bluuebunny/crossref_metadata_2025 huggingface dataset:
Henoch-Schönlein Purpura with Severe Gastrointestinal Involvement in Adult ICU Patients – Role of Blood Coagulation Factor XIII
Authors: von Bierbrauer A. , Egbring R. , Schmidt J.A.
Published: June 2009

Objective: Investigation of the role of factor XIII (FXIII) and FXIII substitution in Henoch-Schönlein purpura with severe gastrointestinal involvement in adult intensive care unit patients. Design: Prospective study. Setting: Medical intensive care unit of a university hospital. Patients: All consecutive adult patients who were admitted to our 7-bed medical intensive care unit due to Henoch-Schönlein purpura with severe gastrointestinal involvement during a 36-month period. Interventions: Substitution of FXIII (Fibrogammin HS; Behringwerke, Marburg, Germany) in cases of FXIII activity being below 60% of normal range on admission. Repeated substitution until FXIII activity was increased to normal ranges and cessation of abdominal pain and bleeding was achieved. Results: 5 patients were enrolled in the study. All had decreased FXIII activity (8-58% of normal) on admission, and in all patients FXIII substitution therapy was applied (total dose 2,500-33,750 IU). High-dose FXIII substitution &(> 15,000 IU; 4 patients) resulted in rapid cessation (1-5 days) of abdominal pain and bleeding complications accompanied by ultrasonographically demonstrable shrinking of the initially monstrous swelling of the gut wall. In the patient receiving only 2,500 IU FXIII, FXIII activity failed to increase to normal range and clinical symptoms did not improve. In all patients, intermittent peaks of the elastase-αl-protease inhibitor complex in plasma (peak values 450-950 ng/ml) were found, suggesting a recurrent release of elastase from inflammatory cells. Elastase is considered to cause a specific degradation of FXIII, leading to bleeding into the intestinal wall. Conclusions: In Henoch-Schönlein purpura with gastrointestinal involvement, careful and frequent examinations of the coagulation system, especially of FXIII, are necessary. The results of the coagulation data suggest that severe FXIII deficiency is due to a specific degradation by proteolytic enzymes (such as elastase) as well as consumption within the immense hemorrhagic edema of the intestinal wall. High-dose FXIII substitution therapy should be taken into consideration in cases with Henoch-Schönlein purpura and severe gastrointestinal involvement.
Immunoaffinity Selection of CD34+ Blood Cells for Allogeneic Transplantation
Authors: Arseniev L. , Link H. , Kadar J.G. , Lieb B. , Battmer K. , Südmeier I. , Stucki A. , Pape I. , Novotny J. , Ganser A. , Hertenstein B.
Published: June 2009

Background: Transplantation of selected allogeneic or autolo-gous CD34+ cells has become a widespread method for purging of hematopoietic grafts. Specific immunoselection, based on avidin-biotin affinity with a CD34 monoclonal antibody, represents one of the commercially available techniques. Materials and Methods: Input and output of 47 CD34+ cell immunoselection procedures in healthy sibling donors were analyzed for nucleated and CD34+ cell content, CD34+ cell subset distribution, and colony growth. CD34+ blood cells were mobilized with G-CSF (2×5 μg/kd/day subcutaneously for 5-7 days). In 16 allogeneic donors (group A) 2 consecutive leukaphereses from days 4 and 5 of G-CSF application were pooled, washed, and the CD34+ cells were immunoselected. In group B (17 donors) platelets were removed from each leuk-apheresis (n = 54) immediately after its completion. Before immunoselection and after pooling, two washing steps were performed. Results: By reducing platelets in the primary product, the mean CD34+ cell yield increased 1.8-fold (p = 0.005), without influencing ‘purity’ (mean 70%). The main cell loss in group A occurred during selection on the column. In group B the initial platelet elimination and washing of the leukapher-esis products caused the main CD34+ cell losses. The yields for CFU-GM and BFU-E in group A vs. group B were: 27% vs. 27% and 17% vs. 27%, respectively. All major CD34+ cell subsets were maintained by the immunoselection. Conclusion: The procedure lasted between 130 and 180 min and provided a means for rapid CD34+ cell selection with more than 50% recovery. Further efforts on improvement of yields and/or purity should concentrate on the nonsystem-dependent preselection procedures.
Comparison of the Effects of Antihypertensive Agents on Central Blood Pressure and Arterial Stiffness in Isolated Systolic Hypertension
Authors: Mackenzie Isla S. , McEniery Carmel M. , Dhakam Zahid , Brown Morris J. , Cockcroft John R. , Wilkinson Ian B.
Published: June 2009

