bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a calcium hydroxide/chlorhexidine paste as intracanal dressing in human primary teeth with necrotic pulp against Porphyromonas gingivalis and Enterococcus faecalis
Authors: GONDIM JULIANA O. , AVACA‐CRUSCA JULIANA S. , VALENTINI SANDRO R. , ZANELLI CLESLEI F. , SPOLIDORIO DENISE M. P. , GIRO ELISA M. A.
Published: August 2011

International Journal of Paediatric Dentistry 2012; 22: 116–124

Background.  Intracanal medication is important for endodontic treatment success as it eliminates microorganisms that persist after biomechanical preparation.

Aim.  To evaluate the effect of two intracanal medications against Porphyromonas gingivalis and Enterococcus faecalis in the root canals of human primary teeth with necrotic pulp with and without furcal/periapical lesion, using quantitative real‐time polymerase chain reaction (qRT‐PCR).

Design.  Thirty‐two teeth with necrotic pulp were used. Twelve teeth did not present lesion, and 20 teeth presented radiographically visible furca/periapical lesion. Microbiological samples were collected after coronal access and biomechanical preparation. The teeth were medicated with calcium hydroxide pastes prepared with either polyethylene glycol or chlorhexidine. After 30 days, the medication was removed and a third collection was performed. Microbiological samples were processed using qRT‐PCR. Data were analysed by Wilcoxon and Mann–Whitney tests (α = 0.05).

Results.  There was no significant difference in the microbiota present in the primary teeth with and without furcal/periapical lesion. Biomechanical preparation was effective in reducing the number of microorganisms (P < 0.05). The intracanal medications had similar antibacterial activity.

Conclusion.  The association of chlorhexidine with calcium hydroxide did not increase the antibacterial activity of the intracanal medication in the treatment of primary teeth with necrotic pulp with and without furcal/periapical lesion.
The role of school‐based dental programme on dental caries experience in Yogyakarta Province, Indonesia
Authors: AMALIA ROSA , SCHAUB ROB M. H. , WIDYANTI NIKEN , STEWART ROY , GROOTHOFF JOHAN W.
Published: August 2011

International Journal of Paediatric Dentistry 2012; 22: 203–210

Objectives.  To assess the effectiveness of a school‐based dental programme (SBDP) in controlling caries by measuring the relationship between the SBDP performance and caries experience in children aged 12 in Yogyakarta Province, Indonesia, by taking into account influencing factors.

Methods.  A cross‐sectional survey was undertaken of 1906 children participating in SBDPs. Four SBDPs were chosen by good and poor performances in urban and rural areas. Caries was assessed using WHO criteria whereas behaviour and socio‐demographic factors were collected using a questionnaire administered to the children.

Results.  The decayed, missed, and filled teeth (DMFT) of children in good SBDPs (2.8 ± 2.4) was lower than that of the counterparts (3.8 ± 3.4). From path analysis using a structural equation model (SEM), place of residence (OR = 4.0) was shown to have a strongest direct relationship to caries experience, whereas SBDP performance showed no direct relationship. At the same time, SBDP performance was significantly related to frequencies of dental visits (OR = 0.3), sugar consumption (OR = 0.8), and tooth brushing (OR = 3.2), which in turn are interrelated with place of residence, gender, and mother’s education.

Conclusions.  The study suggests that the differences in DMFT of children in good and poor performance SBDPs were caused by relation to social factors rather than by relation to oral health service activities.
The lifeworld characteristics of mental health nurses engaging in talk‐based therapies: a qualitative study from Scotland and England
Authors: HURLEY J.
Published: August 2011

Accessible summary

Nursing enviconanunderronments challenge new roles in talk based therapies.

These environments are uncertain, complex and unpredictable.

Intra‐personal capabilities help mitigate these challenges.

Twenty‐four mental health nurses were interviewed to gain a greater understanding of their experiences of working within roles delivering talk‐based therapies. The study participants, while echoing the broad direction and purpose of policy that supports mental health nurses expanding talk‐based therapy roles, also offered insights into the challenges associated with embedding these roles into mental health settings. One area of findings analysed using Nvivo 8 software related to the characteristics of the environments in which these roles are, or will be enacted. Three key characteristics of these environments were: (1) low power and worth; (2) obstacles to success; and (3) uncertainty. Responses to the challenges found within this study are required from individual nurses, local organizations and strategic levels of nursing to ensure the successful implementation and uptake of talk‐based therapy roles into the mental health nursing profession.
Lack of Jun‐N‐terminal kinase 3 (JNK3) does not protect against neurodegeneration induced by 3‐nitropropionic acid
Authors: Junyent F. , de Lemos L. , Verdaguer E. , Pallàs M. , Folch J. , Beas‐Zárate C. , Camins A. , Auladell C.
Published: August 2011

F. Junyent, L. de Lemos, E. Verdaguer, M. Pallàs, J. Folch, C. Beas‐Zárate, A. Camins and C. Auladell (2012) Neuropathology and Applied Neurobiology38, 311–321

Lack of Jun‐N‐terminal kinase 3 (JNK3) does not protect against neurodegeneration induced by 3‐nitropropionic acid

