bluuebunny/crossref_metadata_2025 huggingface dataset:
Waist Circumference as a Predictor of Adiponectin Levels in Peritoneal Dialysis Patients: A 12-Month Follow-up Study
Authors: Bazanelli Ana Paula , Kamimura Maria Ayako , Canziani Maria Eugenia Fernandes , Manfredi Silvia Regina , Cuppari Lilian
Published: September 2012

Objectives

This prospective study, conducted at the dialysis unit of the Nephrology Division, Federal University of Sao Paulo–Oswaldo Ramos Foundation, Brazil, aimed to evaluate whether waist circumference (WC) can predict adiponectin levels in patients undergoing peritoneal dialysis (PD).

Methods

Among 115 patients on PD at a single dialysis center who were evaluated at 6 and 12 months, 57% were men, 31% had diabetes, mean age was 52.8 ± 16.1 years, body mass index was 25 ± 4.3 kg/m2, and dialysis vintage was 13 months (range: 5 – 33 months). We measured WC at the umbilicus level. Adiponectin was determined by an enzyme-linked immunosorbent assay.

Results

At baseline, WC was inversely associated with adiponectin ( r = –0.48, p < 0.01). After adjustment for sex, age, diabetes, peritoneal clearance, and residual renal function, WC was an independent determinant of serum adiponectin (β = –0.52; 95% confidence interval: –0.73 to –0.31; p < 0.001). In the prospective analysis, after adjustment for confounders, changes in WC predicted changes in adiponectin. For each unit increase in WC, adiponectin declined by 0.39 mg/L ( p < 0.001).

Conclusions

This study demonstrates that WC is associated with adiponectin and, more importantly, that this simple marker of central adiposity was able to predict changes in adiponectin levels over time.
Diabetes Influences Peritoneal Morphology in Uremic Patients at the Initiation of Peritoneal Dialysis
Authors: Mizumasa Tohru , Hirakata Hideki , Kuroki Yusuke , Katafuchi Ritsuko , Yotsueda Hideki , Mitsuiki Koji , Nakashima Yutaka , Tsuruya Kazuhiko
Published: September 2012

Background

The peritoneum begins to undergo morphologic changes before the start of peritoneal dialysis (PD), particularly in diabetic patients. The present study was conducted to investigate the effects of diabetes on the peritoneum.

Methods

This study involved 17 patients who began receiving PD and had diabetes as an underlying disease (DM group), and 30 patients without diabetes who served as a control group (nonDM group). At the start of PD, the parietal peritoneum was sampled to assess submesothelial connective tissue thickness, number of capillaries and postcapillary venules, and indications of vasculopathy (grades 0 – 3).

Results

Submesothelial connective tissue thickness was significantly greater in the DM group than in the nonDM group ( p < 0.01). The number of capillaries was significantly greater in the DM group ( p < 0.01). Based on multivariate linear regression analysis, diabetes was identified as a significant independent variable of both submesothelial connective tissue thickness and number of capillaries ( p < 0.01).

Conclusions

In diabetic patients, morphologic changes of the peritoneum are marked at the start of PD.
Minilaparotomy Salvage of Malfunctioning Catheters in Peritoneal Dialysis
Authors: Li Jian-ri , Cheng Chi-hung , Chiu Kun-yuan , Cheng Chen-li , Yang Chi-rei , Ho Hao-chung , Ko Jiunn-liang , Ou Yen-chuan
Published: September 2012

♦Background

Catheter malfunction is a common and significant complication during peritoneal dialysis (PD). We developed a minilaparotomy procedure to rescue malfunctioning catheters and to prevent recurrence of malfunction.

♦Methods

From 2006 to 2011, 11 patients receiving PD had a malfunctioning catheter. In all patients, a 2-cm incision, 5 cm caudally to the previous peritoneal entry site was used to correct the malfunctioning catheter, with concomitant fixation of the catheter to the peritoneum.

♦Results

Catheter tip migration occurred in 7 patients, omental wrapping in 3, and blood clot obstruction in 1. The mean onset time to catheter malfunction was 197.5 days (range: 4 – 1270 days), and the mean operating time was 41 minutes (range: 35 – 56 minutes). There was no recurrence of catheter malfunction and no surgery-related peritonitis.

♦Conclusions

Our minilaparotomy procedure is safe and feasible for the salvage of malfunctioning PD catheters.
Frequency and Microbiology of Peritonitis and Exit-Site Infection among Obese Peritoneal Dialysis Patients
Authors: Nessim Sharon J. , Komenda Paul , Rigatto Claudio , Verrelli Mauro , Sood Manish M.
Published: September 2012

Background

Data on obesity as a risk factor for peritonitis and catheter infections among peritoneal dialysis (PD) patients are limited. Furthermore, little is known about the microbiology of PD-related infections among patients with a high body mass index (BMI).

Methods

Using a cohort that included all adult patients residing in the province of Manitoba who received PD during the period 1997 – 2007, we studied the relationship between BMI and PD-related infections. After categorizing patients into quartiles of BMI, a multivariate Cox regression model was used to determine the independent relationship between BMI and peritonitis or exit-site infection (ESI). We also studied whether increasing BMI was associated with a propensity to infections with particular organisms.

Results

Among 990 PD patients, 938 (95%) had accurate BMI data available. Those 938 patients experienced 1338 peritonitis episodes and 1194 exit-site infections. In unadjusted analyses, patients in the highest BMI quartile (median: 33.5; interquartile range: 31.9 – 36.4) had an increased risk of peritonitis overall, and also an increased risk of peritonitis with gram-positive organisms and coagulase-negative Staphylococcus (CNS). After multivariate adjustment for age, sex, diabetes, cause of renal disease, Aboriginal race, PD modality, and S. aureus nasal carriage, the relationship between overall peritonitis risk and BMI disappeared, but the increased risk of CNS peritonitis among patients in the highest BMI quartile persisted (hazard ratio: 1.80; 95% confidence interval: 1.06 to 3.06; p = 0.03). There was no increased risk of ESI among patients in the highest BMI quartile on univariate analysis or after multivariate adjustment.

