bluuebunny/crossref_metadata_2025 huggingface dataset:
El impacto de la información estereotípica y de la autocategorización sobre la categorización racial en Brasil
Authors: Cano Ignacio , Schweiger-Gallo Inge
Published: September 2008

La mayor parte de los estudios sobre sesgos y discriminación racial examinan si los miembros de las minorías raciales sufren, en circunstancias equivalentes, una percepción o un tratamiento más negativo que el otorgado a la mayoría. Este estudio invirtió las variables dependiente e independiente y comprobó si la asociación de una persona con contenidos negativos propios del estereotipo de la minoría aumenta la probabilidad de que dicha persona sea categorizada como miembro de esa minoría racial, así como si dicho proceso se observa principalmente a la hora de categorizar miembros del exogrupo discriminado. Los resultados obtenidos mostraron que la probabilidad de categorizar a una persona como miembro de un grupo racial no varió en función de la información estereotípica suministrada pero sí en función del grupo en el que el perceptor se auto-categorizaba, tanto para los miembros de la minoría como para los de la mayoría. Se discuten las implicaciones de dicho estudio para la auto-atribución versus hetero-atribución racial.
Los valores culturales y el desarrollo socioeconómico: una comparación entre teorías culturales
Authors: Ros María
Published: September 2008

Las teorías transculturales de Hofstede (1980), Schwartz (1994), Triandis (1995) e Inglehart (1998) representan en la actualidad las formulaciones más contrastadas sobre las dimensiones culturales de valores. A pesar del interés y popularidad del modelo de Inglehart, no existen trabajos que traten de analizar la validez convergente y discriminante de esta teoría con relación a otras teorías culturales. Este trabajo trata de llenar este hueco comparando la dimensión de Post-materialismo de Inglehart con las dimensiones culturales de Autonomía, Conservación, Jerarquía, Igualitarismo, Armonía y Competencia de Schwartz, para lo cual seguimos varios procedimientos. En primer lugar, estudiamos la relación entre las puntuaciones en las dimensiones culturales de ambos modelos con una muestra de 40 países. A continuación, relacionamos las dimensiones culturales convergentes con variables externas, macrosociales y macroeconómicas, de estas mismas sociedades. Finalmente, analizamos el impacto de la cultura, medida por los valores, y del nivel socioeconómico previo sobre el desarrollo económico y el desarrollo social de las mismas sociedades. Los resultados indican que la similaridad conceptual entre las dos teorías se produce entre las dimensiones culturales del Postmaterialismo, Autonomía Intelectual y Afectiva e Igualitarismo, y que los valores son resultado de una serie de condiciones macroeconómicas y macrosociales. Así, mientras que el crecimiento económico refuerza los valores materiales, el desarrollo humano refuerza valores más solidarios. Ahora bien, la orientación de valores explica gran parte del desarrollo económico y del desarrollo humano posterior.
La contribución de valores, nacionalismo étnico e identidad comparativa a la xenofobia: un estudio intercultural
Authors: Grad Héctor , Sanz Alberto
Published: September 2008

Se investiga el impacto de los valores personales, la identidad comparativa (europea vs. nacional) y las representaciones sociales de la nación sobre las actitudes xenófobas de los jóvenes mediante encuestas a muestras representativas de la población de 18–24 años en cuatro países europeos (N total = 1904). Se muestra que la representación étnica (vs. cívica) de la nación modula la relación de las identidades sociales con la xenofobia.

La investigación previa ha establecido que los valores universalistas y las identidades supranacionales inhiben la xenofobia pero Licata y Klein (2002) sostienen que la identidad europea puede reforzarla. Un análisis trans-cultural mediante ecuaciones estructurales revela que los valores de Conservación, la identidad nacional, y la representación étnica de la nación refuerzan la xenofobia, mientras que los valores universalistas y la identidad europea la debilitan. Finalmente, la representación étnica de la nación predice la xenofobia mejor que las identidades sociales.

La identidad comparativa demuestra su utilidad para estudiar las identidades sociales anidadas. Se discuten las implicaciones para la identidad y la construcción europea.
Valores e identidades nacional y europea: un estudio transcultural
Authors: Ros María , Rodríguez Miryam , Casado Cristina
Published: September 2008

En el presente estudio, se han analizado la importancia y el significado de la identidad nacional y europea. Utilizando la teoría de los valores personales de Schwartz (2001), 2.418 jóvenes europeos de la República Checa, Eslovaquia, Alemania y España han respondido a un cuestionario que mide la importancia de sus identidades nacional y europea, y una forma abreviada del PVQ de 22 valores personales. Entrevistas personales a una sub-muestra de 42 jóvenes españoles también exploran el significado de su identidad europea.

Los resultados muestran que los jóvenes comparten una importancia similar de valores personales: sus identidades nacional y europea ocupan una posición media en su jerarquía de valores personales, aunque se identifican en mayor medida con su identidad nacional. Ambas identidades se encuentran vinculadas a las dimensiones bipolares de auto-promoción y de conservación de la teoría de valores personales. Las dos identidades poseen significados similares aunque reciben distinto grado de importancia.