Isolated systolic hypertension is an important risk factor for cardiovascular disease and results primarily from elastic artery stiffening. Although various drug therapies are used to lower peripheral blood pressure (BP) in patients with isolated systolic hypertension, the effects of the 4 major classes of antihypertensive agents on central BP, pulse pressure (PP) amplification, and arterial stiffness in this condition are not clear. Fifty-nine patients over the age of 60 years with untreated isolated systolic hypertension (systolic BP ≥140 mm Hg and diastolic BP ≤90 mm Hg) were randomly assigned to receive 1 of the following 4 antihypertensive agents: perindopril, atenolol, lercanidipine, or bendrofluazide. BP was measured using a mercury sphygmomanometer, and augmentation index and carotid-femoral (aortic) pulse wave velocity were measured at baseline, after 2 weeks of placebo therapy, and at the end of 10 weeks of active therapy. Peripheral systolic BP and peripheral PP were reduced similarly after treatment with all 4 classes of drug. However, central PP was only reduced significantly by perindopril, lercanidipine, and bendrofluazide, whereas atenolol had no effect. Lercanidipine reduced the augmentation index, whereas atenolol increased it. Aortic pulse wave velocity was not changed by any of the drugs. In summary, despite similar reductions in peripheral systolic and PPs with the 4 classes of drug, changes in central pressure and augmentation index varied. Because central PP and increased wave reflections are considered important risk factors in patients with isolated systolic hypertension, the choice of therapy may be influenced by these findings in the future.
Clinical and Laboratory Assessment of Dehydration Severity in Children With Acute Gastroenteritis
Authors: Parkin Patricia C. , Macarthur Colin , Khambalia Amina , Goldman Ran D. , Friedman Jeremy N.
Published: June 2009

Objective. To evaluate clinical and laboratory assessment of dehydration severity in children, 1 to 36 months, with acute gastroenteritis. Study design. Clinical and laboratory measures and weight change following rehydration were collected for enrolled children. Setting. Pediatric emergency department. Results. Likelihood ratio (LR+) and 95% confidence interval (CI): for a clinical score of 0, the LR+ was 2.2 (95% CI = 0.9-5.3); for a clinical score of 1 to 4, the LR+ was 1.3 (95% CI = 0.90-1.74); for a clinical score of 5 to 8, the LR+ was 5.2 (95% CI = 2.2-12.8); for a venous pH <7.32, the LR+ was 7.2 (95% CI = 2.4-21.9); and for serum bicarbonate <18 mmol/L, the LR+ was 11.6 (95% CI = 3.5-38.0). Conclusion. Clinicians may find it useful to incorporate the Clinical Dehydration Scale and laboratory measures into clinical decision-making algorithms to assess dehydration severity in children with acute gastroenteritis.
Does Picky Eating Affect Weight-for-Length Measurements in Young Children?
Authors: Ekstein Sivan , Laniado David , Glick Benjamin
Published: May 2009

Objectives: Picky eating is a major source of parental concern, and children with picky eating habits are potentially at risk for nutritional deficits. This research aimed to determine whether picky eating is related to being underweight in young children. Methods: Participants included 34 children with picky eating behavior who were referred to the Pediatric Feeding and Nutrition Clinic for evaluation and 136 healthy controls.Weight and height measurements were obtained, and weight-to-length data were calculated for each child. Results: In all, 7 of 34 children (20.6%) in the picky eaters group and 9 of 136 children (6.6%) in the control group were underweight ( P = .02). Underweight was found in 15 children (14.2%) at or under 36 months and in 1 child (1.6%) older than 36 months ( P = .002). Conclusions: Children with picky eating habits, especially those younger than 3 years of age, are at increased risk of being underweight.
Inhibition of Gastroesophageal Reflux by Semi‐solid Nutrients in Patients With Percutaneous Endoscopic Gastrostomy
Authors: Nishiwaki Shinji , Araki Hiroshi , Shirakami Yohei , Kawaguchi Junji , Kawade Naofumi , Iwashita Masahide , Tagami Atsushi , Hatakeyama Hiroo , Hayashi Takao , Maeda Teruo , Saitoh Koushirou
Published: June 2009

Background: Aspiration is one of the major complications after percutaneous endoscopic gastrostomy (PEG). The administration of semi‐solid nutrients by means of gastrostomy tube has recently been reported to be effective in preventing aspiration pneumonia. The effects of semi‐solid nutrients on gastroesophageal reflux, intragastric distribution, and gastric emptying were evaluated. Methods: Semi‐solid nutrients were prepared by liquid nutrients mixed with agar at the concentration of 0.5%. The distribution of the administered radiolabeled liquid and semi‐solid nutrients was monitored by a scintillation camera for 15 post‐PEG patients. The percentage of esophageal reflux, the distribution of the proximal and distal stomach, and the gastric emptying time were evaluated. Results: The percentage of gastroesophageal reflux was significantly decreased in semi‐solid nutrients (0.82 ± 1.27%) compared with liquid nutrients (3.75 ± 4.25%), whereas the gastric emptying time was not different. The distribution of semi‐solid nutrients was not different from liquid nutrients in the early phase, whereas higher retention of liquid nutrients in the proximal stomach was observed in the late phase. Conclusions: Gastroesophageal reflux was significantly inhibited by semi‐solid nutrients. One of the mechanisms of the inhibition is considered to be an improvement in the transition from the proximal to distal stomach in semi‐solid nutrients.
Dublin Core metadata semantics: an analysis of the perspectives of information professionals
Authors: Park Jung-ran , Childress Eric
Published: May 2009

This study examines Dublin Core (DC) metadata semantics drawn from the perspectives and experiences of cataloguing and metadata professionals. The study ascertains the extent of difficulty in applying the DC metadata elements encountered by these professionals and examines factors engendering such difficulties during the metadata application process. Comments drawn from the survey participants ( n = 141) show that conceptual ambiguities (41%) and semantic overlaps (45%) of the surveyed DC metadata elements are the most frequently cited factors causing difficulty and confusion, in turn leading to variant interpretations of DC metadata elements. This has the potential to bring forth inconsistent and inaccurate applications and implementation of the DC standard across institutions which can directly affect semantic interoperability across digital repositories. The high degree of difficulty (55.3%) engendered by the Relation field indicates that further examination of this element is needed.
Smoking-associated Squamous Metaplasia in Olfactory Mucosa of Patients with Chronic Rhinosinusitis
Authors: Yee Karen K. , Pribitkin Edmund A. , Cowart Beverly J. , Vainius Aldona A. , Klock Christopher T. , Rosen David , Hahn Chang-Gyu , Rawson Nancy E.
Published: June 2009