Conclusions

Among Canadian PD patients, obesity was not associated with an increased risk of peritonitis overall, but may be associated with a higher risk of CNS peritonitis.
Effects of Climatic Region on Peritonitis Risk, Microbiology, Treatment, and Outcomes: A Multicenter Registry Study
Authors: Cho Yeoungjee , Badve Sunil V. , Hawley Carmel M. , McDonald Stephen P. , Brown Fiona G. , Boudville Neil , Wiggins Kathryn J. , Bannister Kym M. , Clayton Philip , Johnson David W.
Published: September 2012

♦Background

The impact of climatic variations on peritoneal dialysis (PD)–related peritonitis has not been studied in detail. The aim of the current study was to determine whether various climatic zones influenced the probability of occurrence or the clinical outcomes of peritonitis.

♦Methods

Using ANZDATA registry data, the study in cluded all Australian patients receiving PD between 1 October 2003 and 31 December 2008. Climatic regions were defined according to the Köppen classification.

♦Results

The overall peritonitis rate was 0.59 episodes per patient–year. Most of the patients lived in Temperate regions (65%), with others residing in Subtropical (26%), Tropical (6%), and Other climatic regions (Desert, 0.6%; Grassland, 2.3%). Compared with patients in Temperate regions, those in Tropical regions demonstrated significantly higher overall peritonitis rates and a shorter time to a first peritonitis episode [adjusted hazard ratio: 1.15; 95% confidence interval (CI): 1.01 to 1.31]. Culture-negative peritonitis was significantly less likely in Tropical regions [adjusted odds ratio (OR): 0.42; 95% CI: 0.25 to 0.73]; its occurrence in Subtropical and Other regions was comparable to that in Temperate regions. Fungal peritonitis was independently associated with Tropical regions (OR: 2.18; 95% CI: 1.22 to 3.90) and Other regions (OR: 3.46; 95% CI: 1.73 to 6.91), where rates of antifungal prophylaxis were also lower. Outcomes after first peritonitis episodes were comparable in all groups.

♦Conclusions

Tropical regions were associated with a higher overall peritonitis rate (including fungal peritonitis) and a shorter time to a first peritonitis episode. Augmented peritonitis prophylactic measures such as antifungal therapy and exit-site care should be considered in PD patients residing in Tropical climates.
Impact of cyclodextrins on the behavior of amphiphilic ligands in aqueous organometallic catalysis
Authors: Bricout Hervé , Léonard Estelle , Len Christophe , Landy David , Hapiot Frédéric , Monflier Eric
Published: September 2012

In this study, we showed that the addition of randomly modified β-cyclodextrin (RAME-β-CD) in aqueous medium could have a beneficial impact on the catalytic performances of phosphane-based aggregates in the Pd-catalyzed cleavage of allyl carbonates (Tsuji–Trost reaction). The RAME-β-CD/phosphane supramolecular interactions helped explain the catalytic results. The presence of RAME-β-CD in the aqueous compartment improved the phosphane-based aggregate dynamics. The exchanges between the hydrophobic substrate-containing aggregate core and the catalyst-containing aqueous phase were then greatly favored, resulting in an increase in the catalytic performances.
Outcome of Lamivudine-Resistant Chronic Hepatitis B after up to 5 Years of Combination Therapy with Adefovir
Authors: Seto Wai-Kay , Liu Kevin , Fung James , Wong Danny Ka-Ho , Yuen John Chi-Hang , Hung Ivan Fan-Ngai , Lai Ching-Lung , Yuen Man-Fung
Published: September 2012

Background

There is a paucity of data on the long-term efficacy of combination lamivudine and adefovir therapy in patients with lamivudine-resistant chronic hepatitis B.

Methods

We determined the cumulative virological, serological and biochemical outcomes of 165 lamivudine-resistant chronic hepatitis B patients on lamivudine and adefovir for up to 5 years. Resistance profiles using a line probe assay were determined among patients with detectable viraemia. The significance of different baseline and on-treatment virological parameters was analysed.

Results

The median age and duration of follow-up were 45.1 years and 37.1 months, respectively. The cumulative rates of HBV DNA undetectability (<20 IU/ml), alanine aminotransferase normalization and hepatitis B e antigen seroconversion up to 5 years were 74.0%, 95.1% and 44.4%, respectively. One patient achieved hepatitis B surface antigen seroclearance. The 5-year cumulative resistance rate to adefovir was 10.2%. Among different baseline and on-treatment virological parameters, week 24 HBV DNA<200 IU/ml was associated with an increased chance of long-term virological suppression ( P<0.001, OR 13.89, 95% CI 3.90, 49.46). Primary non-response and high baseline viral titres were not useful in predicting long-term virological outcomes. The 5-year cumulative rate of serum creatinine elevation >0.5 mg/dl was 4.1%.

Conclusions

Combination lamivudine and adefovir therapy for up to 5 years achieved modest rates of virological suppression, but resistance developed in only 10.2% of patients. Week 24 HBV DNA<200 IU/ml was predictive of favourable long-term virological outcomes and could be used to assist treatment decisions on continuing lamivudine and adefovir or switching to more potent therapy.
Cytolytic Nanoparticles Attenuate HIV-1 Infectivity
Authors: Hood Joshua L , Jallouk Andrew P , Campbell Nancy , Ratner Lee , Wickline Samuel A
Published: September 2012

Background

We investigated whether cytolytic melittin peptides could inhibit HIV-1 infectivity when carried in a nanoparticle construct that might be used as a topical vaginal virucide. Free melittin and melittin-loaded nanoparticles were prepared and compared for cytotoxicity and their ability to inhibit infectivity by CXCR4 and CCR5 tropic HIV-1 strains.