Los resultados de las entrevistas sobre el significado de la identidad europea coinciden con el significado medido a través de la teoría de valores personales.
Valores humanos en trabajadores de bajo nivel educativo en Natal (Brasil)
Authors: Borges Livia
Published: September 2008

Las investigaciones sobre valores humanos se han incrementado bajo la influencia de la teoría de los tipos motivacionales que abarca una tipología de valores y una estructura dinámica. En dicha perspectiva, se han desarrollado cuestionarios para la medición de los distintos tipos de valores, siendo uno de ellos el Portrait Values Questionnaire (PVQ). En Brasil existe la necesidad de contar con instrumentos de investigación útiles para segmentos de la población de bajo nivel educativo. En la presente investigación se aplicó el referido cuestionario a 474 trabajadores de sectores económicos en los que predomina un nivel educativo bajo. Para analizar las respuestas se aplicaron el análisis factorial (AF) y el smallest space analysis (SSA). A partir de los resultados del AF se identificó una estructura con cuatro factores—Pacifismo-hedónico, Poder, Religiosidad y Conformidad—mientras que gracias al SSA se identificaron siete tipos de valores: Poder-logro, Poder-estimulación, Autodirección, Hedonismo Religioso, Universalismo, Benevolencia y Conformidad. Los resultados revelaron que, entre las personas de bajo nivel formativo, las diferencias entre tipos de valores pierden en exactitud pero presentan nuevos sentidos.
Identidad comparativa y valores: introducción al Número Monográfico en recuerdo de María Ros
Authors: Fernández-Dols José-Miguel , Schweiger-Gallo Inge
Published: September 2008

Este artículo constituye el prólogo al número especial que Revista de Psicología Social dedica a María Ros (1951–2006). Los autores, consideran las dos líneas de investigación que estructuran las aportaciones de Ros, la identidad y los valores, para presentar cada uno de los artículos que componen este número. Los trabajos de Huici, Gómez y Bustillos, Grad y Sanz, y Cano y Schweiger-Gallo ilustran el interés y eco que ha suscitado el concepto de identidad comparativa, acuñado por Ros y su equipo. Por otro lado, los trabajos de Ros; Ros, Rodríguez y Casado, así como el de Borges, conforman un puente entre el estudio de la identidad comparada y los valores, en consonancia con la línea desarrollada por el equipo de Ros.

Este monográfico pone de manifiesto que el concepto de identidad comparativa, acuñado por Ros y su equipo, transforma el análisis de la identidad social en los estudios transculturales y en la Psicología Social en general. Se vislumbran también las estrechas relaciones entre la identidad social, los valores y el cambio social.
Rehabilitation Counseling Graduate Students' Preferences for Employment
Authors: Lustig Daniel C. , Strauser David R.
Published: September 2008

A national study of rehabilitation counseling graduate students and state—federal rehabilitation counselors investigated whether there were differences between (a) what graduate students preferred to do upon graduation and what they believed vocational rehabilitation counselors did, (b) what graduate students preferred to do upon graduation and what vocational rehabilitation counselors perceived they did, and (c) what students believed vocational rehabilitation counselors did and what counselors perceived they did. Results indicated graduate students preferred to spend more time on counseling and less time on case management than state—federal vocational rehabilitation counselors perceived they did. Graduate students were accurate in their estimates of the amount of time vocational rehabilitation counselors stated they spent on counseling and inaccurate in their estimates of time spent on case management. Implications for recruitment and retention of rehabilitation counseling graduate students are discussed.
Review Essay: Apprehending the “Social”
Authors: Sadovnikov Slava
Published: September 2008

The two books reviewed here are different efforts to embrace the vast subject called “social thought.” The second edition of The Blackwell Dictionary of Modern Social Thought, edited by William Outhwaite with Alain Touraine, contains numerous updates; yet it also has some disadvantages compared to the first edition. Social Thought: From the Enlightenment to the Present, edited by Alan Sica, is a bold but controversial attempt at gathering in one anthology as many social thinkers as possible.
Review of A Large Clinical Series: Sedation and Analgesia Usage with Airway Pressure Release and Assist-control Ventilation for Acute Lung Injury
Authors: Fan Eddy , Khatri Priyanka , Mendez-Tellez Pedro A. , Shanholtz Carl , Needham Dale M.
Published: September 2008

Background: Our objective was to compare sedative and analgesic doses, agents, and sedation status in patients with airway pressure release ventilation (APRV) versus assist-control (AC) ventilation on the first day after acute lung injury diagnosis.

Methods: Observational study at 3 teaching hospitals. Results: Of 240 patients, 165 received APRV or AC ventilation on day 1 (17 APRV, 148 AC). The median Acute Physiology and Chronic Health Evaluation II score was lower in the APRV versus AC group [17 (14-20) vs. 25 (21-32), P < .001]. Median total doses of sedatives and analgesics were lower in APRV versus AC (29 vs. 98 mg of midazolam-equivalents, P < .001) and (1200 vs. 2400 mcg of fentanylequivalents, P = .006). APRV patients were less sedated versus AC (median Richmond Agitation-Sedation Scale —2 vs. —4, P < .002). Conclusions: APRV may be associated with decreased sedation and analgesia medications and improved sedation status. Differences in the patients receiving APRV versus AC ventilation may have contributed to this conclusion. Further investigation is needed.
Hemodynamic Effects and Safety of Nesiritide in Neonates with Heart Failure
Authors: Simsic Janet M. , Mahle William T. , Cuadrado Angel , Kirshbom Paul M. , Maher Kevin O.
Published: September 2008

Objective: Evaluate effects and safety of nesiritide (Natrecor, Scios Inc) human B-type natriuretic peptide, in neonates with heart failure.

Methods: Seventeen neonates, not responding to conventional therapy, treated with nesiritide were retrospectively reviewed.

