bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative studies of placentation and immunology in non-human primates suggest a scenario for the evolution of deep trophoblast invasion and an explanation for human pregnancy disorders
Authors: Carter Anthony M
Published: January 2011

Deep trophoblast invasion in the placental bed has been considered the hallmark of human pregnancy. It occurs by two routes, interstitial and endovascular, and results in transformation of the walls of the spiral arteries as they traverse the decidua and the inner third of the myometrium. Disturbances in this process are associated with reproductive disorders such preeclampsia. In contrast, trophoblast invasion in Old World monkeys occurs only by the endovascular route and seldom reaches the myometrium. Recently, it was shown that this pattern is maintained in gibbons, but that the human arrangement also occurs in chimpanzee and gorilla. There is an interesting parallel with results from placental immunology regarding the evolution of the major histocompatability complex class I antigen HLA-C and its cognate receptors. HLA-C is not present in Old World monkeys or gibbons. It emerged in the orangutan and became polymorphic in the lineage leading to gorilla, bonobo, chimpanzee, and human. Interaction between HLA-C1 and HLA-C2 on the surface of trophoblast and killer immunoglobulin-like receptors (KIRs) expressed by uterine natural killer cells are important regulators of trophoblast invasion. Evolution of this system in great apes may have been one prerequisite for deep trophoblast invasion but seems to have come at a price. The evidence now suggests that certain combinations of maternal genotype for KIRs and fetal genotype for HLA-C imply an increased risk of preeclampsia, fetal growth restriction, and recurrent abortion. The fetal genotype is in part derived from the father providing an explanation for the paternal contribution to reproductive disorders.
Prosthetic Treatment of Congenital Hard and Soft Palate Defects
Authors: Yenisey Murat , Cengiz Seda , Sankaya ∣ş∣
Published: January 2011

Obturator prostheses are used to improve mastication, speech, and swallowing by reestablishing oronasal separation and aesthetics in maxillary defect patients. A sectional and magnetically retained functional removable speech bulb prosthesis was planned to treat the congenitally cleft hard and soft palates of this patient. The obturator part, localized into lateral nasal undercuts covered with sound mucosa, was used to retain the complete denture. Two pieces of the prosthesis were joined together by a magnet in the mouth. A special hinge mechanism was added to join the complete denture and functional velopharyngeal parts of the prosthesis for the treatment of velopharyngeal inadequacy. Sufficient retention was obtained, and no major complications were seen in the patient's prosthesis in periodic controls.
Prognosis and Prognostic Factors of the Micropapillary Pattern in Patients Treated for Stage II and III Serous Borderline Tumors of the Ovary
Authors: Uzan Catherine , Kane Aminata , Rey Annie , Gouy Sebastien , Camatte Sophie , Pautier Patricia , Lhommé Catherine , Haie-Meder Christine , Duvillard Pierre , Morice Philippe
Published: January 2011

Learning Objectives

After completing this course, the reader will be able to: Discuss the prognostic impact of a micropapillary pattern in patients with stage II and III serous borderline ovarian tumors (SBOT).Consider when conservative surgery is an appropriate intervention in patients with SBOT-MP.

CME This article is available for continuing medical education credit at CME.TheOncologist.com

Background.

To determine the prognosis of a micropapillary (MP) pattern in patients with stage II and stage III serous borderline tumor of the ovary (SBOT).

Methods.

Review of patients with stage II and stage III SBOT treated or referred to our institution with characterization of an MP pattern and its clinical impact.

Results.

In 1969–2006, 168 patients were reviewed. Fifty-six patients had SBOT-MP. The rate of conservative surgery was lower in the SBOT-MP group than in the typical SBOT group, but the rate of patients with more than three peritoneal sites with implants was higher in the SBOT-MP group. The rate of invasive implants was not statistically different between the two groups. Eighteen recurrences were observed (six of them in the form of invasive disease) in the SBOT-MP group. Only one death was observed. The overall survival times and recurrence-free intervals were similar in both groups. The only prognostic factor for recurrence in the SBOT-MP group was the use of conservative surgery.

Conclusions.

In the present series, an MP pattern doesn't appear to signify a poor prognosis. The only prognostic factor for recurrence in SBOT-MP was the use of conservative surgery. Further studies on the MP pattern are needed to evaluate prognosis and the results of conservative surgery.
Report of a Phase II Study of Clofarabine and Cytarabine in De Novo and Relapsed and Refractory AML Patients and in Selected Elderly Patients at High Risk for Anthracycline Toxicity
Authors: Agura Edward , Cooper Barry , Holmes Houston , Vance Estil , Berryman Robert Brian , Maisel Christopher , Li Sandy , Saracino Giovanna , Tadic-Ovcina Mirjana , Fay Joseph
Published: January 2011

Purpose.

To determine the efficacy and safety of clofarabine and cytarabine (Ara-C) in adult patients with relapsed or refractory acute myeloid leukemia (AML) and in elderly patients with untreated AML and heart disease.

Patients and Methods.

Patients with relapsed/refractory AML and older patients for whom there was a concern over toxicity from additional anthracyclines received 5 days of clofarabine, 40 mg/m2 per day i.v. over 1 hour, followed 4 hours later by Ara-C, 1,000 mg/m2 per day i.v. over 2 hours.

Results.