Methods

TZM-bl reporter cells expressing luciferase under the control of the HIV-1 promoter were incubated with HIV-1 NLHX (CXCR4) or HIV-1 NLYU2 (CCR5) viral strains and different doses of soluble CD4 (positive control) or free melittin to determine infectivity and viability. Melittin-loaded nanoparticles were formulated and different doses tested against VK2 vaginal epithelial cells to determine cell viability. Based on VK2 viability, melittin nanoparticles were tested for prevention of CXCR4 and CCR5 tropic HIV-1 infectivity and viability of TZM-bl reporter cells. Low-speed centrifugation was used to compare the ability of blank non-melittin nanoparticles and melittin nanoparticles to capture CCR5 tropic HIV-1.

Results

As expected, the soluble CD4 positive control inhibited CXCR4 (50% inhibitory concentration [IC50] 3.7 μg/ml) and CCR5 (IC50 0.03 μg/ml) tropic HIV-1 infectivity. Free melittin doses <2 μM were not cytotoxic and were highly effective in reducing HIV-1 infectivity for both CXCR4 and CCR5 strains in TZM-bl reporter cells, while VK2 vaginal cell viability was adversely affected at all free melittin doses tested. However, VK2 cell viability was not affected at any dose of melittin-loaded nanoparticles. Melittin nanoparticles safely and significantly decreased CXCR4 (IC50 2.4 μM and IC90 6.9 μM) and CCR5 (IC50 3.6 μM and IC90 11.4 μM) strain infectivity of TZM-bl reporter cells. Furthermore, melittin nanoparticles captured more HIV-1 than blank nanoparticles.

Conclusions

These data illustrate the first proof-of- concept for therapeutic and safe nanoparticle-mediated inhibition of HIV-1 infectivity. Future investigations appear warranted to explore the antiviral prophylactic potential of melittin nanoparticles to capture, disrupt and prevent initial infection with HIV-1 or potentially other enveloped viruses.
Pharmacokinetics of Darunavir/Ritonavir in Asian HIV-1-Infected Children Aged ≥7 Years
Authors: Chokephaibulkit Kulkanya , Prasitsuebsai Wasana , Wittawatmongkol Orasri , Gorowara Meena , Phongsamart Wanatpreeya , Sophonphan Jiratchiya , Kerr Stephen J , Vanprapar Nirun , Puthanakit Thanyawee , Pasomsap Chayapa , Suwanlerk Tulathip , Sekar Vanitha , Burger David , Ananworanich Jintanat ,   the HIV-NAT 113 Pharmacokinetic Study Group
Published: September 2012

Background

The Asian population, in general, has higher antiretroviral concentrations than those who are not Asian, but there are limited pharmacokinetic data for darunavir/ritonavir in Asian children.

Methods

Thai children aged ≥7 years and with body weight (BW)≥20 kg who were on darunavir/ritonavir for ≥2 weeks underwent 12-h pharmacokinetics with blood sampling before and at 1, 2, 4, 6, 8, 10 and 12 h post-dosing. Darunavir/ritonavir doses were 375/100 mg twice daily (BW 20 to <30 kg, n=12), 450/100 mg twice daily (BW 30 to <40 kg, n=2) or 600/100 mg twice daily (BW ≥40 kg, n=5). Ritonavir 100 mg soft gel capsules were used instead of solution.

Results

Of the 19 children, 8 were female, median age was 13 years (range 7-16) and median BW was 29.4 kg. The median duration of darunavir/ritonavir treatment was 11 months. The geometric mean values for darunavir were 60.3 hxmg/l for the area under the concentration–time curve at 0–12 h (AUC0–12), 8.3 mg/l for the maximum concentration (Cmax) and 3.1 for the concentration prior to the next dose (C12) with no differences between dosing groups. All had C12 above the protein binding adjusted 50% effective concentration (EC50) of protease inhibitor-resistant virus (0.55 mg/l). The darunavir pharmacokinetic parameters were similar to those in non-Asian individuals from the DELPHI study, in which 13 of 20 with BW<40 kg used 50 or 60 mg ritonavir boosting.

Conclusions

Thai children aged ≥7 years who were on standard darunavir dosing with 100 mg ritonavir boosting had adequate and comparable darunavir AUC0–12, Cmax and C12 to non-Asian children who mainly used lower doses of ritonavir boosting. A ritonavir boosting dose of 100 mg can be used for children weighing ≥20 kg, particularly when lower dose formulations are unavailable or if intolerant to the solution.
Monocyte Chemoattractant-1 as a Urinary Biomarker for the Diagnosis of Activity of Lupus Nephritis in Brazilian Patients
Authors: ROSA RENATA FERREIRA , TAKEI KIOKO , ARAÚJO NAFICE C. , LODUCA SÔNIA M.A. , SZAJUBOK JOSÉ C.M. , CHAHADE WILIAM H.
Published: September 2012

Objective.

Monocyte chemotactic protein (MCP-1), involved in the pathogenesis of lupus nephritis (LN), has recently been indicated as a new biomarker of kidney activity in systemic lupus erythematosus (SLE). Our aim was to assess urinary MCP-1 (uMCP-1) as a biomarker of renal activity in patients with SLE and to compare it to other disease activity markers, using the ELISA.

