4 protection against adverse remodeling in hypertrophic cardiac disease is not driven by its prevention of myocardial nitric oxide synthase uncoupling, as presumed previously. Instead, benefits from exogenous
BH
4 are mediated by a protective effect coupled to suppression of inflammatory pathways and myocardial macrophage infiltration.
Ascidian fauna (Tunicata, Ascidiacea) of subantarctic and temperate regions of Chile
Authors: TURON XAVIER , CAÑETE JUAN I. , SELLANES JAVIER , ROCHA ROSANA M. , LÓPEZ-LEGENTIL SUSANNA
Published: March 2016

We studied the ascidian fauna from two zones located in subantarctic (Punta Arenas, latitude 53º) and temperate Chile (Coquimbo, latitude 29º). The different oceanographic features of the two zones, with influence of the Humboldt Current in the north and the Cape Horn Current System and freshwater inputs in the south, led to markedly different ascidian faunas. A total of 22 species were recorded, with no shared species across the two areas (11 species each). The new species Polyzoa iosune is described, Lissoclinum perforatum is found for the first time in the Pacific Ocean, and Synoicum georgianum and Polyzoa minor are new to the Chilean fauna. The populations of Ciona in the Coquimbo area (formerly attributed to Ciona intestinalis) correspond to the species Ciona robusta. A total of 35 Cytochrome oxidase (COI) sequences of the standard barcode region have been obtained for 17 of the 22 species reported.
On the status of three nominal species in the synonymy of Dendrelaphis calligaster (Günther, 1867) (Serpentes: Colubridae)
Authors: Rooijen Johan van , Vogel Gernot
Published: March 2016

The taxonomic status of three nominal species in the synonymy of the wide ranging Australo-Papuan snake Dendrelaphis calligaster (Günther, 1867) was investigated. Dendrophis meeki Boulenger, 1895 was shown to represent an insular population of D. gastrostictus instead of D. calligaster and is therefore transferred to the synonymy of the former. A description is given of the syntypes of D. meeki. Dendrelaphis calligaster distinguendus Meise & Hennig, 1932 was found to be fairly distinct from other populations of D. calligaster. However, it is not diagnosable and may not represent an independently evolving lineage. Therefore, its placement in the synonymy of D. calligaster is maintained. A neotype (ZMB 24024) is designated and described because the original types were destroyed during World War II. Finally, Dendrophis salomonis Günther, 1872 was demonstrated to be indistinct from the D. calligaster metapopulation. It too is maintained in the synonymy of D. calligaster. A description of the syntypes is provided.
A revised classification of the Icteridae (Aves) based on DNA sequence data
Authors: REMSEN J. V. JR. , POWELL ALEXIS F. L. A. , SCHODDE RICHARD , BARKER F. KEITH , LANYON SCOTT M.
Published: March 2016

The higher-level classification of the New World blackbirds (Icteridae; Aves) has remained relatively stable for nearly a half-century, with most currently used classifications (e.g. Sibley & Monroe 1990; Jaramillo & Burke 1999; Fraga 2011; Remsen et al. 2015) following Blake’s (1968) delimitation and sequence of genera in the Peters Check-list of Birds of the World series. Early molecular studies (e.g., Lanyon 1992, 1994; Johnson & Lanyon 1999; Price & Lanyon 2002; Cadena et al. 2004) produced only minor modifications.
Place Attachment Enhances Psychological Need Satisfaction
Authors: Scannell Leila , Gifford Robert
Published: March 2016

Attachment to place may contribute to individuals’ well-being. We evaluated whether visualizing a place of attachment (compared with visualizing a nonattached familiar place) could increase the satisfaction of key psychological needs. Place attachment visualizations increased participants’ levels of self-esteem, meaning, and belonging. Furthermore, visualizing places at a certain geographical scale helped to improve meaning, self-esteem, and belonging among participants who had been ostracized. This is the first study to treat place attachment as an independent variable in an experimental design, so it broadens the options for internally valid, methodologically diverse place attachment research.
Recommodification, Unemployment, and Health Inequalities
Authors: Farrants Kristin , Bambra Clare , Nylen Lotta , Kasim Adetayo , Burstrom Bo , Hunter David
Published: March 2016

Recommodification, the withdrawal of social welfare, has been going on for some decades in both Sweden and England. Recommodification disproportionately affects the unemployed because of their weak market position. We investigated the impact recommodification has had on health inequalities between the employed and unemployed in Sweden and England. Using national surveys, odds ratios for the likelihood of reporting less than good health between the employed and unemployed were computed annually between 1991 and 2011. The correlation between these odds ratios and net replacement rates was then examined. Health inequalities between the employed and unemployed were greater in 2011 than in 1991 in both countries. Sweden began with smaller health inequalities, but by 2011, they were in line with those in England. Sweden experienced more recommodification than England during this period, although it started from a much less commodified position. Correspondingly, correlation between unemployment benefit generosity and health inequalities was stronger in Sweden than in England. Recommodification is linked to ill health among the unemployed and to the health gap between the employed and unemployed. We propose that further recommodification will be associated with increased health inequalities between the employed and unemployed.