Thirty patients were enrolled. The median age was 67 years (range, 38–82 years) and 18 (60%) had received at least one prior therapy. Eleven (37%) patients had a history of cardiovascular disease and were considered to be at high risk for anthracycline toxicity. High-risk cytogenetic abnormalities were present in 14 (47%) patients. The overall response rate (complete remission [CR] plus partial remission) was 53%, including a CR in 14 patients (47%). Responses were observed in all cytogenetic risk groups and in patients who had received up to five prior therapies. The median disease-free survival interval was 9.5 months. The 30-day mortality rate was 20% (de novo AML, 8%; relapsed/refractory AML, 28%). Of the 14 patients achieving a CR, half were able to proceed to curative hematopoietic stem cell transplantation.

Conclusions.

Clofarabine in combination with Ara-C is effective in both untreated and previously treated patients with AML. In addition, it represents a useful remission induction strategy to serve as a bridge to transplantation in older patients with AML.
Accurate Classification of Metastatic Brain Tumors Using a Novel MicroRNA-Based Test
Authors: Mueller Wolf C. , Spector Yael , Edmonston Tina Bocker , St. Cyr Brianna , Jaeger Diana , Lass Ulrike , Aharonov Ranit , Rosenwald Shai , Chajut Ayelet
Published: January 2011

Background.

Identification of the tissue of origin of a brain metastatic tumor is vital to its management. Carcinoma of unknown primary (CUP) is common in oncology, representing 3%–5% of all invasive malignancies. We aimed to validate a recently developed microRNA-based quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) test for identifying the tumor tissue of origin, first in a consecutive cohort of metastatic tumors of known origin and then in a cohort of CUP cases resected from the central nervous system (CNS).

Patients and Methods.

One hundred two resected CNS metastatic tumors with known origin, previously classified based on the patient's clinical history and pathological data, as well as a second cohort of resected CNS tumors from 57 patients originally diagnosed as CUP were studied. A qRT-PCR diagnostic assay that measures the expression level of 48 microRNAs was used to classify the tissue of origin of these metastatic tumors.

Results.

In this blinded study, the test predictions correctly identified the reference diagnosis of the samples of known origin, excluding samples from prostate origin, in 84% of cases. In the second CUP patient cohort, the test prediction was in agreement with the diagnosis that was later confirmed clinically or with pathological evaluation in 80% of cases.

Conclusion.

In a cohort of brain and spinal metastases, a previously developed test based on the expression of 48 microRNAs allowed accurate identification of the tumor tissue of origin in the majority of cases. The high accuracy of this test in identifying the tissue of origin of metastases of unknown primary is demonstrated for the first time and may have broad clinical application.
Micropapillary Pattern in Newly Diagnosed Borderline Tumors of the Ovary: What's in a Name?
Authors: Jr. Leitao Mario M.
Published: January 2011

The study by Uzan and colleagues published in this issue of The Oncologist on the prognosis of patients with serous borderline tumors of the ovary with a micropapillary pattern is reviewed.
Law in Crisis: A Look at Governmental Powers in the Face of a Public Health Disaster
Authors: Gaines Brandon
Published: January 2011

The failed governmental response to Hurricane Katrina revealed that when it comes to catastrophic incidents, the United States lacks a defined command structure and adequate pre-disaster planning. This article focuses on the interplay between local, state, and federal governments when preparing for  and responding to  public health emergencies. Hurricane Katrina is an effective case study for this analysis because it illustrates where governmental powers succeed and where they fail. Also, the evolution of disaster preparation on a state and national level is demarcated by Katrina: one can better understand the strengths and flaws of the system when it is compared to the system pre-Katrina. The purpose of this overview is to discuss the legal issues and complication that arise in the face of a public health emergency. It is important to understand what went wrong so that we can learn how to respond to a future disaster.
The Unknowing Volunteers: Population Testing in the United States
Authors: DuBois Katie
Published: January 2011

In late 1949, vulnerability tests with simulants were started in response to the Report on Special [Biological Warfare (BW)] Operations which pointed out the U.S. susceptibility to [biological warfare] BW attack. The army considered these tests to be a necessary as a part of the research arm of the biological warfare program. This paper provides an overview and legal perspective regarding historical population testing in the United States.
Role of Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Children on Dialysis
Authors: Chaudhuri Abanti , Sutherland Scott M. , Begin Brandy , Salsbery Kari , McCabe Lonisa , Potter Donald , Alexander Steven R. , Wong Cynthia J.
Published: January 2011

Background and objectives

Pre- or postdialysis BP recordings are imprecise, can be biased, and have poor test–retest reliability in children on dialysis. We aimed to examine the possible differences between pre- and postdialysis BP levels and 24-hour ambulatory BP monitoring (ABPM) in diagnosis of hypertension (HTN).

Design, setting, participants, & measurements

Twenty-four children on dialysis had 24-hour ABPM in the interdialytic period, and values were compared with average pre- and postdialysis systolic BP (SBP) and diastolic BP (DBP) recordings that week. Each patient had an echocardiogram to determine presence of left ventricular hypertrophy (LVH).

Results

By ABPM, 8% of patients had white coat HTN and 12% had masked HTN. There was no significant difference in diagnosis of systolic HTN based on ABPM daytime SBP mean or load and postdialysis SBP. However, only 15% of patients had diastolic HTN based on postdialysis measures, whereas 46% of patients had significantly elevated daytime DBP loads and 71% had high nighttime DBP loads on ABPM. Forty-eight percent of patients were SBP nondippers. Children with LVH had higher daytime and nighttime SBP loads, significantly higher daytime and nighttime DBP loads, and lesser degree of nocturnal dipping of SBP compared with those who did not.

