bluuebunny/crossref_metadata_2025 huggingface dataset:
Nanostructured thin films based on phthalocyanines: electrochromic displays and sensors
Authors: Rodriguez-Mendez Maria Luz , Antonio de Saja José
Published: July 2009

The group of the University of Valladolid is a multidisciplinary team formed by chemists, physicists and engineers. The activities of the group are focused to the study of the physicochemical properties of nanostructured Langmuir-Blodgett thin films based on phthalocyanines and their applications. Films of a variety of phthalocyanine molecules including several metallophthalocyanines, lanthanide double decker phthalocyanines and heteroleptic derivatives have been prepared. Their spectroelectrochemical properties have been described in detail and compared with those observed in disordered casted films or microcrystalline evaporated films. The group has dedicated special attention to films based on rare earth double decker compounds due to their unique semiconducting, optical and electrochemical properties. A rich electrochromism has been demonstrated in thin films of this family of compounds. The reversibility is improved in nanostructured Langmuir-Blodgett films. This has permitted development of an electrochromic display that can change its color from blue to green and finally to red. At the present moment, our main objective is the design of sensors able to detect gases and liquids. It has been demonstrated that thin film assemblies based on rare earth bisphthalocyanines modify their conductivity and their optical properties in the presence of electron donor or electron acceptors gases. Changes are also observed when the devices are exposed to Volatile Organic Compounds such as esters, alcohols or aldehydes which are responsible of odors in foods and beverages. Liquid sensors have also been developed. Their working principle is based in the fact that the rich electrochemical properties of phthalocyanine thin films are extremely sensitive to the nature of the electrolytic solution. Arrays of phthalocyanines have been used to construct an electronic nose able to discriminate odors from a variety of foods and beverages. Similarly, phthalocyanines have also been used to construct an electronic tongue based on voltammetric sensors. This is one of the main contributions of the group to the field of sensors.
Optimization of Low‐Thrust Limited‐Power Trajectories in a Noncentral Gravity Field—Transfers between Orbits with Small Eccentricities
Authors: da Silva Fernandes Sandro
Published: July 2009

Numerical and first‐order analytical results are presented for optimal low‐thrust limited‐power
trajectories in a gravity field that includes the second zonal harmonic J2 in the gravitational potential. Only transfers between orbits with small eccentricities are considered. The optimization problem is formulated as a Mayer problem of optimal control with Cartesian elements—position and velocity
vectors—as state variables. After applying the Pontryagin Maximum Principle, successive canonical
transformations are performed and a suitable set of orbital elements is introduced. Hori method—a
perturbation technique based on Lie series—is applied in solving the canonical system of differential
equations that governs the optimal trajectories. First‐order analytical solutions are presented for
transfers between close orbits, and a numerical solution is obtained for transfers between arbitrary
orbits by solving the two‐point boundary value problem described by averaged maximum Hamiltonian,
expressed in nonsingular elements, through a shooting method. A comparison between analytical and
numerical results is presented for some maneuvers.
A Bayes Estimator of Parameters of Nonlinear Dynamic Systems
Authors: Boguslavsky I. A.
Published: July 2009

A new multipolynomial approximations algorithm (the MPA algorithm) is proposed for estimating the state vector θ of virtually any dynamical (evolutionary) system. The input of the algorithm consists of discrete‐time observations Y. An adjustment of the algorithm is required to the generation of
arrays of random sequences of state vectors and observations scalars
corresponding to a given sequence of time instants.
The distributions of the random factors (vectors of the initial
states and random perturbations of the system, scalars of random observational errors)
can be arbitrary but have to be prescribed beforehand.
The output of the algorithm is a vector polynomial series
with respect to products of nonnegative integer powers of the results of real observations or
some functions of these results. The sum of the powers does not exceed some
given integer d. The series is a vector polynomial approximation of the vector E(θ∣Y), which is the conditional expectation of the vector under evaluation
(or given functions of the components of that vector). The vector coefficients of the
polynomial series are constructed in such a way that the approximation errors uniformly
tend to zero as the integer d increases. These coefficients are found by the Monte‐Carlo method and a process
of recurrent calculations that do not require
matrix inversion.
On the Complexities of Selected Satisfiability and Equivalence Queries over Boolean Formulas and Inclusion Queries over Hulls
Authors: Subramani K.
Published: July 2009

This paper is concerned with the computational complexities of three types of queries, namely, satisfiability,
equivalence, and hull inclusion. The first two queries are analyzed over the domain of CNF formulas, while
hull inclusion queries are analyzed over continuous and discrete sets defined by rational polyhedra. Although
CNF formulas can be represented by polyhedra over discrete sets, we analyze them separately on account
of their distinct structure. In particular, we consider the NAESAT and XSAT versions of satisfiability over
HornCNF, 2CNF, and Horn⊕2CNF formulas. These restricted families find applications in a number of
practical domains. From the hull inclusion perspective, we are primarily concerned with the question of
checking whether two succinct descriptions of a set of points are equivalent. In particular, we analyze the
complexities of integer hull inclusion over 2SAT and Horn polyhedra. Hull inclusion problems are important
from the perspective of deriving minimal descriptions of point sets. One of the surprising consequences of
our work is the stark difference in complexities between equivalence problems in the clausal and polyhedral
domains for the same polyhedral structure.
Positive Solution to Nonzero Boundary Values Problem for a Coupled System of Nonlinear Fractional Differential Equations
Authors: Wang Jinhua , Xiang Hongjun , Liu Zhigang
Published: July 2009