Aims: 3‐Nitropropionic acid (3‐NP) is a toxin that replicates most of the clinical and pathophysiological symptoms of Huntington's disease, inducing neurodegeneration in the striatum due to the inhibition of mitochondrial succinate dehydrogenase. Different pathways have been implicated in the cell death induced by 3‐NP in rodents. One of them is the Jun‐N‐terminal kinase (JNK) pathway, which may play a role in the neurodegenerative process in different diseases. Moreover, the lack of one isoform of JNK (JNK3) has been associated with neuroprotection in different experimental models of neurodegeneration. Therefore, in the present study the role of JNK3 in the experimental Huntington's model induced by 3‐NP administration was evaluated. Methods: 3‐NP was intraperitoneally administered once a day for 3 days to wild‐type and Jnk3‐null mice. Coronal brain sections were used to determine cell death and astrogliosis in striatum. Western blots were performed to determine the involvement of different pathways in both wild‐type and Jnk3‐null mice. Results: Although JNK activation was observed following 3‐NP administration, the results indicate that the lack of JNK3 does not confer neuroprotection against 3‐NP toxicity. Thus, other pathways must be involved in the neurodegeneration induced in this model. One of the possible pathways towards 3‐NP‐induced apoptosis could involve the calpains, as their activity was increased in wild‐type and Jnk3‐null mice. Conclusion: Although JNK3 is a key protein involved in cell death in different neurodegenerative diseases, the present study demonstrates that the lack of JNK3 does not confer neuroprotection against 3‐NP‐induced neuronal death.
Infectivity and sporulation potential of Phytophthora kernoviae to select North American native plants
Authors: Fichtner E. J. , Rizzo D. M. , Kirk S. A. , Webber J. F.
Published: August 2011

Phytophthora kernoviae exhibits comparable epidemiology to Phytophthora ramorum in invaded UK woodlands. Because both pathogens have an overlapping geographic range in the UK and often concurrently invade the same site, it is speculated that P. kernoviae may also invade North American (NA) forests threatened by P. ramorum, the cause of Sudden Oak Death. This paper addresses the susceptibility of select NA plants to P. kernoviae, including measures of disease incidence and severity on wounded and unwounded foliage. The potential for pathogen transmission and survival was investigated by assessing sporangia and oospore production in infected tissues. Detached leaves of Rhododendron macrophyllum, Rhododendron occidentale and Umbellularia californica, and excised roots of U. californica and R. occidentale were inoculated with P. kernoviae and percent lesion area was determined after 6 days. Leaves were then surface sterilized and misted to stimulate sporulation and after 24 h sporangia production was assessed. The incidence of symptomless infections and sporulation were recorded. All NA native plants tested were susceptible to P. kernoviae and supported sporangia production; roots of U. californica and R. occidentale were both susceptible to P. kernoviae and supported sporangia production. Oospore production was also observed in U. californica roots. The results highlight the vulnerability of select NA native plants to infection by P. kernoviae, suggest that symptomless infections may thwart pathogen detection, and underscore the importance of implementing a proactive and adaptive biosecurity plan.
Characteristics of sediment in transport in the swash zone of a steep estuarine foreshore
Authors: SAINI SHERESTHA , JACKSON NANCY L. , NORDSTROM KARL F.
Published: August 2011

Cross‐shore grading of sediment has been observed on the surface of estuarine beaches but the swash zone processes responsible for this grading have not been measured. This study was conducted to provide an explanation for the cross‐shore grading of sediment on a predominantly sandy estuarine foreshore. Data on wave and swash characteristics and sediment trapped in the uprush and backwash during 25 swash events were gathered from mid‐rising to mid‐falling tide on a small transgressive barrier in Delaware Bay, New Jersey, USA. Sediment is predominantly quartz and feldspar, medium to coarse sands with a gravel fraction of granules and pebbles. Wave energies increased with tidal rise. The percentage of gravel in transport in the uprush and backwash is similar (11% and 13%) during the rising tide when the swash zone is at mid‐foreshore, decreases in the uprush (9%) and increases in the backwash (18%) when the swash zone is on the upper foreshore. When the swash zone is at mid‐foreshore on the falling tide, the quantity of gravel in the backwash (30%) is greater than in the uprush (24%). The low proportion of gravel within the foreshore prior to trapping, and the increase in the percentage of gravel when the waves and swash are on the upper foreshore, suggests that the step is the primary source of gravel high on the foreshore. The size of the step increases as wave heights increase with tidal rise. The rate of delivery of gravel into the swash is enhanced by sediment entrained during wave breaking and interaction of the uprush with the previous backwash. The lag in the rate of step migration relative to breaker migration during the falling tide increases the likelihood of mining gravel from the step and subsequent transport in the uprush and backwash. These findings are important for low energy estuarine beaches sensitive to small changes in tidal range and wave energy that cause sedimentological change across the foreshore.
Magma intrusion mechanisms and redistribution of seismogenic stress at Mt. Etna volcano (1997–1998)
Authors: Bonanno Amalia , Palano Mimmo , Privitera Eugenio , Gresta Stefano , Puglisi Giuseppe
Published: August 2011

Terra Nova, 23, 339–348, 2011

Several volcanoes worldwide have shown changes in their stress state as a consequence of the deformation produced by the pressurization of a magmatic body. This study investigated seismic swarms occurring on the western flank of Mt. Etna in January 1997–January 1998. Integrating seismic observations and geodetic data, we constrained the seismogenic fault system, and on the basis of stress tensor inversion and SHMAX analyses, we inferred an inflating pressure source located at 5.5 km b.s.l. beneath the west portion of summit area. Evaluation of Coulomb failure stress related to the proposed model showed how a large part of the seismogenic fault underwent a significant Coulomb failure stress increase (500 kPa). We inferred the presence of a sub‐vertical faulted region, potentially weak, N50°E‐oriented beneath the western sector of Mt. Etna. This structure could be brought closer to failure, thereby generating seismic swarms as the effect of elastic stress transfer induced by movement and/or overpressure of magmatic masses within the upper crust under the volcano.
A clinically significant interaction between tacrolimus and multiple proton pump inhibitors in a kidney transplant recipient
Authors: Maguire Michelle , Franz Thaddeus , Hains David S.
Published: August 2011

Maguire M, Franz T, Hains DS. A clinically significant interaction between tacrolimus and multiple proton pump inhibitors in a kidney transplant recipient.  Pediatr Transplantation 2011. © 2011 John Wiley & Sons A/S.

