bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility of the Assessment of Echogenicity in the Identification of Symptomatic Carotid Artery Atheroma Plaques in Ischemic Stroke Patients
Authors: Ruiz-Ares G. , Fuentes B. , Martínez-Sánchez P. , Martínez-Martínez M. , Díez-Tejedor E.
Published: November 2011

Background and Purpose: Echogenicity of atheroma carotid plaques is related to a higher risk of stroke. Clinical and subjective ultrasound criteria are used to identify symptomatic plaques, but the standardized grayscale median (GSM) value may be an objective tool for this diagnosis. Our aim was to analyze the utility of assessing the echogenicity of atheroma carotid plaques in the identification of symptomatic plaques. Methods: Observational prospective study with inclusion of acute noncardioembolic anterior cerebral circulation ischemic stroke patients. Only patients with bilateral atheroma plaques were included. Echogenicity of plaques was measured by a digital and standardized grayscale system in carotid ultrasound B-mode (longitudinal projection) conducted within the first week after admission. Results: Sixty-six patients were included and 132 plaques were examined. Symptomatic atheroma plaques were less echogenic than asymptomatic ones (GSM 20.0 vs. 29.0; p = 0.002). A ROC curve analysis showed the predictive value of GSM with an AUC of 0.707 (95% CI 0.592–0.823; p = 0.002) and pointed to a value of 24.4 as the optimal cut-off level to identify a plaque as symptomatic (74% sensitivity; 67% specificity). This GSM cut-off point remained significantly associated with a high probability of symptomatic plaque even after the inclusion of the degree of carotid stenosis (either >70% or >50%) in the multivariate logistic regression models. Conclusions: The assessment of echogenicity of atheroma carotid plaques by the GSM value combined with clinical characteristics and stenosis degree may be useful in the identification of symptomatic plaques.
Preterm Prelabor Rupture of Membranes and Fetal Survival after Minimally Invasive Fetal Surgery: A Systematic Review of the Literature
Authors: Beck Veronika , Lewi Paul , Gucciardo Leonardo , Devlieger Roland
Published: November 2011

Objective: Iatrogenic preterm prelabor rupture of membranes (iPPROM; <37 weeks of gestation) is a major complication of fetal surgery. Little information is available about risk factors and incidence. Methods: We systematically reviewed reported iPPROM rates, gestational age at delivery and fetal survival after representative minimally invasive antenatal procedures. Results: A total of 1,146, 36 and 194 cases with mean iPPROM rates of 27, 31 and 26% were included for placental laser in twin-twin transfusion syndrome, shunting in lower urinary tract obstruction and interventions for twin-reversed arterial perfusion, respectively. In the statistical analysis, the maximum diameter of the instrument predicted iPPROM rate and was significantly related to gestational age at birth as well as fetal survival. Information on duration of the respective procedures was scarce and did not allow for meaningful analysis. Conclusions: iPPROM occurs in about 30% of cases treated by minimally invasive fetal surgery. The maximum diameter of the instrument explains iPPROM rate, gestational age at birth and fetal survival. Great variations in the reporting of iPPROM make data analysis difficult.
Clinical Implications of Non-A-Type NPM1 and FLT3 Mutations in Patients with Normal Karyotype Acute Myeloid Leukemia
Authors: Park Borae G. , Chi Hyun-Sook , Park Seo-Jin , Min Sook Kyoung , Jang Seongsoo , Park Chan-Jeoung , Kim Dae-Young , Lee Jung-Hee , Lee Je-Hwan , Lee Kyoo-Hyung
Published: November 2011

Mutations in the nucleophosmin (NPM1) and fms-like tyrosine kinase-3 (FLT3) genes are the most commonly observed mutations in patients with normal-karyotype acute myeloid leukemia (AML-NK). We analyzed the prognostic effects and interactions of these mutations in 201 AML-NK patients. NPM1 and FLT3 mutations were found in 38.3 and 24.9% of AML-NK patients, respectively. NPM1 mutations (NPM1mut), especially in patients without FLT3 mutations (FLT3mut), were associated with a favorable outcome. However, NPM1mut did not affect survival. FLT3mut tended to be associated with a poor survival outcome. FLT3mut showed no prognostic effects in patients with A-type NPM1mut. However, FLT3mut were associated with a significantly worse prognosis in patients with non-A-type NPM1mut. The prognostic interaction between the NPM1 and FLT3 mutations was significant in patients with non-A-type NPM1mut.
Persistent Hyperglycemia at 24–48 h in Acute Hyperglycemic Stroke Patients Is Not Associated with a Worse Functional Outcome
Authors: Ntaios G. , Abatzi C. , Alexandrou M. , Lambrou D. , Chatzopoulos S. , Egli M. , Ruiz J. , Bornstein N. , Michel P.
Published: November 2011