We consider the existence and uniqueness of positive solution to nonzero boundary values problem for a coupled system of fractional differential equations. The differential operator is taken in the standard Riemann‐Liouville sense. By using Banach fixed point theorem and nonlinear differentiation of Leray‐Schauder type, the existence and uniqueness of positive solution are obtained. Two examples are given to demonstrate the feasibility of the obtained results.
Pharmacological Treatment of Apathy in Neurodegenerative Diseases: A Systematic Review
Authors: Drijgers Rosa L. , Aalten Pauline , Winogrodzka Ania , Verhey Frans R.J. , Leentjens Albert F.G.
Published: July 2009

Objective: To evaluate the efficacy of pharmacological treatment of apathy in patients with neurodegenerative diseases. Methods: Systematic review of studies assessing the effects of pharmacological treatment on apathy in neurodegenerative diseases. Results: Thirty-five studies were included: 2 meta-analyses, 13 randomized controlled trials (RCTs), 14 open-label studies, 5 case series, and 1 single case study. Eight studies included apathy as a primary outcome. A cholinesterase inhibitor was investigated in 24 studies, methylphenidate in 5, and other medications in 6 studies. Most RCTs of cholinesterase inhibitors reported a small but statistically significant improvement of apathetic symptoms. Conclusions: Although some medications are promising candidates for further study, there is as yet insufficient evidence that pharmacological treatment improves apathetic symptoms in patients with neurodegenerative disease. Large-scale, placebo-controlled RCTs with apathy as a primary outcome measure are needed to establish the potential benefit of pharmacological treatment of apathy.
Emerging Pharmacologic Therapies for Wet Age-Related Macular Degeneration
Authors: Ni Zhang , Hui Peng
Published: July 2009

As researchers and clinicians are beginning to understand that wet age-related macular degeneration (AMD) is more than simply a vascular disease that includes angiogenic, vascular and inflammatory components, they are exploring new agents with different mechanisms of action addressing multiple targets in this complex pathophysiology. Some of them are already available in human trials or even approved vascular epithelial growth factor (VEGF) blockers such as Macugen, Lucentis, Avastin, VEGF Trap-Eye and Cand5; VEGF receptor blockers such as TG100801, vatalanib, pazopanib, Sirna-027 and a vaccine approach; inflammation inhibitors and immunosuppressants such as Retaane, Kenalog, ARC1905, POT-4, OT-551. The last group is mixed, containing agents such as Zybrestat, AdPEGF, Sirolimus, JSM6427, ATG003, E10030. This article reviews these currently emerging agents and briefly discusses the next step for the treatment of wet AMD.
Fetuin-A Early after Renal Transplantation
Authors: Urbanová M. , Kalousová M. , Zima T. , Skibová J. , Wohlfahrt P. , Viklický O.
Published: July 2009

Background: Fetuin-A is a major inhibitor of ectopic calcium phosphate precipitation and an acute phase reactant. Its deficiency, common in end-stage renal disease, has been suggested to be associated with cardiovascular complications. The aim of this study was to monitor fetuin-A levels in the early period after renal transplantation. Methods: 30 deceased donor kidney recipients treated with calcineurin inhibitor-based immunosuppression were followed prospectively for the first 3 months and the association of fetuin-A levels with clinical and laboratory parameters was evaluated. Results: Despite a correlation of fetuin-A levels with creatinine clearance (r = 0.348, p < 0.01) and estimated GFR (r = 0.331, p < 0.01), no significant increase in fetuin-A levels over the first 3 months was observed. Moreover, a significant decrease in serum fetuin-A levels was noted at 2 weeks (p < 0.001). Subsequently, fetuin-A levels increased (p < 0.001) reaching pretransplant values at month 3. Conclusions: In this study there was no increase of fetuin-A levels during the first 3 months, but a decrease 2 weeks after transplantation was observed.
Validation of Arteriograph – A New Oscillometric Device to Measure Arterial Stiffness in Patients on Maintenance Hemodialysis
Authors: Nemcsik János , Egresits József , El Hadj Othmane Taha , Fekete Bertalan Csaba , Fodor Erzsébet , Szabó Tamás , Járai Zoltán , Jekkel Csaba , Kiss István , Tislér András
Published: July 2009

Background: Measuring arterial stiffness (augmentation index (AI), aortic pulse wave velocity (PWV)) in hemodialysis (HD) patients has prognostic significance. To assess its validity, the new oscillometric Arteriograph device (AIA, PWVA) was compared to the validated PulsePen tonometer (AIP, PWVP). Methods: AI and PWV were measured in 98 patients with both devices before HD. Validity was evaluated by Pearson’s correlation, Bland-Altman analysis, and by assessing the prognostic value of AI and PWV to predict cardiovascular (CV) mortality over 29 months. Results: Correlation between AIP and AIA was significant (R = 0.527, p < 0.001). The mean difference of AI values obtained by the two devices was –20.6%, and 30% of the paired AI differences fall outside the ±1 SD boundary of the mean between-device difference. There was no significant correlation between the PWVP and PWVA readings (R = 0.173, p = 0.097). The average difference of PWV values by the two devices was –1.2 m/s, and 20.6% of the paired PWV differences fall outside the ±1 SD boundary. In survival analyses, only PWVP but not PWVA was significantly related to CV mortality. Conclusion: Lack of correlation between PWVP and PWVA and lack of prognostic significance of PWVA suggest limited validity of Arteriograph to determine PWV in patients on HD.
Accuracy of Sphygmanometers at Pharmacies
Authors: Erdem Dilek Gurgenyatagi , Erdem Emre , Dilek Melda , Aydogdu Turkan , Selim Nevzat , Demiray Feride , Sari Aysel , Akpolat Tekin
Published: July 2009