Methods.

Seventy-five female Brazilian patients with SLE and a control group participated in our study. Patients with SLE were distributed among 3 groups according to kidney involvement and classified according to disease activity based on clinical and laboratory measures such as urinary sediment, proteinuria, kidney function, C3, C4, anti-dsDNA, disease activity index, and renal SLE disease activity index. The serum and uMCP-1 concentrations were measured by sandwich ELISA.

Results.

In the A-LN group (active lupus nephritis: SLE with kidney involvement), the concentration of uMCP-1 was significantly higher than in other groups. A cutoff point was established using the results of the control group to apply this test in the detection of LN. A-LN had a higher frequency of positive results for uMCP-1 in comparison to the other groups (p < 0.001). To detect disease activity in patients with LN, a new cutoff was determined based on the results of patients with SLE with kidney involvement. Setting specificity at 90%, the sensitivity of the test was 50%.

Conclusion.

The high specificity makes uMCP-1 a useful test as a predictor of kidney activity in SLE, especially when associated to other measures used in clinical practice.
Risk of Failure of a Clinical Drug Trial in Patients with Moderate to Severe Rheumatoid Arthritis
Authors: JAYASUNDARA KAVISHA S. , KEYSTONE EDWARD C. , PARKER JAYSON L.
Published: September 2012

Objective.

We conducted a systematic review to determine the risk of drug failure in clinical testing with patients with moderate to severe rheumatoid arthritis (RA).

Methods.

Therapies for RA were investigated by reviewing phase I to phase III studies conducted from December 1998 to March 2011. Clinical trial success rates were calculated and compared to industry standards. Trial failures were classified as either commercial or clinical failures. The exclusion criteria for drugs in this study: drugs that were started in phase I studies prior to January 1998 for this indication; or studies that enrolled patients who were methotrexate-naive and/or had failed biologic therapy.

Results.

A search in clinicaltrials.gov and approved drugs for the indication yielded a total of 69 drugs that met the study criteria. The cumulative success rate was determined to be 16%, which is equivalent to the industry standard of 16%. For each phase, the frequency of clinical failures exceeded commercial failures. Clinical studies equally comprised investigations of small molecules and biological agents, but biologics seemed to exhibit a higher success rate overall.

Conclusion.

Clinical trial risk in RA with the 84% failure rate reported here is at par with industry performance and phase II success rate seems to be highly predictive of phase III success.
Low Copy Number of the Fc-γ Receptor 3B GeneFCGR3BIs a Risk Factor for Primary Sjögren’s Syndrome
Authors: NOSSENT JOHANNES C. , RISCHMUELLER MAUREEN , LESTER SUE
Published: September 2012

Objective.

Immune complexes play an important role in the pathogenesis of primary Sjögren’s syndrome (pSS). Crosslinking of the neutrophil-specific Fc-γ receptor 3b (FCGR3B) facilitates immune complex clearance, and copy number variation (CNV) of theFCGR3Bgene is known to reduce the uptake, and potentially clearance, of circulating immune complexes. Our objective was to determine whetherFCGR3BCNV is a risk factor for pSS.

Methods.

This was a cross-sectional study of patients with established pSS (n = 174) and population-matched controls (n = 162).FCGR3BCNV was determined by a quantitative real-time polymerase chain reaction assay, using genomic DNA as template and Taqman chemistry. Reactions were performed as a duplex, with RNAse P as the reference gene. Clinical and serological data were analyzed for their association withFCGR3Bcopy number (CN).

Results.

LowFCGR3BCN (< 2 copies) was a risk factor for pSS in this cohort (p = 0.016), and combined results from this and a previous study yielded an overall OR of 2.3 (95% CI 1.3, 3.9, p = 0.003). Among patients with pSS in our cohort, lowFCGR3BCN was not associated with anti-Ro ± La autoantibodies, but was associated with lower rheumatoid factor titers (p = 0.001) and serum IgG levels (p = 0.031).

Conclusion.

We confirmed that, similarly to other systemic autoimmune diseases,FCGR3BCN is a genetic susceptibility factor for pSS. As in rheumatoid arthritis, the mechanism does not appear to be related to seropositivity for characteristic autoantibodies.
Increasing Treatment in Early Rheumatoid Arthritis Is Not Determined by the Disease Activity Score But by Physician Global Assessment: Results from the CATCH Study
Authors: PYNE LONNIE , BYKERK VIVIAN P. , BOIRE GILLES , HARAOUI BOULOS , HITCHON CAROL , THORNE J. CARTER , KEYSTONE EDWARD C. , POPE JANET E.
Published: September 2012

Objective.

To determine the factors most strongly associated with an increase in therapy of early rheumatoid arthritis (ERA).

Methods.

Data from the Canadian Early Arthritis Cohort (CATCH) were included if the patient had ≥ 2 visits and baseline and 6 months data. A regression analysis was done to determine factors associated with treatment intensification.

Results.

Of 1145 patients with ERA, 790 met inclusion criteria; mean age was 53.4 years (SD 14.7), mean disease duration 6.1 months (SD 2.8), 75% were female, baseline Disease Activity Score-28 (DAS28) was 4.7 (SD 1.8) and 2.9 (SD 1.8) at 6 months for included patients. Univariate factors for intensifying treatment were physician global assessment (MDGA; OR 7.8 and OR 7.4 at 3 and 6 months, respectively, p < 0.0005), swollen joint count (SJC; OR 4.7 and OR 7.3 at 3 and 6 months, p < 0.0005), and DAS28 (OR 3.0 and OR 4.6 at 3 and 6 months, p < 0.0005). In the regression model only MDGA was strongly associated with treatment intensification (OR 1.5 and OR 1.2 at 3 and 6 months, p < 0.0005); DAS28 was not consistently predictive (OR 1.0, p = 0.987, and OR 1.2, p = 0.023, at 3 and 6 months). DAS28 was the reason for treatment intensification 2.3% of the time, compared to 51.7% for SJC, 49.9% for tender joint count, and 23.8% for MDGA. For the same SJC, larger joint involvement was more likely to influence treatment than small joints at 3 months (OR 1.4, p = 0.027).

