bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of supplementation of tef (Eragrostis tef) straw with different levels of noug (Guizotia abyssinica) meal on worked Arsi oxen (Bos indicus)
Authors: Mengistu Ashenafi , Ebro Abule , Assefa Tadesse , Hirpa Adane , Shenkute Belete
Published: March 2007

Supplementing the tef (Eragrostis tef) straw feed of Arsi oxen (Bos indicus) with 1, 2 or 4 kg per animal per day of noug (Guizotia abyssinica) meal for 90 days improved growth parameters. Supplementation significantly increased feed intake, average daily gain, and the weight of dressed carcass and lean meat. Supplementation with 1 kg of noug meal was the most profitable, giving a net return per animal of US$17.10, whereas a sole diet of tef straw gave a loss of US$18.66 per animal. Copyright © 2007 John Wiley & Sons, Ltd
Development of a new tapioca product with tropical fruit pulp and soy extract
Authors: de Brito Edy Sousa , dos Santos Garruti Deborah , Silva Daniele Sales
Published: March 2007

Tapioca is a traditional product with great acceptability, especially in Brazil. As a starch‐based food, its nutritional quality is limited to carbohydrates. The aim of this work was to evaluate the contribution of tropical fruit pulps and soy extract to tapioca's nutritional and sensory characteristics. The products were formulated with dried tapioca starch (63%) supplemented by acerola or mango fruit pulps or by soy extract in selected combinations (37%). The mixtures were homogenised and roasted for starch gelatinisation. The final product was submitted to vitamin C and protein determinations and sensory analysis (appearance, flavour, texture and overall acceptance). Vitamin C content of the acerola tapioca products was significantly increased. Protein content was increased by supplementation with soy but the absolute levels were still quite low. Acceptability by sensory attributes of formulated tapiocas was similar to, or in some cases higher than, the traditional product. Copyright © 2007 John Wiley & Sons, Ltd.
Successful ultrasound‐guided laser treatment of fetal hydrops caused by pulmonary sequestration
Authors: Oepkes D. , Devlieger R. , Lopriore E. , Klumper F. J. C. M.
Published: March 2007

Microcystic or solid‐looking fetal lung lesions associated with hydrops are associated with a high mortality rate. The most common of these lesions are microcystic congenital cystic adenomatoid malformations and pulmonary sequestrations (PS). Performing open fetal surgery by hysterotomy and lobectomy has, until now, been the only therapeutic option available following diagnosis of these lesions in the second trimester. Here we describe a new minimally invasive technique for the treatment of PS in the second trimester. Laser coagulation of the feeding systemic artery of the sequestration was performed under ultrasound guidance. The blood flow to the lung tumor was successfully arrested and hydrops reversed. The child was born at term and, at the time of writing, was alive and well at 2 years of age.

Large PS with hydrops can be treated successfully by ultrasound‐guided minimally invasive laser surgery. It is therefore important to utilize color Doppler ultrasound imaging for identification of a systemic feeding blood vessel in solid fetal lung tumors. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Comparison of Outcomes Following Ileostomy versus Colostomy for Defunctioning Colorectal Anastomoses
Authors: Tilney Henry S. , Sains Parvinder S. , Lovegrove Richard E. , Reese George E. , Heriot Alexander G. , Tekkis Paris P.
Published: March 2007

Background

The present study evaluated outcomes of patients undergoing proximal diversion using either a loop ileostomy or loop colostomy following distal colorectal resection for malignant and non‐malignant disease.

Methods

A literature search of the Medline, Ovid, Embase and Cochrane databases was performed to identify studies published between 1966 and 2006, comparing loop ileostomy and loop colostomy to protect a distal colorectal anastomosis. A random effect meta‐analytical technique was used and sensitivity analysis performed on studies published since 2000, higher quality papers, those reporting on 70 or more patients, and those reporting outcomes following colorectal cancer resections.

Results

Seven studies, including three randomised controlled trials, satisfied the inclusion criteria. Outcomes of a total of 1,204 patients were analysed, of whom 719 (59.7%) underwent defunctioning loop ileostomy. High stoma output was more common following ileostomy formation (OR = 5.39, 95% CI: 1.11, 26.12, P = 0.04), but wound infections following their reversal were significantly fewer (OR = 0.21, 95% CI: 0.07, 0.62, P = 0.004). Overall complications were less frequent for ileostomy patients in the subgroup of high quality studies (OR = 0.22, 95% CI: 0.08, 0.59, P = 0.003).

Conclusion

The results of this meta‐analysis suggest that ileostomy may be preferable to colostomy when used to defunction a distal colorectal anastomosis. Wound infections following stoma reversal were reduced, as were overall stoma‐related complications and incisional hernia following stoma reversal for ileostomy patients in high quality studies.
VEGF‐C Expression in Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus
Authors: Möbius Christian , Freire José , Becker Ingrid , Feith Marcus , Brücher Björn L. D. M. , Hennig Michael , Siewert J. Rüdiger , Stein Hubert J.
Published: March 2007

Background

Vascular endothelial growth factor C (VEGF‐C) is the only factor known to cause lymphangiogenesis. In esophageal cancer the histologic tumor type and lymph node metastasis are independent predictors of recurrence and poor outcome. To evaluate the rule of VEGF‐C expression in esophageal cancer, we investigated 113 specimens, 59 squamous cell and 54 adenocarcinomas of the esophagus.