Background: Recently, it was shown that the relation between admission glucose and functional outcome after ischemic stroke is described by a J-shaped curve, with a glucose range of 3.7–7.3 mmol/l associated with a favorable outcome. We tested the hypothesis that persistence of hyperglycemia above this threshold at 24–48 h after stroke onset impairs 3-month functional outcome. Methods: We analyzed all patients with glucose >7.3 mmol/l on admission from the Acute STroke Registry and Analysis of Lausanne (ASTRAL). Patients were divided into two groups according to their subacute glucose level at 24–48 h after last well-being time (group 1: ≤7.3 mmol/l, group 2: >7.3 mmol/l). A favorable functional outcome was defined as a modified Rankin Score (mRS) ≤2 at 3 months. A multiple logistic regression analysis of multiple demographic, clinical, laboratory and neuroimaging covariates was performed to assess predictors of an unfavorable outcome. Results: A total of 1,984 patients with ischemic stroke were admitted between January 1, 2003 and October 20, 2009, within 24 h after last well-being time. In the 421 patients (21.2%) with admission glucose >7.3 mmol/l, the proportion of patients with a favorable outcome was not statistically significantly different between the two groups (59.2 vs. 48.7%, respectively). In multiple logistic regression analysis, unfavorable outcome was significantly associated with age (odds ratio, OR: 1.06, 95% confidence interval, 95% CI: 1.03–1.08 for every 10-year increase), National Institute of Health Stroke Score, NIHSS score, on admission (OR: 1.16, 95% CI: 1.11–1.21), prehospital mRS (OR: 12.63, 95% CI: 2.61–61.10 for patients with score >0), antidiabetic drug usage (OR: 0.36, 95% CI: 0.15–0.86) and glucose on admission (OR: 1.16, 95% CI: 1.02–1.31 for every 1 mmol/l increase). No association was found between persistent hyperglycemia at 24–28 h and outcome in either diabetics or nondiabetics. Conclusions: In ischemic stroke patients with acute hyperglycemia, persistent hyperglycemia (>7.3 mmol/l) at 24–48 h after stroke onset is not associated with a worse functional outcome at 3 months whether the patient was previously diabetic or not.
A New Image-Based Stroke Registry Containing Quantitative Magnetic Resonance Imaging Data
Authors: Kim Dong-Eog , Park Kyoung-Jong , Schellingerhout Dawid , Jeong Sang-Wuk , Ji Myung-Goo , Choi Won Jun , Tak Yoon-Oh , Kwan Geon-Hwan , Koh Eun Ah , Noh Sang-Mi , Jang Hyung Yeol , Kim Tae-Yun , Jeong Ji-Won , Lee Jae Sung , Choi Heung-Kook
Published: November 2011

Background: Conventional stroke registries contain alphanumeric text-based data on the clinical status of stroke patients, but this format captures imaging data in a very limited form. There is a need for a new type of stroke registry to capture both text- and image-based data. Methods and Results: We designed a next-generation stroke registry containing quantitative magnetic resonance imaging (MRI) data, ‘DUIH_SRegI’, developed a supporting software package, ‘Image_QNA’, and performed experiments to assess the feasibility and utility of the system. Image_QNA enabled the mapping of stroke-related lesions on MR onto a standard brain template and the storage of this extracted imaging data in a visual database. Interuser and intrauser variability of the lesion mapping procedure was low. We compared the results from the semi automatic lesion registration using Image_QNA with automatic lesion registration using SPM5 (Statistical Parametric Mapping version 5), a well-regarded standard neuroscience software package, in terms of lesion location, size and shape, and found Image_QNA to be superior. We assessed the clinical usefulness of an image-based registry by studying 47 consecutive patients with first-ever lacunar infarcts in the corona radiata. We used the enriched dataset comprised of both image-based and alphanumeric databases to show that diffusion MR lesions overlapped in a more posterolateral brain location for patients with high NIH Stroke Scale scores (≧4) than for patients with low scores (≤3). In April 2009, we launched the first prospective image-based acute (≤1 week) stroke registry at our institution. The registered data include high signal intensity ischemic lesions on diffusion, T2-weighted, or fluid attenuation inversion recovery MRIs, and low signal intensity hemorrhagic lesions on gradient-echo MRIs. An interim analysis at 6 months showed that the time requirement for the lesion registration (183 consecutive patients, 3,226 MR slices with visible stroke-related lesions) was acceptable at about 1 h of labor per patient by a trained assistant with physician oversight. Conclusions: We have developed a novel image-based stroke registry, with database functions that allow the formulation and testing of intuitive, image-based hypotheses in a manner not easily achievable with conventional alphanumeric stroke registries.
Impact of Cannabis Treatment on the Quality of Life, Weight and Clinical Disease Activity in Inflammatory Bowel Disease Patients: A Pilot Prospective Study
Authors: Lahat Adi , Lang Alon , Ben-Horin Shomron
Published: November 2011

Background and Aims: Inflammatory bowel disease (IBD) patients suffer from significant morbidity and diminished life quality. The plant cannabis is beneficial in various gastrointestinal diseases, stimulating appetite and causing weight gain. Our aims were to assess whether treatment with inhaled cannabis improves quality of life, disease activity and promotes weight gain in these patients. Methods: Patients with long-standing IBD who were prescribed cannabis treatment were included. Two quality of life questionnaires and disease activity indexes were performed, and patient’s body weight was measured before cannabis initiation and after 3 months’ treatment. Results: Thirteen patients were included. After 3 months’ treatment, patients reported improvement in general health perception (p = 0.001), social functioning (p = 0.0002), ability to work (p = 0.0005), physical pain (p = 0.004) and depression (p = 0.007). A schematic scale of health perception showed an improved score from 4.1 ± 1.43 to 7 ± 1.42 (p = 0.0002). Patients had a weight gain of 4.3 ± 2 kg during treatment (range 2–8; p = 0.0002) and an average rise in BMI of 1.4 ± 0.61 (range 0.8–2.7; p = 0.002). The average Harvey-Bradshaw index was reduced from 11.36 ± 3.17 to 5.72 ± 2.68 (p = 0.001). Conclusions: Three months’ treatment with inhaled cannabis improves quality of life measurements, disease activity index, and causes weight gain and rise in BMI in long-standing IBD patients.
Interleukin-1 and Stroke: Biomarker, Harbinger of Damage, and Therapeutic Target
Authors: Denes Adam , Pinteaux Emmanuel , Rothwell Nancy J. , Allan Stuart M.
Published: November 2011