Abstract:  The shared metabolism of PPIs and tacrolimus through the CYP enzyme system has been associated with clinically significant drug interactions, especially in patients who are classified as CYP 2C19 PMs. However, existing data are conflicting, indicating that a single mechanism does not account for all interactions. A drug interaction between tacrolimus and omeprazole, esomeprazole, but not lansoprazole, occurred in an 18‐yr‐old female kidney transplant recipient classified as a CYP 2C19 extensive (normal) metabolizer. This case suggests that further research is needed to establish the definitive mechanism of this potentially serious drug–drug interaction. Physicians prescribing PPIs in organ transplant recipients with tacrolimus immunosuppression should consider close pharmacokinetic monitoring of tacrolimus when starting or switching a PPI.
Severe hyperinsulinemia, decreased GLUT3 and GLUT4 expression, and increased retinol binding protein 4 in a patient with chronic graft‐versus‐host disease post bone marrow transplantation
Authors: Livadas Sarantis , Voutetakis Antonis , Bourhis Jean‐Claude , Maratou Eirini , Dimitriadis George , Margeli Alexandra , Chandrinou Helen , Goussetis Evgenios , Papassotiriou Ioannis , Dacou‐Voutetakis Catherine
Published: August 2011

Livadas S, Voutetakis A, Bourhis J‐C, Maratou E, Dimitriadis G, Margeli A, Chandrinou H, Goussetis E, Papassotiriou I, Dacou‐Voutetakis C. Severe hyperinsulinemia, decreased GLUT3 and GLUT4 expression, and increased retinol binding protein 4 in a patient with chronic graft‐versus‐host disease post bone marrow transplantation.  Pediatr Transplantation 2011. © 2011 John Wiley & Sons A/S.

Abstract:  Hyperinsulinemia with or without DM2 is a frequent long‐term sequela of BMT, especially following cGvHD. In this report, an extensive evaluation of a patient with cGvHD is described: glucose and insulin during OGTT, markers of inflammation, adiponectin and RBP4, body composition analysis, and the kinetics of GLUT3 and GLUT4 in circulating monocytes were evaluated. Hyperinsulinemia, associated with partial lipodystrophy, elevated RBP4, low adiponectin levels, and decreased expression of GLUT3 and GLUT4 were detected. The defects disclosed in this particular patient possibly explain, at least in part, the mechanisms underlying insulin resistance in patients undergoing BMT. It is not clear whether insulin resistance was caused by the drugs, the process itself, or the residual damage to the muscles and/or adipose tissue.
Genotype, phenotype, and outcomes of nine patients with T‐B+NK+ SCID
Authors: Yu Grace P. , Nadeau Kari C. , Berk David R. , de Saint Basile Geneviève , Lambert Nathalie , Knapnougel Perrine , Roberts Joseph , Kavanau Kristina , Dunn Elizabeth , Stiehm E. Richard , Lewis David B. , Umetsu Dale T. , Puck Jennifer M. , Cowan Morton J.
Published: August 2011

Yu GP, Nadeau KC, Berk DR, de Saint Basile G, Lambert N, Knapnougel P, Roberts J, Kavanau K, Dunn E, Stiehm ER, Lewis DB, Umetsu DT, Puck JM, Cowan MJ. Genotype, phenotype, and outcomes of nine patients with T‐B+NK+ SCID. Pediatr Transplantation 2011: 15: 733–741. © 2011 John Wiley & Sons A/S.

Abstract:  There are few reports of clinical presentation, genotype, and HCT outcomes for patients with T‐B+NK+ SCID. Between 1981 and 2007, eight of 84 patients with SCID who received and/or were followed after HCT at UCSF had the T‐B+NK+ phenotype. One additional patient with T‐B+NK+ SCID was identified as the sibling of a patient treated at UCSF. Chart reviews were performed. Molecular analyses of IL7R, IL2RG, JAK3, and the genes encoding the CD3 T‐cell receptor components δ (CD3D), ε (CD3E), and ζ (CD3Z) were carried out. IL7R mutations were documented in four patients and CD3D mutations in two others. Three patients had no defects found. Only two of nine patients had an HLA‐matched related HCT donor. Both survived, and neither developed GVHD. Five of seven recipients of haploidentical grafts survived. Although the majority of reported cases of T‐B+NK+ SCID are caused by defects in IL7R, CD3 complex defects were also found in this series and should be considered when evaluating patients with T‐B+NK+ SCID. Additional genes, mutations in which account for T‐B+NK+ SCID, remain to be found. Better approaches to early diagnosis and HCT treatment are needed for patients lacking an HLA‐matched related donor.
Enhancing the scopolamine production in transgenic plants of Atropa belladonna by overexpressing pmt and h6h genes
Authors: Wang Xirong , Chen Min , Yang Chunxian , Liu Xiaoqiang , Zhang Lei , Lan Xiaozhong , Tang Kexuan , Liao Zhihua
Published: August 2011