Conclusion

ABPM is more informative than pre- and postdialysis BPs and improves the predictability of BP as a risk factor for target organ damage. Diagnosis and treatment monitoring of HTN among pediatric dialysis patients is enhanced with addition of ABPM.
Prediction of high pressure liquid heat capacities of organic compounds by a group contribution method
Authors: Jovanovic Jovan , Knezevic-Stevanovic Andjela , Grozdanic Dusan
Published: January 2011

A new method for estimating high pressure liquid heat capacities based on
molecular structure and group contribution is proposed. A common set of
structural groups was employed. The method was developed using 67 sets of 43
organic compounds with 3449 experimental heat capacity data. A small number
of measured compounds, data points per compound and other comparable methods
were observed. This is a simple first-order approximation with acceptable
accuracy of 2.548%.
A Proposed Framework for Behavioral Accounting Research
Authors: Birnberg Jacob G.
Published: January 2011

ABSTRACT: Behavioral accounting research (BAR) is richer today, in the topics covered, the methods used, and the range of sub-areas of accounting in which it is performed, than ever before. This paper offers a framework within which BAR literature can be viewed as a whole rather than in segments, such as by accounting sub-areas or by research method. The framework classifies BAR by the focus of the research: the individual, group, organization, or the society within which accounting exists. The purpose of the framework is to help researchers in BAR to appreciate the insights to their research questions that can be found in BAR using another research method or studying a similar issue in another sub-area of accounting. Existing research in each of these four areas is discussed to illustrate the usefulness of the framework. In addition, behavioral research in other disciplines that could impact BAR and areas of potential future research are discussed.
Retail Investors’ Perceptions of the Decision-Usefulness of Economic Performance, Governance, and Corporate Social Responsibility Disclosures
Authors: Cohen Jeffrey , Holder-Webb Lori , Nath Leda , Wood David
Published: January 2011

ABSTRACT: Academic literature and the business press have placed increased attention on the corporate disclosure of nonfinancial information. This study uses a survey of 750 retail investors to examine perceptions about indicators of economic performance, corporate governance policies and performance, and corporate social responsibility. Survey results indicate that retail investors currently are most concerned with economic performance information, followed by governance, and then corporate social responsibility information. Those respondents who currently hold socially responsible investments use more of all three types of nonfinancial information than respondents who currently do not hold socially responsible investments. Further, retail investors clearly prefer to obtain information about corporate social responsibility information from a third-party source and governance information from an audited or regulated document, while they use both sources to garner information about indicators of economic performance. Respondents expressed an interest in increasing their use of nonfinancial information in the future. When respondents were asked to indicate the specific types of information they had the greatest interest in using in the future, economic performance indicators such as market share, customer satisfaction, and product innovation information were predominant.
Do Managers Intend to Use the Same Negotiation Strategies as Partners?
Authors: McCracken Susan , Salterio Steven E. , Schmidt Regan N.
Published: January 2011

ABSTRACT: Most auditor client management (ACM) negotiations occur between partners and client management; however, managers also attempt to resolve issues with client management. Given that ACM negotiation impacts the financial statements, an understanding of whether the intended negotiation strategies of partners and managers differ is important. A key feature of the ACM setting is that partners have more power/status and experience than managers. Prior research provides conflicting predictions about the use of integrative strategies based on experience or power/status. Our results, consistent with the power/status hypothesis, demonstrate managers are more likely than partners to intend to use integrative strategies. Conversely, research on distributive strategies provides similar predictions for partner/manager strategy usage for experience and power/status. We find partners are more likely to intend to use the contending strategy and managers are more likely to intend to use the compromising and concessionary strategies. However, these findings are dependent on accounting context.
Primacy or Recency? A Study of Order Effects When Nonprofessional Investors are Provided a Long Series of Disclosures
Authors: Pinsker Robert
Published: January 2011

ABSTRACT: Firms have the incentive to aggregate multiple pieces of good and bad news together in a consistent direction (i.e., all positive news or all negative news) and disclose it either sequentially or all together (simultaneously) in order to reduce the risk of stock price volatility or large stock price declines. Unfortunately for investors, disclosure patterns such as these may result in order effects, which reduce decision quality. My paper examines the results of three experiments in order to determine: (1) which order effect, if any, results when long series of consistent direction voluntary disclosures are made, and (2) if the sequential or simultaneous nature of the disclosures exacerbates any order effect found. The first two experiments use undergraduates as participants, while the third experiment uses actual nonprofessional investors to try and tease out explanations for the experimental findings.

I find recency effects for all conditions in all experiments, and significantly greater recency effects for the sequential conditions relative to the simultaneous conditions in the 40-cue experiments. Additionally, results of the supplemental experiment provide evidence that nonprofessional investors can be information seeking and active in their investment decision-making, which can prohibit attention decrement. Findings contribute to the voluntary disclosure, judgment and decision-making (JDM), and belief revision literatures, as well as highlight the context-specific nature of the belief-adjustment model’s predictions.
Associations Between Concentrations of Vitamin D and Concentrations of Insulin, Glucose, and HbA1c Among Adolescents in the United States
Authors: Ford Earl S. , Zhao Guixiang , Tsai James , Li Chaoyang
Published: January 2011

OBJECTIVE

Our objective was to examine the associations between concentrations of vitamin D and concentrations of insulin, glucose, and HbA1c in a nationally representative sample of adolescents in the U.S.