Inflammation is established as a contributor to cerebrovascular disease. Risk factors for stroke include many conditions associated with chronic or acute inflammation, and inflammatory changes in the brain after cerebrovascular events contribute to outcome in experimental studies, with growing evidence from clinical research. The brain is extremely susceptible to inflammatory challenge, but resident glia, endothelial cells and neurones can all mount a pronounced inflammatory response to infection or injury. Recent discoveries highlight the importance of peripherally-derived immune cells and inflammatory molecules in various central nervous system disorders, including stroke. The inflammatory cytokine, interleukin-1 (IL-1), plays a pivotal role in both local and systemic inflammation, and is a key driver of peripheral and central immune responses to infection or injury. Inhibition of IL-1 has beneficial effects in a variety of experimental paradigms of acute brain injury and is a promising clinical target in stroke. We propose that blockade of IL-1 could be therapeutically useful in several diseases which are risk factors for stroke, and there is already considerable pre-clinical and clinical evidence that inhibition of IL-1 by IL-1 receptor antagonist may be valuable in the management of acute stroke.
High Cholesterol Feeding May Induce Tubular Dysfunction Resulting in Hypomagnesemia
Authors: Favaro Vanessa F. , Oshiro-Monreal Fabíola M. , de Bragança Ana Carolina , Andrade Lucia , Seguro Antonio Carlos , Helou Claudia M.B.
Published: November 2011

Background/Aims: Hypomagnesemia may induce hypercholesterolemia, but the contrary has not been described yet. Thus, magnesium homeostasis was evaluated in rats fed a cholesterol-enriched diet for 8 days. This study has a relevant clinical application if hypomagnesemia, due to hypercholesterolemia, is confirmed in patients with long-term hypercholesterolemia. Methods: Both hypercholesterolemic (HC) and normocholesterolemic rats (NC) were divided into sets of experiments to measure hemodynamic parameters, physiological data, maximum capacity to dilute urine (CH2O), variations (Δ) in [Ca2+]i and the expression of transporter proteins. Results: HC developed hypomagnesemia and showed high magnesuria in the absence of hemodynamic abnormalities. However, the urinary sodium excretion and CH2O in HC was similar to NC. On the other hand, the responses to angiotensin II by measuring Δ [Ca2+]i were higher in the thick ascending limb of Henle’s loop (TAL) of HC than NC. Moreover, high expression of the cotransporter NKCC2 was found in renal outer medulla fractions of HC. Taken together, the hypothesis of impairment in TAL was excluded. Actually, the expression of the epithelial Mg2+ channel in renal cortical membrane fractions was reduced in HC. Conclusion: Impairment in distal convoluted tubule induced by hypercholesterolemia explains high magnesuria and hypomagnesemia observed in HC.
Do Journals Publishing in the Field of Urology Endorse Reporting Guidelines? A Survey of Author Instructions
Authors: Kunath Frank , Grobe Henrik R. , Rücker Gerta , Engehausen Dirk , Antes Gerd , Wullich Bernd , Meerpohl Jörg J.
Published: November 2011

Introduction: Reporting guidelines aim to ensure adequate and complete reporting of clinical studies and are an indispensable tool to translate scientific results into clinical practice. The extent to which reporting guidelines are incorporated into the author instructions of journals publishing in the field of urology remained unclear. Materials and Methods: We assessed the author instructions of uro-nephrological journals indexed in ‘Journal Citation Reports 2009’. Two authors independently assessed the author guidelines. We evaluated additional information including whether a journal was published by or in association with a medical association. Discrepancies were resolved by re-checking the respective author instructions and by discussion with a third author. Results: The recommendations of the International Committee of Journal Editors were endorsed by 32 journals (58.2%) but were mentioned in 12 (37.5%) only to give general advice about manuscript preparation. Fourteen journals (25.5%) mentioned at least one reporting guideline, with CONSORT the most frequently cited. Journals with high impact factors were more likely to endorse CONSORT (p < 0.009). Other reporting guidelines were mentioned by <6% of the journals. Conclusion: All key stakeholders involved in the publication process should more frequently promote the awareness and use of reporting guidelines.
Neutrophil Activation in Severe, Early-Onset COPD Patients versus Healthy Non-Smoker Subjects in vitro: Effects of Antioxidant Therapy
Authors: Milara Javier , Juan Gustavo , Peiró Teresa , Serrano Adela , Cortijo Julio
Published: November 2011