Results: Average age 16 + 8 days; weight 3.2 + 0.6 kg. Fifteen treated with concomitant inotropic therapy; all with diuretics. Twelve received loading dose; followed by continuous infusions of 0.005 mcg/kg/min (2); 0.01 mcg/kg/min (12); 0.02 mcg/kg/min (3). Length of therapy 5 + 4 days. No change in heart rate or blood pressure between baseline, 1 hour or 24 hours of nesiritide infusion. Decrease central venous pressure (CVP) 24 hours after infusion (p = 0.03). Ins-out ratio improved in 29%. No difference in pre and post therapy BUN and creatinine (Cr). 18% had hypotension requiring intervention.

Conclusions: Nesiritide use in neonates may improve hemodynamics as demonstrated by reduction in CVP. All patients tolerated bolus dosing, however, transient hypotension occurred in 18% of neonates with continuous infusion.
From the Kitchen to the Bedroom
Authors: DeSouza Eros R. , Cerqueira Elder
Published: September 2008

Sexual harassment has been investigated mostly in developed countries. The authors examined frequency rates and consequences of sexual harassment among female domestic workers in Brazil. Twenty-six percent had been sexually harassed at work during the past year. Live-in workers were at significantly greater risk for experiencing sexual harassment than those residing in their own homes, when controlling for participants' age, race, and social class. Women residing in their employers' residences used more alcohol and drugs than their counterparts. Harassed women had significantly higher self-esteem impairment and anxiety and depression than nonharassed women. Nonharassed women residing in their own homes had the best physical well-being. Concerning participants' worst sexually harassing experiences, the perpetrators were likely to be men (75%), who also engaged in more severe types of sexual harassment than female perpetrators. The emotional reactions to such incidents were significantly more negative when perpetrated by men than by women. Implications for foreign in-home workers employed by Europeans and North Americans are discussed.
Deviant Lifestyles and Violent Victimization at School
Authors: Nofziger Stacey
Published: September 2008

This study examines how the lifestyles of juveniles influence violent victimization at school. Using data from the National Survey of Adolescents, this study demonstrates that both indirect victimization, through witnessing violence, and sexual and physical assaults of students are pervasive problems at schools. Although a number of individual and structural characteristics predict the risk of becoming a victim at school, the most consistent predictor of violent victimization is the juvenile's own deviant lifestyle. Those who participate in a deviant lifestyle substantially increase their odds of all three forms of victimization. Therefore, even within the relatively controlled setting of schools, juveniles who participate in deviant lifestyles are at a high risk for victimization.
The Problem of Women's Sociality in Contemporary North American Feminist Memoir
Authors: Taylor Judith
Published: September 2008

Systematic analysis of 25 contemporary North American feminist memoirs reveals the significance of this kind of cultural production in the life of the women's movement. In memoir, feminists contest dominant movement narratives, recast and reclaim conventional gender stereotypes, and use their experiences to refine movement ideas and goals. Combining sociological aggregation and pattern identification and interpretivist understandings of memoir's empirical significance, this research indicates that feminists have spent considerable energy focused on transforming not just relations between women and men but among women themselves. To this end, they assert that feminists must acknowledge two difficult “truths”—women are emotionally damaged, and women are not as socially capable as convention would suggest. By analyzing such arguments, this article indicates feminist memoir is a vehicle through which actors do not simply uphold but also contest movement narratives, refining or abandoning movement frames that wear thin as lived experience contradicts them.
Primary Intratesticular Spindle Cell Tumors: Interdigitating Dendritic Cell Tumor and Inflammatory Myofibroblastic Tumor
Authors: Nistal Manuel , Gonzalez-Peramato Pilar , Serrano Alvaro , Reyes-Mugica Miguel , Cajaiba Mariana M.
Published: September 2008

Spindle cell neoplasms arising in the testis are uncommon; most cases belong to the category of gonadal stromal tumors, and the presence of distinctive clinical and pathological features usually lead to a definitive diagnosis. In some instances, however, the diagnosis of these tumors can be challenging and special techniques are needed. The present study reports 2 unusual cases of primary intratesticular tumors showing a striking morphology, characterized by spindle to stellate cells in a lymphoid background. The diagnosis of interdigitating dendritic cell tumor and inflammatory myofibroblastic tumor was established in the 2 cases, and their probable origin in cells of the accessory immune system is discussed. Although both tumors share similar histological features, their immunohistochemical profiles were decisive for a definitive diagnosis.
Peripheral Eosinophilia Camouflaging Anaplastic Large Cell Lymphoma
Authors: Powers Michelle L. E. , Watson Brian W. , Frater John L. , Kreisel Friederike , Hassan Anjum
Published: September 2008

Eosinophilia is a nonspecific laboratory finding, often noted incidentally during routine blood analysis. When persistent, eosinophilia can herald an underlying parasitic infection, drug reaction or less commonly, a neoplastic process. Anaplastic large cell lymphoma (ALCL) and tissue eosinophilia has been described; however, such cases have not displayed marked leukocytosis with eosinophilia. This article reports a patient presenting with marked leukocytosis with profound peripheral eosinophilia initially thought to be related to a chronic myeloproliferative disorder, likely chronic eosinophilic leukemia. After further diagnostic evaluation, ALCL was noted in the bone marrow, masked by the myeloid hyperplasia and eosinophilia. This case emphasizes the importance of a full diagnostic workup for T-cell malignancies, including ALCL rather than focusing on the far less common eosinophilia-associated myeloid malignancies in the clinicopathologic setting of marked eosinophilia. Moreover, bone marrow involvement by ALCL is exceedingly rare and when noted, presents as one or more localized lytic lesions. This is the first reported case of ALCL primarily involving bone marrow without radiographic evidence of lytic bone lesions.
Langerhans Cell Sarcoma Involving Gallbladder and Peritoneal Lymph Nodes: A Case Report
Authors: Gang Zhao  , Meng Luo  , Wu Zhi-Yong , Qiang Liu  , Bin Zhang  , Gao Run-Ling , Zhang Zhi-Qi
Published: September 2008