Methods

The expression of VEGF‐C was evaluated using immunohistochemistry (IHC) on 59 paraffin‐embedded archival specimens from patients with squamous cell esophageal carcinomas and 54 paraffin‐embedded archival specimens of patients with esophageal adenocarcinomas arising in Barrett’s mucosa. All patients had a complete tumor resection. A complete and updated follow‐up was available for all patients.

Results

The expression of VEGF‐C was significantly different between the two histological types of esophageal tumors. Patients with squamous cell carcinoma and lymph node metastases had a significantly higher VEGF‐C expression (P < 0.01). In patients with adenocarcinoma of the esophagus there was no correlation between VEGF‐C expression and clinicopathological parameters. High VEGF‐C expression tended to be correlated with poor survival in squamous cell cancer but not in adenocarcinoma of the esophagus.

Conclusions

The present study indicates that VEGF‐C may play a role in tumor progression via lymphangiogenesis in squamous cell carcinoma of the esophagus. This seems not to be true for the adenocarcinoma of the esophagus. These data could help with the understanding of the different onset and characteristics of lymph node metastasis in squamous cell carcinoma and adenocarcinoma of the esophagus.
High Incidence of Tracheomalacia in Longstanding Goiters: Experience from an Endemic Goiter Region
Authors: Agarwal Amit , Mishra Anand K. , Gupta Sushil K. , Arshad Farah , Agarwal Anil , Tripathi M. , Singh P. K.
Published: March 2007

Background

Our institute caters to a large number of patients with large, longstanding multinodular goiters; tracheal deviation and resulting airway problems like tracheomalacia are relatively common. However, the literature is sparse on the criteria of early diagnosis and optimum management of tracheomalacia, which our study highlights.

Methods

This retrospective study analyzed 900 thyroidectomies carried out during 1990–2005 for which data from 28 patients treated for tracheomalacia after thyroidectomy were available for analysis. Criteria for making a diagnosis of tracheomalacia after thyroidectomy included one or more of the following: normal vocal cord mobility, absence of glottic or subglottic edema or hematoma, soft and floppy trachea on palpation, obstruction to spontaneous respiration on gradual withdrawal of the endotracheal tube.

Results

Mean duration of thyroid enlargement was 13.75 years. Only 7 patients had a history of stridor. Tracheostomy was performed in 26 patients, and 2 patients were put on prolonged intubation. Tracheostomy was performed in 18 patients on the operating table, and 8 in the recovery room. The mean weight of the gland was 442 g and histopathology revealed that 11 cases were benign goiter. The tracheostomy tube was removed after an average of 8.5 days. There were no cases of tracheal stenosis on long‐term follow‐up.

Conclusions

Patients with longstanding goiter, even when benign, are more prone to develop tracheomalacia. On the basis of our experience we strongly advocate tracheostomy intraoperatively if the trachea is soft and floppy and/or collapse of the trachea is observed following gradual withdrawal of the endotracheal tube.
QuiCk‐IntraOperative Bio‐Intact PTH Assay at Parathyroidectomy for Secondary Hyperparathyroidism
Authors: Matsuoka Susumu , Tominaga Yoshihiro , Sato Tetsuhiko , Uno Nobuaki , Goto Norihiko , Katayama Akio , Uchida Kazuharu , Takami Hiroshi
Published: March 2007

Background

In uremic patients, metabolism of 1‐84 parathyroid hormone (PTH) and fragments are delayed, and in these patients, the usefulness of intraoperative PTH assay may be problematic. We evaluated the usefulness of the QuiCk‐IntraOperative Bio‐Intact PTH (QPTH) assay for uremic patients with secondary hyperparathyroidism who required total parathyroidectomy (PTx) with forearm autograft. The purpose of our study was to recognize whether QPTH in uremic patients was useful to determine during operation whether complete PTx had been achieved.

Methods

Forty‐four patients who underwent initial PTx were enrolled in this study. Blood samples were drawn just after induction of general anesthesia (basal samples), immediately after removal of the last gland, and at 5, 10, 15, and 30 minutes, and at the first morning after PTx. The assay was performed immediately after sample collection. Reductions of PTH levels were evaluated and expressed in percentage of basal levels.

Results

The mean PTH levels in 41 patients, excluding 3 in whom the PTH level did not drop significantly (>60 pg/ml), measured by QPTH at anesthesia, 0, 5, 10, 15, and 30 minutes were 734.3, 104.7, 58.8, 37.4, 27.0, 16.3 pg/ml, corresponding to 100%, 17.1%, 9.3%, 5.8%, 4.1%, 2.4% of the preexcision values, respectively. If the cutoff value was defined as 10.8% at 10 minutes, the sensitivity was 100% and specificity 90%. When the QPTH level dropped to under 10.8% at 10 minutes, we could consider that all glands were removed.

Conclusions

QPTH in uremic patients is very useful to determine whether complete PTx is achieved during operation.
Short‐term Tracking of Atherosclerosis in Operated and Unoperated Human Carotid Arteries by High Resolution Magnetic Resonance Imaging
Authors: Martin Kirt , Brownfield Douglas , Karmonik Christof , Sanford Lee , Torres Lynne , Insull William , Morrisett Joel
Published: March 2007

Introduction

A previous study demonstrated the efficacy of a phospholipid (PL) complexed with a protein (apoAI Milano) in causing 4.6% regression of atheroma volume as assessed by intravascular ultrasonography (IVUS) in a group of 47 patients with carotid atherosclerosis. The results of this study raised the question of whether the phospholipid alone could produce a similar effect.