Conclusion.

MDGA was strongly associated with an increase in treatment at 3 and 6 months in ERA, whereas DAS28 was not. Physicians rarely stated that DAS28 was the reason for increasing treatment.
Anti-DFS70/LEDGF Antibodies Are More Prevalent in Healthy Individuals Compared to Patients with Systemic Autoimmune Rheumatic Diseases
Authors: MAHLER MICHAEL , PARKER TODD , PEEBLES CAROL L. , ANDRADE LUIS E. , SWART ANDREAS , CARBONE YVETTE , FERGUSON DAVID J. , VILLALTA DANILO , BIZZARO NICOLA , HANLY JOHN G. , FRITZLER MARVIN J.
Published: September 2012

Objective.

Antinuclear antibodies (ANA) are a serological hallmark of systemic autoimmune rheumatic diseases (SARD) such as systemic lupus erythematosus (SLE). While a number of ANA patterns detected by indirect immunofluorescence (IIF) have diagnostic significance, autoantibodies producing the dense fine speckled (DFS) pattern have been reported to be more prevalent in healthy individuals than in SARD.

Methods.

Sequential samples submitted for ANA testing were screened for anti-DFS antibodies by IIF (n = 3263). Samples with the DFS pattern were tested for anti-DFS70/lens epithelium–derived growth factor (LEDGF) antibodies by ELISA and by a novel chemiluminescence assay (CIA, Quanta Flash DFS70). Sera from patients with various diseases and healthy individuals were tested for anti-DFS70/LEDGF antibodies by CIA. A cohort of 251 patients with SLE was used to analyze serological and clinical associations of anti-DFS70 antibodies.

Results.

The frequency of anti-DFS antibodies by IIF was 1.62%. The prevalence of anti-DFS70/LEDGF antibodies as detected by CIA in the different cohorts was 8.9% in healthy individuals, 2.8% in SLE, 2.6% in rheumatoid arthritis, 4.0% in asthma, 5.0% in interstitial cystitis, 1.7% in Graves’ disease, and 6.0% in Hashimoto’s thyroiditis. Of note, the prevalence of anti-DFS70/LEDGF antibodies was significantly higher in healthy individuals compared to patients with SARD (p = 0.00085). In SLE results, anti-DFS70/LEDGF antibodies were not significantly associated with clinical features or other autoantibodies typically found in SLE. Only 1/7 SLE sera showed anti-DFS70/LEDGF, but no other autoantibody reactivity.

Conclusion.

“Monospecific” anti-DFS70/LEDGF antibodies may represent a biomarker for differentiating SARD from non-SARD individuals, but there is a need for a reliable assay to ensure reactivity to DFS70.
Rehabilitation Strategies for Prolonged Recovery in Pediatric and Adolescent Concussion
Authors: Vidal Paul G. , Goodman Arlene M. , Colin Amy , Leddy John J. , Grady Matthew F.
Published: September 2012

CME Educational Objectives

1.

Identify the time frame that distinguishes concussion with typical recovery trajectory vs. atypical prolonged recovery trajectory.

2.

Use directed physical examination to identify deficits that may be addressed by targeted rehabilitation strategies.

3.

Implement exercise strategies in the rehabilitation of concussion with atypical prolonged recovery outside of the typical return-to-play protocol.

Most pediatric and adolescent concussion patients will heal within 1 month. However, 10% to 20% of adolescent concussions will take longer than 1 month to heal. In this subgroup, prolonged symptoms might include vestibular system deficits, residual neck muscle whiplash injury, exercise intolerance/dysautonomia, and memory issues. At this stage in recovery, these problems respond better to “active rehabilitation” via specific targeted strategies rather than to strict rest. During follow-up office visits, a careful history and physical exam can elicit specific deficits and help customize a rehabilitation program to maximize recovery.
Early Postoperative Outcomes Between Arthroscopic and Mini-open Repair for Rotator Cuff Tears
Authors: Cho Chul-Hyun , Song Kwang-Soon , Jung Gu-Hee , Lee Young-Kuk , Shin Hong-Kwan
Published: September 2012

The purpose of this study was to compare early postoperative outcomes between arthroscopic and mini-open repair for rotator cuff tears smaller than 3 cm to determine whether arthroscopic repair causes less postoperative pain and allows for faster recovery of range of motion. Sixty patients scheduled for rotator cuff repair were randomized to either an arthroscopic repair group (30 patients) or a mini-open repair group (30 patients). Pain level, range of motion, shoulder stiffness, and complications were compared between the 2 groups from immediately postoperatively to 6 months postoperatively.

Although no statistically significant difference was found in mean visual analog scale pain scores between the 2 groups during the 6 months postoperatively, mean visual analog scale pain score was significantly lower in the arthroscopic repair group compared with the mini-open repair group at postoperative days 1 and 2 (
P
=.02 and
P
=.04, respectively). No significant difference existed in postoperative range of motion, duration of rehabilitation, shoulder stiffness, or complications between the 2 groups; however, the use of additional analgesics in the arthroscopic repair group was significantly lower than in the mini-open repair group (
P
=.03).