Background: Neutrophils and oxidative stress have been implicated in the pathogenesis of COPD. Severe, early-onset COPD is characterized by a rapid decline in the lung function at an early age; however, nothing is known about neutrophil activation in COPD patients. Objectives: The aim of this study was to evaluate peripheral blood neutrophil activation in severe, early-onset COPD patients versus healthy non-smokers and the effect of N-acetyl-L-cysteine (NAC) on neutrophil activation in vitro. Methods: Neutrophils were isolated from 15 severe, early-onset COPD patients and 15 age-matched healthy subjects and stimulated with N-formyl- Met-Leu-Phe (fMLP) in the presence or absence of NAC (10 µM to 10 mM). Neutrophil chemotaxis, elastase release, reactive oxygen species (ROS), intracellular thiols and apoptosis were measured by Boyden chamber, spectrofluorometry, CMFDA and H2DCF-DA dyes and by annexin V-FITC, respectively. Results: Chemotaxis of peripheral blood neutrophils from COPD patients in response to fMLP was 30% more increased than that observed in healthy subjects. Elastase release in response to fMLP was 2-fold higher in neutrophils from COPD patients versus healthy subjects. Intracellular thiol levels were 30% lower in COPD and ROS was approximately 30% higher in COPD versus healthy neutrophils. Spontaneous apoptosis showed no differences in both groups of patients and fMLP-induced apoptosis was higher in COPD. Pre-treatment with the antioxidant NAC effectively attenuated neutrophil chemotaxis, elastase release and ROS as well as effectively increased thiol levels in COPD. Conclusions: Neutrophils in severe, early-onset COPD patients are highly activated and this is alleviated by NAC in vitro.
Clinical, Physiological and Anti-Inflammatory Effect of Montelukast in Patients with Cough Variant Asthma
Authors: Takemura Masaya , Niimi Akio , Matsumoto Hisako , Ueda Tetsuya , Matsuoka Hirofumi , Yamaguchi Masafumi , Jinnai Makiko , Chin Kazuo , Mishima Michiaki
Published: November 2011

Background: Cough variant asthma (CVA) is a phenotype of asthma presenting solely with coughing, characterized by airway hyperresponsiveness, eosinophilic inflammation and a cough response to bronchodilators. Leukotriene receptor antagonists (LTRAs) are antiasthma medications with anti-inflammatory and bronchodilatory properties. Although LTRAs exert antitussive effects in CVA, the mechanisms involved are unknown. Objectives: This study aimed to clarify the antitussive mechanisms of LTRAs in CVA patients. Methods: We prospectively observed the effect of montelukast (10 mg) daily for 4 weeks in 23 consecutive nonsmoking adults with anti-inflammatory treatment-naive CVA. We evaluated, before and after treatment, the cough visual analogue scale (VAS), pulmonary function (spirometry and impulse oscillation), methacholine airway responsiveness, cough receptor sensitivity, expressed by the concentration of capsaicin inducing 2 or more (C2) and 5 or more (C5) coughs, sputum eosinophil counts and levels of inflammatory mediators, including cysteinyl leukotrienes, leukotriene B4, prostaglandin (PG) D2, PGE2, PGF2α and thromboxane B2. We compared the baseline characteristics of the patients based on the symptomatic response to montelukast, defined as a decrease in the cough VAS of >25% (n = 15) or ≤25% (n = 8). Results: Montelukast significantly decreased the cough VAS (p = 0.0008), sputum eosinophil count (p = 0.013) and cough sensitivity (C2: p = 0.007; C5: p = 0.039), whereas pulmonary function, airway responsiveness and sputum mediator levels remained unchanged. Multivariate analysis showed that a better response to montelukast was associated solely with younger age (p = 0.032). Conclusion: The antitussive effect of montelukast in CVA may be attributed to the attenuation of eosinophilic inflammation rather than its bronchodilatory properties.
Fetal and Neonatal Diagnosis of Interrupted Aortic Arch: Associations and Outcomes
Authors: Axt-Fliedner Roland , Kawecki Andrea , Enzensberger Christian , Wienhard Julia , Degenhardt Jan , Schranz Dietmar , Vogel Melanie
Published: November 2011

Objective: Interrupted aortic arch (IAA) is a rare but serious anomaly. Prenatal diagnosis is challenging and published data are limited. The aim of the study was to review the data of fetuses and neonates diagnosed with IAA during a 16-year period at Children’s Hospital Giessen. Methods: Retrospective ascertainment of 8 fetuses and 20 neonates with a confirmed diagnosis of IAA from 1994 to 2010 by reviewing the hospital database of the cardiovascular program of the prenatal and pediatric cardiology clinics at the University Hospital Giessen. Results: Eighteen cases with IAA type B and 10 cases with IAA type A were found. After 2005, prenatal diagnosis was achieved in 8 cases and postnatal imaging confirmed IAA in all 8 neonates. Twenty-nine percent of individuals had a chromosomal anomaly, with microdeletion 22q11.2 being the most common abnormality (n = 6, 21%). In 46% (13/28) other complex cardiac anomalies were present. Mortality after surgery was 18%. Long-term morbidity and mortality was due to neurological impairment in the presence of microdeletion 22q11.2 and the need of surgical or catheter re-intervention. Conclusion: Despite the difficulties and challenges in diagnosis, the prenatal detection rate of IAA is increasing. Associated complex cardiac and chromosomal abnormalities influence the outcome of patients with IAA and are important issues of parental counseling.
Diagnostic Accuracy of Noninvasive Detection of Fetal Trisomy 21 in Maternal Blood: A Systematic Review
Authors: Verweij E.J. , van den Oever J.M.E. , de Boer M.A. , Boon E.M.J. , Oepkes D.
Published: November 2011