Few studies have examined the induction of squamous metaplasia in human olfactory nasal tissue caused by tobacco use and the implications it may have for olfaction, particularly when there are pre-existing insults, such as chronic rhinosinusitis (CRS). Quantitative histopathological analyses were performed on Alcian blue- and H&E-stained sections of nasal biopsies taken from the upper aspect of the middle turbinate of CRS patients. Chronic rhinosinusitis patients who were current smokers had a predominance of squamous metaplasia in the olfactory sensory epithelium, whereas CRS patients who were nonsmokers and were not exposed to secondhand cigarette smoke had a prevalence of goblet cell hyperplasia. In spite of this difference, the groups did not differ significantly in olfactory threshold sensitivity. The impact of primary cigarette smoke on olfaction and a possible role of squamous metaplasia in preserving olfactory neurogenesis are discussed.
Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up
Authors: Klintberg Ingrid Hultenheim , Gunnarsson Ann-Christine , Svantesson Ulla , Styf Jorma , Karlsson Jòn
Published: May 2009

Objective: To describe the clinical changes following two different physiotherapy treatment protocols after rotator cuff repair.

Design: A prospective, randomized pilot study with a two-year follow-up.

Subjects: Five women and nine men, 55 (40—64) years old, were included.

Intervention: The progressive group (n = 7) started with dynamic, specific muscle activation of the rotator cuff the day after surgery as well as passive range of motion. After four weeks of immobilization the loading to the rotator cuff increased and in a progressive manner throughout the rehabilitation. In the traditional group (n = 7) the rotator cuff was protected from loading. Patients were immobilized for six weeks and started with passive range of motion the day after surgery. No specific exercises to the rotator cuff were introduced during this period.

Main measures: A clinical evaluation was made preoperatively, 3, 6, 12 and 24 months after surgery. Pain rating during activity and at rest, patient satisfaction, active range of motion and muscle strength, Constant score, hand in neck, hand in back and pour out of a pot, as well as Functional Index of the Shoulder were used.

Results: At two years follow-up, the progressive group and traditional group scored pain during activity visual analogue scale (VAS) 2/0 mm and pain at rest 0/0 mm, respectively. The groups attained 170/175° in active abduction in standing and 70/90° in passive external rotation while lying in supine. Using Constant score, the groups attained 82/77 points respectively.

Conclusion: The present study showed that the progressive protocol produced no adverse effects compared with the traditional protocol.
Positioning to prevent or reduce shoulder range of motion impairments after stroke: a meta-analysis
Authors: Borisova Yelena , Bohannon Richard W
Published: May 2009

Objective: To assess the effectiveness of positioning on range of motion of the paretic shoulder following stroke.

Data sources: We searched PubMed, CINAHL, EMBASE, Science Citation Index, PEDro, Cochrane Controlled Trails Register and article reference lists.

Review methods: Randomized controlled trials reporting range of motion outcomes of shoulder positioning programmes for patients with stroke were examined independently by the two authors. Studies reporting external rotation range of motion outcomes were abstracted and their quality was rated.

Results: Five studies, all published in 2000 or later, were included. Shoulder external rotation range of motion was lost by control groups (mean = 11.0—18.4°) and experimental (positioning) groups (mean = 6.1° to 19.2 °) in every study.

The standardized mean difference between groups was -0.216 (95% confidence interval -0.573 to 0.141). These findings and the demonstration of homogeneity between and within groups do not support positioning (as practised) as an effective intervention for preventing or slowing the development of range-of-motion impairments of the paretic shoulder after stroke.

Conclusion: This meta-analysis failed to support the benefit of positioning the paretic upper extremity to prevent or reduce shoulder external rotation range of motion impairments after stroke.
Longevity and Causes of Death of Adult Males in the Medici Di Bicci Family
Authors: Lippi Donatella , Matucci Cerinic Marco , Albury W.R. , Weisz George M.
Published: May 2009

The Medici family was prominent in Europe between the fifteenth and eighteenth centuries. Their contributions to political, economic, and artistic life have remained persistent preoccupations for historians. The medical history of this family, however, was relatively neglected prior to the middle of the twentieth century, probably due to the scarcity of relevant information. Retrospective study of the diseases of the Medici has developed more intensely since World War II, when exhumation of the skeletons of family members became possible. The present researchers are engaged in a new assessment of the data now available, starting with an analysis of the longevity and causes of death of adult males in the family. Our findings show clear longevity trends in the two branches of the family. These trends cannot be explained on the basis of current knowledge, but recognition of their existence may help to orient future research.
Bioresorbable Pins and Interference Screws for Fixation of Hamstring Tendon Grafts in Anterior Cruciate Ligament Reconstruction Surgery
Authors: Stengel Dirk , Casper Dirk , Bauwens Kai , Ekkernkamp Axel , Wich Michael
Published: May 2009

Background

Biodegradable cross-pins have been shown to provide higher failure loads than do screws for fixation of hamstring tendons under laboratory conditions.