Arthroscopic and mini-open repair had equivalent clinical outcomes in the early postoperative period. The hypothesis that arthroscopic repair would cause less postoperative pain and allow faster recovery of range of motion in the early postoperative period compared with mini-open repair was not supported.
Pseudoparalysis: The Importance of Rotator Cable Integrity
Authors: Denard Patrick J. , Koo Samuel S. , Murena Luigi , Burkhart Stephen S.
Published: September 2012

The purpose of this study was to clinically examine the relationship between rotator cable integrity and the presence of pseudoparalysis. A retrospective review was performed of a consecutive series of arthroscopic repairs of massive rotator cuff tears performed between January 2007 and June 2009. A total of 127 massive tears were identified. Group 1 comprised 24 patients with preoperative pseudoparalysis. Group 2 comprised 97 patients (103 repairs) with active forward flexion more than 90°.

In group I, no patient maintained integrity of both rotator cable attachments; 1 rotator cable attachment was disrupted in 45.8% of cases; and both rotator cable attachments were disrupted in 54.2% of cases. In group II, both rotator cable attachments were intact in 22.3% of cases; 1 rotator cable attachment was disrupted in 62.1% of cases; and both rotator cable attachments were disrupted in 15.5% of cases. The difference in the distribution of cable attachments between the 2 groups was statistically significant (
P
<.001). Overall, preoperative pseudoparalysis predicted a disruption of both rotator cables with 88.8% specificity, 44.8% sensitivity, and 77.8% accuracy.

Pseudoparalysis requires the disruption of at least 1 rotator cable attachment. This study reinforces the concept of rotator cable integrity and the ability of patients to maintain forward flexion above shoulder level and highlights the importance of reinforcing the rotator cable attachments in the repair of massive rotator cuff tears.
Mobile Media Use, Multitasking and Distractibility
Authors: Levine Laura E. , Waite Bradley M. , Bowman Laura L.
Published: September 2012

Portable media devices are ubiquitous and their use has become a core component of many people’s daily experience, but to what effect? In this paper, the authors review research on the ways in which media use and multitasking relate to distraction, distractibility and impulsivity. They review recent research on the effects of media multitasking on driving, walking, work, and academic performance. The authors discuss earlier research concerning the nature of media’s impact on attention and review cognitive and neuropsychological findings on the effects of divided attention. Research provides clear evidence that mobile media use is distracting, with consequences for safety, efficiency and learning. Greater use of media is correlated with higher levels of trait impulsivity and distractibility, but the direction of causality has not been established. Individuals may become more skilled at media multitasking over time, but intervention is currently required to improve the safe and effective use of mobile media.
Transitioning Towards a Low-Carbon Hydrogen Economy in the United States
Authors: Lam Jacqueline C. K. , Hills Peter , Wong Esther C. T.
Published: September 2012

This paper describes the process of transitioning to a low-carbon hydrogen economy in the United States and the role of transition management (TM) in this process. Focusing on the transition process for hydrogen-based energy and transport systems in the United States, especially California, this study outlines the key characteristics of TM that have been employed in managing the transition. Several characteristics of TM have been noted in the United States’ hydrogen transition, including: (a) the complementarity of the long-term vision with incremental targets, (b) the integration of top-down and bottom-up planning, (c) system innovations and gradualism, (d) multi-level approaches and interconnectedness, and (e) reflexivity by learning and experimenting. These characteristics are instrumental in bringing about the development and initial commercialization of hydrogen fuel cell vehicles and related energy infrastructure in the United States.
An Architecture for Managing Knowledge and System Dynamism in the Worldwide Sensor Web
Authors: Moodley Deshendran , Simonis Ingo , Tapamo Jules Raymond
Published: September 2012

Sensor Web researchers are currently investigating middleware to aid in the dynamic discovery, integration and analysis of vast quantities of both high and low quality, but distributed and heterogeneous earth observation data. Key challenges being investigated include dynamic data integration and analysis, service discovery and semantic interoperability. However, few efforts deal with managing knowledge and system dynamism. Two emerging technologies that have shown promise in dealing with these issues are ontologies and software agents. This paper presents an integrated ontology driven agent based Sensor Web architecture for managing knowledge and system dynamism. An application case study on wildfire detection is used to illustrate the operation of the architecture.
Outcome after systemic thrombolysis is predicted by age and stroke severity: an open label experience with recombinant tissue plasminogen activator and tirofiban
Authors: Seitz Rudiger J. , Sukiennik Judith , Siebler Mario
Published: September 2012

Stroke patients can recover upon intravenous thrombolysis but remain impaired in lacking recanalization. We sought to investigate the clinical effect of systemic thrombolysis with an intravenous bolus of 20 mg recombinant tissue plasminogen activator (rtPA) and an infusion of body-weight adjusted tirofiban for 48 hours in acute stroke. This prospective, open label study, included 192 patients (68±13 years, 50% males) treated between 1 January 2005 and 31 December 2007. The neurological deficit was assessed with the National Institutes of Health stroke scale (NIHSS). Follow-up was performed using a telephone interview of modified Rankin Scale (mRS) and Barthel index. The site of cerebral artery occlusion was determined by computed tomography or magnetic resonance angiography. Data were analyzed by descriptive statistics and multiple regression analyses. Eighty-one percent of the patients had an infarct in the middle cerebral artery (MCA) territory and were severely affected with a median NIHSS of 10. During treatment on the Stroke Unit the patients improved (P<0.0001) except for patients who deceased due to malignant infarction (n=10) or cerebral haemorrhage (n=6); 18 percent deceased within 100 days which was predicted by older age (76 + 10 years, P<0.05) and more severe affection on admission (P<0.0001). Also, these patients more frequently had atrial fibrillation (P<0.03) than the surviving patients. The surviving patients had more frequently distal MCA occlusions and improved further (P<0.0001). At follow-up 48% of the patients had a mRS of 0 and 1. Similarly to intravenous thrombolysis with body-weight adjusted rtPA, poor prognosis was predicted by higher age, more severe neurological deficit at stroke admission, and a proximal MCA occlusion. Half of the surviving patients improved to no or minimal impairment.
Stabilization of Metastatic Myxopapillary Ependymoma with Sorafenib
Authors: Fegerl Gundula , Marosi Christine
Published: September 2012

