bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of body mass index on the location of the right adrenal vein in patients with primary aldosteronism
Authors: Iwasaki Toshitaka , Kurisu Satoshi , Mitsuba Naoya , Ishibashi Ken , Dohi Yoshihiro , Nishioka Kenji , Kihara Yasuki
Published: July 2012

Background:

Variable location of the orifice of the right adrenal vein appears to be associated with a poor success rate of sampling, especially in less experienced hands. We described the spectrum of the location of the right adrenal vein, and identified the relation of its location to body mass index in patients with primary aldosteronism.

Methods and results:

The study population consisted of 95 patients with primary aldosteronism who underwent adrenal venous sampling. On the basis of the anterior view of the right adrenal venogram, the cranio-caudal level of the orifice of right adrenal vein was determined relative to vertebral bodies and disks. In 93 (98%) of the 95 patients, the orifice was located at a level ranging from the upper segment of T11 to the upper segment of L1. In the remaining two patients, it was located at the level of the lower segment of T10. High body mass index was associated with the higher level of the orifice of right adrenal vein.

Conclusion:

Our data suggested that the location of the orifice of right adrenal vein was largely related to body mass index in patients with primary aldosteronism.
The efficacy and safety of romiplostim in adult patients with chronic immune thrombocytopenia
Authors: Cooper Nichola , Terrinoni Ilaria , Newland Adrian
Published: July 2012

Romiplostim is a thrombopoietin peptide mimetic agent recently approved for the treatment of adults with chronic immune thrombocytopenia (ITP). In randomized controlled studies, this agent has demonstrated an increase in the platelet count in the majority of patients with ITP, both in splenectomized and nonsplenectomized patients. In up to 5 years of follow up, its safety profile has been favorable, suggesting this could be a novel therapeutic agent in patients with ITP. This article summarizes the development of this new agent and explores its safety and efficacy in adults with chronic ITP.
Evolution of specifier proteins in glucosinolate-containing plants
Authors: Kuchernig Jennifer C , Burow Meike , Wittstock Ute
Published: July 2012

Background

The glucosinolate-myrosinase system is an activated chemical defense system found in plants of the Brassicales order. Glucosinolates are stored separately from their hydrolytic enzymes, the myrosinases, in plant tissues. Upon tissue damage, e.g. by herbivory, glucosinolates and myrosinases get mixed and glucosinolates are broken down to an array of biologically active compounds of which isothiocyanates are toxic to a wide range of organisms. Specifier proteins occur in some, but not all glucosinolate-containing plants and promote the formation of biologically active non-isothiocyanate products upon myrosinase-catalyzed glucosinolate breakdown.

Results

Based on a phytochemical screening among representatives of the Brassicales order, we selected candidate species for identification of specifier protein cDNAs. We identified ten specifier proteins from a range of species of the Brassicaceae and assigned each of them to one of the three specifier protein types (NSP, nitrile-specifier protein, ESP, epithiospecifier protein, TFP, thiocyanate-forming protein) after heterologous expression in Escherichia coli. Together with nine known specifier proteins and three putative specifier proteins found in databases, we subjected the newly identified specifier proteins to phylogenetic analyses. Specifier proteins formed three major clusters, named AtNSP5-cluster, AtNSP1-cluster, and ESP/TFP cluster. Within the ESP/TFP cluster, specifier proteins grouped according to the Brassicaceae lineage they were identified from. Non-synonymous vs. synonymous substitution rate ratios suggested purifying selection to act on specifier protein genes.

Conclusions

Among specifier proteins, NSPs represent the ancestral activity. The data support a monophyletic origin of ESPs from NSPs. The split between NSPs and ESPs/TFPs happened before the radiation of the core Brassicaceae. Future analyses have to show if TFP activity evolved from ESPs at least twice independently in different Brassicaceae lineages as suggested by the phylogeny. The ability to form non-isothiocyanate products by specifier protein activity may provide plants with a selective advantage. The evolution of specifier proteins in the Brassicaceae demonstrates the plasticity of secondary metabolism within an activated plant defense system.
Presence of S100A9-positive inflammatory cells in cancer tissues correlates with an early stage cancer and a better prognosis in patients with gastric cancer
Authors: Fan Biao , Zhang Lian-Hai , Jia Yong-ning , Zhong Xi-Yao , Liu Yi-Qiang , Cheng Xiao-Jing , Wang Xiao-Hong , Xing Xiao-Fang , Hu Ying , Li Ying-Ai , Du Hong , Zhao Wei , Niu Zhao-Jian , Lu Ai-Ping , Li Ji-You , Ji Jia-Fu
Published: July 2012

Background

S100A9 was originally discovered as a factor secreted by inflammatory cells. Recently, S100A9 was found to be associated with several human malignancies. The purpose of this study is to investigate S100A9 expression in gastric cancer and explore its role in cancer progression.