Langerhans cell sarcoma (LCS) is a rare proliferation of Langerhans cells with overtly malignant cytologic features and spreads aggressively. LCSs show a multiorgan involvement, including skin, lymph nodes, lung, and bone. The authors report an LCS in a 74-year-old woman that involved the gallbladder and the peritoneal lymph nodes. Imaging revealed a tumor in the gallbladder and the peritoneal lymph nodes. The tumor cells were positive for CD1a, S-100 protein, and Langerin (CD207). Although the ultrastructural analysis failed to demonstrate any Birbeck granules, the histomorphological and immunohistochemical findings supported the diagnosis of LCS. After surgical resection, she showed no recurrent or metastatic signs for 8 months without any other adjuvant therapy. This is the first case of LCS involving the gallbladder and the peritoneal lymph nodes. This report also includes a review of the literature concerning this rare disease.
Extensive Ganglioneuromatosis of Gallbladder
Authors: Sakuma Takahiko , Hirota Masaki , Ohashi Hiroshi , Kakudo Kennichi , Kawano Kiyoshi
Published: September 2008

A case of extensive ganglioneuromatosis (GN) of gallbladder is presented. A 38-year-old man presented with a hepatic hilar mass (∅ ~ 48 mm) and gall stones. He had undergone total thyroidectomy for medullary thyroid carcinoma 8 years earlier. The hepatic hilus tumor, which had been clinically suspected to be a lymph node metastasis from the medullary thyroid carcinoma, was found to be pheochromocytoma. The gallbladder, resected with a clinical diagnosis of cholelithiasis, showed extensive transmural GN despite a grossly normal appearance. Taking into account the past history, the patient was diagnosed as having multiple endocrine neoplasia 2b (MEN2b)–associated GN of gallbladder and ectopic pheochromocytoma. As GN of gallbladder in MEN2b has been rarely reported, the histological findings are described in detail and a brief review of literature is carried out.
Human Cloning and the Raelians
Authors: Alcíbar Miguel
Published: September 2008

In this article, the author analyzes the reported coverage on human cloning and the Raelians in the Spanish newspaper El País. On December 27, 2002, Brigitte Boisselier, the director of the biotechnology company Clonaid, part of the International Raelian Movement, announced they had successfully cloned a baby girl. This news report enlivened the controversy on human cloning, which originated in February 1997 with the news of Dolly's birth. El País constructed the controversy as a fundamental problem of scientific policy. This study suggests that El País wants to persuade policy makers to establish limited regulations on experimentation with embryo stem cells for therapeutic purposes. To achieve this goal, this newspaper used scientific sources selected ad hoc and a series of well-defined rhetorical strategies.
Quantitative PCR and Disaccharide Profiling to Characterize the Animal Origin of Low-Molecular-Weight Heparins
Authors: Houiste Céline , Auguste Cécile , Macrez Céline , Dereux Stéphanie , Derouet Angélique , Anger Pascal
Published: September 2008

Low-molecular-weight heparins (LMWHs) are widely used in the management of thrombosis and acute coronary syndromes. They are obtained by the enzymatic or chemical depolymerization of porcine intestinal heparin. Enoxaparin sodium, a widely used LMWH, has a unique and reproducible oligosaccharide profile which is determined by the origin of the starting material and a tightly controlled manufacturing process. Although other enoxaparin-like LMWHs do exist, specific release criteria including the origin of the crude heparin utilized for their production, have not been established. A quantitative polymerase chain reaction method has been developed to ensure the purity of the porcine origin of crude heparin, with a DNA detection limit as low as 1 ppm for bovine, or 10 ppm for ovine contaminants. This method is routinely used as the release acceptance criterion during enoxaparin sodium manufacturing. Furthermore, when the process removes DNA, other analytical techniques can be used to assess any contamination. Disaccharide profiling after exhaustive depolymerization can determine the presence of at least 10% bovine or 20% ovine material; multivariate analysis is useful to perform the data analysis. Consistent with the availability of newer technology, these methods should be required as acceptance criteria for crude heparins used in the manufacture of LMWHs to ensure their safety, quality, and immunologic profile.
Utility of the PFA-100 Instrument and the Novel Multiplate Analyzer for the Assessment of Aspirin and Clopidogrel Effects on Platelet Function in Patients With Cardiovascular Disease
Authors: Mueller Thomas , Dieplinger Benjamin , Poelz Werner , Haltmayer Meinhard
Published: September 2008

This study evaluated the utility of the PFA-100 and the Multiplate analyzer for the assessment of aspirin and clopidogrel effects on platelet function in patients with cardiovascular disease. Platelet function was determined with the PFA-100 using collagen+epinephrine (CEPI) and collagen+adenosine-5’-diphosphate (CADP) cartridges, and with whole blood impedance aggregometry using the Multiplate ASPI and ADP+PG tests (aggregation triggered with arachidonic acid and ADP+ prostaglandin E1, respectively). Four study groups were identified from the 154 patients enrolled: patients without antiplatelet therapy, patients with 100 mg aspirin daily but without clopidogrel treatment, patients with 75 mg clopidogrel daily but without aspirin treatment, and patients with both 100 mg aspirin daily plus 75 mg clopidogrel daily. It was found that the PFA-100 instrument is useful for detection of aspirin but not for detection of a clopidogrel effect, while the Multiplate analyzer is useful for specific detection of both aspirin and clopidogrel effects on platelet function.
Cognitive impairment in multiple sclerosis
Authors: Patti F
Published: September 2008