Atropa belladonna is officially deemed as the commercial plant to produce scopolamine in China. In this study we report the simultaneous overexpression of two functional genes involved in biosynthesis of scopolamine, which encode the upstream key enzyme putrescine N‐methyltransferase (PMT) and the downstream key enzyme hyoscyamine 6β‐hydroxylase (H6H), respectively, in transgenic herbal plants Atropa belladonna. Analysis of gene expression profile indicated that both pmt and h6h were expressed at a higher level in transgenic lines, which would be favorable for biosynthesis of scopolamine. High‐performance liquid chromatography result suggested that transgenic lines could produce higher accumulation of scopolamine at different levels compared with wild‐type lines. Scopolamine content increased to 7.3‐fold in transgenic line D9 compared with control lines. This study not only confirms that co‐overexpression of pmt and h6h is an ideal method to improve the biosynthetic capacity of scopolamine but also successfully cultivates the transgenic line D9, which significantly enhanced the scopolamine accumulation. Our research can serve as an alternative choice to provide scopolamine resources for relative industry, which is more competitive than conventional market.
Male sex, hiatus hernia, and Helicobacter pylori infection associated with asymptomatic erosive esophagitis
Authors: Wang Pin‐Chao , Hsu Ching‐Sheng , Tseng Tai‐Chung , Hsieh Tsung‐Cheng , Chen Chien‐Hwa , Su Wei‐Chih , Lin Hans Hsienhong , Wang Chia‐Chi
Published: August 2011

Background and Aims:  Asymptomatic erosive esophagitis (AEE) is an easily forgotten subgroup of gastroesophageal reflux disease due to its lack of warning symptoms, despite having the risk of developing complications, such as bleeding, stricture, or even esophageal adenocarcinoma.

Methods:  A total of 2843 potentially eligible patients were screened at the health management center of Buddhist Tzu Chi General Hospital. A total of 1001 patients responded to the survey and gave informed consent; 998 patients who completed the reflux disease diagnostic questionnaire were enrolled. Of them, 594 patients who had no reflux symptoms were included for final analysis. The presence and severity of erosive esophagitis was graded according to the Los Angeles classification. Active infection of Helicobacter pylori (H. pylori) was determined by the Campylo‐like organism (CLO) test during endoscopies.

Results:  A total of 14.5% (86/594) of asymptomatic patients had endoscopic findings of erosive esophagitis. In the univariate analysis, male sex and hiatus hernia were significantly associated with AEE. Positive CLO tests had a trend association. Based on the multivariate analysis, male sex (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.35–3.98), hiatus hernia (OR: 4.48, 95% CI: 2.35–89.17), and positive CLO test (OR: 0.57, 95% CI: 0.34–0.95) were associated with AEE, as compared to the healthy controls.

Conclusions:  AEE is not a rare condition, and constitutes 14.5% of the asymptomatic population. Male sex, hiatus hernia, and H. pylori infection are factors associated with AEE. These findings are not only helpful in identifying such asymptomatic patients, but also provide information to improve understanding of the relationship between H. pylori infection, reflux symptoms, and erosive esophagitis.
Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan
Authors: Tsay Feng‐Woei , Tseng Hui‐Hwa , Hsu Ping‐I , Wang Kai‐Ming , Lee Ching‐Chang , Chang Shiuh‐Nan , Wang Huay‐Min , Yu Hsien‐Chung , Chen Wen‐Chi , Peng Nan‐Jing , Lai Kwok‐Hung , Wu Deng‐Chyang
Published: August 2011

Background and Aims:  Most clinical trials concerning sequential therapy have been conducted in Italy. The efficacy of sequential therapy for Helicobacter pylori (H. pylori) eradication in Asia remains unclear. The aim of this study was to compare the efficacy of sequential therapy with standard triple therapy in Taiwan.

Methods:  From January 2005 to December 2009, 233 H. pylori‐infected patients receiving either a 10‐day sequential therapy (40 mg pantoprazole and 1 g amoxicillin, twice daily, for the initial 5 days, followed by 40 mg pantoprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily, for the subsequent 5 days, n = 118) or a 7‐day standard triple therapy (40 mg pantoprazole, 500 mg clarithromycin, and 1 g amoxicillin twice daily for 7 days, n = 115) were included in the retrospective study. All the patients underwent a follow‐up endoscopy with a rapid urease test and histological examination or a urea breath test at 8 weeks after the end of anti‐H. pylori therapy to assess H. pylori status.

Result:  Intention‐to‐treat analysis demonstrated a significantly higher eradication rate for the sequential group than for the triple group (93% vs 80%, respectively, P = 0.003). Per‐protocol analysis also showed similar results (93% vs 80%, P = 0.005). Both groups had similar frequencies of adverse events (29% vs 22%) and drug compliance (98% vs 97%).

Conclusion:  Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan. The novel treatment can be used as a first‐line therapy for H. pylori infection for Taiwanese.
Does unintentional macular translocation after retinal detachment repair influence visual outcome?
Authors: Pandya Vivek B , Ho I‐Van , Hunyor Alex P
Published: August 2011

Abstract

Background:  To document the occurrence of postoperative macular translocation after retinal detachment repair and discuss its influence on visual outcome.

Design:  Retrospective case series in a tertiary care setting.