Background/Aims: The aims of this study are to assess the reasons of using sphygmomanometers at pharmacies and to evaluate their accuracy. Methods: 135 devices (118 aneroid, 1 mercury, and 16 automated) from 125 pharmacies (located in Samsun city center) were included in the study. A non-randomized, cross-sectional design was used for the study protocol which had two parts: assessment of devices and a questionnaire about the pharmacy and present sphygmomanometer(s). Results: 40 (30%) of the 135 sphygmomanometers were inaccurate. 65 (48%) of the devices were older than 1 year and there was no correlation between the duration of the ownership of the sphygmomanometers and their inaccuracy (p > 0.05). Blood pressure measurement is a frequent practice at pharmacies. The aneroid type of sphygmomanometers was common. A limited number of devices were checked for accuracy before. The number of validated devices was low. Conclusion: Training programs for pharmacists including the accuracy of sphygmomanometers and regular checks of sphygmomanometers for accuracy will be beneficial to the community and to the subjects requesting measurement of blood pressure at the pharmacies.
Functional Outcomes among Premature Infants with Intraventricular Hemorrhage
Authors: Vassilyadi Michael , Tataryn Zachary , Shamji Mohammed F. , Ventureyra Enrique C.G.
Published: July 2009

Objective: This work evaluated the mortality and functional outcomes of premature infants sustaining intraventricular hemorrhage (IVH). These outcomes were analyzed for their association with IVH severity, development of hydrocephalus and need for ventriculoperitoneal (VP) shunt insertion. Methods: A retrospective review was performed of neonates at the Children’s Hospital of Eastern Ontario who sustained IVH (1989–2005). Logistic regression tested demographic predictors of IVH severity, development of hydrocephalus and mortality. χ2 analysis differentiated functional outcomes and mortality by IVH grade, development of hydrocephalus and intervention for cerebrospinal fluid diversion. All analyses used the 0.05 significance level. Results: Data were available for 284 patients with an average follow-up of 5.1 years. These were distributed as grade I (n = 135), grade II (n = 52), grade III (n = 43) and grade IV (n = 54), with lower gestational age and birth weight predicting disease severity. Hydrocephalus developed in 21% of patients, of whom 39% required VP shunt insertion. Overall mortality of 20% depended on IVH grade and was highest for grade IV patients (59%). Functional independence diminished with IVH severity, and patients with hydrocephalus fared worse than those without this sequel. Outcomes of patients developing hydrocephalus were similar whether or not they eventually required VP shunt insertion. Conclusions: This study describes a large cohort of neonatal IVH, describing how disease severity affects mortality and functional outcome. The overall mortality of nearly 1 in 5 patients is primarily of grade IV patients, with no difference between grade II and grade III. Further, patients surviving their hydrocephalus exhibited no worse functional deterioration if they required surgical intervention.
Single-Stage Treatment of Spina Bifida with Hydrocephalus Based on a Prediction Rule Derived from Preoperative Cranial Ultrasound
Authors: Wakhlu Ashish , Wakhlu Geeta , Saxena Sunita , Tandon R.K.
Published: July 2009

Aims: It was the aim of this study to report a prospective study of 110 spina bifida patients with hydrocephalus treated by simultaneous ventriculoperitoneal (VP) shunt and repair of the meningomyelocele. Methods: Between January 2005 and February 2008, 264 patients with spina bifida were admitted to the author’s department. Those patients in whom the preoperative cranial ultrasonography measurement of the bifrontal diameter was >26 mm, the bicaudate diameter >20 mm and the diameter of the body of the lateral ventricle >26 mm were predicted to develop postoperative hydrocephalus (n = 245). Of these, 110 patients underwent simultaneous (group 1) VP shunt with repair of the meningomyelocele, while 135 (group 2) underwent sequential surgery due to the preference of the attending consultant. Results: Twenty-two of the 110 patients in group 1 developed complications (wound problems, cerebrospinal fluid leak, shunt malfunction, death) compared with 38 of 135 patients in group 2. The remaining patients had an uneventful postoperative and follow-up course. Conclusions: Simultaneous VP shunt with surgery for hydrocephalus was feasible in our setup. The rate of complications was not higher than in staged surgery. Single-stage repair of spina bifida with hydrocephalus offers considerable advantage in the form of a reduction in hospital burden, costs and patient morbidity.
Clinical Characteristics and Outcomes of Lung Cancer with Pulmonary Embolism
Authors: Chuang Yu-Min , Yu Chong-Jen
Published: July 2009