Purpose

To compare the clinical results of biodegradable pins (RigidFix) and interference screws (BioCryl) for fixation of hamstring grafts in arthroscopically assisted anterior cruciate ligament reconstruction.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

To test the hypothesis of a difference of 1.0 ± 1.2 mm in anterior knee laxity between the two fixation options, 54 patients were randomly assigned to groups via a block randomization scheme and sealed envelopes. All patients underwent standardized hamstring graft reconstruction and had similar postoperative aftercare by an accelerated rehabilitation protocol. Measures assessed at baseline and after 1 and 2 years of follow-up included (1) the side-to-side difference in anterior laxity (KT-1000 arthrometer), (2) Short Form 36 physical and mental component scores, and (3) the International Knee Documentation Committee form scores.

Results

After 1 and 2 years, 26 and 21 patients in the BioCryl group and 28 and 24 patients in the RigidFix group were available for follow-up examination. No significant difference was noted in instrumented anterior translation between BioCryl and RigidFix fixation: 1 year, 0.11 (95% CI, —0.60 to 0.82; P = .7537); 2 years, 0.33 (95% CI, —0.43 to 1.08 mm; P = .3849). Also, there were no significant differences in the mean physical and mental component scores and International Knee Documentation Committee form scores and in overall complication and surgical revision rates. A pin dislocation was classified as the sole procedure-specific serious adverse event.

Conclusion

Bioresorbable pins do not provide better clinical results than do resorbable interference screws for hamstring graft fixation in anterior cruciate ligament reconstruction surgery.
Hospital waste management status in Iran: a case study in the teaching hospitals of Iran University of Medical Sciences
Authors: Farzadkia Mahdi , Moradi Arash , Mojtaba Shah Mohammadi  , Jorfi Sahand
Published: June 2009

Hospital waste materials pose a wide variety of health and safety hazards for patients and healthcare workers. Many of hospitals in Iran have neither a satisfactory waste disposal system nor a waste management and disposal policy. The main objective of this research was to investigate the solid waste management in the eight teaching hospitals of Iran University of Medical Sciences. In this cross-sectional study, the main stages of hospital waste management including generation, separation, collection, storage, and disposal of waste materials were assessed in these hospitals, located in Tehran city. The measurement was conducted through a questionnaire and direct observation by researchers. The data obtained was converted to a quantitative measure to evaluate the different management components. The results showed that the waste generation rate was 2.5 to 3.01 kg bed—1 day—1, which included 85 to 90% of domestic waste and 10 to 15% of infectious waste. The lack of separation between hazardous and non-hazardous waste, an absence of the necessary rules and regulations applying to the collection of waste from hospital wards and on-site transport to a temporary storage location, a lack of proper waste treatment, and disposal of hospital waste along with municipal garbage, were the main findings. In order to improve the existing conditions, some extensive research to assess the present situation in the hospitals of Iran, the compilation of rules and establishment of standards and effective training for the personnel are actions that are recommended.
Association of Campylobacter jejuni Infection with Childhood Guillain-Barré Syndrome: A Case-Control Study
Authors: Kalra Veena , Chaudhry Rama , Dua Tarun , Dhawan Benu , Sahu Jitendra K. , Mridula B.
Published: June 2009

A prospective case-control study was conducted to determine the association between Campylobacter jejuni infection and childhood Guillain-Barré syndrome in the Indian population. We found evidence of recent Campylobacter jejuni infection in 27.7% of patients with Guillain-Barré syndrome, as compared with 2.3% in neurological controls (P = .003) and 2.3% in nonneurological controls (P = .003). Of the 15 patients with Campylobacter jejuni infection, 8 (53.3%) reported having had diarrhea within 12 weeks before the onset of the neurologic illness. Our results suggest association between recent Campylobacter jejuni infection and bulbar weakness (P = .043). No statistical difference was observed between the Campylobacter jejuni positive and negative groups with respect to age, other clinical features, albuminocytological dissociation, and residual paralysis at follow-up. It is concluded that subclinical Campylobacter jejuni infection is an important antecedent illness in childhood Guillain-Barré syndrome in the Indian population.
Deprivation and Dysphagia in Premature Infants
Authors: Bingham Peter M.
Published: June 2009

The developmental trajectory of feeding features increasingly rhythmic ingestive behavior patterns. Sucking and swallowing by the fetus and infant, including fetal consumption of amniotic fluid, depend upon brainstem central pattern generators whose activity is increasingly influenced by chemosensory and oral-tactile input. This neurobiological fact underlies the clinical discovery that oral-tactile stimulation via pacifier stimulates ingestive behavior in tube-fed, premature infants and improves their feeding skills. However, little is known regarding the degree to which oral sensory deprivation may contribute to feeding problems in these patients. Evidence of deprivation-induced neuropathologic effects in rodents further underlines the potential impact of sensory deprivation in premature newborns, whose transition period from tube to oral feeding often lasts weeks beyond term equivalent gestational age. Studies exploring the link between early dysphagia and later developmental impairment could clarify experiential antecedents of cerebral injury. Trials of sensory interventions to promote feeding development are warranted.
Psychiatric Comorbidity Differences in Clinic-Referred Children and Adolescents With ADHD According to the Subtypes and Gender
Authors: Ghanizadeh Ahmad
Published: June 2009