Methods

To answer this question a trial of 39 subjects at five sites was designed. Patients with > 15% stenosis of at least one carotid artery as determined by US underwent intravenous PL (200 mg/kg) or placebo infusions weekly for 8 weeks. The wall/outer wall ratio, percent lipid‐rich/necrotic core, and percent calcification were measured as a proportion of the vessel wall by magnetic resonance imaging (MRI) at 0, 4, 8, and 14 weeks.

Results

The substudy of seven of these patients evaluated at our site allowed comparison of the dimensions of five unoperated‐unoperated carotid pairs and two operated‐unoperated pairs. In patient 1, MRI measurements on unoperated left and unoperated right carotids tracked almost identically over the 14‐week study. Both carotids showed similar increases in the volumes of the total wall (+61% vs. 56%), the normal wall (+51% vs. 49%), and plaque (+99% vs. 85%). Both carotids showed similar decreases in lumen volume (−11% vs. −17%). The other four unoperated‐unoperated carotid pairs showed dimensional changes over 14 weeks similar to those of patient 1. In patient 2, who underwent left endarterectomy, the operated carotid had a total artery volume of 2300 mm3, about twofold greater than the unoperated carotid (1100 mm3). Operated and unoperated carotid measurements tracked in parallel. The unoperated carotid had volume increases of 25% (+200 mm3) in total wall, +19% (+100 mm3) in normal wall, and 43% (+75 mm3) in plaque. The operated carotid lumen showed no significant changes. Patient 7, who also underwent left endarterectomy, exhibited carotid changes similar to those of patient 2.

Conclusions

Individual unoperated carotid pairs have volumes that track almost identically. In unilateral operated carotid pairs, the operated artery has 1.5‐ to 2.0‐fold greater volume than unoperated carotids. In each of our two unilaterally operated patients, the operated carotid had decreased plaque volume (−3%, −58%), whereas the unoperated carotid had increased plaque volume (+43%, +7%). Among the five unoperated patients, one pair had 85%/99% increase in plaque volume; one pair had −15%/−10% decrease; and the other three pairs had intermediate changes. This study provides additional support to the view that unoperated human carotid arteries are bilaterally symmetrical.
Intrathyroid Parathyroid Adenoma in Primary Hyperparathyroidism: Can It Be Predicted Preoperatively?
Authors: Abboud Bassam , Sleilaty Ghassan , Ayoub Selim , Hachem Kamal , Smayra Tarek , Ghorra Claude , Abadjian Gerard
Published: March 2007

Introduction

The role of cervical ultrasonography (US)‐guided surgery for intrathyroid parathyroid adenoma in primary hyperparathyroidism is rarely reported. The aim of this study was to elucidate the role of cervical US in identifying this entity.

Methods

From 1996 to 2003, cervical explorations were performed in 178 patients (mean age 57 years) with primary hyperparathyroidism. High‐resolution cervical US was performed in all of the patients. Patients’ characteristics were reviewed to identify predictive factors for intrathyroid adenoma.

Results

Cervical US identified abnormal parathyroid glands in 163 of 178 patients, with a positive predictive value (PPV) of 100%. Six patients (3.4%) were found to have intrathyroid parathyroid adenomas (two in the superior parathyroid and four in the inferior parathyroid). Cervical US predicted this anomaly in four of six patients (67%) in whom the thyroid gland was not nodular and allowed total enucleation of the adenoma to be performed in three and subtotal thyroid loboisthmectomy in three; these operations were performed uneventfully and rapidly. The PPV in this anomaly was 80%. Thirteen patients required postoperative calcium supplementation for 2 to 4 months, and all were normocalcemic at the time of the last clinic visit, with follow‐up varying from 12 to 96 months. On multivariable analysis, no factor predicted intrathyroid localization of parathyroid adenoma.

Conclusions

The PPV of high‐resolution cervical US for identifying an abnormal parathyroid gland was 100% in this series. It was 80% for predicting intrathyroid localization of the adenoma. This method allows us to shorten the operating time by guiding the exploration immediately toward the thyroid gland.
Platelets Promote Liver Regeneration in Early Period after Hepatectomy in Mice
Authors: Murata Soichiro , Ohkohchi Nobuhiro , Matsuo Ryota , Ikeda Osamu , Myronovych Andriy , Hoshi Reiko
Published: March 2007

Background

Platelets contain several growth factors, including platelet‐derived growth factor and hepatocyte growth factor.

Materials and methods

We examined the effects of platelet increment on liver regeneration after 70% hepatectomy. Hepatectomies were carried out in male BALB/c mice, and subsequently divided into three groups: (i) untreated mice, (ii) thrombocytotic mice induced with thrombopoietin, and (iii) thrombocytopenic mice induced with anti‐platelet antibody. Growth kinetics in the liver were analyzed as a function of the liver/body weight ratio, the mitotic index, the proliferating cell nuclear antigen labeling index and Ki‐67 labeling index. Activation of signal transduction pathways relating to cell proliferation were examined, including the STAT3, Akt, and ERK1/2 pathways. Platelet accumulation in the residual liver was quantified by immunohistochemistry and transmission electron microscopy.