Background: Cancer patients have a higher risk for thrombosis that is usually related to advanced stage and poor prognosis. This study aimed to identify the clinical picture and outcome of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients with pulmonary embolism (PE). Patients and Methods: From 1996 to 2005, the clinical presentation of lung cancer patients with PE was evaluated. Their survival was compared with matched controls by log-rank test. Results: A total of 24 patients, 17 men (70.8%) and 7 women (median age: 62.5 years), were identified. Nineteen patients (79.2%) initially presented with advanced lung cancer (16 stage IV, 1 stage III-b NSCLC and 2 extensive-stage SCLC). Wells’ clinical prediction score for PE only predicted moderate probability (median: 5.25). In patients with PE, survival was significantly shorter than in matched control patients (243.5 vs. 327 days, p = 0.01). This difference was more significant when PE presented concomitant with cancer (p = 0.003) than when PE developed during cancer treatment (p = 0.206). Conclusions: PE is an important event in lung cancer patients which usually occurs in advanced disease and affects survival. In patients presenting PE at the initial diagnosis of cancer, the prognosis was the worst.
Pegfilgrastim Administered on the Same Day with Dose-Dense Adjuvant Chemotherapy for Breast Cancer Is Associated with a Higher Incidence of Febrile Neutropenia as Compared to Conventional Growth Factor Support: Matched Case-Control Study of the Hellenic Cooperative Oncology Group
Authors: Skarlos Dimosthenis V. , Timotheadou Eleni , Galani Eleni , Samantas Epaminondas , Grimani Irene , Lianos Evangelos , Aravantinos Gerasimos , Xanthakis Ioannis , Pentheroudakis George , Pectasides Dimitrios , Fountzilas George
Published: July 2009

Objective: Recombinant human granulocyte-colony-stimulating factors such as filgrastim and pegfilgrastim have been employed as primary and secondary prophylaxis against neutropenia in cancer patients receiving chemotherapy. This study was conducted to evaluate the rate of febrile neutropenia in patients with high-risk early breast cancer receiving dose-dense chemotherapy and, as primary prophylaxis, either pegfilgrastim 6 mg fixed dose on the same day as chemotherapy or filgrastim on days 2–10 of each cycle. Secondary objectives included the rate of severe neutropenia, treatment delays and dose reductions. Methods: This was a nonrandomized matched case-control study with 214 patients receiving dose-dense chemotherapy. Each group receiving supportive therapy included 107 patients (pegfilgrastim and filgrastim groups). Results: Fourteen patients (13%) in the pegfilgrastim group developed febrile neutropenia as compared to 1 patient (1%) in the filgrastim group (p = 0.001). No statistically significant differences regarding the rate of severe neutropenia, treatment delays and dose reductions were observed. Conclusion: The results demonstrate that pegfilgrastim administered as primary prophylaxis on the same day as dose-dense chemotherapy is less efficacious than filgrastim administered on days 2–10 of each chemotherapy cycle. For the particular regimens given in this retrospective matched case-control study, the current recommendation for administering pegfilgrastim at least 24 h after chemotherapy completion seems justified. However, further randomized controlled trials are needed to clarify this finding.
`We Have all theBases Covered'
Authors: Theberge Nancy
Published: July 2009

Three professions that figure prominently in sport medicine in Canada are athletic therapy, physiotherapy and chiropractic. These professions are characterized by blurred occupational boundaries, arising from overlap in the content of practice and differences within the professions in the skills of individual practitioners. Accordingly, they face challenges in establishing jurisdiction over professional practice. This article examines the claims made by practitioners in these professions about the contributions of their own profession and how it is different from the others. The analysis draws upon interviews with 33 practitioners. Findings indicate that physiotherapy is positioned as the profession against which athletic therapists and chiropractors each locate themselves. Athletic therapists argue they are the sport specialists; this is challenged by the development of sport specializations in physiotherapy and chiropractic. Chiropractors assert specialized knowledge that enables them to contribute to athletes' performance. The increasing rationalization of sport provides a context in which chiropractors' assertions to contribute to performance offers a particularly meaningful basis for claiming a position in sport medicine.
A Content Analysis of News Coverage of Asian Female Olympic Athletes
Authors: Yu Chia-Chen
Published: July 2009

Asian female athletes' prominent performances have caught the media's attention for coverage. Despite the success of Asian female athletes, stereotypes and expectations of feminine characteristics towards female athletes may still exist, especially in Asia where there is long history of a male-dominated society. The major purpose of this study was to gain an understanding of how the media covers Asian female Olympic athletes and to see if sports writers emphasize feminine characteristics in news coverage when reporting Asian female Olympic athletes. Content analysis was administered to review news stories of Asian female Olympic athletes who were reported in 266 sport news articles from 1 January 2000 to 31 August 2008. The results indicated that sports such as diving and the marathon are more likely to be covered although Asian female Olympic athletes have been successful in other sports. Topics and content related to athletes' achievements in sports, physical/athletic strength, and psychological characteristics were frequently included in the news stories.
Public Broadcasting, Sport, and Cultural Citizenship
Authors: Scherer Jay , Whitson David
Published: July 2009

In this article we examine the recent debate over the continued role of the Canadian Broadcasting Corporation (CBC) in airing National Hockey League (NHL) games on its iconic television show, Hockey Night in Canada (HNIC) . Specifically, we outline the heightened competition between the CBC and private networks for the most desirable sports rights in the context of the explosive growth of subscription television. We then review how the CBC was, in the face of this competition and to the surprise of many commentators, able to secure a new contract with the NHL in 2006. We argue here that, while Canada's public network will never again have the place in Canadian life that it had in the early days of television (Rutherford, 1990), HNIC remains an important investment because it acts as a critical promotional platform for the public network, as well as providing a sizeable revenue stream that subsidizes the network's other programming. We will also argue that providing free-to-air broadcasts of the sport that matters most to Canadians is an issue of cultural citizenship, and thus an important part of the mandate of a public broadcaster, and a matter of national interest.
Apologetic Behavior Among Female Athletes
Authors: Davis-Delano Laurel R. , Pollock April , Ellsworth Vose Jennifer
Published: July 2009