Participants:  Five eyes of five patients presenting to our clinic with macula‐off rhegmatogenous retinal detachment.

Methods:  All patients underwent surgical repair of the retinal detachment, with regular postoperative follow‐up, including macular optical coherence tomography and fundus autofluorescence.

Main Outcome Measures:  Visual acuity and subjective visual symptoms in patients with anatomically successful retinal detachment repair, in whom inadvertent macular translocation was noted.

Results:  Our series demonstrates the presence of unintentional macular translocation after retinal detachment repair, detected by fundus autofluorescence imaging. In contrast to previous reports, we document inadvertent macular translocation in one patient after scleral buckling surgery. In each case, the retina was fully reattached postoperatively and no other complications were identified. There was variability in the symptoms and objective visual outcomes after surgery.

Conclusions:  Inadvertent macular translocation can occur following repair of macula‐off retinal detachment, and may be a significant contributor to poorer visual outcome after retinal detachment, despite objective surgical success.
Clock‐hour laminar displacement and age in primary open‐angle glaucoma and normal tension glaucoma
Authors: Rho Chang Rae , Park Hae‐Young Lopilly , Lee Na Young , Park Chan Kee
Published: August 2011

Abstract

Background:  To find out the relationship between laminar displacement and age between patients with primary open‐angle glaucoma and normal tension glaucoma.

Design:  Retrospective study conducted at a tertiary university hospital

Participants or Samples:  Twenty‐six eyes of 26 primary open‐angle glaucoma patients and 52 eyes of 52 normal tension glaucoma patients.

Methods:  Patients were scanned with a Stratus optical coherence tomography apparatus to measure the retinal nerve fibre layer thickness and to visualize the cross‐sectional laminar displacement of 12 clock‐hour segments, 30 degrees each. Depth1 was defined as the longest distance between the retinal pigment epithelium and the anterior laminar cribrosa surface, which represents the amount of laminar displacement.

Main Outcome Measure:  Partial correlation coefficients adjusted by mean deviation and intraocular pressure between (i) retinal nerve fibre layer thickness and age, and (ii) Depth1 and age.

Results:  In the primary open‐angle glaucoma group, strong negative correlations (approximately −0.343 ∼ −0.738) were found between Depth1 and age. Eight of 12 clock‐hour segments' correlations were significant after Bonferroni correction (α = 0.0021; 24 comparisons). However, no significant correlations were found between Depth1 and age in the normal tension glaucoma group. When the correlation coefficients were compared between the two groups, eight clock‐hour segments showed significant differences after Bonferroni correction.

Conclusions:  The significantly different correlation between laminar displacement and age between primary open‐angle glaucoma and normal tension glaucoma patients may suggest a different role of the lamina cribrosa to the disease.
Comparison of intraocular pressure measurement between rebound, non‐contact and Goldmann applanation tonometry in treated glaucoma patients
Authors: Vincent Stephen J , Vincent Roslyn A , Shields David , Lee Graham A
Published: August 2011

Abstract

Background:  To compare the intraocular pressure readings obtained with the iCare rebound tonometer and the 7CR non‐contact tonometer with those measured by Goldmann applanation tonometry in treated glaucoma patients.

Design:  A prospective, cross‐sectional study was conducted in a private tertiary glaucoma clinic.

Participants or Samples:  One hundred nine (54 males : 55 females) patients including only eyes under medical treatment for glaucoma.

Methods:  Measurement by Goldmann applanation tonometry, iCare rebound tonometry and 7CR non‐contact tonometry.

Main Outcome Measures:  Intraocular pressure.

Results:  There were strong correlations between the intraocular pressure measurements obtained with Goldmann and both the rebound and non‐contact tonometers (Spearman r‐values ≥ 0.79, P < 0.001). However, there were small, statistically significant differences between the average readings for each tonometer. For the rebound tonometer, the mean intraocular pressure was slightly higher compared with the Goldmann applanation tonometer in the right eyes (P = 0.02), and similar in the left eyes (P = 0.93); however, these differences did not reach statistical significance. The Goldmann correlated measurements from the non‐contact tonometer were lower than the average Goldmann reading for both right (P < 0.001) and left (P > 0.01) eyes. The corneal compensated measurements from the non‐contact tonometer were significantly higher compared with the other tonometers (P ≤ 0.001).

Conclusions:  The iCare rebound tonometer and the 7CR non‐contact tonometer measure intraocular pressure in fundamentally different ways to the Goldmann applanation tonometer. The resulting intraocular pressure values vary between the instruments and will need to be considered when comparing clinical versus home acquired measurements.
Prevalence of trachoma in a single community, 1975–2007
Authors: Taylor Hugh R , English Dallas R , Field Barry A , Spicer Paul E , Graham Doris M
Published: August 2011

Abstract

Background:  To determine the change in the prevalence in active trachoma in children in a remote Aboriginal community over a 32‐year period.

Design:  Data used from two cross‐sectional studies repeated in the same community 32 years apart.

Participants or Samples:  Children aged 5–13 years living in the community.

Methods:  Thirty‐five mm photographs of the everted upper lid taken in 1975 and digital photographs taken in 2007 were graded using a fine trachoma‐grading scheme.

Main Outcome Measure:  The age‐specific prevalence and severity of trachoma was compared at the two time points.