RESEARCH DESIGN AND METHODS

We used data for 1,941 adolescents, aged 12–17 years, who participated in the National Health and Nutrition Examination Survey between 2001 and 2006.

RESULTS

Adjusted concentrations of insulin were ~24% lower among male subjects with a concentration of vitamin D ≥75 nmol/L than among male subjects with a concentration of vitamin D <50 nmol/L (P = 0.003). Concentrations of vitamin D were inversely associated with concentrations of glucose only among Mexican American male subjects (P = 0.007). No significant associations between concentrations of vitamin D and HbA1c were detected.

CONCLUSIONS

Our results support an inverse association between concentrations of vitamin D and insulin primarily in adolescent male subjects.
Infectious disease — a genetic view
Authors: Jarošíková Taťána
Published: January 2011

Genetic analysis of resistance to infectious disease reveals many important cues that have led to new insights into the interaction between pathogen and host. This knowledge might help with a better prognosis for diseases, and to the development of novel therapeutics. This review focuses on genes and loci that control susceptibility to diseases with an important epidemiologic impact, such as AIDS, hepatitis B, gastritis and peptic ulcer, tuberculosis, leprosy, malaria, schistosomiasis and leishmaniasis. New perspectives for the integration of human and mouse genetics that contribute greatly to our understanding of regulatory mechanisms in health and disease, are also discussed.
Traumatic lateral expulsion of the L-4 vertebral body from the spinal column
Authors: Wilkinson Jeffrey S. , Riesberry Martha A. , Mann Sumeer A. , Fourney Daryl R.
Published: January 2011

Traumatic lateral spondyloptosis is mostly a lateral shearing injury that must be tremendous enough to completely disrupt the strong musculoligamentous and bony structures. This injury has only been described at single levels in the lumbar spine. Lateral expulsion of a vertebral body from the spinal column due to 2-level adjacent spondyloptosis has not been previously reported.

This 16-year-old girl was referred to our center for the management of an extremely unusual L2–5 fracture-dislocation. Motor deficits were incomplete and sacral sensation was spared. Three-dimensional reconstructed CT scans revealed a fracture involving the superior L-4 vertebral body and endplate. There was also complete disruption of the L4–5 disc space. The majority of the L-4 vertebral body was expelled to the right of the spinal column, with the collapse of L-3 and a small remnant of the L-4 superior endplate onto L-5. Surgical management involved decompression, reduction, reconstruction of L-4 with a cage, and L1–ilium stabilization and fusion. Only a few attachments of the psoas muscles had to be divided to roll the L-4 vertebral body out posterolaterally, similar to the method of complete en bloc spondylectomy used in oncology. Neurological recovery has thus far included the resumption of normal bladder and bowel function, as well as ambulation with the use of a right leg brace.

Perhaps this type of fracture has not been previously described because many patients would be expected to succumb to vascular or visceral injury. The authors believe this is the first case report of double lateral spondyloptosis at adjacent levels, resulting in expulsion of the vertebral body from the spinal column.
Long-term stability after multilevel cervical laminectomy for spinal cord tumor resection in von Hippel-Lindau disease
Authors: Asthagiri Ashok R. , Mehta Gautam U. , Butman John A. , Baggenstos Martin , Oldfield Edward H. , Lonser Russell R.
Published: January 2011

Object

Despite the frequent multiplicity and development of new spinal cord hemangioblastomas that require multiple resections in patients with von Hippel-Lindau (VHL) disease, the long-term effects of spinal surgery on spinal column stability in this neoplasia disorder are not known. To determine the effect of multilevel cervical laminectomy for spinal cord tumor resection in VHL, the authors analyzed long-term clinical and radiographic outcomes.

Methods

The authors included consecutive patients enrolled in a prospective VHL disease natural history study who underwent cervical laminectomy(s) for spinal cord hemangioblastoma resection. Serial clinical examinations, neck disability indices, and radiographs (static and dynamic), as well as operative records, were analyzed.

Results

Twenty-five adult patients (16 female, 9 male) with VHL disease underwent 34 operations (mean 1.4 ± 0.7 [± SD]/patient) for the resection of cervical spinal cord hemangioblastomas (mean number of lamina removed/surgery 3.0 ± 1.3). The mean age at surgery was 33.9 ± 11.9 years (range 18–61 years), and the mean follow-up duration was 9.1 ± 5.6 years. At last follow-up, radiographic criteria indicated that 9 patients (36%) had spinal column instability, 13 patients (52%) developed a cervical spinal deformity, 4 patients (16%) developed moderate to severe neck disability, and 3 patients (12%) met the criteria for clinical instability. Removal of the C-2 lamina was associated with the development of clinical instability (p = 0.02, Fisher exact test); older age at surgery was associated with the development of cervical deformity (p = 0.05, logistic regression); and a greater number of operations (suboccipital–T4) were associated with increased neck disability indices (p = 0.01, linear regression).