Background: Both pregnant women and providers of obstetric care are aware of the rapid advances in noninvasive prenatal diagnosis (NIPD) of fetal trisomies, and appear to look forward to its clinical introduction. Objectives: To review and critically assess the published literature on diagnostic accuracy of NIPD using cell-free fetal DNA or RNA in maternal blood to detect fetal trisomy 21. Method: An electronic search was performed in MEDLINE, EMBASE and the Cochrane library (1997 to April 2011). Of a total of 201 citations, 9 studies were eligible for full-text analysis by 2 independent reviewers, using the QUADAS tool. Results: Two of the 9 analyzed studies complied with the criteria of the QUADAS tool. Combining the selected 2 studies, with a total of 681 pregnancies included, overall sensitivity was 125/125 (100%, 95% CI 97.5–100%) and specificity 552/556 (99.3%, 95% CI 98.7–99.3%). Conclusions: NIPD of fetal trisomy 21, using fetal nucleic acids in maternal plasma, appears to have a high diagnostic accuracy. Large-scale prospective studies are awaited before implementation in clinical practice.
Patient-Reported Outcomes in Adult Survivors with Single-Ventricle Physiology
Authors: Overgaard Dorthe , Schrader Anne-Marie , Lisby Karen H. , King Catriona , Christensen Rie F. , Jensen Helena F. , Idorn Lars , Søndergaard Lars , Moons Philip
Published: November 2011

Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs across functional classes, and (3) to compare PROs between patients and controls. Methods: A case-control study in two adult congenital heart programmes with 62 adult survivors with SVP were matched to 172 healthy controls. A wide range of PROs were measured using validated questionnaires. The treating physician classified patients according to the Ability Index. Results: Patients with SVP have a good functional status. Patients in Ability Index class I consistently reported the best scores, similar to those of healthy controls. Negative associations were found between functional class and outcomes of perceived health and quality of life. For patients in Ability Index class II and III, PROs were poorer. Conclusions: PROs in patients with SVP are generally good.
Family Planning Choices in Couples Using Contraception without Knowing They Are Infertile: Should Newly-Wed Men Undergo a Routine Spermiogram?
Authors: Kiran Hakan , Arikan Deniz Cemgil , Coskun Ayhan , Kaplanoglu Mustafa , Kiran Gurkan , Ozdemir Ozgur , Cetin M. Turan
Published: November 2011

Introduction: Newly-weds choose to use contraception either to spend the first years of their marriage more freely, because of economic reasons or because of the increase in working career women. We studied the reasons for infertility and the rate of contraception use in the first years of marriage among couples with primary infertility and evaluated the use of a spermiogram as a screening test in newly-wed men. Subjects and Methods: In this cross-sectional study, 302 couples with primary infertility who were treated at our infertility clinic were included in the study. The couples were divided into 2 groups: group 1 (infertile couples who have used contraception) consisted of 67 couples and group 2 (infertile couples who did not use contraception) consisted of 235 couples. Results: Sixty-seven (22.5%) infertile couples stated that they had used no contraception in the first years of their marriage. In group 1, 35.8% of couples were diagnosed as having unexplained infertility, while 28.4% of them had male factor, 31.3% female factor and 4.5% a combination of male and female factor infertility. Sixteen men with male factor infertility used coitus interruptus (3–36 months) or condoms (6–12 months) unnecessarily. Conclusions: Infertility counseling in the early days of marriage and a spermiogram performed at that time could be beneficial for the newly-wed couples even if they do not want a child at the time. To perform a spermiogram as a screening test in all newly-wed men should be discussed.
Prospective Randomized Study on the Efficacy of Blue Light in the Treatment of Psoriasis Vulgaris
Authors: Weinstabl Antonia , Hoff-Lesch Susanne , Merk Hans F. , von Felbert Verena
Published: November 2011

Background:Blue light has no known toxic effects on human skin, but reduces the proliferative capacity of keratinocytes in vitro. We therefore investigated the efficacy of blue light in the treatment of psoriasis vulgaris (PV). Methods: Forty patients with mild to moderate PV and bilateral plaques were assigned to two groups. Group 1 (n = 20) received irradiation at home with blue light (light-emitting diode, LED, emission maximum: 420 nm) once daily for 4 weeks. In parallel, group 2 (n = 20) performed irradiations with another blue light device (LED emission maximum: 453 nm). The contralateral control plaques remained untreated in both groups. Results: Thirty-seven patients completed the trial. The main study parameter, the difference of Local Psoriasis Severity Index (LPSI) scores of the irradiated plaques compared to the control plaques, showed statistically significant improvement after 4 weeks of treatment in both groups [group 1 (420 nm): n = 17, p = 0.04; group 2 (453 nm): n = 20, p = 0.04]. Accordingly, plaque status as assessed by both the physicians and the patients improved continuously during the 4 weeks of treatment and steadily declined thereafter. Conclusion: Blue light appears to be a promising treatment modality in PV that warrants further evaluation in larger studies.
Neuroanatomical Correlates of Cognitive Performance in Late Life
Authors: Zhang Haobo , Sachdev Perminder S. , Wen Wei , Kochan Nicole A. , Zhu Wanlin , Crawford John D. , Brodaty Henry , Slavin Melissa J. , Reppermund Simone , Kang Kristan , Trollor Julian N.
Published: November 2011

Background/Aim: While a number of studies examined the neuroanatomical correlates of cognitive function in older adults, the results have been inconsistent. Examination of a large epidemiologically acquired sample with high-resolution magnetic resonance imaging has the potential to enhance the evidence in this field. Methods: The participants were 326 non-demented elderly adults undergoing a battery of neuropsychological tests and brain magnetic resonance imaging scans. Regression analyses were performed to examine the correlation between voxel-based grey matter (GM) volume and four cognitive domain scores. Results: Positive correlations were observed between specific GM volumes and cognitive domains, i.e. bilateral temporal lobes and hippocampi with language; bilateral temporal, parietal, and occipital lobes with processing speed; and bilateral frontal, temporal, parietal, and occipital lobes with executive function. The positive correlation between verbal memory performance and GM volume in the bilateral medial temporal lobes was not significant after correction for age. Conclusion: Our findings suggest that the location of GM correlates of cognitive tests is largely consistent with the conventional understanding of the neuroanatomical basis of cognition. However, the lack of hemispheric predominance in these GM correlates, and the extensively positive correlation between GM volume and cognitive performance, perhaps reflects the characteristics of the ageing brain.
Determinants of Blood Uric Acid Levels in a Dyslipidemic Arab Population
Authors: Al-Meshaweh Ahoud F. , Jafar Yaqoub , Asem Mohammad , Akanji Abayomi O.
Published: November 2011