Results:  Images were available from 82 children in 1975 and from 92 children in 2007. The overall prevalence of active trachoma (trachomatous inflammation follicular and or trachomatous inflammation intense) was 59% in 1975 and in 2007 was significantly lower at 23% (P < 0.001). The overall severity grades of active trachoma had also decreased significantly for each sign from 1975 to 2007 (all P values from the rank‐sum test were less than 0.001). However, in 2007, there were still some children with severe active trachoma and severe scarring still occurred.

Conclusion:  Although the prevalence and severity of active trachoma in children have decreased significantly over the last 30 years in this community, trachoma still remains a significant public health problem. One third of the children have active trachoma, a figure in excess of the threshold set as a public health problem by the World Health Organization.
Engineering multiple genomic deletions in Gram‐negative bacteria: analysis of the multi‐resistant antibiotic profile of Pseudomonas putida KT2440
Authors: Martínez‐García Esteban , de Lorenzo Víctor
Published: August 2011

The genome of the soil bacterium Pseudomonas putida strain KT2440 has been erased of various determinants of resistance to antibiotics encoded in its extant chromosome. To this end, we employed a coherent genetic platform that allowed the precise deletion of multiple genomic segments in a large variety of Gram‐negative bacteria including (but not limited to) P. putida. The method is based on the obligatory recombination between free‐ended homologous DNA sequences that are released as linear fragments generated upon the cleavage of the chromosome with unique I‐SceI sites, added to the segment of interest by the vector system. Despite the potential for a SOS response brought about by the appearance of double stranded DNA breaks during the process, fluctuation experiments revealed that the procedure did not increase mutation rates – perhaps due to the protection exerted by I‐SceI bound to the otherwise naked DNA termini. With this tool in hand we made sequential deletions of genes mexC, mexE, ttgA and ampC in the genome of the target bacterium, orthologues of which are known to determine various degrees of antibiotic resistance in diverse microorganisms. Inspection of the corresponding phenotypes demonstrated that the efflux pump encoded by ttgA sufficed to endow P. putida with a high‐level of tolerance to β‐lactams, chloramphenicol and quinolones, but had little effect on, e.g. aminoglycosides. Analysis of the mutants revealed also a considerable diversity in the manifestation of the resistance phenotype within the population and suggested a degree of synergism between different pumps. The directed edition of the P. putida chromosome shown here not only enhances the amenability of this bacterium to deep genomic engineering, but also validates the corresponding approach for similar handlings of a large variety of Gram‐negative microorganisms.
Long‐term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years
Authors: Gilling Peter J. , Wilson Liam C. , King Colleen J. , Westenberg Andre M. , Frampton Christopher M. , Fraundorfer Mark R.
Published: August 2011

Study Type – Therapy (RCT)

Level of Evidence 1b

What's known on the subject? and What does the study add?

HoLEP has been widely adopted worldwide as an alternative to TURP but long term results have been lacking despite the strong scientific basis for the technique.

This study provides long‐term results from the original RCT comparing the two techniques.

OBJECTIVE

To assess the durability of holmium laser enucleation of prostate in comparison to transurethral resection of the prostate (TURP).

PATIENTS AND METHODS

Patients were enrolled in the present study between June 1997 and December 2000 and followed per protocol.

All patients were urodynamically obstructed with a prostate volume of between 40 and 200 mL.

At long‐term follow‐up, variables assessed included Benign Prostatic Hyperplasia Impact Index (BPHII), International Continence Society Short Form Male questionnaire (ICSmale‐SF) and the International Index of Erectile Function (IIEF).

Adverse events, including the need for retreatment, were specifically assessed.

RESULTS

Thirty‐one (14 holmium laser enucleation of the prostate [HoLEP] and 17 TURP) of the initial 61 patients were available, with 12 deceased and 18 lost to follow‐up.

The mean (range) follow‐up was 7.6 (5.9–10.0) years and the mean (±sd) age at follow‐up was 79.8 (±6.2) years.

The mean (±sd) values (HoLEP vs TURP) were as follows: maximum urinary flow rate (Qmax), 22.09 ± 15.47 vs 17.83 ± 8.61 mL/s; American Urological Association (AUA) symptom score, 8.0 ± 5.2 vs 10.3 ± 7.42; quality of life (QOL) score 1.47 ± 1.31 vs 1.31 ± 0.85; BPHII, 1.53 ± 2.9 vs 0.58 ± 0.79; IIEF‐EF (erectile function), 11.6 ± 7.46 vs 9.21 ± 7.17; ICSmale Voiding Score (VS), 4.2 ± 3.76 vs 3.0 ± 2.41; ICSmale Incontinence Score (IS), 3.07 ± 3.3 vs 1.17 ± 1.4.

There were no significant differences in any variable between the two groups beyond the first year.

Of the assessable patients, none required re‐operation for recurrent BPH in the HoLEP arm and three (of 17) required re‐operation in the TURP arm .

CONCLUSION

The results of this randomized trial confirm that HoLEP is at least equivalent to TURP in the long term with fewer re‐operations being necessary.
Clinical elicitation of the penilo‐cavernosus reflex in circumcised men
Authors: Podnar Simon
Published: August 2011

Study Type – Aetiology (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

It is known that foreskin, but not glans penis, contains a high density of fine‐touch mechanoreceptors. Clinically the penilo‐cavernosus reflex provides information on function of the sacral nerves. The study demonstrated that in the majority of circumicised men this reflex cannot be elicited clinically, but can be measured neurophysiologically.

OBJECTIVE

• To test clinical observations that the penilo‐cavernosus reflex is much more difficult to elicit in circumcised men.