Most studies that report apologetic behavior by female athletes employ observation or in-depth interviews. Although these studies provide great insight, they do not enable us to systematically compare apologetic behavior across a wide variety of athletes, sports, geographical locations, and time periods. The authors developed a questionnaire for such comparative purposes. The authors then used this questionnaire to study apologetic behavior on three collegiate teams. Most respondents reported that they either engaged in numerous apologetic behaviors on an occasional basis or a few apologetic behaviors on a more regular basis. The most common apologetic behaviors involved efforts to look feminine, apologize for aggression, and mark themselves as heterosexual. Softball players engaged in more apologetic behavior than soccer and basketball players. The authors urge others to utilize this questionnaire for comparative purposes.
Shall We Be Resolute?
Authors: Uzan-Milofsky Marie
Published: July 2009

Can we change our rational mode of deliberation in order to benefit from cooperation? Two philosophers believe we can. Indeed, David Gauthier and Ned McClennen argue that it is rational to replace the standard form of rationality as described in game theory with a constrained form of rationality. Such a change of rationality is possible because it enables agents to gain from mutual advantage and to avoid the costs of enforcement systems. If these philosophers are right, the consequences of their argument would be groundbreaking in social contract theories. Unfortunately, in this article, I want to argue that the change of rationality they claim possible is not only rationally inferior to the standard form of rationality but is also non-viable as a stand-alone rational concept.
Review: Effect of probiotics on gastrointestinal function: evidence from animal models
Authors: Verdú Elena F. , Bercik Premysl , Collins Stephen M.
Published: July 2009

The digestive tract works through a complex net of integrative functions. At the level of the gut, this integration occurs between the immune, neuromotor and endocrine systems, the intestinal barrier and gut luminal contents. Gastrointestinal function is controlled and coordinated by the central nervous system to ensure effective motility, secretion, absorption and mucosal immunity. Thus, it is clear that the gut keeps a tightly regulated equilibrium between luminal stimuli, epithelium, immunity and neurotransmission in order to maintain homeostasis. It follows that perturbations of any of these systems may lead to gut dysfunction. While we acknowledge that the gut—brain axis is crucial in determining coordinated gut function, in this review we will focus on peripheral mechanisms that influence gastrointestinal physiology and pathophysiology. We will discuss the general hypothesis that the intestinal content is crucial in determining what we consider normal gastrointestinal physiology, and consequently that alteration in luminal content by dietary, antibiotic or probiotic manipulation can result in changes in gut function. This article focuses on lessons learned from animal models of gut dysfunction.
Changes in venous function after foam sclerotherapy of varicose veins
Authors: Brunken A , Rabe E , Pannier F
Published: July 2009

Objectives

Foam sclerotherapy of varicose veins has recently proven to be an effective, economic and safe treatment modality. The present study attempts to evaluate the haemodynamic changes after sclerotherapy in addition to the clinical results.

Methods

In a prospective observation trial, 67 sites (2/3 of which were recurrent varicose [RV] veins after previous treatment) in 53 patients were treated with polidocanol foam, and the results were assessed clinically, by duplex, photoplethysmography and strain gauge plethysmography.

Results

With the exception of two sites (3.0%), all treatments resulted at least in an improvement, and about 80% of the treated veins were completely occluded as demonstrated by duplex ultrasound examination. The haemodynamical results accordingly reflected a significant improvement of the venous function. Patients with post-thrombotic syndrome showed poorer results.

Conclusion

Foam sclerotherapy is a highly effective and safe method for the treatment of primary and RV veins.
Prospective five-year study of ultrasound-guided foam sclerotherapy in the treatment of great saphenous vein reflux
Authors: Chapman-Smith P , Browne A
Published: July 2009

Objectives

The purpose of this study was to determine the long-term efficacy, safety and rate of recurrence for varicose veins associated with great saphenous vein (GSV) reflux treated with ultrasound-guided foam sclerotherapy (UGFS).

Methods

A five-year prospective study was performed, recording the effect on the GSV and saphenofemoral junction (SFJ) diameters, and reflux in the superficial venous system over time. UGFS was the sole treatment modality used in all cases, and repeat UGFS was performed where indicated following serial annual ultrasound.

Results

No serious adverse outcomes were observed – specifically no thromboembolism, arterial injection, anaphylaxis or nerve damage. There was a 4% clinical recurrence rate after five years, with 100% patient acceptance of success. Serial annual duplex ultrasound demonstrated a significant reduction in GSV and SFJ diameters, maintained over time. There was ultrasound recurrence in 27% at 12 months, and in 64% at five years, including any incompetent trunkal or tributary reflux even 1 mm in diameter being recorded. Thirty percent had pure ultrasound recurrence, 17% new vessel reflux and 17% combined new and recurrent vessels on ultrasound. Of all, 16.5% required repeat UGFS treatment between 12 and 24 months, but less than 10% in subsequent years. The safety and clinical efficacy of UGFS for all clinical, aetiological, anatomical and pathological elements classes of GSV reflux was excellent.