There are controversial or even opposite findings about gender and prevalence of comorbid psychiatric disorders among different subtypes of attention-deficit hyperactivity disorder (ADHD). The participants were children with attention-deficit hyperactivity disorder. Gender, subtype of attention-deficit hyperactivity disorder, and the interaction effects were evaluated by logistic regression. Of the 171 children, 73 (42.7%) were of the combined subtype, 45 (26.3%) inattentive, and 52 (31.0%) were hyperactive/impulsive. The prevalence of attention-deficit hyperactivity disorder subtypes was not different between genders. There was no significant difference of gender by subtype interaction effects on the children's age. This study does not provide evidence supporting attention-deficit hyperactivity disorder subtypes as distinct clinical entities in terms of comorbidity. Association of attention-deficit hyperactivity disorder subtypes and psychiatric disorders in Iran is somehow different from that in some studies conducted in the Western culture. It is more similar to that of other Asian countries.
Magnetoencephalography Evaluation of Febrile Seizures in Young Children
Authors: Anninos Photios , Kotini Athanasia , Tsalkidis Aggelos , Dipla Vasiliki , Chatzimichael Athanasios
Published: May 2009

The aim of this study is to assess any cerebral dysfunction in young children, who experienced febrile seizures, by means of magnetoencephalography. Our study population included 15 children (9 boys, 6 girls) within the age range of 2 to 7 years. The magnetoencephalography data were recorded with a 122-channel biomagnetometer. Equivalent current dipoles were calculated for epileptic spikes on magnetoencephalography recordings according to the single dipole model. Of 15 children, 8 showed equivalent current dipoles that located at the left—temporal, right—temporal, occipital, and frontal lobe, as active regions responsible for febrile seizures. We assumed that the interictal epileptiform discharges are a consequence of febrile seizures. Of course, further study in a larger number of patients is needed to evaluate the exact role of the equivalent current dipoles, in young children, who experienced febrile seizures.
The Presence of Attention-Deficit Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Disorder Worsen Psychosocial and Educational Problems in Tourette Syndrome
Authors: Debes Nanette , Hjalgrim Helle , Skov Liselotte
Published: May 2009

We assessed the psychosocial and educational consequences of Tourette syndrome using a structured interview and child behavior checklist in 314 children with Tourette syndrome and 81 healthy controls. Of the children with Tourette syndrome, 59.0% needed some kind of educational support, 44.7% had been teased, and 61.8% withheld themselves from taking part in social activities because of Tourette syndrome-related problems. There were significantly more psychosocial and educational problems in children with Tourette syndrome compared with healthy controls. A higher rate of these problems was also seen if the comorbidities attention-deficit hyperactivity disorder (ADHD) and/or obsessive compulsive disorder were present. It is very important for the physicians, teachers, and other professionals to be aware of the high prevalence of these social and educational problems to be able to deal with them and to teach the families to cope with them.
Effectiveness of an Intervention to Improve Breastfeeding Knowledge and Attitudes Among Fifth-grade Children in Brazil
Authors: Bottaro Silvania M. , Giugliani Elsa R. J.
Published: June 2009

This cluster-randomized trial evaluated the effectiveness and residual effect of an educational intervention to improve breastfeeding knowledge and attitudes among fifth grade children of both sexes in Brazil. Schools were considered clusters and analysis of variance was used to compare an intervention group (n = 298) and a control group (n = 253) regarding knowledge, perceptions, and beliefs about breastfeeding before and after the intervention, measured through a standardized 25-item, multiple-choice questionnaire. The scores in the intervention group improved significantly, with the effect lasting at least 3 months. The intervention had greater impact on girls and on students between 9 and 11 years of age when compared with boys and students between 12 and 17 years old and also between students from public schools. Results suggest that pro-breastfeeding interventions in schools improve breastfeeding knowledge and attitudes. J Hum Lact. 25(3):325-332.
Effects of a Prenatal Intervention on Breastfeeding Initiation Rates in a Latina Immigrant Sample
Authors: Sandy James M. , Anisfeld Elizabeth , Ramirez Erline
Published: June 2009

A randomized controlled trial study design was used to investigate the effectiveness of a Healthy Families America model prenatal intervention for increasing breastfeeding rates among Latina immigrants residing in an impoverished New York City community. Exposure to the intervention did not affect mother report of any breastfeeding (ABF) during the first week postpartum, but it did affect mother report of exclusive breastfeeding (EBF). Thirty-two percent (44/137) of mothers exposed to the intervention reported EBF during the first week postpartum compared to 20% (20/101) of mothers not exposed to the intervention (odds ratio 1.92; 95% confidence interval 1.05-3.52). This positive effect of the intervention on EBF remained statistically significant after controlling for the negative effect of household income on EBF (adjusted odds ratio, 1.89; 95% confidence interval, 1.02-3.50). Additional research is needed on the effectiveness of breastfeeding promotion programs targeting low-income Latinas. J Hum Lact. 25(4):404-411.
Attitudes of social science students in Israel and Austria towards the Belated Twins scenario—an exploratory study
Authors: Prainsack Barbara , Hashiloni-Dolev Yael , Kasher Asa , Prainsack Josef
Published: May 2009