Results

In thrombocytotic and thrombocytopenic mice, liver/body weight ratios and Ki‐67 labeling indices were significantly increased and significantly decreased, respectively, compared with untreated mice 48 hours post‐hepatectomy. The Akt pathway was strongly activated, and platelet accumulation was significantly increased in thrombocytotic group 5 minutes post‐hepatectomy compared with normal and thrombocytopenic groups. After hepatectomy platelets accumulated in the sinusoids of liver and promoted hepatocyte proliferation in early period after hepatectomy.

Conclusion

By increasing or decreasing the platelet, marked changes in liver regeneration can occur, due to differences in cellular signaling and mitosis.
Liver Resection for Metastases from Renal Cell Carcinoma
Authors: Thelen Armin , Jonas S. , Benckert C. , Lopez‐Hänninen E. , Rudolph B. , Neumann U. , Neuhaus P.
Published: March 2007

Background

This study was conducted to evaluate the safety and efficacy of liver resection in patients with hepatic metastases from renal cell carcinoma and to identify selection criteria for patients suitable for resection.

Methods

Between January 1988 and March 2006, 31 patients underwent liver resection for metastases from renal cell carcinoma. Patients were identified from a prospective database and retrospectively reviewed. Patient, tumor, and operative parameters were analyzed for their influence on long‐term survival.

Results

The overall 1‐, 3‐ and 5‐year survival rates were 82.2%, 54.3%, and 38.9%, respectively. One patient was deceased and 4 developed complications during the postoperative course. In the univariate analysis, site of the primary tumor (P = 0.013), disease‐free interval (P = 0.012), and resection margins (P = 0.008) showed significant influence on long‐term survival. In the multivariate analysis, only the resection margins were identified as an independent prognostic factor after liver resection.

Conclusions

Liver resection is effective and safe in the treatment of patients with hepatic metastases from renal cell carcinoma and offers the chance of long‐term survival and cure. Achieving a margin‐negative resection is the most important criterion in the selection of suitable patients for liver resection. However, the number of patients in the present study was small, and investigations of larger series may provide further prognostic parameters in these patients.
Prenatal Fatty Acid Status and Immune Development: The Pathways and the Evidence
Authors: Prescott Susan L. , Dunstan Janet A.
Published: March 2007

This review explores the effects of dietary long chain polyunsaturated fatty acids (LCPUFA) on various aspects of early immune development and their potential role in the development or the prevention of immune disease. Modern diets have become increasingly rich in n‐6 LCPUFA and relatively n‐3 LCPUFA deficient. These potentially “pro‐inflammatory” dietary changes have clear implications for the immature and developing fetal immune system. It is now well known that immunological abnormalities precede the development of allergic disease and are frequently evident at birth or in the first months of life. This has lead to the hypothesis that potential effects of LCPUFA could be greatest in very early life before immune responses and clinical phenotype are established. Here we summarise the evidence that patterns of LCPUFA exposure in pregnancy can influence aspects of fetal immune in ways that are consistent with the immunological properties of these nutrients in adults. Specifically, human studies have shown that higher levels of n‐3 LCPUFA are associated with reduction in neonatal oxidative stress, reduced production of inflammatory leukotienne B4 (LTB4) and altered T cell function. Inverse correlations between n‐3 LCPUFA levels and neonatal T cell cytokine production, are consistent with adult studies showing reduction in T cell cytokine production with fish oil supplementation. At this stage the relevance of these effects in the prevention of disease is unclear. Although there have been no effects of postnatal fish oil supplementation (from 6 months of age) on allergy prevention, preliminary studies suggest possible merits in pregnancy and there are ongoing pregnancy intervention studies to address this more definitively.
The Effect of Partial Acylglycerols on the Exchange Between Liquid and Solid Tripalmitoylglycerol
Authors: Smith Paul R. , Furó István , Smith Kevin W. , Cain Fred
Published: March 2007

Exchange of molecules between liquid and solid components of a triacylglycerol (TAG) system is an important process in the degradation of many food components as well as for many industrial processes such as fractionation. NMR is a technique that can be used to measure the exchange between solid and liquid phases. In this work we show that monoacylglycerols (MAG) and diacylglycerols (DAG) have a retarding effect on the rate of exchange between solid and liquid TAG. In particular dipalmitoylglycerol significantly retards the rate of exchange. It is postulated that this result suggests that exchange occurs primarily through certain hotspots, probably kinks and defects on the crystal surface. MAG and, in particular, DAG can block these hotspots. It is suggested that because of their molecular structure they can partially co‐crystallize with the TAG crystal during the exchange process and then block further exchange.
Myosin S2 is not required for effects of myosin binding protein‐C on motility
Authors: Shaffer Justin F. , Razumova Maria V. , Tu An-Yue , Regnier Michael , Harris Samantha P.
Published: March 2007

The unique myosin binding protein‐c “motif” near the N‐terminus of myosin binding protein‐C (MyBP‐C) binds myosin S2. Previous studies demonstrated that recombinant proteins containing the motif and flanking regions (e.g., C1C2) affect thin filament movement in motility assays using heavy meromyosin (S1 plus S2) as the molecular motor. To determine if S2 is required for these effects we investigated whether C1C2 affects motility in assays using only myosin S1 as the motor protein. Results demonstrate that effects of C1C2 are comparable in both systems and suggest that the MyBP‐C motif affects motility through direct interactions with actin and/or myosin S1.
Outcomes of septal surgery
Authors: Calder N J , Swan I R C
Published: March 2007

Objective:

To assess the change in health-related quality of life following septal surgery.