Conclusion

The popularity of this outpatient technique with patients reflects ease of treatment, lower cost, lack of downtime and elimination of venous signs and symptoms. Patients accept that UGFS can be repeated readily if required for recurrence in this common chronic condition. The subclinical ultrasound evidence of recanalization or new vein incompetence needs to be considered in this light.
New Insights into the Molecular Basis of the House Dust Mite-Induced Allergic Response
Authors: Jacquet Alain
Published: July 2009

House dust mite (HDM) represents world-wide one of the most common source of aeroallergens word-wide and more than 50% of allergic patients are sensitized to these allergenic molecules. Although the induction of specificTh2 cells as well as IgE by HDM is well understood, the events that control the initial Th2 polarization in response to HDM are still poorly defined. Notably, mechanisms by which HDM is recognized by the airway mucosa, interacts with barrier epithelial cells, leading to dendritic cell (DC) recruitment, activation, and subsequent Th2-mediated responses, remains to be elucidated. Moreover, whereas the allergenicity of the group 1 major mite allergens could be largely explained by their intrinsic proteolytic activity, the fundamental mechanistic question regarding the putative intrinsic allergenic properties of the group 2 major mite allergen remained unanswered to date.

This review summarizes new insights into diverse determinants that contribute to the HDM allergenicity. In addition to the auto-adjuvant capacity of the two major mite allergen Der p 1 and 2, due to proteolytic activity and functional mimicry of the Toll-like receptor 4 (TLR4) co-receptor MD2 respectively, contaminating factors derived from HDM carriers, mainly endotoxins (LPS) et β-glucans, are very important to activate the innate immune response which, in turns, is involved in the development of allergic response by HDM.
Population Viability Analysis and Genetic Diversity of the Endangered Red DeerCervus elaphusPopulation from Mesola, Italy
Authors: Zachos Frank E. , Hajji Ghaiet M. , Hmwe San San , Hartl Günther B. , Lorenzini Rita , Mattioli Stefano
Published: July 2009

The Mesola red deerCervus elaphusin the Po delta are the only native red deer population on the Italian mainland and have been the focus of conservationists and wildlife biologists for some time. In our study, we present a genetic analysis of 25 Mesola red deer on the basis of 20 polymorphic microsatellite loci, aiming at estimating the population's genetic diversity and at providing information for a future genetic screening. In addition, we carried out a population viability analysis (PVA) with demographic and life‐history data available from a long‐term population survey, simulating different management scenarios. Genetic diversity was very low compared to the rest of Europe (observed and expected heterozygosity 0.50 and 0.61, respectively), and an overall excess of homozygosity was indicative of inbreeding. Calculations of the probability of identity and genotype mismatch frequencies suggested that between five and seven highly informative loci were sufficient to resolve individuals with reasonable certainty. The PVA yielded a generally poor outlook, but at the same time, it showed that management measures already taken significantly increased population viability. A sensitivity analysis revealed that inbreeding depression and possible catastrophes had a huge impact on the population's prospects. However, the establishment of two subpopulations and successful attempts at reducing the consequences of catastrophic events were able to significantly mitigate the harmful effects of both inbreeding and environmental stochasticity. These results, in particular the splitting of the population, may be of general interest to conservationists dealing with unique threatened populations.
Factors Affecting Beech Fagus sylvatica Bark Stripping by Red Deer Cervus elaphus in a Mixed Forest
Authors: Saint‐Andrieux Christine , Bonenfant Christophe , Toïgo Carole , Basille Mathieu , Klein François
Published: July 2009

Bark stripping by large herbivores is widespread, yet poorly understood. Our study was carried out in a 2000‐ha area situated in the Vosges Mountains, France, where beech Fagus sylvatica bark is heavily bark stripped by red deer Cervus elaphus. We tested whether the seasonal variation in the frequency of beech bark stripping by red deer was correlated with bark nutritive value or bark mechanical properties (using an index of bark detachability). We also evaluated whether red deer selected beech trees based on the chemical composition of their bark (e.g. carbohydrates and minerals). Bark‐stripped trees had slightly higher carbohydrate contents than non‐stripped trees, but this difference resulted from a physiological reaction of the tree to bark stripping. Bark composition was similar between stripped and non‐stripped trees spring and summer, but was easier to detach during these periods than during autumn and winter. Therefore, beech bark stripping by red deer in the Vosges Mountains does not appear to be driven by nutritional needs, but it may help deer in improving digestion efficiency.
Efficacy of Sampling Techniques for Determining Species Richness Estimates of Reptiles and Amphibians
Authors: Hutchens Stan J. , DePerno Christopher S.
Published: July 2009