This article discusses results of a questionnaire survey of 156 university students in Israel and Austria examining reactions towards the Belated Twins scenario, which entails the artificial twinning of embryos of which one is immediately carried to term while the other one is born later. The scenario resembles a case of human reproductive cloning in terms of result (the creation of genetically identical individuals in a time-delayed manner) but it involves gamete fusion like “natural” reproduction. By means of qualitative text analysis we discuss the core themes mobilized both in support and opposition to the scenario. While Israeli and Austrian respondents held similar general attitudes (about half were in favour of legalizing Belated Twins, while about a third opposed it), they drew partly on different arguments to arrive at their conclusions. In both groups, uncertainty stemming from “novel” elements in the scenario was regularly interpreted as negatively exacerbating existing issues.
Diaries from cannabis users: an Interpretative Phenomenological Analysis
Authors: Boserman Cristina
Published: June 2009

This article is based on research, which aimed to uncover the meanings behind the experience of cannabis use. Six participants were recruited and asked to keep a diary for 15 days. Data were analysed using Interpretative Phenomenological Analysis (IPA). Four master themes emerged and were explored in detail. These were: `Withdrawing from everyday life', `Indulging in the here-and-now of the emotional body', `The containment of the sacred space' and `Living the addiction'. The author draws on the theoretical insights of Analytical Psychology in an attempt to capture and explain the dynamics emerging from participants' experiences. Throughout the narratives the use of cannabis, commonly regarded as a risky practice, appears to incarnate an attempt to reconnect with the here-and-now of the emotional body, as a way to escape from a convulsive consumeristic society. However, as the author argues, the lack of a conscious integration of the same convulsive consumeristic aspects within the psyche, leads participants into being `possessed' by these same forces, ultimately leading to a repetitive and compulsive addictive behaviour.
Holding onto womanhood: a qualitative study of heterosexual women with sexual desire loss
Authors: Hinchliff Sharron , Gott Merryn , Wylie Kevan
Published: June 2009

This article explores heterosexual women's accounts of sexual desire loss, particularly the ways in which it can affect their sense of themselves as women. In-depth interviews were conducted with 17 participants recruited through a psychosexual clinic in England, and the data analysed using a material-discursive approach. The findings showed that having sexual desire loss often challenged participants' perceptions of themselves as women. Specific challenges related to dealing with isolation and `otherness', addressing their own feelings of not being `proper wives' because they did not sexually satisfy their partners and maintaining a sense of sexual attractiveness in the absence of sexual desire. Participants responded to these challenges in various ways, often renegotiating their identities as women. The findings are discussed in relation to theorizing women's sexuality and their implications for health care.
Cholangiocarcinoma
Authors: Whitlock Patti J.
Published: May 2009

Cholangiocarcinoma is a rare, primary cancer of the biliary tree that can be difficult to diagnose with all imaging modalities. The presenting clinical symptoms of nausea, vomiting, and jaundice can be consistent with classic cholecystitis symptoms, increasing the risk of a missed diagnosis. The most often seen risk factor for cholangiocarcinoma is primary sclerosing cholangitis (PSC). In most cases, the initial diagnostic finding is intrahepatic ductal dilatation. Once an actual mass is seen, liver transplantation is the necessary treatment plan because of likely hepatic metastasis. There is a slight recurrence rate of cholangiocarcinoma even in a transplanted liver. A high percentage of cases are treated with only palliative care. This case presents a classic example of cholangiocarcinoma at the porta hepatis, involving a hyperechoic mass in a dilated common bile duct with abnormalities of the intrahepatic bile ducts and gallbladder.
The Asn505 mutation of the c-MPL gene, which causes familial essential thrombocythemia, induces autonomous homodimerization of the c-Mpl protein due to strong amino acid polarity
Authors: Ding Jianmin , Komatsu Hirokazu , Iida Shinsuke , Yano Hiroki , Kusumoto Shigeru , Inagaki Atsushi , Mori Fumiko , Ri Masaki , Ito Asahi , Wakita Atsushi , Ishida Takashi , Nitta Masakazu , Ueda Ryuzo
Published: May 2009

We previously reported that a dominant-positive activating mutation (Asn505) in the transmembrane domain (TMD) of c-MPL, which encodes the thrombopoietin receptor, caused familial essential thrombocythemia. Here, we show that the Asn505 mutation induces both autonomous dimerization of c-Mpl and signal activation in the absence of its ligand. Signal activation was preserved in a truncated mutant of Asn505 that lacked the extracellular domain of c-MPL. We also found that the substitution of the amino acid (AA) residue at position 505 with others of strong polarity (Glu, Asp, or Gln) also resulted in activated dimerization without ligand stimulation. Overall, these data show that the Asn505 mutation transduced the signal through the autonomous dimerization of the c-MPL protein due to strong AA polarity. This finding provides a new insight into the mechanism of disease causation by mutations in the TMD of cytokine/hematopoietic receptors.
Bone marrow cell derived arginase I is the major source of allergen-induced lung arginase but is not required for airway hyperresponsiveness, remodeling and lung inflammatory responses in mice
Authors: Niese Kathryn A , Collier Ann R , Hajek Amanda R , Cederbaum Stephen D , O'Brien William E , Wills-Karp Marsha , Rothenberg Marc E , Zimmermann Nives
Published: June 2009

Background

Arginase is significantly upregulated in the lungs in murine models of asthma, as well as in human asthma, but its role in allergic airway inflammation has not been fully elucidated in mice.