Background

Cognitive impairment is increasingly being recognized as a common and disabling symptom of multiple sclerosis (MS) that contributes to poor quality of life in affected patients. Despite the high prevalence of cognitive impairment in MS, cognitive function is not assessed routinely in clinical practice or in clinical trials. The perception that cognitive assessments are costly, time-consuming, complicated, and difficult to administer and interpret has contributed, at least in part, to the failure to incorporate cognitive testing into standard clinical evaluation of patients with MS. Detailed studies of cognitive impairment in MS are rare and guidelines for the assessment of cognitive function in MS are lacking.

Treatment

How to manage cognitive decline in MS also requires further study. Licensed disease-modifying drug (DMD) treatments for MS reduce brain lesion development, and associations between brain lesions and cognitive performance have been reported, providing a rationale for DMD treatment of MS-associated cognitive impairment. There is some evidence for cognitive benefits of DMDs, but as few pivotal DMD trials included cognitive assessments, the effects of these agents on cognition are not fully understood and more studies are needed.

Conclusions

It is only through further studies that it will be possible to identify patients with, or at risk of, cognitive impairment and to provide appropriate therapy to limit the effects of this potentially devastating symptom.
CNS demyelination and quadrivalent HPV vaccination
Authors: Sutton I , Lahoria R , Tan IL , Clouston P , Barnett MH
Published: September 2008

Vaccination is generally considered safe in patients with multiple sclerosis (MS). We report five patients who presented with multifocal or atypical demyelinating syndromes within 21 days of immunization with the quadrivalent human papilloma virus (HPV) vaccine, Gardasil®. Although the target population for vaccination, young females, has an inherently high risk for MS, the temporal association with demyelinating events in these cases may be explained by the potent immuno-stimulatory properties of HPV virus-like particles which comprise the vaccine. A prospective case–control study of patients with MS or clinically isolated demyelinating syndromes receiving the Gardasil® vaccine may provide relevant safety data in this population.
Analysis of cerebrospinal fluid and cerebrospinal fluid cells from patients with multiple sclerosis for detection of JC virus DNA
Authors: Iacobaeus E , Ryschkewitsch C , Gravell M , Khademi M , Wallstrom E , Olsson T , Brundin L , Major EO
Published: September 2008

Objective

1) To determine whether JC virus (JCV) DNA was present in the cerebrospinal fluid (CSF) and blood from patients with multiple sclerosis (MS) in comparison with controls and 2) to find out if our clinical material, based on presence of JCV DNA, included any patient at risk for progressive multifocal leukoencephalopathy (PML).

Methods

The prevalence of JCV DNA was analyzed in CSF and plasma from 217 patients with MS, 86 patients with clinically isolated syndrome (CIS), and 212 patients with other neurological diseases (OND). In addition, we analyzed CSF cells, the first report of JCV DNA in CSF cells in a single sample, and peripheral blood cells in a subgroup of MS ( n = 49), CIS ( n = 14) and OND ( n = 53).

Results

A low copy number of JCV DNA was detected in one MS cell free CSF sample and in one MS CSF cell samples. None of these had any signs of PML or developed this disease during follow-up. In addition, two OND plasma samples were JCV DNA positive, whereas all the other samples had no detectable virus.

Conclusion

A low copy number of JCV DNA may occasionally be observed both in MS and other diseases and may occur as part of the normal biology of JC virus in humans. This study does not support the hypothesis that patients with MS would be at increased risk to develop PML, and consequently screening of CSF as a measurable risk for PML is not useful.
Early highly aggressive MS successfully treated by hematopoietic stem cell transplantation
Authors: Fagius J , Lundgren J , Öberg G
Published: September 2008

Background

During the last 15 years, high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) has globally been performed for severe multiple sclerosis (MS). Most patients have been in progressive phase with long disease duration. As a rule, treatment effect has been minor or moderate.

Patients

Since 2004, we have performed HSCT in nine young patients with “malignant” relapsing–remitting MS. Criteria for treatment were short duration of disease; very frequent, severe relapses; recent improvement periods indicating potential for recovery after strong immunosuppression.

Findings

Median age at treatment was 27 (range 9–34) years, MS duration 26 (4–100) months, and annualized relapse rate 10 (4–12). Median Disability Status Scale (extended disability status scale, EDSS) at HSCT was 7.0 (3.5–8.0). Median follow-up time April 2008 is 29 (23–47) months. Median EDSS improvement is 3.5 (1.0–7.0), clearly surpassing most previous reports. One patient relapsed mildly with rapid recovery 7 months after HSCT. All patients are otherwise stable, median EDSS being 2.0 (0–6.0). Before HSCT, 61 relapses occurred in 82 patient months; during follow-up, one relapse in 289 patient months.