Study design:

Post-intervention, health-related quality of life questionnaire.

Participants:

Adult patients undergoing septal surgery, recruited from two sources (the Scottish ENT outcomes study and the North Glasgow National Health Service Trust) over an 18-month period.

Main outcome measure:

Glasgow benefit inventory score.

Results:

A total of 149 Glasgow benefit inventories were returned. Of these, 13 were incomplete and were thus excluded, leaving 136 to be analysed. The response rate from the Scottish ENT outcomes study patients was 55 per cent and the response rate from the North Glasgow National Health Service Trust patients was 41 per cent, giving an overall response rate of 49 per cent. The mean Glasgow benefit inventory score was 11.3 (standard deviation 20, 95 per cent confidence interval 7.8 to 14.7). This result was similar to those of other studies using the Glasgow benefit inventory to assess septal surgery outcomes.

Conclusion:

Patients reported minimal improvement in their health-related quality of life following septal surgery.
Efficacy of Gyrus diego® microdissector at varying oscillation speeds
Authors: Sim R J , McDonald S , Gillett S
Published: March 2007

Objective:

To determine the efficacy of the Gyrus diego® microdissector at increasing oscillation speeds, using an in vitro tissue model.

Background:

It had not previously been established whether microdissectors were more efficient at higher or lower speeds.

Methods:

We investigated the effect of varying microdissector oscillation speeds on the weight of material aspirated in a given time. A 4 mm straight blade was used with constant suction strength. Jelly and liver were used to simulate polyps and muscle plus connective tissue, respectively. Water was used as a control. Repeat readings were taken at speeds of 1000, 2000, 3000, 4000 and 5000 rpm. Data were analysed using linear bivariate regression.

Results:

The results showed significant linear trends in the cases of liver and jelly, with faster cutter speeds being associated with higher aspiration rates.

Conclusion. These results suggest that microdissector efficacy increases with speed, up to 5000 rpm.
Fibro-osseous lesion of the middle turbinate: ossifying fibroma or fibrous dysplasia?
Authors: Galvan O , Gassner E M , Neher A , Gunkel A R
Published: March 2007

Benign fibro-osseous tumours of the head and neck region seldom appear in the midface and nasal cavity. Correct differential diagnosis of fibro-osseous tumours is crucial for adequate therapy, as their clinical aggressiveness seems to differ.

The rather uncommon case of a 14-year-old boy with a tumour of the middle turbinate is presented. The radiologic appearance of the tumour, on computed tomography and magnetic resonance imaging scans, was consistent with fibrous dysplasia. Angiography revealed extensive vascularisation of the tumour from both the internal and external carotid arteries. To avoid ipsilateral blindness following embolisation, a superselective embolisation of the supplying blood vessels was performed. The tumour was completely resected via an endoscopic approach. Histopathology revealed an ossifying fibroma.

This case emphasises the importance of interpretation of the clinical, radiological and histological features before planning definitive treatment. Moreover, when fibro-osseous tumours are suspected, the possibility of extensive, complicated vascularisation must be considered. This case underwent radical resection, with no recurrence after four years' follow up.
Sacculo-collic response in otosclerosis and following successful stapes surgery
Authors: Stapleton E , Mills R , Tham J C
Published: March 2007

Introduction:

The sacculo-collic reflex is believed to be a short latency, otolith-mediated myogenic response to sound. With the application of air-conducted sound, one would expect an absent response in stapes fixation, as a fixed stapes footplate will not transmit a pressure wave to the saccule.

Methods:

Fifty patients (70 stapes surgery ears, 26 otosclerotic ears and four normal ears) and 40 controls underwent repeated sacculo-collic tests.

Results:

The results support the proposed mechanism for the sacculo-collic response. The study also suggests that, whilst stapedotomy piston prostheses are effective in the reversal of conductive hearing loss, they produce an insufficient pressure wave to elicit a myogenic response to sound.

Conclusion:

The sacculo-collic test could be a useful tool for screening otolith function and inferior vestibular nerve integrity, but further work is needed to determine the effect of stapes surgery on saccular function.
Idiopathic, inflammatory, medial meatal, fibrotising otitis presenting with lichen planus
Authors: Hopsu E , Pitkäranta A
Published: March 2007

Background:

Background: Of the acquired ear canal atresias, idiopathic, inflammatory, medial meatal, fibrotising otitis has been suggested as a distinct disease entity, for reasons of aetiology.

Objective:

To report three more cases of idiopathic, inflammatory, medial meatal, fibrotising otitis and to further consider the possible relationship between this condition and lichen planus.

Patients:

Three adult patients with idiopathic, inflammatory, medial meatal, fibrotising otitis, two with bilateral aural symptoms, treated and followed up at the department of otorhinolaryngology of Helsinki University Hospital.

Results:

We found idiopathic, inflammatory, medial meatal, fibrotising otitis, affecting solely the glabrous skin of the osseous part of the external ear canals, in three patients who also suffered from severe oral lichen planus.