The ability to detect reptiles and amphibians is influenced by environmental and behavioural variables and detection probabilities, but studies to determine herpetofauna species richness often employ only a small number of sampling techniques, primarily drift fence arrays, visual encounter surveys, and coverboards (i.e. primary techniques). However, using only two or three sampling techniques can underestimate species richness. To evaluate the efficacy of sampling methodologies in determining the species richness of herpetofauna, we employed 11 different sampling techniques. We hypothesized that adding standardized road searches, polyvinyl chloride (PVC) piping grids, line transects, auditory surveys (i.e. secondary techniques), opportunistic encounters, aquatic funnel traps, crayfish traps and basking traps (i.e. tertiary techniques) would better portray species richness. Observed species richness (Sabs, species physically detected or observed), Chao2 estimates of species richness (S), unique species captured (i.e. species detected by only one technique), cost, and cost‐per‐species‐captured for individual techniques and categories (i.e. primary, secondary and tertiary) were used to determine efficacy. Primary capture methodologies detected 13 species (S = 14). Secondary and tertiary sampling techniques captured 18 and 24 species, respectively (S = 29 and 25). All sampling methodologies combined captured 33 species for a Chao2 estimate of 34. More unique species were captured by tertiary techniques than by primary or secondary methodologies. Costs for primary techniques were much higher than for secondary and tertiary methodologies. To better determine species richness, we recommend that future research incorporate multiple sampling methodologies in addition to more common techniques.
Pattern of Metabolic Syndrome in Clinical Practice
Authors: Islam Quazi Tarikul , Haque Md Azizul , Ali ASM Shawkat , Ekram ARM Saifuddin , Hussain Sultana Monira , Azad Khan Abul Kalam , Hossain Ahmed
Published: July 2009

1068 randomly sampled adult Bangladeshi people were studied during a period of six months from October 2004 to March 2005. It was a randomized, prospective study. Cases that fulfilled two criteria of metabolic syndrome (MetS) were evaluated to see pattern and types of MetS. Out of 1068 patients, 110 (10.3%) fulfilled the inclusion criteria. 101 (9.4%) cases were labeled as metabolic syndrome according to NCEP ATP III criteria, 09 cases had only two criteria. 40 cases were male & 70 cases were female (M:F= 1:1.8). Mean age of patients with was 44.88, ranging from the age of 20-68 years. Majority (55%) of the patients were in the age group of 30-49 years. Half of the cases had BMI 30-34.9. Mean body weight of male was 85.9 kg and of female was 78.2 kg. Mean waist circumference of male was 41.7 inches and of female 40 inches. Mean HDL for male was 38.3 mg/dL and for female is 40.2 mg/dL. Mean Triglyceride for male was 172.1 and for female was 169.3 mg/dL. Mean total cholesterol for male was 216.7 and for female was 207.6 mg/dL. Mean systolic blood pressure (SBP) for men is 162 mm Hg & diastolic blood pressure (DBP) 99 mm Hg and for female mean SBP 155 and DBP 96 mm Hg. Metabolic syndrome is more prevalent in the 3rd and 4th decade of life in both sexes. It is almost twice common in female than male. Combination of hypertension, obesity & dyslipidemia comprises nearly 40% of its presentation.    doi: 10.3329/jom.v10i2.2813 J MEDICINE 2009; 10 : 48-51
Clinical Presentation and Epidemiology of Stroke :A Study of 100 Cases
Authors: Siddique Md Abu Naser , Nur Zannatun , Mahbub Md Shahriar , Alam Md Billal , Miah Md Titu
Published: July 2009

The stroke patients comprise a large number of hospital admissions and stroke is one of leading cause of significant mortality and morbidity. This prospective observational study was carried out among 100 hospitalized stroke patients admitted into different medicine units of Chittagong Medical College Hospital (CMCH), with a view to study clinical presentation and epidemiology of stroke. Data, collected in prescribed protocol, were analyzed in simple statistical percentage and cases were selected irrespective of age and sex. Stroke was found most commonly in 51-60 age group (45%in hemorrhagic and 51.75% in ischemic stroke).Most of the patients were male with male, female ratio 3:1 in hemorrhagic stroke and 1.35:1 in ischemic stroke. Most of the patients were from rural area (60% in hemorrhagic stroke and 57.5 in ischemic stroke). Ischemic stroke was found in 80% cases and hemorrhagic stroke was found in 20% cases. The commonest presentation in both ischemic and hemorrhagic stroke was hemiplegia or hemiparesis. Rightsided hemiparesis was the predominant finding in both types. Headache (60%) and vomiting (75%) were found to be more common accompaniment of hemorrhagic stroke. In case of ischemic stroke the association with these clinical features was less marked where headache was present in 46.25% and vomiting in 40% cases. 50% of patients of hemorrhagic stroke presented with Glasgow Coma Scale (GCS) level 9-12(grade2) and 5% with GCS level 4 - 8(Grade 3). Whereas, 52.5% of patients of ischemic stroke presents with GCS 9-12 and also 46.25% with GCS13-14 (grade 1). Hypertension was the commonest risk factor associated with both types of stroke. In hemorrhagic stroke it was 80% and in ischemic stroke it was found in 56.25% eases. Smoking was associated with 50% of hemorrhagic and 55% of ischemic stroke. Diabetes mellitus was associated with 26.25% of ischemic stroke   doi: 10.3329/jom.v10i2.2820 J MEDICINE 2009; 10 : 86-89
Contrast-Induced Nephropathy in 118 Coronary Angiographic Cases
Authors: Haque AFM Shamsul , Rabbani Md Golam , Hossain Muhammad Rabiul , Rashid Md Hayder , Mostafi Mamun , Rahman AKM Mijanur
Published: July 2009