Conclusion

This small series of patients with “malignant” relapsing–remitting MS suggests HSCT to be an effective treatment option for this relatively rare disease course. It further suggests that future criteria for HSCT in MS should be close to the present ones.
Interferon-β bioactivity measurement in multiple sclerosis: feasibility for routine clinical practice
Authors: van der Voort LF , Kok A ,   A Visser, Oudejans CBM , Caldano M , Gilli F , Bertolotto A , Polman CH , Killestein J
Published: September 2008

Background

Neutralising antibodies (NAb) to interferon beta (IFNβ) are associated with a reduced bioactivity and efficacy of IFNβ in multiple sclerosis (MS). Unclear is how to apply IFNβ bioactivity measurements (quantification of Myxovirus resistance protein A (MxA) mRNA) in clinical practice.

Objectives

To evaluate value and feasibility of IFNβ bioactivity measurement with a single MxA mRNA measurement for screening and a second measurement before and after IFNβ administration for definite confirmation of IFNβ bioactivity status.

Methods

In 79 MS patients MxA mRNA expression was determined 4 hours after IFNβ administration. If inadequate, MxA mRNA expression testing was repeated 3 months afterwards, comparing post- and pre injection samples to determine whether IFNb bioactivity was persistently lacking. MxA mRNA expression was compared to NAβ titres, determined by the cytopathic effect assay (CPE).

Results

NAb titres correlated significantly with MxA mRNA expression and MxA mRNA induction. Of all screened patients, only one patient had adequate MxA mRNA expression and high NAb titres simultaneously. Of the biological non-responders at second measurement (21/55), 17 (81%) were high-titre NAb positive, 1 (5%) was low-titre NAb positive and 3 (14%) were NAb negative. Without considering the pre-injection measurement, two more NAb negative patients would have tested negative for IFNβ bioactivity, emphasizing the need of a pre-injection sample.

Conclusions

Our data suggest that for IFNβ bioactivity screening a single post-injection measurement seems reasonable. However, MxA induction measurement based on both pre- and post-IFNβ injection samples at second measurement is somewhat more precise in determining ultimate IFNβ bioactivity status.
Differential diagnosis of suspected multiple sclerosis: a consensus approach
Authors: Miller DH , Weinshenker BG , Filippi M , Banwell BL , Cohen JA , Freedman MS , Galetta SL , Hutchinson M , Johnson RT , Kappos L , Kira J , Lublin FD , McFarland HF , Montalban X , Panitch H , Richert JR , Reingold SC , Polman CH
Published: September 2008

Background and objectives

Diagnosis of multiple sclerosis (MS) requires exclusion of diseases that could better explain the clinical and paraclinical findings. A systematic process for exclusion of alternative diagnoses has not been defined. An International Panel of MS experts developed consensus perspectives on MS differential diagnosis.

Methods

Using available literature and consensus, we developed guidelines for MS differential diagnosis, focusing on exclusion of potential MS mimics, diagnosis of common initial isolated clinical syndromes, and differentiating between MS and non-MS idiopathic inflammatory demyelinating diseases.

Results

We present recommendations for 1) clinical and paraclinical red flags suggesting alternative diagnoses to MS; 2) more precise definition of “clinically isolated syndromes” (CIS), often the first presentations of MS or its alternatives; 3) algorithms for diagnosis of three common CISs related to MS in the optic nerves, brainstem, and spinal cord; and 4) a classification scheme and diagnosis criteria for idiopathic inflammatory demyelinating disorders of the central nervous system.

Conclusions

Differential diagnosis leading to MS or alternatives is complex and a strong evidence base is lacking. Consensus-determined guidelines provide a practical path for diagnosis and will be useful for the non-MS specialist neurologist. Recommendations are made for future research to validate and support these guidelines. Guidance on the differential diagnosis process when MS is under consideration will enhance diagnostic accuracy and precision.
Potential side effect of high-dose corticosteroid relapse treatment: acute generalized exanthematous pustulosis (AGEP)
Authors: Ziemssen T , Bauer A , Bär M
Published: September 2008

Introduction

High-dose glucocorticosteroids (GC) are the treatment of choice for acute relapses in patients with multiple sclerosis as proven by several controlled clinical trials. The common adverse effects of GC are well known

Case Presentation

In this study, we report on the exceptional case of a young female treated with intravenous high-dose prednisolone for optic neuritis who developed acute generalized exanthematous pustulosis (AGEP). AGEP is a rare cutaneous adverse reaction induced most frequently by antimicrobial or antihypertensive drugs and viral infections. It is characterized by a febrile erythematous and pustular rash and blood granulocytosis.

Conclusion

In our patient, switching to dexamethasone for the next relapse was tolerated well and is an option for treatment. AGEP is a rare adverse effect of carticosteroid treatment.
The Diabetic Foot in 2008: An Update From the 12th Malvern Diabetic Foot Meeting
Authors: Ndip Agbor , Bowling Frank , Stickings Daryl , Rayman Gerry , Boulton Andrew J. M.
Published: September 2008

Every 2 years, Great Malvern, a small town in the county of Worcestershire, England, is home to the oldest international meeting on the diabetic foot that started about a quarter of a century ago. The 12th Malvern Diabetic Foot meeting, held from May 14 to 16, 2008, was attended by delegates and speakers from 5 continents and more than 25 countries. Strategic clinical specialties involved in diabetic foot management were prominently represented. Virtually every aspect of diabetic foot care was covered during this 3-day meeting through invited plenary lectures, practical interactive workshops, and scientific oral presentations. The evidence base underpinning current foot care was critically appraised, and topical issues on the diabetic foot were revisited. This review puts together key messages emanating from the meeting. All effort has been made to highlight clearly where consensus exists as well as outline areas where controversy persists.
“Chasing Rainbows” in Albany: City Beautiful, City Practical 1900-1925
Authors: Pipkin John S.
Published: September 2008