Conclusions:

The aetiopathology or pathophysiology of idiopathic, inflammatory, medial meatal, fibrotising otitis may be linked with lichen planus. Early, active treatment of idiopathic, inflammatory, medial meatal, fibrotising otitis with local corticosteroids may prevent total medial meatal atresia.
Seroprevalence ofHelicobacter pyloriinfection in patients with chronic nonspecific pharyngitis: preliminary study
Authors: Aladag İ , Bulut Y , Guven M , Eyibilen A , Yelken K
Published: March 2007

Background and objectives:

Chronic nonspecific pharyngitis is a chronic inflammation of the pharynx. It is found worldwide, and treatment is difficult. The underlying aetiopathogenesis is still controversial. The aim of this study was to investigateHelicobacter pyloriseroprevalence in chronic nonspecific pharyngitis patients without other possible causative factors for chronic pharyngeal irritation and withoutH pylorigastric mucosal infection.

Materials and methods:

Forty-one patients with symptoms of chronic nonspecific pharyngitis and 30 healthy control subjects were enrolled in this prospective, controlled, clinical study. In both study and control groups, selected patients were shown to have gastric mucosa uninfected byH pylori, as demonstrated by the 14C-urea breath test. Comprehensive otorhinolaryngological examination did not elicit any factor contributing to the chronic pharyngeal complaint. SerumH pyloriimmunoglobulin G antibody titres were assayed using serum enzyme-linked immunosorbent assay. The difference between the study and control groups was analysed by the chi-square test (the likelihood ratio was used).

Results:

Thirty-two of the 41 patients (78 per cent) and 14 of the 30 control subjects (46.7 per cent) were found to beH pyloripositive. Patients with chronic nonspecific pharyngitis were found to have a significantly higher rate ofH pyloriseropositivity than the control group (p = 0.016).

Conclusion:

These data may be important in developing future treatment strategies for chronic nonspecific pharyngitis.
Morbidity and mortality of post-tonsillectomy bleeding: analysis of cases
Authors: Cohen D , Dor M
Published: March 2007

Objectives:

To analyse the circumstances of mortality in post-tonsillectomy bleeding cases, in order to better manage serious problems during resuscitation.

Design:

Reports of inquiry committees on post-tonsillectomy mortalities.

Setting:

State of Israel Ministry of Health committees.

Participants:

Senior otolaryngologists and related professionals, and the involved medical staff who participated in the inquiry committees.

Main outcomes measures:

Identification of actions causing undesirable effects on resuscitation outcomes.

Results:

In recent years, the post-tonsillectomy mortality rate in Israel has been one in 12 000. The two main causes of death have been severe haemorrhagic shock and airway obstruction.

Conclusions:

Active bleeding should be treated, rather than waiting for spontaneous resolution. An efficient airway should be established early during resuscitation, either by intubation (within two minutes) or by cricothyroidotomy. The two main factors endangering the patient's life during resuscitation are severe blood loss, interfering with effective cardiac output, and airway obstruction. Blood loss should be quickly substituted.
Clinical presentation of postnatal and non-postnatal depressive episodes
Authors: COOPER CARLY , JONES LISA , DUNN EMMA , FORTY LIZ , HAQUE SAYEED , OYEBODE FEMI , CRADDOCK NICK , JONES IAN
Published: March 2007

Background

The relationship of postnatal (postpartum) depression (PND) to episodes of depression occurring at other times is not well understood. Despite a number of studies of clinical presentation, there is little consistency in the literature. We have undertaken within- and between-individual comparisons of the clinical presentation of postnatal (PN) and non-postnatal (NPN) depressive episodes in women with recurrent depression.

Method

In a sample of well-characterized, parous women meeting DSM-IV and ICD-10 criteria for recurrent major depressive disorder, the clinical presentation of episodes of major depression with onset within 4 weeks of giving birth (PND group,n=50) were compared with (i) the non-postnatal episodes of women with PND, and (ii) episodes of major depression in parous women who had not experienced episodes of mood disorder in relation to childbirth (NPND group,n=132). In addition, the non-postnatal episodes of the PND group of women were compared with the depressive episodes of the NPND group.

Results

The small number of differences found between PN and NPN depressive episodes, such as reduced early morning wakening in postnatal episodes, are likely to be explicable by the context of having a new baby rather than by any difference in the nature of the underlying depression.

Conclusions

The results do not point to substantial differences in clinical presentation between episodes of major depression occurring in relation to childbirth and at other times. Other avenues of research are therefore required to demonstrate a specific relationship between childbirth and depression.
Personality diatheses: a superior explanation than disorder
Authors: TYRER PETER
Published: March 2007

Diatheses confer vulnerability to disorder but are not necessarily manifest overtly or consistently. It is suggested that the main empirical findings of studies with abnormal personality support the notion that they are diatheses rather than disorders. This includes their onset early in life, their variability of expression dependent on setting, their greater association with more severe disorders and their acceptance as intrinsic components of functioning by most suffering from these conditions. It is argued that a separate axis of classification for personality diatheses rather than disorders is justified.
Characteristics and functions of non-suicidal self-injury in a community sample of adolescents
Authors: LLOYD-RICHARDSON ELIZABETH E. , PERRINE NICHOLAS , DIERKER LISA , KELLEY MARY L.
Published: March 2007

Background

Few studies have investigated non-suicidal self-injury (NSSI), or the deliberate, direct destruction of body tissue without conscious suicidal intent, and the motivations for engaging in NSSI among adolescents. This study assessed the prevalence, associated clinical characteristics, and functions of NSSI in a community sample of adolescents.

Method

A total of 633 adolescents completed anonymous surveys. NSSI was assessed with the Functional Assessment of Self-Mutilation (FASM).