We report on a 59-year old woman with three huge intrathoracal masses that were accidentally diagnosed when she consulted a physician for upper abdominal discomfort. A biopsy revealed that they were metastases of a coccygeal myxopapillary ependymoma, resected 20 years before. As neither resection, debulking, nor radiation therapy were considered to be indicated, systemic therapy with temozolomide was started. At the first evaluation after four months, the metastases had progressed. Imatinib delayed the progression, but had to be stopped after six months because of critical increased pleural effusion. Using the multikinase inhibitor sorafenib, the disease was stabilized and an acceptable quality of life could be obtained for one year.
Geology, Ellef Ringnes Island south, Nunavut
Authors: Evenchick C A , Embry A F
Published: September 2012

Ellef Ringnes Island lies in the western Queen Elizabeth Islands, Nunavut, Canada (parts of NTS 69-C, -D, -E, -F, -G and 79-D, -E, -H). The bedrock consists mainly of Jurassic to latest Cretaceous sedimentary rocks of the Sverdrup Basin, and a thin veneer of
Neogene sediments in the far north, adjacent to the Arctic Ocean. Strata are intruded by Cretaceous mafic sills and dykes, disrupted by several evaporite diapirs, and folded by northwest-trending folds associated with Eurekan (Paleogene) deformation. The majority of sills are concentrated close to
the contact between Deer Bay and Isachsen formations (late Valanginian), but range as high as the lower Hassel Formation (late Albian). In the central and southern island, steeply dipping extensional faults occur in patterns radial to the evaporite domes. In the northern half of the island, steep
faults and associated minor folds trend north-northeast, with the addition of east trending normal faults in the far north.
Prensa, geografía y monopolio. La forma de las noticias en web de periódicos de EE UU *
Authors: Barnhurst Kevin G.
Published: September 2012

Los periódicos estadounidenses que publican ediciones electrónicas en Internet no parecen reinventarse a sí mismos online. Al contrario, las versiones web reproducen la esencia de sus ediciones impresas de un modo que resulta muy similar para los lectores. La búsqueda de historias online puede ser un proceso que conlleva numerosos saltos de página y desplazamientos por la pantalla, pero sólo unas pocas informaciones tienen elementos añadidos, como hiperenlaces a información adicional, imágenes o recursos interactivos. Las versiones de Internet no suelen añadir ni cambiar el texto de los artículos, y su presentación es visualmente escasa, especialmente comparada con la impresa, que tiene una variedad tipográfica más rica y que presenta muchas más imágenes. Los resultados sugieren que los editores de la edición impresa utilizan la presencia de Internet como un lugar de bajo coste que conserva su posición en el mercado estadounidense y levanta una barrera a la entrada de competidores regionales y alternativas ideológicas en la arena informativa de Estados Unidos.
Surgically Correctable Fetal Anomalies: Ultrasound Diagnosis and Management
Authors: Honemeyer Ulrich , Zaputovic Sanja , Turudic Tanja
Published: September 2012

A significant proportion of fetal anomalies are surgically correctable. Their accurate and reliable prenatal diagnosis is of great importance, and will have significant influence on both postnatal and postsurgical outcome. The influence of prenatal diagnosis of simple structural defects will interfere with organ development. In the light of recent achievements, traditional teratology has to be reexamined more critically.

How to cite this article

Zaputovic S, Stanojevic M, Honemeyer U, Turudic T, Kurjak A. Surgically Correctable Fetal Anomalies: Ultrasound Diagnosis and Management. Donald School J Ultrasound Obstet Gynecol 2012;6(3):237-256.
Baseline Scan and Ultrasound Diagnosis of PCOS
Authors: Nagori CB
Published: September 2012

Success of any assisted reproductive technology is dependent on selection of correct stimulation protocol. This is based on prestimulation assessment of female to assess ovarian response and reserve. But, this assessment can also be done by ultrasound scan on 2nd to 3rd day of menstrual cycle, named as ‘baseline scan’. This scan is done to categorize ovary into one of the four types: Normal ovaries, low reserve ovaries, poorly responding ovaries and polycystic ovaries. Patients with polycystic ovarian syndrome have variable pictures of ovaries on ultrasound. Understanding the evolution of polycystic ovarian syndrome can explain these variations. Moreover, ultrasound findings can also be correlated with the biochemical and hormonal derangements. This scan also predicts the ovarian reserve and response that can guide to decide the stimulation protocols for ART. This scan includes the use of b mode, Doppler and 3D ultrasound with 3D power Doppler. It consists of assessing ovarian size, antral follicle count (AFC), stromal echogenecity and stromal flow chiefly. Dose calculation is chiefly done based on ovarian volume, AFC and stromal flow.

How to cite this article

Panchal S, Nagori CB. Baseline Scan and Ultrasound Diagnosis of PCOS. Donald School J Ultrasound Obstet Gynecol 2012;6(3):290-299.
Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa
Authors: Naik Sudhir M
Published: September 2012

Background/objectives

Swallowing problems following total laryngectomy are significantly lesser compared to other partial laryngectomies as a permanent seperation between the trachea and esophagus is seen in the earlier. Sometimes, the patient complains of difficulty in propelling bolus through the oral cavity and pharynx as a result of the loss of hyoid bone, which is the anchor for the tongue. The increased pressure in the narrowed pharyngoesophageal segment following laryngectomy requires the tongue to move with greater force.