From 1900 to 1921 Albany, New York was run by a Republican machine embarrassed by an unsightly and unsanitary riverfront. Graft, engineering concerns, state mandates, and intractable railroads shaped an initial plan that was vetoed by the governor. Moving forward from this debacle, the machine hired Arnold Brunner, who developed a plan for Albany in the City Beautiful idiom. When the Democrats took over in 1922, they repudiated aesthetic planning as “chasing rainbows.” However, practical and aesthetic discourses coexisted, serving different audiences and purposes, and each served in different ways to legitimate a vision of comprehensive planning in the early 1920s.
Patient Perception of Medicare Fee Schedule of Laparoscopic Procedures
Authors: Madan Atul K. , Dhawan Naveen , Tichansky David S. , Harper Jason
Published: September 2008

Introduction. It seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient perception and opinion of Medicare reimbursements to surgeons related to laparoscopic surgery. Our hypothesis was that patients think the surgeon Medicare fee schedule is higher than actuality. Methods. Patients filled out an IRB exempted survey. The survey included a written description of laparoscopic gastric bypass, laparoscopic adjustable gastric band placement, laparoscopic cholecystectomy and an initial patient visit for 30 minutes. All participants were asked to give their thoughts of what Medicare currently reimburses for these procedures as well as what the payment should be. The survey also asked other questions about reimbursement related to Medicare. Results. There were 96 participants in the investigation with 43% of patients not filling in reimbursements for at least one procedure. Most patients (88%) looked at their bills from physicians and insurance companies carefully. For each procedure, the mean reimbursements were approximately 10 times higher than the patient perception of both the amount Medicare currently pays and the amount Medicare should pay compared to the actual fee. For the initial patient visit, the patients overestimated the payment by 158% and thought the Medicare should pay 199% of the actual fee. Most of the patients (98%) thought Medicare should pay more for more difficult cases and 85% thought Medicare should pay more if the patient visits the surgeon more times during the global period. While 32% of the patients feel Medicare pay physicians well, 91% thought that Medicare should increase fees. Conclusion. Most of our patients overestimated what Medicare currently pays for some laparoscopic procedures. Surgeons need to do a better job in educating patients and the general public about the Medicare fee schedule.
Anatomy of NOTES Gastrotomy in Human Tissue
Authors: Stadlhuber Rudolf Johannes , Yano Fumiaki , Mittal Sumeet K. , Hunt Brandon , Filipi Charles J.
Published: September 2008

Background Transoral natural orifice translumenal endoscopic surgery (NOTES) procedural success depends on a secure gastrotomy closure. Balloon gastrotomy is the most common technique to date, but the stomach-layer defect sizes and their relationship in human tissue has not been determined. Methods Ten 2-cm diameter controlled radial expansion balloon gastrotomies were performed in ex vivo human tissue. All gastrotomies were located on the anterior stomach wall. The main axis of the elliptical-shaped serosal and longitudinal muscle layer opening, the mucosal opening, and the circular muscle layer opening (after removal of mucosa) was measured. All steps were photo documented and electronically analyzed for common opening size. Results The average common opening was 1 ± 0.6 to 1.3 cm, although the main axis of a single layer can be as long as 2.2 cm. The average serosal/longitudinal muscle layer defect measured 1.5 cm, the average mucosal defect 1.6 cm, and the average circular muscle layer defect 1.5 cm. Conclusion These findings on NOTES gastrotomy anatomy demonstrate the complexity of the stomach wall opening and the challenge of providing a fail-safe gastrotomy closure. Further in vivo human studies are advised.
Single Port Sigmoidectomy in an Experimental Model With Survival
Authors: Leroy Joel , Cahill Ronan A. , Peretta Silvana , Marescaux Jacques
Published: September 2008

Introduction. Single port laparoscopic access could reduce morbidity associated with additional trocar placement and, through the development of a hybrid intermediate, facilitate the clinical adoption of evolving techniques such as natural orifice transluminal endoscopic surgery. Advanced trocar technology, as much as adapted surgical technique, seems necessary to best facilitate this, however. Methods. A novel port (Airseal, Surgiquest) that uses vortex technology to create an air-curtain seal to maintain the pneumoperitoneum while facilitating the simultaneous passage of multiple working instruments was trialed. For this, 6 pigs (30 kg each) underwent sigmoid resection and reanastomosis using the port as the sole laparoscopic access for conventional instrumentation. All animals were thereafter survived for observation during a 2-week convalescence before undergoing repeat general anesthesia, sigmoidoscopy for anastomotic assessment, and forensic laparotomy for determination of intraperitoneal healing and complications. Results. The operation was technically feasible via a single port within a short time in every animal (mean duration 12.3 minutes). One anastomosis had to redone because of staple misfire but this too was accomplishable without additional port placement. All animals survived and convalesced normally without evincing clinical complication. At follow-up, all anastomoses were patent at sigmoidoscopy and only 1 animal had evidence of complicated anastomotic healing (the same animal that had needed anastomotic refashioning). Conclusions. Single port colonic resection and reanastomosis is readily achievable in this animal model. As an operative approach, it may both advance in its own right as much as facilitate the evolution and clinical incorporation of other developmental access routes.
NF-κB1 and c-Rel cooperate to promote the survival of TLR4-activated B cells by neutralizing Bim via distinct mechanisms
Authors: Banerjee Ashish , Grumont Raelene , Gugasyan Raffi , White Christine , Strasser Andreas , Gerondakis Steve
Published: September 2008