Conclusions

Whereas patients with VHL disease will often require multiple laminectomies for cervical spinal cord hemangioblastoma resection, a limited number of patients (12%) will develop clinical instability. Because prophylactic cervical instrumentation confers limited benefit at the time of spinal cord tumor resection for most patients, and because these patients need life-long MR imaging of the spinal cord, the quality of which may be affected by instrumentation, longitudinal clinical and radiological evaluation may be used to determine which patients will require stabilization.
Chronic spontaneous diploic hematoma
Authors: González-Tortosa José , de San Pedro Javier Ros , Parrilla Guillermo , Ferri-Ñiguez Belen , Martínez-Lage Juan F.
Published: January 2011

The authors report the case of a 23-year-old woman with café-au-lait spots and axillary and inguinal freckling who presented with a diploic chronic spontaneous hematoma of the left parietal bone. To the authors' knowledge, this case represents the first description of a diploic hematoma in a patient with stigmata of neurofibromatosis Type 1 unrelated to head trauma. Plain skull radiography showed an osteolytic lesion with well-circumscribed margins, corresponding to the hematoma, together with exuberant perilesional vascular markings. Angiography demonstrated an incidental aneurysm of the left supraclinoidal internal carotid artery and an unusual cortical venous drainage toward the diploic vessels. The blood flow of these vessels on the right hemicranium was sluggish and exhibited enlarged diploic venous lacunas. The authors hypothesize that the hematoma was formed by both an abnormal venous drainage toward the diploic vascular net, together with a vasculopathy that caused stenosis and obstruction of the normal drainage pathways from these vessels.
Anacardic acid induces caspase-independent apoptosis and radiosensitizes pituitary adenoma cells
Authors: Sukumari-Ramesh Sangeetha , Singh Nagendra , Jensen Michael A. , Dhandapani Krishnan M. , Vender John R.
Published: January 2011

Object

Pituitary adenomas, which are common intracranial tumors, are associated with significant patient morbidity due to hormone secretion or mass effect or as a complication of therapy. Epigenetic regulation has emerged as an important component of malignant tumor pathogenesis, although the contribution in the progression of benign pituitary tumors remains largely unexplored. The present study evaluates the effect of anacardic acid (6-pentadecyl salicylic acid), a natural histone acetyltransferase inhibitor, on pituitary adenoma cells.

Methods

The concentration- and time-dependent effects of anacardic acid on the viability of GH3 and MMQ pituitary adenoma cells were determined by 3-(4,5-dimethylthiazoyl-2-yl)-2,5-diphenyltetrazolium bromide assay. Cell cycle phase distribution, protein expression, and percentage of apoptotic cells were assessed by flow cytometry and Western blotting. Colony forming assays were used to study the radiosensitizing effect of anacardic acid.

Results

The present study identifies a novel antiproliferative and cytotoxic effect of anacardic acid on pituitary adenoma cells. These effects were associated with an increase in poly([adenosine diphosphate]-ribose) polymerase cleavage, sub-G1 arrest, and annexin V staining, consistent with apoptotic cell death; however, the pancaspase inhibitor carbobenzoxy-valyl-alanyl-aspartyl-(O-methyl)-fluoromethylketone failed to reverse anacardic acid–induced cell death, suggesting a possible nonclassical apoptotic mechanism. Anacardic acid also reduced the expression of survivin and X-linked inhibitor of apoptosis protein, antiapoptotic proteins associated with cellular survival and radioresistance, and radiosensitized pituitary adenoma cells.

Conclusions

These findings warrant further exploration of anacardic acid as a single agent or as an adjunct to radiation therapy for the treatment of pituitary tumors.
The epidemiological trends of head injury in the largest Canadian adult trauma center from 1986 to 2007
Authors: Cadotte David W. , Vachhrajani Shobhan , Pirouzmand Farhad
Published: January 2011

Object

This study documents the epidemiology of head injury over the course of 22 years in the largest Level I adult trauma center in Canada. This information defines the current state, changing pattern, and relative distribution of demographic factors in a defined group of trauma patients. It will aid in hypothesis generation to direct etiological research, administrative resource allocation, and preventative strategies.

Methods

Data on all the trauma patients treated at Sunnybrook Health Sciences Centre (SHSC) from 1986 to 2007 were collected in a consecutive, prospective fashion. The authors reviewed these data from the Sunnybrook Trauma Registry Database in a retrospective fashion. The aggregate data on head injury included demographic data, cause of injury, and Injury Severity Score (ISS). The collected data were analyzed using univariate techniques to depict the trend of variables over years. The authors used the length of stay (LOS) and number of deaths per year (case fatality rate) as crude measures of outcome.

Results

A total of 16,678 patients were treated through the Level I trauma center at SHSC from January 1986 to December 2007. Of these, 9315 patients met the inclusion criteria (ISS > 12, head Abbreviated Injury Scale score > 0). The median age of all trauma patients was 36 years, and 69.6% were male. The median ISS of the head-injury patients was 27. The median age of this group of patients increased by 12 years over the study period. Motorized vehicle accidents accounted for the greatest number of head injuries (60.3%) although the relative percentage decreased over the study period. The median transfer time of patients sustaining a head injury was 2.58 hours, and there was an approximately 45 minute improvement over the 22-year study period. The median LOS in our center decreased from 19 to 10 days over the study period. The average case fatality rate was 17.4% over the study period. In multivariate analysis, more severe injuries were associated with increased LOS as was increasing time from injury to hospital presentation. Age and injury severity were independently predictive of mortality.