Objectives: The objective of this study was to explore the relationships between circulating uric acid and lipid levels and components of the metabolic syndrome (MetS) in Arab dyslipidemic patients, a group already at high coronary artery disease risk. Subjects and Methods: The medical records of 1,229 subjects (632 men, 597 women) referred for treatment of dyslipidemia and followed up for at least 12 months were reviewed. Serum levels of uric acid and lipids (total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein) and other variables in the National Cholesterol Education Program ATP III criteria definition of MetS were assessed at initial presentation and every 4– 6 months, under specific lipid-lowering treatment (statins and/or fibrates), in each of the subjects. Their respective associations were explored by appropriate logistic regression techniques with control for confounding risk factors, including age, gender and body mass index. Results: 306 subjects (24.9%) of the study population were hyperuricemic; they were more likely to be men, obese and diabetic. Also the serum uric acid level (mean ± SD) was greater in men with MetS compared with men without (377.0 ± 98.0 vs. 361.6 ± 83.1 µmol/l, p < 0.05), an observation not reproduced in women. Uric acid levels had significant associations with the presence of fasting hyperglycemia, hypertension and large waist circumference (WC) in men, but only with large WC in women. With statin treatment, uric acid levels decreased by 10% within 1 year of treatment; with fibrates, uric acid levels remained unchanged or slightly increased. Conclusion: The data showed that hyperuricemia is common in dyslipidemic patients in Kuwait, where its important determinants are male sex, obesity, diabetes and statin treatment.
Poor Outcomes in Elderly Kidney Transplant Recipients Receiving Alemtuzumab Induction
Authors: Hurst Frank P. , Altieri Maria , Nee Robert , Agodoa Lawrence Y. , Abbott Kevin C. , Jindal Rahul M.
Published: November 2011

Introduction: Alemtuzumab and rabbit antithymocyte globulin (rATG) are being used with increasing frequency as induction agents in kidney transplantation. Using the US Renal Data Base System, we analyzed the safety profile of these agents in the elderly. Methods: In a cohort of patients transplanted from January 2000 to July 2009 and followed through 2009, we assessed the effect of induction on allograft loss and death among elderly recipients. Recipients were censored at dates of allograft loss, death or the end of study. Independent associations between induction agents and allograft loss or death were examined using multivariate analysis with forward stepwise Cox regression. Results: Among 130,402 patients with first transplants, 14,907 were age 65 years or older. 4,466 (30%), 3,049 (20.5%), 1,501 (10.1%), and 999 (6.7%) were induced with thymoglobulin, basiliximab, daclizumab, and alemtuzumab, respectively. After adjusting for baseline differences, induction with alemtuzumab was associated with an increased risk of graft loss and death, with an adjusted hazard ratio (AHR) of 1.26 (95% CI 1.08–1.48). Risk was also present at other age cutoffs [age >60 (AHR 1.16; 95% CI 1.03–1.31; p = 0.014), age >70 (AHR 1.43; 95% CI 1.13–1.81; p = 0.003) and age >75 (AHR 1.68; 95% CI 1.07–2.63; p = 0.024)]. Conclusions: In the elderly, alemtuzumab is associated with an escalating risk of death and graft loss in recipients of kidney transplantations.
Time Course of Acute Neuroprotective Effects of Lidocaine Evaluated by Brain Impedanciometry in the Global Ischemia Model
Authors: Wix-Ramos R. , Eblen-Zajjur A.
Published: November 2011

Voltage-activated sodium channels play a primary role during ischemic brain edema and thus are a pharmacological target for therapy. Lidocaine, a sodium channel blocker, was tested in male Sprague-Dawley rats anesthetized with thiobarbital (60 mg·kg–1 i.p.) and perfused i.v. with Ringer’s solution (n = 9) or lidocaine (0.75 mg·kg–1, n = 9, or 1.5 mg·kg–1, n = 6). Two tungsten microelectrodes were implanted in the cerebral cortex to register changes in tissue impedance in response to the voltage fall of a square wave electric pulse (100 µA, 10 ms), before and after infusion of lidocaine or Ringer’s solution and during global cerebral ischemia due to a respiratory arrest induced by D-tubocurarine. Lidocaine infusion under normoxic conditions did not change voltage values (Mann-Whitney U = 51; p > 0.05). In animals infused with Ringer’s solution, the voltage fall induced by global cerebral ischemia was fast for ∼8 min at –8.0 ± 2.3%·min–1 followed by a slow decay at –0.96 ± 0.17%·min–1. The time constant of voltage decay (λ) was 215.6 s (F = 547.4; p = 0.00000). Voltage values of lidocaine-infused animals were significantly higher than those of rats infused with Ringer’s solution (U = 100; p = 0.000089). The decay rates were –4.97 ± 1.36%·min–1 (fast phase) and –1.04 ± 0.3%·min–1 (slow phase) with λ = 672.5 s (+211.9%; p = 0.000000). These results suggest that lidocaine significantly reduced cerebral impedance, hence exerting a strong early anti-edema effect probably by blocking voltage-activated sodium channels.
Average Daily Blood Pressure, Not Office Blood Pressure, Is Associated With Progression of Cerebrovascular Disease and Cognitive Decline in Older People
Authors: White William B. , Wolfson Leslie , Wakefield Dorothy B. , Hall Charles B. , Campbell Patrick , Moscufo Nicola , Schmidt Julia , Kaplan Richard F. , Pearlson Godfrey , Guttmann Charles R.G.
Published: November 2011

Background—

High blood pressure (BP) is a risk factor for cerebrovascular disease, including stroke. Little is known about the importance of BP on the progression of microvascular disease of the brain, which has been associated with functional decline in mobility and cognition in older people.