The nuclear factor-κB (NF-κB) pathway is crucial for the survival of B cells stimulated through Toll-like receptors (TLRs). Here, we show that the heightened death of TLR4-activated nfkb1−/− B cells is the result of a failure of the Tpl2/MEK/ERK pathway to phosphorylate the proapo-ptotic BH3-only protein Bim and target it for degradation. ERK inactivation of Bim after TLR4 stimulation is accompanied by an increase in A1/Bim and Bcl-xL/Bim complexes that we propose represents a c-Rel–dependent mechanism for neutralizing Bim. Together these findings establish that optimal survival of TLR4-activated B cells depends on the NF-κB pathway neutralizing Bim through a combination of Bcl-2 prosurvival protein induction and Tpl2/ERK-dependent Bim phosphorylation and degradation.
Genetic associations with thalidomide mediated venous thrombotic events in myeloma identified using targeted genotyping
Authors: Johnson David C. , Corthals Sophie , Ramos Christine , Hoering Antje , Cocks Kim , Dickens Nicholas J. , Haessler Jeff , Goldschmidt Harmut , Child J. Anthony , Bell Sue E. , Jackson Graham , Baris Dalsu , Rajkumar S. Vincent , Davies Faith E. , Durie Brian G. M. , Crowley John , Sonneveld Pieter , Van Ness Brian , Morgan Gareth J.
Published: September 2008

A venous thromboembolism (VTE) with the subsequent risk of pulmonary embolism is a major concern in the treatment of patients with multiple myeloma with thalidomide. The susceptibility to developing a VTE in response to thalidomide therapy is likely to be influenced by both genetic and environmental factors. To test genetic variation associated with treatment related VTE in patient peripheral blood DNA, we used a custom-built molecular inversion probe (MIP)–based single nucleotide polymorphism (SNP) chip containing 3404 SNPs. SNPs on the chip were selected in “functional regions” within 964 genes spanning 67 molecular pathways thought to be involved in the pathogenesis, treatment response, and side effects associated with myeloma therapy. Patients and controls were taken from 3 large clinical trials: Medical Research Council (MRC) Myeloma IX, Hovon-50, and Eastern Cooperative Oncology Group (ECOG) EA100, which compared conventional treatments with thalidomide in patients with myeloma. Our analysis showed that the set of SNPs associated with thalidomide-related VTE were enriched in genes and pathways important in drug transport/metabolism, DNA repair, and cytokine balance. The effects of the SNPs associated with thalidomide-related VTE may be functional at the level of the tumor cell, the tumor-related microenvironment, and the endothelium. The clinical trials described in this paper have been registered as follows: MRC Myeloma IX: ISRCTN68454111; Hovon-50: NCT00028886; and ECOG EA100: NCT00033332.
Dendritic cell microvilli: a novel membrane structure associated with the multifocal synapse and T-cell clustering
Authors: Fisher Phyllis J. , Bulur Peggy A. , Vuk-Pavlovic Stanimir , Prendergast Franklyn G. , Dietz Allan B.
Published: September 2008

Polarizing effects of productive dendritic cell (DC)–T-cell interactions on DC cytoskeleton have been known in some detail, but the effects on DC membrane have been studied to a lesser extent. We found that T-cell incubation led to DC elongation and segregation of characteristic DC veils to the broader pole of the cell. On the opposite DC pole, we observed a novel membrane feature in the form of bundled microvilli. Each villus was approximately 100 nm in diameter and 600 to 1200 nm long. Microvilli exhibited high density of antigen-presenting molecules and costimulatory molecules and provided the physical basis for the multifocal immune synapse we observed during human DC and T-cell interactions. T cells preferentially bound to this site in clusters often contained both CD4+ and CD8+ T cells.
Clinical and molecular predictors of thrombocytopenia and risk of bleeding in patients with von Willebrand disease type 2B: a cohort study of 67 patients
Authors: Federici Augusto B. , Mannucci Pier M. , Castaman Giancarlo , Baronciani Luciano , Bucciarelli Paolo , Canciani Maria T. , Pecci Alessandro , Lenting Peter J. , De Groot Philip G.
Published: September 2008

Type 2B von Willebrand disease (VWD2B) is caused by an abnormal von Willebrand factor (VWF) with increased affinity for the platelet receptor glycoprotein Ib-α (GPIb-α) that may result in moderate to severe thrombocytopenia. We evaluated the prevalence and clinical and molecular predictors of thrombocytopenia in a cohort of 67 VWD2B patients from 38 unrelated families characterized by VWF mutations. Platelet count, mean platelet volume, and morphologic evaluations of blood smear were obtained at baseline and during physiologic (pregnancy) or pathologic (infections, surgeries) stress conditions. Thrombocytopenia was found in 20 patients (30%) at baseline and in 38 (57%) after stress conditions, whereas platelet counts were always normal in 16 patients (24%) from 5 families carrying the P1266L/Q or R1308L mutations. VWF in its GPIb-α–binding conformation (VWF–GPIb-α/BC) was higher than normal in all except the 16 cases without thrombocytopenia (values up to 6-fold higher than controls). The risk of bleeding was higher in patients with thrombocytopenia (adjusted hazard ratio = 4.57; 95% confidence interval, 1.17-17.90) and in those with the highest tertile of bleeding severity score (5.66; 95% confidence interval, 1.03-31.07). Prediction of possible thrombocytopenia in VWD2B by measuring VWF–GPIb-α/BC is important because a low platelet count is an independent risk factor for bleeding.