Conclusions

These data will provide useful information to guide future studies on the changing patterns of head injury, possible mechanisms of injury, and efficient resource allocation for management of this condition.
Topical tazarotene cream (0.1%) in the treatment of facial acne: An open clinical trial
Authors: Zakaria ASM , Paul HK , Rahman MA , Islam MT , Choudhury AM
Published: January 2011

Background: Tazarotene is a new 3rd generation topical acetylenic retinoid. It normalizes keratinocyte differentiation, reduces keratinocyte proliferation and decreases expression of inflammatory markers. Tazarotene was approved by US FDA in 1997 for acne vulgaris.Objectives: To evaluate the efficacy and safety of topical tazarotene 0.1% cream in the treatment of facial acne.Materials and methods: 67 patients with facial acne in the age range of 13-30 years were enrolled in the study. Purposive sampling was done. Patients were treated with topical Tazarotene cream (0.1%) and were instructed to apply the medication as a thin film over the affected area in the evening once daily for 12 weeks. Follow-up was done at 2nd, 4th week, 8th week and at 12th week.Results: Of the 67 patients, 53% got remission, 9% had good response, 34% had poor response and there was no response in 4% of the patients by 12 weeks of treatment. Among the patients, 9 (13.43%) developed mild side effects. Conclusion: Topical tazarotene cream (0.1%) is a effective and safe treatment option for acne vulgaris affecting face. It is mostly effective in grade-1 and grade-2 acne.DOI: 10.3329/bmrcb.v36i2.6985Bangladesh Med Res Counc Bull 2010; 36: 43-46
Impaired fasting glucose and impaired glucose tolerance in rural population of Bangladesh
Authors: Rahim MA , Khan AK Azad , Nahar Quamrun , Ali SMK , Hussain Akhtar
Published: January 2011

The prevalence of type 2 diabetes is rapidly rising all over the world at an alarming rate. Over the past 30 years, the increase in prevalence is rising exponentially in South Asian region, data suggest a three fold increase (from 2.0 to 7.0%) in the urbanizing population of Bangladesh within 5 years. However, the prevalence of various degrees of glucose intolerance i.e. type 2 diabetes, impaired glucose tolerance and impaired fasting glucose considered vital for prevention are still unknown in this population. The objective of the study was to estimate the prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) with their demographic and anthropometric characteristics in a reasonable large sample compare to other studies conducted in Bangladesh. A random sample of 5000 rural population aged ≥ 20 years was included in this cross sectional study. Fasting blood glucose (FBG) level was measured from 3981 individuals and 2-hr blood glucose (BG) was done on 3954 subjects, excluding known diabetic cases (n= 27). Height, weight, waist and hip circumference including blood pressure and demographic information was also collected. The prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly detected type 2 diabetes (T2DM) were 1.3%, 2.0% and 7.0% respectively. IFG, IGT, IFG+IGT were more prevalent in females than males. Age, body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) were higher in glucose–intolerant subjects than in normal glucose tolerant (NGT) group. FBG and 2-hr BG values were correlated in NGT and DM subjects. Our data suggest that estimation of FBG value identifies more people with diabetes compared to 2-hr BG estimation. These findings need to be further examined in other settings with urban and rural populations for the justification of FBG for screening of diabetes in Bangladeshi population for development of intervention strategy for the prevention and management of abnormal glucose tolerance. The significance of IFG as a precursor of diabetes and CVD will become evident only from longitudinal studies in different ethnic groups. DOI: 10.3329/bmrcb.v36i2.6986Bangladesh Med Res Counc Bull 2010; 36: 47-51
Study on association of cutaneous tuberculosis with pulmonary tuberculosis
Authors: Mahmud TAK , Paul HK , Zakaria ASM , Rahman MA , Chowdhury MAJ
Published: January 2011

Background: Tuberculosis continues to be a health problem in many countries. There may be simultaneous multiple organ involvement. Diagnosis of one organ disease may lead to missing off diagnosis of other organ involvement.Objectives: The present study was done to analyze the association of cutaneous tuberculosis with pulmonary tuberculosis.Material and methods: Through purposive sampling a total of 23 patients of suspected cutaneous tuberculosis were primarily enrolled in this cross sectional study. History was taken and examinations were done to find out types of cutaneous lesions and to explore a pulmonary involvement. Investigations including CBC with ESR, Mantoux test and Skin biopsy were done for each and every patient. Those who had cutaneous tuberculosis on histopathology chest x-ray were done to detect pulmonary lesions. After investigations 2 patients were excluded due to absence of tubercular infection. Finally 21 patients were included in this study. Data were collected in a predesigned structured questionnaire.Results: Out of 21 patients 16 (76.19%) were male and 5(23.81%) were female with a male to female ratio of 3.2:1. Age range varies from 5-70 years with a mean of 29.76±18.2 years. MT was positive in 76.20% of patients. CXR showed 23.81% of the patients with cutaneous TB had simultaneous pulmonary involvement. The association is statistically significant (p<0.05).Conclusions: Patients with Cutaneous tuberculosis may have pulmonary involvement in a statistically significant number. In any patient with cutaneous TB, meticulous systemic examinations and relevant investigations have to be done to explore pulmonary involvement. DOI: 10.3329/bmrcb.v36i2.6988Bangladesh Med Res Counc Bull 2010; 36: 57-60
Oral health status of disabled children
Authors: Nahar Sultana Gul , Hossain Md Amzad , Howlader Mohammod Borhan Uddin , Ahmed Anam
Published: January 2011