Contrast-induced nephropathy (CIN) is the third leading cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. The aim of the present study was to find out the incidence and outcome of CIN in patients undergoing coronary angiography using standard cardiac cath lab protocol. This observational study was carried out in patients undergoing Coronary angiography with or without Percutaneous coronary interventions (PCI) in CMH Dhaka from July 2007 to July 2008. Exclusion criteria were chronic kidney disease (CKD), nephrotoxic medications, severe hypotension, severe heart failure (NYHA class IV) and severe anaemia. Out of 118 cases two demonstrated impaired renal function and both of them were diabetic. The incidence was found to be 1.69 % and outcome was satisfactory in these cases. Renal function of both the patients gradually became normal within next two weeks. No patient required dialysis.   doi: 10.3329/jom.v10i2.2822 J MEDICINE 2009; 10 : 94-96
Extensively Drug-resistant Tuberculosis(XDR-TB)
Authors: Ahasan HAM Nazmul , Ayaz KFM , Hossain Ahmed , Rashid MA , Chowdhury Riaz Ahmed
Published: July 2009

doi: 10.3329/jom.v10i2.2823 J MEDICINE 2009; 10 : 97-99
Biochemical Cardiac Markers in Clinical Cardiology
Authors: Pasupathi Palanisamy , Rao Y Yagneswara , Farook Jawahar , Bakthavathsalam Govindaswamy
Published: July 2009

Millions of patients present annually with chest pain, but only 10% to 15% have myocardial infarction. Lack of diagnostic sensitivity and specificity of clinical and conventional markers prevents or delays treatment and leads to unnecessary costly admissions. Comparative data are lacking on the new markers, yet using all of them is inappropriate and expensive. The biochemical marker determination to clinical cardiology and discusses some important developments in this field. Biochemical markers play a pivotal role in the diagnosis and management of patients with acute coronary syndrome (ACS), as witnessed by the incorporation of cardiac troponins into new international guidelines for patients with ACS and in the redefinition of myocardial infarction. Despite the success of cardiac troponins, there is still a need for the development of early markers that can reliably rule out ACS from the emergency room at presentation and also detect myocardial ischaemia in the absence of irreversible myocyte injury. The cardiac natriuretic peptides, Laboratory Medicine are also assuming a role in the assessment of cardiac function. Biochemical markers now play an important role in the detection of disease, risk stratification and the monitoring of therapy. Keywords: Biochemical markers, Myocardial infarction, Troponin, Brain natriuretic peptide   doi: 10.3329/jom.v10i2.2824   J MEDICINE 2009; 10 : 100-108
Cerebral Venous Sinus Thrombosis: An Uncommon Presentation of Headache Mimicking Subarachnoid Hemorrhage
Authors: Sultana Naima , Chowdhury Monzurul H , Mahbub Md Shahriar , Alam Md Billal
Published: July 2009

Cerebral venous sinus thrombosis is a rare disorder accounting for less than 1% of all strokes. It is more common in children and young adults. Here we report a rare and interesting case of cerebral venous l sinus thrombosis mimicking subarachnoid hemorrhage. A 40 years old women, presented with sudden onset of headache, vomiting and unconsciousness associated with convulsions. She had a history of taking oral contraceptives for the last 12 years. Clinical examinations showed ill-looking women with Glasgow Coma Scale of 12 along with neck rigidity and bilateral papilloedema. Although initially we suspected her as a case of subarachnoid hemorrhage, subsequent investigations with MRI and MRV showed to be a case of superior sagittal and transverse sinus thrombosis. Treatment with anticoagulation recovered her from headache and papilloedema. Serum levels of thrombophilic factors were within the normal physiological limits. Thus we concluded that although cerebral venous thrombosis is 100 times less than the cerebral arterial disease, a women presented with sudden onset of headache and vomiting with long term use of oral contraceptives, cerebral thrombosis should be considered as a differential.  Key words: Cerebral venous sinus thrombosis , Sagittal sinus thrombosis, Subarachnoid hemorrhage , Magnetic resonance venography. doi: 10.3329/jom.v10i2.2826   J MEDICINE 2009; 10 : 115-118
Recurrent Metastasis of Epithelial Ovarian Cancer in Cervical, Submandibular and Suboccipital Lymph Nodes
Authors: Mousavi Azam Sadat , Behnamfar Fariba , Mehrdad Nili
Published: July 2009

Ovarian carcinoma is the second most common gynecologic cancer and the leading cause of death from gynecologic malignancy. The management of recurrent ovarian cancer has been individualized. Reports of recurrence in supradiaphragmatic lymph nodes are rare. We describe the finding of metastatic tumor involving cervical, submandibular and suboccipital lymph nodes in a 77-year-old patient with ovarian carcinoma. Keywords: scalene lymph node, ovarian cancer, lymphadenopathy, recurrence   doi: 10.3329/jom.v10i2.2830   J MEDICINE 2009; 10 : 128-131
Silent Trace Eliminates Differential Eyeblink Learning in Abstinent Alcoholics
Authors: Fortier Catherine Brawn , Maksimovskiy Arkadiy L. , Venne Jonathan R. , LaFleche Ginette , McGlinchey Regina E.
Published: July 2009

Chronic alcoholism has profound effects on the brain, including volume reductions in regions critical for eyeblink classical conditioning (EBCC). The current study challenged abstinent alcoholics using delay (n = 20) and trace (n = 17) discrimination/reversal EBCC. Comparisons revealed a significant difference between delay and trace conditioning performance during reversal (t (35) = 2.08, p < 0.05). The difference between the two tasks for discrimination was not significant (p = 0.44). These data support the notion that alcoholics are increasingly impaired in the complex task of reversing a previously learned discrimination when a silent trace interval is introduced. Alcoholics’ impairment in flexibly altering learned associations may be central to their continued addiction.