Results

Some form of NSSI was endorsed by 46·5% (n=293) of the adolescents within the past year, most frequently biting self, cutting/carving skin, hitting self on purpose, and burning skin. Sixty per cent of these, or 28% of the overall sample, endorsed moderate/severe forms of NSSI. Self-injurers reported an average of 12·9 (s.d.=29·4) incidents in the past 12 months, with an average of 2·4 (s.d.=1·7) types of NSSI used. Moderate/severe self-injurers were more likely than minor self-injurers, who in turn were more likely than non-injurers, to have a history of psychiatric treatment, hospitalization and suicide attempt, as well as current suicide ideation. A four-factor model of NSSI functions was indicated, with self-injurers likely to endorse both reasons of automatic reinforcement and social reinforcement. The most common reasons for NSSI were ‘to try to get a reaction from someone’, ‘to get control of a situation’, and ‘to stop bad feelings’.

Conclusions

Community adolescents reported high rates of NSSI, engaged in to influence behaviors of others and to manage internal emotions. Intervention efforts should be tailored to reducing individual issues that contribute to NSSI and building alternative skills for positive coping, communication, stress management, and strong social support.
The profile and risks of suicidal behaviours in the Nigerian Survey of Mental Health and Well-Being
Authors: GUREJE OYE , KOLA LOLA , UWAKWE RICHARD , UDOFIA OWOIDOHO , WAKIL ABBA , AFOLABI EBENEZER
Published: March 2007

Background. Suicide is a leading cause of death worldwide but information about it is sparse in Sub-Saharan Africa. Suicide-related behaviours can provide an insight into the extent of this compelling consequence of mental illness.

Method. Face-to-face interviews were conducted with a representative sample of persons aged 18 years and over (n=6752) in 21 of Nigeria's 36 states (representing about 57% of the national population). Suicide-related outcomes, mental disorders, as well as history of childhood adversities were assessed using the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).

Results. Lifetime prevalence estimates of suicide ideation, plan and attempts were 3·2% [95% confidence interval (CI) 1·4–6·5], 1·0% (95% CI 0·4–7·5) and 0·7% (95% CI 0·5–1·0) respectively. Almost two of every three ideators who made a plan went on to make an attempt. The highest risks for transition from ideation to plan and from plan to attempt were in the first year of having ideation or plan respectively. Mental disorders, especially mood disorders, were significant correlates of suicide-related outcomes. Childhood adversities of long separation from biological parents, being raised in a household with much conflict, being physically abused, or being brought up by a woman who had suffered from depression, anxiety disorder, or who had attempted suicide were risk factors for lifetime suicide attempt.

Conclusions. History of childhood adversities and of lifetime mental disorders identify persons at high-risk for suicide-related outcomes. Preventive measures are best delivered within the first year of suicide ideation being expressed.
Two-phase survey of eating disorders in gifted dance and non-dance high-school students in Taiwan
Authors: TSENG MEG MEI-CHIH , FANG DAVID , LEE MING-BEEN , CHIE WEI-CHU , LIU JEN-PEI , CHEN WEI J.
Published: March 2007

Background

Despite a growing body of literature reporting eating disorders (EDs) in non-Western countries in recent years, most of these studies are limited to questionnaire-based surveys or case-series studies. This study aimed to investigate the prevalence and correlates of EDs in Taiwanese high-school students.

Methods

The study subjects consisted of all the female high-school students enrolled in the gifted dance class in 2003 in Taiwan (n=655) and non-dance female students randomly chosen from the same school (n=1251). All the participants were asked to complete self-report questionnaires, including the 26-item Eating Attitudes Test (EAT-26) and the Bulimic Investigatory Test Edinburgh (BITE). All the screen positives and an approximate 10% random sample of the screen negatives were then interviewed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders Patient Version (SCID-I/P).

Results

The prevalence of individual EDs was much higher in the dance [0·7% for anorexia nervosa (AN), 2·5% for bulimia nervosa (BN) and 4·8% for EDs, not otherwise specified (EDNOS)] than in the non-dance (0·1, 1·0 and 0·7% respectively) students. Multivariate logistic regression analyses revealed that being in the dance class, higher concern about body shape and lower family support were correlates of EDs for all students, whereas lower parental education level was associated with EDs only for non-dance students.

Conclusion

EDs were more prevalent in the weight-concerned subpopulation. Although AN is still rare, BN has emerged as a comparable prevalent disorder in Taiwan, as in Western countries.
A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults
Authors: FARAONE STEPHEN V. , BIEDERMAN JOSEPH , WILENS TIMOTHY E. , ADAMSON JOEL
Published: March 2007

Background

Studies of adults with attention deficit hyperactivity disorder (ADHD) show an elevated prevalence of substance use disorders (SUDs) and the substance abuse literature shows that ADHD is elevated in substance users. Some researchers postulate that stimulant treatment of ADHD increases the risk for SUD in ADHD patients but follow-up studies suggest treatment protects patients from subsequent SUDs. This report uses retrospective data to assess the impact of prior ADHD pharmacotherapy on SUDs in 206 ADHD adults (n=79 late-onset ADHD, n=127 full ADHD) grouped by lifetime history of ADHD treatment (no treatment, past treatment, current and past treatment).

Method

Structured Clinical Interview for DSM-IV (SCID) data were used to establish abuse and dependence, and Drug Use Screening Inventory (DUSI) responses were used to establish prevalence of use, preference for cigarettes, alcohol and drugs of abuse, complications from use, and motivation for use (get high, change mood, sleep better).