PATIENTS AND METHODS

• Men consecutively referred for uro‐neurological or uro‐neurophysiological examination were prospectively included.

• Those with possible sacral neuropathic lesions were excluded.

• A history was obtained, and a clinical neurological examination was performed.

• The penilo‐cavernosus reflex was tested clinically and neurophysiologically using electrical and mechanical stimulation.

• Reflex elicitability scores in groups of circumcised men, men with foreskin retraction and a control group of uncircumcised men were compared using the Mann–Whitney U test.

RESULTS

• The reflex was clinically non‐elicitable in 73%, 64% and 8% of 30 circumcised men, 15 men with foreskin retraction, and 29 control men, respectively.

• The scored reflex elicitability was significantly (P < 0.001) higher in control men than in the other two groups clinically, but not neurophysiologically.

CONCLUSION

• The study confirmed the lower clinical and similar neurophysiological elicitability of the penilo‐cavernosus reflex in circumcised men and in men with foreskin retraction. This finding needs to be taken into account by urologists and other clinicians in daily clinical practice.
Association between smoking cessation and sexual health in men
Authors: Harte Christopher B. , Meston Cindy M.
Published: August 2011

Study Type – Prevention (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

Tobacco use is the single most preventable cause of disease and death, and – among other medical sequelae – is associated with elevated rates of erectile dysfunction. This is the first study that shows that quitting smoking enhances both physiological and self‐reported indices of sexual health in long‐term male smokers. It is hoped that these results may serve as a novel means to motivate men to quit smoking.

OBJECTIVE

To provide the first empirical investigation of the association between smoking cessation and indices of physiological and subjective sexual health in men.

SUBJECTS AND METHODS

Male smokers, irrespective of erectile dysfunction status, who were motivated to stop smoking (‘quitters’), were enrolled in an 8‐week smoking cessation programme involving a nicotine transdermal patch treatment and adjunctive counselling.

Participants were assessed at baseline (while smoking regularly), at mid‐treatment (while using a high‐dose nicotine transdermal patch), and at a 4‐week post‐cessation follow‐up.

Physiological (circumferential change via penile plethysmography) and subjective sexual arousal indices (continuous self‐report), as well as self‐reported sexual functioning were assessed at each visit.

RESULTS

Intent‐to‐treat analyses indicated that, at follow‐up, successful quitters (n= 20), compared with those who relapsed (n= 45), showed enhanced erectile tumescence responses, and faster onset to reach maximum subjective sexual arousal.

Although successful quitters displayed across‐session enhancements in sexual function, they did not show a differential improvement compared with unsuccessful quitters.

CONCLUSIONS

Smoking cessation significantly enhances both physiological and self‐reported indices of sexual health in long‐term male smokers, irrespective of baseline erectile impairment.

It is hoped that these results may serve as a novel means to motivate men to stop smoking.
Factors associated with ejaculatory and orgasmic dysfunction in men with erectile dysfunction: analysis of clinical trials involving the phosphodiesterase type 5 inhibitor tadalafil
Authors: Paduch Darius A. , Bolyakov Alexander , Beardsworth Anthony , Watts Steven D.
Published: August 2011

Study Type – Prognosis (cohort series)

Level of Evidence 2a

What's known on the subject? and What does the study add?

Many men with ejaculatory dysfunction (EjD) or orgasmic dysfunction (OD) do not seek medical attention. In fact, relatively high proportions of men with erectile dysfunction (ED) have abnormal EjD or OD, and even mild ED is associated with them. Because of the overlap of ED, EjD, and OD, the presence of any one condition should prompt questions about, or a work‐up for, the other two.

OBJECTIVE

To determine frequencies of, and risk factors for, ejaculatory dysfunction (EjD) and orgasmic dysfunction (OD) in men with different degrees of erectile dysfunction (ED).

PATIENTS AND METHODS

Baseline data from 28 ED trials were integrated and analysed.

The International Index of Erectile Function Question 9 (IIEF‐Q9; ‘When you had sexual stimulation or intercourse, how often did you ejaculate?’) and IIEF‐Q10 (‘How often did you have the feeling of orgasm with or without ejaculation?’) were used to evaluate ejaculatory and orgasmic functions.

Responses of ‘almost never or never’ or ‘a few times (much less than half the time)’ were taken as evidence of EjD or OD, respectively, whereas responses of ‘almost always or always’ or ‘most times (much more than half the time)’ were taken as evidence of normal function.

Estimates of the relative risks (RRs) of EjD or OD were determined for multiple patient characteristics.

RESULTS

Among 12 130 study participants with available data, only 5117 (42.2%) reported normal ejaculatory function, and 4321 (35.6%) normal orgasm, regardless of ED severity.

Among subjects with poor ejaculatory function, 16.7% had mild ED, and among subjects with poor sensation of orgasm, 21.9% had mild ED.

Frequencies of EjD and OD increased with increasing ED severity. Of the 5117 individuals with normal ejaculatory function, 796 (15.6%) had poor sensation of orgasm. Of the 4321 subjects with normal orgasm, 226 (5.2%) had poor ejaculatory function.

Men with (vs without) EjD or OD tended to be younger: 53.7 vs 56.9 years and 54.2 vs 56.2 years, respectively.

Factors associated with increased RRs of EjD and OD included cardiomyopathy (RR for EjD 1.74; RR for OD 1.59); cardiac failure (RR 1.40; 1.22); and baseline use (or history of use) of antipsychotics (RR 1.45; 1.30), selective serotonin reuptake inhibitors (RR 1.31; 1.27), and tricyclic antidepressants (RR 1.34; 1.28).