Results

In order to test the hypothesis that arginase has a role in allergic airway inflammation we generated arginase I-deficient bone marrow (BM) chimeric mice. Following transfer of arginase I-deficient BM into irradiated recipient mice, arginase I expression was not required for hematopoietic reconstitution and baseline immunity. Arginase I deficiency in bone marrow-derived cells decreased allergen-induced lung arginase by 85.8 ± 5.6%. In contrast, arginase II-deficient mice had increased lung arginase activity following allergen challenge to a similar level to wild type mice. BM-derived arginase I was not required for allergen-elicited sensitization, recruitment of inflammatory cells in the lung, and proliferation of cells. Furthermore, allergen-induced airway hyperresponsiveness and collagen deposition were similar in arginase-deficient and wild type mice. Additionally, arginase II-deficient mice respond similarly to their control wild type mice with allergen-induced inflammation, airway hyperresponsiveness, proliferation and collagen deposition.

Conclusion

Bone marrow cell derived arginase I is the predominant source of allergen-induced lung arginase but is not required for allergen-induced inflammation, airway hyperresponsiveness or collagen deposition.
Increased levels of soluble CD226 in sera accompanied by decreased membrane CD226 expression on peripheral blood mononuclear cells from cancer patients
Authors: Xu Zhuwei , Zhang Tao , Zhuang Ran , Zhang Yun , Jia Wei , Song Chaojun , Yang Kun , Yang Angang , Jin Boquan
Published: June 2009

Background

As a cellular membrane triggering receptor, CD226 is involved in the NK cell- or CTL-mediated lysis of tumor cells of different origin, including freshly isolated tumor cells and tumor cell lines. Here, we evaluated soluble CD226 (sCD226) levels in sera, and membrane CD226 (mCD226) expression on peripheral blood mononuclear cells (PBMC) from cancer patients as well as normal subjects, and demonstrated the possible function and origin of the altered sCD226, which may provide useful information for understanding the mechanisms of tumor escape and for immunodiagnosis and immunotherapy.

Results

Soluble CD226 levels in serum samples from cancer patients were significantly higher than those in healthy individuals (P< 0.001), while cancer patients exhibited lower PBMC mCD226 expression than healthy individuals (P< 0.001). CD226-Fc fusion protein could significantly inhibit the cytotoxicity of NK cells against K562 cells in a dose-dependent manner. Furthermore, three kinds of protease inhibitors could notably increase mCD226 expression on PMA-stimulated PBMCs and Jurkat cells with a decrease in the sCD226 level in the cell culture supernatant.

Conclusion

These findings suggest that sCD226 might be shed from cell membranes by certain proteases, and, further, sCD226 may be used as a predictor for monitoring cancer, and more important, a possible immunotherapy target, which may be useful in clinical application.
Construction of siRNA/miRNA expression vectors based on a one-step PCR process
Authors: Xu Jun , Zeng Jie Qiong , Wan Gang , Hu Gui Bin , Yan Hong , Ma Li Xin
Published: June 2009

Background

RNA interference (RNAi) has become a powerful means for silencing target gene expression in mammalian cells and is envisioned to be useful in therapeutic approaches to human disease. In recent years, high-throughput, genome-wide screening of siRNA/miRNA libraries has emerged as a desirable approach. Current methods for constructing siRNA/miRNA expression vectors require the synthesis of long oligonucleotides, which is costly and suffers from mutation problems.

Results

Here we report an ingenious method to solve traditional problems associated with construction of siRNA/miRNA expression vectors. We synthesized shorter primers (< 50 nucleotides) to generate a linear expression structure by PCR. The PCR products were directly transformed into chemically competent E. coli and converted to functional vectors in vivo via homologous recombination. The positive clones could be easily screened under UV light. Using this method we successfully constructed over 500 functional siRNA/miRNA expression vectors. Sequencing of the vectors confirmed a high accuracy rate.

Conclusion

This novel, convenient, low-cost and highly efficient approach may be useful for high-throughput assays of RNAi libraries.
Empowerment of disability benefit claimants through an interactive website: design of a randomized controlled trial
Authors: Samoocha David , Bruinvels David J , Anema Johannes R , Steenbeek Romy , van der Beek Allard J
Published: June 2009

Background

Individuals claiming a disability benefit after long-term sickness absence, have to undergo medical disability assessments. These assessments, often carried out by specialized physicians, can be complicated by wrong expectations or defensive attitudes of disability benefit claimants. It is hypothesized that empowerment of these claimants will enhance the physician-patient relationship by shifting claimants from a passive role to a more active and constructive role during disability assessments. Furthermore, empowerment of claimants may lead to a more realistic expectation and acceptance of the assessment outcome among claimants and may lead to a more accurate assessment by the physician.

Methods/Design

In a two-armed randomized controlled trial (RCT), 230 claimants will be randomized to either the intervention or control group. For the intervention group, an interactive website was designed http://www.wiagesprek.nl using an Intervention Mapping procedure. This website was tested during a pilot study among 51 claimants. The final version of the website consists of five interactive modules, in which claimants will be prepared and empowered step-by-step, prior to their upcoming disability assessment. Other website components are a forum, a personal health record, a personal diary, and information on disability assessment procedures, return to work, and coping with disease and work disability. Subjects from the control group will be directed to a website with commonly available information only.