Results

No differences were found in the prevalence of cigarette smoking, alcohol or drug abuse or dependence, as well as no significant differences in 1-month prevalence of any use or use more than 20 times. No differences were found in complications of drug or alcohol use across groups. Subjects with current treatment rated getting high as a motivating factor significantly more frequently than subjects in the past treatment group; this result lost significance when we included ADHD diagnostic category.

Conclusions

Our results are consistent across substances and ADHD diagnoses, and support the hypothesis that pharmacotherapy does not cause subsequent SUDs.
Suicide and other causes of mortality in bipolar disorder: a longitudinal study
Authors: DUTTA RINA , BOYDELL JANE , KENNEDY NOEL , VAN OS JIM , FEARON PAUL , MURRAY ROBIN M.
Published: March 2007

Background. The high risk of suicide in bipolar disorder is well recognized, but may have been overestimated. There is conflicting evidence about deaths from other causes and little known about risk factors for suicide. We aimed to estimate suicide and mortality rates in a cohort of bipolar patients and to identify risk factors for suicide.

Method. All patients who presented for the first time with a DSM-IV diagnosis of bipolar I disorder in a defined area of southeast London over a 35-year period (1965–1999) were identified. Mortality rates were compared with those of the 1991 England and Wales population, indirectly standardized for age and gender. Univariate and multivariate analyses were used to test potential risk factors for suicide.

Results. Of the 239 patients in the cohort, 235 (98·3%) were traced. Forty-two died during the 4422 person-years of follow-up, eight from suicide. The standardized mortality ratio (SMR) for suicide was 9·77 [95% confidence interval (CI) 4·22–19·24], which, although significantly elevated compared to the general population, represented a lower case fatality than expected from previous literature. Deaths from all other causes were not excessive for the age groups studied in this cohort. Alcohol abuse [hazard ratio (HR) 6·81, 95% CI 1·69–27·36, p=0·007] and deterioration from pre-morbid level of functioning up to a year after onset (HR 5·20, 95% CI 1·24–21·89, p=0·024) were associated with increased risk of suicide.

Conclusions. Suicide is significantly increased in unselected bipolar patients but actual case fatality is not as high as previously claimed. A history of alcohol abuse and deterioration in function predict suicide in bipolar disorder.
How do you patent a landscape? The perils of dichotomizing cultural and intellectual property
Authors: Barsh RL
Published: March 2007

For a variety of conceptual, historical, and political reasons, contemporary international law distinguishes between 'natural' land forms, cultural monuments, movable cultural property, the performing arts, and scientific knowledge. Indigenous peoples do not make these distinctions. Rather, they tend to regard landscapes as inherently cultural products in which artworks, literature, performances, and scientific-knowledge systems are inextricably embedded. Scientific knowledge must periodically be rehearsed within the landscape in recitations and performances that remember the historical process by which people and their nonhuman kinfolk constructed the landscape. Detaching specific cultural or scientific 'objects' from the landscape and commodifying them, as is contemplated by most current proposals for protecting indigenous peoples' rights, will undermine the indigenous institutions and procedures necessary for perpetuating the quality and validity of local knowledge.
Climatic factors associated with hospitalizations for rotavirus diarrhoea in children under 5 years of age
Authors: D'SOUZA R. M. , HALL G. , BECKER N. G.
Published: March 2007

This study compares the seasonality of rotavirus diarrhoeal hospital admissions and its relationship to climatic factors across three Australian cities. Weekly admission of rotavirus diarrhoea (1993–2003) in children aged <5 years and weekly average temperature and relative humidity for each city were modelled using a log-linear model with a cubic trend and season. Interactions were included to test for differences in the effect of temperature and humidity between seasons and between cities. Admissions of rotavirus diarrhoea peaked in winter and spring and were lowest in summer. Higher temperature and humidity in the previous week were associated with a decrease in rotavirus diarrhoeal admissions in three cities. The effects of both temperature and humidity on rotavirus admissions in Brisbane differed across seasons. Strategies to combat outbreaks of rotavirus diarrhoea should take climatic factors and seasonal effects into consideration to plan for the excess seasonal hospital admissions.
Protecting contacts of hepatitis A: what's the difference between vaccine and human normal immunoglobulin?
Authors: CROWCROFT N. S.
Published: March 2007

The efficacy of vaccine when time since exposure is prolonged (more than 1 week from onset of illness in the index case) is unknown, but is likely to be significantly lower than human normal immunoglobulin (HNIG). We estimated the number of additional secondary cases that may occur through giving vaccine instead of HNIG to contacts of cases of hepatitis A who are identified more than 1 week after onset in the index case. This was calculated for different levels of vaccine efficacy, assuming HNIG efficacy to be 80–90%. The number of households that need to be treated to prevent one secondary case was calculated using estimates of secondary attack ratios (AR). If more than 1 week has elapsed from onset of illness in the index case, for an average household size of 2·3 people, a vaccine efficacy of 50% and an AR of 10–25%, 8–26 households would need to be treated with vaccine before one additional secondary case would be observed. As UK public health professionals manage around one hepatitis A case per month, it would take from 8 months to over 2 years for them to observe one additional case amongst contacts using vaccine rather than HNIG. It is unlikely that an average practitioner would notice if vaccine were 30% less effective than HNIG. Public health practice and advice to patients and contacts should be based on evidence as well as experience.