110 disabled and 110 normal healthy children with the age range from 3 to 14 were examined in this cross sectional study. The average number of decayed tooth found 5.6 in deciduous and 6.5 in mixed dentition in disabled children, and the numbers were 3.5 and 4.0 respectively in normal children. Average number of missing tooth was 1.3 in disabled and was 1.0 normal child. The oral hygiene index value was 3 in disabled and 2.47 were in healthy children. In the disabled children, 36% respondents had normal gingiva, 50% had mild gingivitis and 14% had marked gingivitis; but in the normal children, about 73% showed normal gingiva, 23% developed mild gingivitis and only 4.5% had marked gingivitis. DOI: 10.3329/bmrcb.v36i2.6989Bangladesh Med Res Counc Bull 2010; 36: 61-63
Preoperative detection of ovarian cancer by color doppler ultrasonography and CA 125
Authors: Hossain Fawzia , Karim Md Nazmul , Rahman Shah Md Mahfuzur , Khan Nazreen , Siddiqui Maruf , Hussain Raihan
Published: January 2011

Purpose: Early detection of ovarian malignancy is of great clinical importance. The high mortality rate is due to the difficulties with the early detection of ovarian cancer. Current research attempted to assess the accuracy of Color Doppler Sonography and serum CA-125 level as diagnostic tool of ovarian tumor.Materials and Methods: In this cross-sectional study, 60 consecutive patients with ovarian tumor attending the Department of Obstetrics and Gynecology of BSMMU were recruited. Of the study participants 23.3% belong to 16-25 year age group, 20% belong to 26-35 years age group and 23.30% each were of 46-55 years and > 55 years age group. All the patients recruited were from in-patient department and had undergone surgery. Following excision, routine histopathology revealed 43.30% malignant (n=26) and 56.7% (n=34) benign ovarian lesion. Data were collected from the clinical history form and bimanual pelvic examination, serum CA 125 levels, estimation of Resistance index (RI), Pulsatility Index (PI), Novel Index by CDS and post-operative histo-pathological findings were then recorded. Sensitivity, specificity, accuracy, positive and negative predictive value of the diagnosis made by CDS, CA125, in the discrimination of the benign and malignant ovarian tumors was calculated. Using Receiver operative characteristics analysis the accuracy of RI, PI, CA 125 and Novel Index in the diagnosis of ovarian tumor (benign or malignant) were assessed.Results: With the Cut-off of <.5, Resistance Index is found to be capable of detecting 92% of malignant cases (sensitivity 91.7), and could detect 89% (specificity 88.9) of benign cases correctly which translates in to 90% accuracy in the diagnosis of ovarian tumor. Predictive values for positive (84.6) and negative (94.1) tests were also found to be quite high. Pulsatility index was found to be moderate accuracy (63.3%) with cutoff <1 for malignancy, however low predictive value for a positive test (38.5) questions its use. Both CA-125 and Novel Index showed similar level of sensitivity and specificity. Although Novel Index is derivative of CA125, Novel Index demonstrated better diagnostic accuracy and negative predictive value. The cutoff for CA 125 was mandated as 83.58. With the value the sensitivity is 76.9% and the specificity is 94.1%. RI is found to be more sensitive in detection of positive cases (Malignant) and CA125 is found to be more accurate in detection of negative cases (Benign). However a combination could be tried to make a better detection.Conclusion: Color Doppler ultra-sonography and CA125 excels in different tasks, the study concludes in favor of concurrent use of the methods for improving efficacy and thus early detection of ovarian malignancy. DOI: 10.3329/bmrcb.v36i2.6991Bangladesh Med Res Counc Bull 2010; 36: 68-73
Guillén de Castro y las teorías políticas sobre el tiranicidio y el derecho de resistencia
Authors: Delgado Morales M.
Published: January 2011

Animé par des motifs d'ordre théâtral, culturel et politique, Guillen de Castro présente fréquemment dans ses œuvres le thème du roi tyran et du droit de résistance de ses sujets. En accord avec les écrivains politiques de l'Espagne du XVIet du XVII siècle, Guillen définit le tyran comme étant antinomique du prince chrétien et une force contraire au bien public de l'État. D'après cet auteur, c'est le droit de tout sujet soumis à un tel tyran que de désobéir à ses ordres et d'utiliser n'importe quels moyens pour venir à bout de sa tyrannie. Au cas où ces moyens n'aboutiraient pas, en raison de l'obstination du tyran, il est permis à la communauté, ou à un de ses sujets, de le tuer. Le sujet qui résiste au tyran doit être considéré comme un serviteur de la patrie et non comme un traître, car si son geste n'est pas guidé par une ambition personnelle, il est accompli pour le bien public. Quand Guillen prend position en faveur du droit de résistance et du droit au tyrannicide, il tente simplement de ramener le pouvoir monarchique à des limites dictées par la raison et la morale chrétienne. Tout son effort dramatique et intellectuel a pour but de rappeler au prince qu'il ne peut transgresser ces lois sans sombrer dans la tyrannie ou faire face à l'inimitié de Dieu, lequel Dieu est à l'origine et à la base de tout pouvoir terrestre.
Métaphore et paradoxe dans deux sonnets de Quevedo
Authors: Blanco Morel Mercedes
Published: January 2011