Approximately two weeks prior to their disability assessment, disability claimants will be recruited through the Dutch Workers Insurance Authority (UWV). Outcomes will be assessed at five occasions: directly after recruitment (baseline), prior to disability assessment, directly after disability assessment as well as 6 and 16 weeks after the assessment. The study's primary outcome is empowerment, measured with the Vrijbaan questionnaire. Secondary outcomes include claimants' satisfaction, perceived justice, coping strategy, and knowledge. A process evaluation will also be conducted.

Discussion

This study evaluates the effectiveness of an interactive website aimed at empowerment of disability claimants. It is hypothesized that by increasing empowerment, the physician-patient relationship may be enhanced and claimants' satisfaction and perceived justice can be improved. Results are expected in 2010.

Trial registration

NTR-1414
OpenFLUX: efficient modelling software for 13C-based metabolic flux analysis
Authors: Quek Lake-Ee , Wittmann Christoph , Nielsen Lars K , Krömer Jens O
Published: June 2009

Background

The quantitative analysis of metabolic fluxes, i.e., in vivo activities of intracellular enzymes and pathways, provides key information on biological systems in systems biology and metabolic engineering. It is based on a comprehensive approach combining (i) tracer cultivation on 13C substrates, (ii) 13C labelling analysis by mass spectrometry and (iii) mathematical modelling for experimental design, data processing, flux calculation and statistics. Whereas the cultivation and the analytical part is fairly advanced, a lack of appropriate modelling software solutions for all modelling aspects in flux studies is limiting the application of metabolic flux analysis.

Results

We have developed OpenFLUX as a user friendly, yet flexible software application for small and large scale 13C metabolic flux analysis. The application is based on the new Elementary Metabolite Unit (EMU) framework, significantly enhancing computation speed for flux calculation. From simple notation of metabolic reaction networks defined in a spreadsheet, the OpenFLUX parser automatically generates MATLAB-readable metabolite and isotopomer balances, thus strongly facilitating model creation. The model can be used to perform experimental design, parameter estimation and sensitivity analysis either using the built-in gradient-based search or Monte Carlo algorithms or in user-defined algorithms. Exemplified for a microbial flux study with 71 reactions, 8 free flux parameters and mass isotopomer distribution of 10 metabolites, OpenFLUX allowed to automatically compile the EMU-based model from an Excel file containing metabolic reactions and carbon transfer mechanisms, showing it's user-friendliness. It reliably reproduced the published data and optimum flux distributions for the network under study were found quickly (<20 sec).

Conclusion

We have developed a fast, accurate application to perform steady-state 13C metabolic flux analysis. OpenFLUX will strongly facilitate and enhance the design, calculation and interpretation of metabolic flux studies. By providing the software open source, we hope it will evolve with the rapidly growing field of fluxomics.
Ruptured gallbladder as the first presentation of breast cancer
Authors: Jones M , Mathew J , Abdullah KE , McCulloch T , Cheung KL
Published: June 2009

Background

Perforation of the gall bladder as a first presentation of breast cancer has not been reported.

Case presentation

Here we present a case of an elderly lady with acute abdomen with evidence of possible perforation of gall bladder on CT scan. Histopathology of the cholecystectomy specimen revealed invasive lobular breast cancer.

Her metastatic breast cancer with right sided primary discovered subsequent to her presentation with acute abdomen is managed successfully with Anastrozole.

Conclusion

We present a rare case of gall bladder perforation from metastatic breast cancer.
Dog ecology and demography in Antananarivo, 2007
Authors: Ratsitorahina Maherisoa , Rasambainarivo Jhon H , Raharimanana Soloherilala , Rakotonandrasana Hary , Andriamiarisoa Marie-Perle , Rakalomanana Fidilalao A , Richard Vincent
Published: June 2009

Background

Rabies is a widespread disease in African domestic dogs and a serious public health problem in developing countries. Canine rabies became established in Africa during the 20th century, coinciding with ecologic changes that favored its emergence in canids.

This paper reports the results of a cross-sectional study of dog ecology in the Antananarivo urban community in Madagascar.

A questionnaire survey of 1541 households was conducted in Antananarivo from October 2007 to January 2008. The study addressed both owned and unowned dogs. Various aspects of dog ecology were determined, including size of dog population, relationship between dogs and humans, rabies vaccination.

Results

Dog ownership was common, with 79.6 to 94.1% (mean 88.9%) of households in the six arrondissements owning dogs. The mean owned dog to person ratio was 1 dog per 4.5 persons and differed between arrondissements (administrative districts), with ratios of 1:6.0 in the first arrondissement, 1:3.2 persons in the 2nd, 1:4.8 in the 3rd, 1:5.2 in the 4th, 1:5.6 in the 5th and 1:4.4 in the 6th arrondissement. Overall, there were more male dogs (61.3%) and the male/female sex ratio was estimated to be 1.52; however, mature females were more likely than males to be unowned (OR: 1.93, CI 95%; 1.39<OR<2.69). Most (79.1%) owned dogs were never restricted and roamed freely to forage for food and mix with other dogs. Only a small proportion of dogs (11.7%) were fed with commercial dog food. Only 7.2% of owned dogs had certificates confirming vaccination against rabies. The proportion of vaccinated dogs varied widely between arrondissements (3.3% to 17.5%).

Conclusion

Antananarivo has a higher density of dogs than many other urban areas in Africa. The dog population is unrestricted and inadequately vaccinated against rabies. This analysis of the dog population will enable targeted planning of rabies control efforts.