Setting

Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru.

Case report

A 52-year-old man with history of difficulty and pain while swallowing and diagnosed as squamous cell carcinoma of the right pyriform fossa extending to the pharyngoepiglottic fold. Incidently, the patient had an old untreated cleft palate. Assessment of the pharyngeal wall involvement on direct laryngoscopy proved that pectoralis major myocutaneous flap patch was needed to reconstruct the pharyngeal lumen. Cleft palate proved a contraindication for surgery as the oral swallowing phase would be affected.

Conclusion

Current management protocols of hypopharyngeal cancers include multifactorial assessment of anatomical and functional outcomes and rehabilitation. Even though no literature is found stating cleft palate as the contraindication for total laryngectomy, chemoradiation was preferred citing swallowing problems.

How to cite this article

Naik SM. Untreated Cleft Palate a Unique Surgical Contraindication in Carcinoma of the Pyriform Fossa. Int J Phonosurg Laryngol 2012;2(1):33-36.
Evaluation of the absolute regional temperature potential
Authors: Shindell D. T.
Published: September 2012

Abstract. The Absolute Regional Temperature Potential (ARTP) is one of the few climate metrics that provides estimates of impacts at a sub-global scale. The ARTP presented here gives the time-dependent temperature response in four latitude bands (90–28° S, 28° S–28° N, 28–60° N and 60–90° N) as a function of emissions based on the forcing in those bands caused by the emissions. It is based on a large set of simulations performed with a single atmosphere-ocean climate model to derive regional forcing/response relationships. Here I evaluate the robustness of those relationships using the forcing/response portion of the ARTP to estimate regional temperature responses to the historic aerosol forcing in three independent climate models. These ARTP results are in good accord with the actual responses in those models. Nearly all ARTP estimates fall within ±20% of the actual responses, though there are some exceptions for 90–28° S and the Arctic, and in the latter the ARTP may vary with forcing agent. However, for the tropics and the Northern Hemisphere mid-latitudes in particular, the ±20% range appears to be roughly consistent with the 95% confidence interval. Land areas within these two bands respond 39–45% and 9–39% more than the latitude band as a whole. The ARTP, presented here in a slightly revised form, thus appears to provide a relatively robust estimate for the responses of large-scale latitude bands and land areas within those bands to inhomogeneous radiative forcing and thus potentially to emissions as well. Hence this metric could allow rapid evaluation of the effects of emissions policies at a finer scale than global metrics without requiring use of a full climate model.
An elusive search for regional flood frequency estimates in the River Nile basin
Authors: Nyeko-Ogiramoi P. , Willems P. , Mutua F. M. , Moges S. A.
Published: September 2012

Abstract. Estimation of peak flow quantiles in ungauged catchments is a challenge often faced by water professionals in many parts of the world. Approaches to address such problem exist, but widely used techniques such as flood frequency regionalisation is often not subjected to performance evaluation. In this study, the jack-knifing principle is used to assess the performance of the flood frequency regionalisation in the complex and data-scarce River Nile basin by examining the error (regionalisation error) between locally and regionally estimated peak flow quantiles for different return periods (QT). Agglomerative hierarchical clustering based algorithms were used to search for regions with similar hydrological characteristics. Hydrological data employed were from 180 gauged catchments and several physical characteristics in order to regionalise 365 identified catchments. The Generalised Extreme Value (GEV) distribution, selected using L-moment based approach, was used to construct regional growth curves from which peak flow growth factors could be derived and mapped through interpolation. Inside each region, variations in at-site flood frequency distribution were modelled by regression of the mean annual maximum peak flow (MAF) versus catchment area. The results showed that the performance of the regionalisation is heavily dependent on the historical flow record length and the similarity of the hydrological characteristics inside the regions. The flood frequency regionalisation of the River Nile basin can be improved if sufficient flow data of longer record length of at least 40 yr become available.
An Investigation of the ICAPM in Japan: Evidence from the Tokyo Stock Exchange with a Review of International and Accounting Research
Authors: Tsuji Chikashi
Published: September 2012

After the recent US and international related literature review, this paper explores the state variables that are priced in the Intertemporal Capital Asset Pricing Model (ICAPM) in Japan. Deriving the time-varying covariance risks by using the multivariate Generalized Autoregressive Conditional Heteroskedasticity (GARCH) model, we analyze the ICAPM in the Tokyo Stock Exchange. Our empirical examinations clarify that in Japan, the time-varying covariance between the first difference of the seasonally adjusted Consumer Price Index and market return and the time-varying covariance between the first difference of the trading volume divided by Japanese Gross Domestic Product and market return are priced in Merton’s ICAPM. Further, we discuss the prospect for asset pricing and accounting research by reviewing the recent combined studies.
Smooth Earning, Annual Compensation and CEO Characteristics
Authors: Charfeddine Lanouar , Bouaine Wided , Smida Housine
Published: September 2012

The systems of compensation remain the main mean to reduce the conflicts of interests between chiefs executives officers (CEOs) and the shareholders. The CEOs  compensation is supposed to be positively correlated with the performance of the company. Consequently, the CEOs can managed profits to   determine their level of compensation or to increase the part of cash  and/or options in compensation. This paper investigates the relationship between the discretionary accruals and annual compensation, current performance, future performance, level of debts and total of assets by using a panel data analysis. Empirical results show that the CEO smoothes results of the company in order to have an evolutionary compensation. Moreover, we showed that the tenure and the proportion of property increase the opportunities of this smoothing and decreases the opportunism of the CEOs as soon as they are rooted.