Methods and Results—

This was a prospective cohort of subjects 75 to 89 years of age to determine relations among vascular risk factors, white matter hyperintensity volume, and functional status. Ninety-nine subjects were enrolled through the use of a balanced 3×3 matrix stratified by age and mobility performance, and 72 subjects completed all sets of baseline and follow-up studies at 2 years. Subjects were excluded if there were medications or systemic or neurological diseases that could compromise mobility. Ambulatory and clinic BP monitoring, magnetic resonance imaging, gait studies, and neuropsychological testing were performed at baseline and after 24 months. Brain classification into normal white matter and T2-hyperintense white matter hyperintensity volume was performed with semiautomated segmentation. Quantitative measures of mobility and cognitive function were obtained longitudinally. Increased ambulatory systolic BP, but not clinic systolic BP, from baseline to 24 month follow-up was associated with increased white matter hyperintensity volume over that same period, as well as measures of executive function/processing speed. Similar associations were observed for 24-hour BP, awake BP, and sleep BP but not for the surge between the sleep and awake time at the 24-month time point.

Conclusions—

These data demonstrate for the first time the importance of 24-hour systolic BP in the progression of brain white matter hyperintensity volume burden associated with impairment of cognitive function in older people. The 24-hour systolic BP may be a potential target for intervention in the elderly to reduce vascular disease of the brain and impairment of function.
Most Read in
Circulation: Cardiovascular Quality and Outcomes
Authors:   The Editors
Published: November 2011

The following articles are being highlighted as part of
Circulation
's Topic Review series. This series will summarize the most important manuscripts, as selected by the editors, published in
Circulation
and the
Circulation
subspecialty journals. The studies included in this article represent the most read manuscripts published on the topic of cardiovascular quality and outcomes in 2009 and 2010.
Grassland management history affects the response of the nematode community to changes in above-ground grazing regime
Authors: Saj Stéphane , Le Roux Xavier , Attard Eléonore , Klumpp Katja , Villenave Cécile
Published: November 2011

Changes in grassland management induce disturbances that influence both soil functioning and soil fauna. This study aimed at determining the extent to which the composition of a grassland soil nematode community could be altered by a shift of grazing regime and the potential feedback that these alterations could provoke on grassland functioning. Therefore, we monitored the composition of the soil nematode community (i.e., plant-, bacterial- and fungal-feeders, omnivores and carnivores) of mesocosms that were sampled from two contrasted long-term field trials (high vs low grazing treatments) and subsequently subjected to high or no grazing for 2 years. The soil nematofauna responded faster and more strongly to the application of an intensive grazing regime on a previously extensively exploited system than the other way round. The application of an intensive grazing regime induced a significant increase in numbers of bacterial feeders and a decrease of the relative abundance of fungal-feeding nematodes. The nematofaunal community structure was determined by both the past and current grazing regimes throughout the 2 years of monitoring. Observed effects on soil microbivores seemed to reflect the 'immediate' above-ground primary production potential and to follow micro-organism dynamics. On the other hand, observed effects on root-feeding nematodes seemed to reflect the integral effect of past and current grazing regimes on plant community root biomass and quality.
Keeping the Dream Alive: Meridian as Alice Walker’s Homage to Martin Luther King and the Beloved Community
Authors: Tewkesbury Paul
Published: November 2011

Abstract

This essay examines the ways in which Alice Walker’s 1976 novel Meridian is shaped by Martin Luther King Jr.’s notion of the Beloved Community, a religious and social ideal that epitomized the goals of the 1960s civil rights movement. Previous studies of Meridian focus on connections between the novel and the movement, but they do not explore the connections between the novel’s spiritual dimensions and King’s religious philosophy. As Walker pays tribute to King and his religious philosophy throughout Meridian, she also fleshes out her own womanist philosophy. Indeed, Walker’s womanist philosophy as revealed in Meridian is more congruent with King’s Christian theology than one might expect, for the values of redemptive suffering, nonviolence, love, and community are as central to the novel as they are to King’s thought.
In whose service? The 1960s’ Czechoslovak Sociologists and their Party
Authors: Voříšek Michael
Published: November 2011

Abstract

This article examines the relationship between sociologists and the Communist Party headquarters in 1960 Czechoslovakia. It is based on the archives of the coordinating body of Czechoslovak sociology, the Scientific Board of Philosophy and Sociology at the Czechoslovak Academy of Sciences. First, the article depicts the synergy between sociology and the powers: the research commissioned by the supreme Party bodies or the Party sponsorship of sociology’s institutionalization. However, instances of lacking material support to the discipline are noted as well. Second, the conflicts between social scientists and the Party headquarters are discussed: namely, the layoff of the philosopher Ivan Sviták in 1964 and the following interventions into the Institute of Philosophy. Finally, the article maps the demands for autonomy as formulated by the scholars in 1968. In concluding, it points to the fact that despite requesting independence from the Communist headquarters, the Marxist elite in the social sciences never abandoned their own claim to hegemony. They resisted both the challenge of non-Marxist scholars in 1968, and the spontaneous claims and complaints that might come from the society at large. In that respect, the sociology of the 1960s seems a perfect child of the Czechoslovak reformist movement.
Cold War in Latin America: The Camelot Project (1964–1965) and the Political and Academic Reactions of the Chilean Left
Authors: Navarro Juan José
Published: November 2011