L'étude comparative de deux sonnets de Quevedo de contenu très semblable nous permet d'isoler une structure très générale que l'on retrouve partout dans la poésie dite conceptiste. Les deux textes se présentent comme des variations musicales sur un thème. Ce thème consiste en deux métaphores complémentaires, créées pour définir les éléments principaux d'une situation anecdotique. Les variations s'opèrent à l'aide d'une gamme très variée de procédés de transport du sens, métonymie, analogie, symbolisme inspiré par la mythologie grecque. Ce dernier procédé joue un grand rôle dans le second sonnet. Le signifiant Midas, introduit en apparence comme ornement périphrastique contingent, organise de fait le poème à travers l'anagramme et l'allusion. Cette présence, dans un sonnet amoureux, d'un mythe caractéristique de la littérature morale, suggère l'unité thématique de l'œuvre de Quevedo par-delà les frontières traditionnelles entre les genres.
Al margen de « Miau » : el mundo de la ópera
Authors: Entenza de Solare B.
Published: January 2011

A través de algunos personajes de Miau, Galdós pone en contacto a sus lectores con diversas facetas del mundo operístico de su tiempo, presentadas sobre la base de una rica información, y cuidando la verdad de cada detalle.
Pedro de Ascanio, comédien et directeur de compagnie dramatique
Authors: Esquerdo Vicenta
Published: January 2011

Dix-huit documents, conservés aux archives de l'Hôpital général de Valence, dans les protocoles de Francisco Lázaro Juseph, permettent de mieux préciser plusieurs aspects importants de la vie professionnelle du comédien Pedro de Ascanio, entre 1634 et 1645. Les historiens du théâtre espagnol classique apprécieront tout particulièrement le document numéro 8, qui donne une liste des comedias jouées par Ascanio à Valence durant la saison 1644-1645.
« Capítulo de Novela » y la génesis de « El reino de este mundo »
Authors: Smith V.
Published: January 2011

« Capitulo de Novela » et la genèse de « El reino de este mundo ».

Comme le savent ceux à qui l'œuvre de Garpentier est familière, cet auteur élaborait ses romans d'une façon méthodique et scrupuleuse et consacrait beaucoup de temps au choix des données historiques qu'il voulait y inclure. Le contenu de certains de ses articles destinés à des revues est repris dans Los pasos perdidos et certains chapitres de El Siglo de las Luces ont vu le jour avant le roman. De même, une ébauche de ce qui devait constituer la troisième partie de El reino de este mundo parut dans la revue Gaceta del Caribe, qui était publiée à La Havane, sous le titre « Capítulo de novela », en 1944. Ce « chapitre » nous permet de comprendre l'élaboration artistique du roman, c'est pourquoi on le reproduit ici à l'intention d'un public plus nombreux. On l'accompagne d'une brève introduction où l'on relève les différences les plus notables entre cette version de 1944 et la définitive de 1949.
Ensayo de análisis estructural del cuento
Authors: de Andrés Gutiérrez M.
Published: January 2011

En 1928 Vladimir Propp publie Morfologija skazky. Sa méthode est le structuralisme. Elle est appliquée aux contes d'Afanasiev. En 1946 Aurelio M. Espinosa fait paraître un corpus de contes recueillis dans la tradition orale et fidèlement transcrits avec leur phonétique originale. En 1975, pour ma part, j'offre ici les résultats de l'application de la méthode de Propp aux contes réunis par Espinosa.

La présente étude se fonde sur l'examen des fonctions du conte, à partir d'un thème, dans trois versions apparemment différenciées, suivant la méthode de Propp. Ma démarche consiste à isoler les fragments dotés d'une fonction qui se trouve classée dans une colonne à part et représentés par un signe. A la fin de la version analysée, je réunis ces symboles, obtenant ainsi une somme des fonctions qui y apparaissent. Une fois terminée l'analyse de quatre contes dont les fonctions ont été ainsi ordonnées, je suis en mesure d'élaborer deux index — celui des fréquences et celui des variantes — qui permettent d'avoir une vue d'ensemble synthétique des structures internes des contes analysés.

Cette méthode, quand on l'applique à plusieurs versions recueillies dans des endroits différents et actualisées par divers individus, permet d'aboutir aux conclusions suivantes : il existe une structure interne du conte qui vertèbre ce genre dans le merveilleux-populaire ; les variantes ne font pas apparaître de différences structurales] elles sont circonstancielles, structurées, ornementales ; l'analyse des fonctions dans le conte ne permet pas seulement 'élaboration de schémas archétypes mais renseigne aussi sur des institutions anthropologiques sous-jacentes dans la narration étudiée (voir, à ce propos, V. Propp, Istoriceskie korni volsebnoj skazki, Leningrad, 1944).
A vueltas con Juan de Luna (y César Oudin)
Authors: Berthelot A.
Published: January 2011

A la suite de l'article de M. Juan M. Lope Blanch dans le Bulletin Hispanique de 1982, intitulé « A vueltas con Jerónimo de Texeda y Juan de Luna », nous avons réexaminé la « princeps » de l'Arte Breve de Juan de Luna de 1616, unique exemplaire connu à ce jour, qui se trouve à la Bibliothèque Municipale du Mans. Nous le comparons avec les trois grammaires espagnoles de César Oudin (1597-1607-1610) que possède également la Bibliothèque Municipale du Mans. L'intérêt de ces opuscules réside moins dans la grammaire proprement dite ou les listes (réduites) de verbes que dans les dialogues qui figurent en appendice et qui sont de véritables petites comédies de mœurs. Le problème de Juan de Luna, auteur du « segundo Lazarillo », est également posé.