CONCLUSIONS

EjD and OD occurred at baseline in more than one in three men enrolled in tadalafil trials. Even men with mild ED reported EjD or OD.

Further studies are warranted to better understand the impacts of EjD and OD on male sexuality and quality of life.
Survival of patients with small cell carcinoma of the prostate during 1973–2003: a population‐based study
Authors: Deorah Sundeep , Rao Marepalli B. , Raman Rachna , Gaitonde Krishnanath , Donovan James F.
Published: August 2011

Study Type – Therapy (inception cohort)

Level of Evidence 2a

What's known on the subject? and What does the study add?

Small cell carcinoma of the prostate is a lethal disease. Survival data is currently based on case reports and single institution case series which give limited information on its prognostic factors. In this large population‐based study, we provide more robust estimates of survival and have defined the prognostic factors.

OBJECTIVE

To describe the survival of patients with primary small cell carcinoma (SCC) of the prostate and assess prognostic factors based on a large population sample.

PATIENTS AND METHODS

A total of 241 cases of SCC of the prostate were reported to the Surveillance, Epidemiology, and End Results (SEER) registries from 1973 to 2003 of which 191 cases were included in our study.

We used the Kaplan–Meier method for estimating survival, and Cox proportional hazard regression modelling to evaluate prognostic variables.

RESULTS

The overall age‐adjusted incidence rate was 0.278 per 1 000 000 (95% confidence interval, 0.239–0.323).

In all, 60.5% presented as metastatic disease compared with 39.5% who presented as local/regional disease (P= 0.012).

The 12, 24, 36, 48 and 60 months observed survival rates were 47.9%, 27.5%, 19%, 17% and 14.3% respectively.

On univariate analyses, age <60, concomitant low‐grade prostatic adenocarcinoma, absence of metastasis, prostatectomy and radiation therapy were favourable prognostic factors.

In multivariate regression modelling, age, pathology and stage were strong predictors of survival.

CONCLUSIONS

Using the SEER database, we present the largest study describing the epidemiology of primary SCC of the prostate.

We found age, concomitant low‐grade prostatic adenocarcinoma, and stage of the disease to be the strongest predictors of survival for patients with prostatic SCC.

Future studies evaluating a broader range of clinical and molecular markers are needed to refine the prognostic model of this relatively rare disease.
Group Influences on Individual Aggression and Prosociality: Early Adolescents Who Change Peer Affiliations
Authors: Berger Christian , Rodkin Philip C.
Published: August 2011

The present study addresses the influence that group norms exert on individual aggressive and prosocial behavior. The study hypothesis is that for early adolescents who change their peer group affiliations, the characteristics of the group they are leaving (departing‐group influence) are not as influential as those of the group that they are joining (attracting‐group influence). From a larger sample of fifth and sixth graders who were followed over a one‐year period, 198 early adolescents were identified as those who changed peer group affiliations. Peer nominations on aggression, prosociality, social preference and popularity, and social network information were collected. Results confirmed that there were significant attracting‐ but not departing‐group influences on aggression and prosociality. Expected associations between aggression, prosocial behavior, and social status were confirmed. The discussion is framed around a social‐ecological perspective that emphasizes the short‐term adaptive nature of aggressive behavior in some peer groups and the need for considering social mobility when assessing group influence on individual behavior.
Subtypes of Nonsocial Play and Psychosocial Adjustment in Malaysian Preschool Children
Authors: Choo Mei Sze , Xu Yiyuan , Haron P. Fatimah
Published: August 2011

This study examined subtypes of nonsocial play and their relation to psychosocial adjustment in Malaysian preschool children (N = 141, 72 boys, M age = 4.65 years). Confirmatory factor analyses revealed that a three‐factor model that distinguished social reticence, solitary‐active play, and solitary‐passive play fit the data reasonably well, and also fit the data better than the alternative one‐ and two‐factor models. The distinction among the three subtypes of nonsocial play was found for both boys and girls. Controlling for children's age, gender, and parents' education, social reticence was related to teachers' ratings of anxious behavior, unsociability, and peer exclusion. Solitary‐active play was associated with parents' ratings of inattentiveness, child difficultness, and teachers' ratings of hyperactivity–distractibility. Solitary‐passive play was related to teachers' ratings of unsociability. The findings provide support for a multidimensional view of nonsocial play in Malaysian children.
How Do People with Intellectual Disabilities and Diabetes Experience and Perceive their Illness?
Authors: Dysch Catherine , Chung Man Cheung , Fox Judy
Published: August 2011

Introduction  Diabetes is a significant health problem amongst people with intellectual disabilities, yet there is a lack of qualitative literature looking specifically at their experiences and perceptions of living with this chronic illness.

Method  Using Interpretative Phenomenological Analysis, this study explored the experiences and perceptions of four people with intellectual disabilities and diabetes.

Results  Results showed that participants demonstrated some knowledge of the language surrounding diabetes, but considerable confusion and uncertainty about their illness. The impact of diabetes was described in terms of physical, emotional and social consequences, and participants spoke of diabetes in the context of co‐existing health problems.

Conclusions  People with intellectual disabilities and diabetes face many challenges when perceiving and coping with their illness. Gaining insight into these challenges could help health professionals work together more effectively and provide appropriate support to people with intellectual disabilities and diabetes.