Abstract

Camelot Project (1964–1965) emerged as a project for social research orientated to measuring, predicting and controlling internal conflicts within peripheral countries. Camelot appeared within the Special Operations Research Office (SORO) of the American University, and was requested by the United States Defense Department to be applied in Chile within the next four years. This article explores the reactions of the Chilean left wing.
Gateway to Western Modernity: The Case of Turkish Women
Authors: Kavakci-Islam Merve
Published: November 2011

Abstract

The Turkish Republic is accepted as one of the most advanced Muslim countries in regards to the emancipation of women, according to widely produced literature about the region. Turkey’s commitment to modernization is the underlying reason behind this premise. Women played a critical role as the symbols of westernization project at the center. I shed light on the women’s empowerment trajectory and examine the extent to which the republic kept up with its promise of emancipating women. A critique of this project from outside sources helps decipher the codes of failing to fulfill the expectations of the female population. I first discuss how the republic rendered women the symbols of modernization and the measures it took to secure this rendering. I then examine women’s empowerment in political, economic and social realms at various time intervals in history. I conclude with some of the current challenges before full emancipation of women in Turkey.
A Sick Sultana in the Ottoman Imperial Palace: Male Doctors, Female Healers and Female Patients in the Early Modern Period
Authors: Shefer-Mossensohn Miri
Published: November 2011

Abstract

Being a human endeavor, medical ethics and clinical practices are affected by a set of social and cultural norms in conjunction with factors pertaining to the patients’ social and financial status. In this paper, I consider how gender and money shaped medical realities in the early modern Ottoman Empire. People of means certainly had more medical options available to them, although that did not necessarily lead to better results. Gender too was naturally an important factor, molding medical options and the relationship between patient and healer. The specific case of the imperial harem will reveal how high socio-economic status has actually curbed women’s medical options, as their access to male doctors was limited. Based on Ottoman archival and legal sources and European travel literature, the paper examines how and why they were limited, and how they went about circumventing such restrictions. The picture that emerges reveals that being a member of the Ottoman elite had its price.
Revolutionary Eschatology: Islam & the End of Time in al-Ṭāhir Waṭṭār’s al-Zilzāl1
Authors: Shakry Hoda El
Published: November 2011

Abstract

This paper analyzes the use of Qurʾanic rhetoric and imagery in al-Ṭāhir Waṭṭār’s 1974 novel al-Zilzāl (The Earthquake). More specifically, it emphasizes Waṭṭār’s employment of Qurʾanic eschatology to blur the boundary between ‘religious’ and ‘secular’ forms of discourse in the construction of Algerian nationalist discourse. The paper investigates al-Zilzāl’s critical engagement with the rhetoric of Arabism and Islamism in post-revolutionary state politics, highlighting the novel’s hybrid genre, its conscious manipulation of narrative time and space, as well as its incorporation of various registers of the Arabic language. Through the mobilization of eschatological notions of struggle, death and sacrifice, al-Zilzāl unsettles a number of authorized narratives on Algerian national identity, language and literature.
Defining Metapoesis in the ʿAbbāsid Age
Authors: Fakhreddine Huda J.
Published: November 2011

Abstract

This article explores the definition of the term meta-poetic and its application to the poetry of the ʿAbbāsid age, focusing on short compositions and excerpts in which poets explicitly voice their critical opinions on poetry. The cultural milieu of the period and the debates and issues that surrounded ʿAbbāsid poetry necessarily influenced poets and their creative processes. ʿAbbāsid poets wrote for an ideal reader/critic not only qualified to appreciate their innovations but also capable of placing their contributions in the continuum of the tradition they were writing against, bringing the relationship with the literary past to the forefront of the poet’s concerns.
Canonical Theism as Ecclesial and Ecumenical Resource
Authors: Castelo Daniel
Published: November 2011

Abstract

This article seeks to survey the movement of canonical theism as a way of introducing it to a Pentecostal readership for the purpose of establishing possible links that could be beneficial for both groups. In particular, the essay utilizes some of the claims of canonical theism to reconsider the place and function of initial-evidence thinking within Classical Pentecostalism. Additionally, the essay explores how the Pentecostal experience and understanding of God would substantiate further the underdeveloped claims to theism that the movement makes.
Fire from Heaven: Pentecostals in the Secular City
Authors: Wariboko Nimi
Published: November 2011

Abstract

Is Harvey Cox’s Fire from Heaven which focused on Pentecostalism merely a mea culpa for the hubris of predicting the death of God in the 1960s or a case of using the “pentecostalization” of religions to describe the shape of religiosity in the emerging global civil society, global secular city? This essay shows how theologically liberal ideas in both his Fire from Heaven and Secular City are today used to theologize the relevant shape of faith in the global civil society in ways that hauntingly suggest Pentecostalism is implicated in the emergence and working of the global secular city which reject notions of transcendence in religion. The essay then challenges pentecostal theologians to seriously consider the question: In what way is Pentecostalism already secularized or secularizing from its core?