Methods

S100A9 expression in gastric tissue samples from 177 gastric cancer patients was assessed by immunohistochemistry. The expression of its dimerization partner S100A8 and the S100A8/A9 heterodimer were also assessed by the same method. The effect of exogenous S100A9 on motility of gastric cancer cells AGS and BGC-823 was then investigated.

Results

S100A9 was specifically expressed by inflammatory cells such as macrophages and neutrophils in human gastric cancer and gastritis tissues. Statistical analysis showed that a high S100A9 cell count (> = 200) per 200x magnification microscopic field in cancer tissues was predictive of early stage gastric cancer. High S100A9-positive cell count was negatively correlated with lymph node metastasis (P = 0.009) and tumor invasion (P = 0.011). S100A9 was identified as an independent prognostic predictor of overall survival of patients with gastric cancer (P = 0.04). Patients with high S100A9 cell count were with favorable prognosis (P = 0.021). Further investigation found that S100A8 distribution in human gastric cancer tissues was similar to S100A9. However, the number of S100A8-positive cells did not positively correlate with patient survival. The inflammatory cells infiltrating cancer were S100A8/A9 negative, while those in gastritis were positive. Furthermore, exogenous S100A9 protein inhibited migration and invasion of gastric cancer cells.

Conclusions

Our results suggested S100A9-positive inflammatory cells in gastric cancer tissues are associated with early stage of gastric cancer and good prognosis.
Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy
Authors: Guez Sophie , Chiarelli Gabriella , Menni Francesca , Salera Simona , Principi Nicola , Esposito Susanna
Published: July 2012

Background

In infants, vitamin B12 deficiency may be due to an inborn error of absorption and metabolism, or nutritional problems.

Case presentation

An exclusively breastfed 5-month-old Italian male infant, who was born after a normal full-term pregnancy to a vegan mother who was apparently daily treated with a multivitamin oral preparation during the second and third trimester, was hospitalised because of poor weight gain, feeding difficulties, severe pallor, muscle hypotonia and somnolence. Upon admission, his weight, length and head circumference were below the third percentile, he had an enlarged liver and spleen, and showed a significant delay in developmental milestones and communicative reactions. He had a hemoglobin level of 4.7 g/dL with an MCV of 84.2 fL, a white blood cell count of 4,680/mm3, and a platelet count of 45,000/mm3. His serum vitamin B12 level was 57 pg/mL (normal value 180–500 pg/mL) and serum folate level 12.8 ng/mL (normal value >3 ng/mL). The results of metabolic examinations excluded a cobalamin C disorder, whereas nutritional screening showed a serum iron concentration of 9 μg/dL and serum ferritin of 4 ng/mL. Magnetic resonance imaging of the brain showed mild dilatation of the lateral ventricles with diffuse delayed myelination. The child was diagnosed as having vitamin B12 and iron deficiency due to nutritional inadequacy and was immediately treated with packed red blood cells, intramuscular vitamin B12 injections, and iron supplementation. A few days after the start of therapy, his hemoglobin levels and other hematological parameters rapidly improved, and a clinical improvement was observed within few weeks. There was an increase in his achievement of developmental milestones, but his development was still retarded seven months after the start of therapy.

Conclusion

This case underlines the importance of adequately controlling maternal vitamin B12 intake during pregnancy by means of supplementation which, in the case of vegan mothers, should be significantly greater than that usually given. Moreover, the supplementation should be continued during lactation in order to avoid the development of signs of deficiency that may be associated with persistent neurological problems in infants. The case also highlights the need to consider vitamin B12 deficiency in infants with severe anemia even if their hematological parameters do not indicate megaloblastic anemia because the concomitant presence of substantial iron deficiency may modify the characteristics of the anemia.
A summary index of infant and child feeding practices is associated with child growth in urban Shanghai
Authors: Ma Jing-Qiu , Zhou Li-Li , Hu Yan-Qi , Liu Jin-Rong , Liu Shan-Shan , Zhang Jie , Sheng Xiao-Yang
Published: July 2012

Background

Recently, an infant and child feeding index (ICFI) constructed on brief recalls of breastfeeding, feeding frequency and food diversification was assumed to provide long-term prediction about child feeding practices. The aim of this study was to investigate the association between the cross-sectional ICFI (CS-ICFI) or longitudinal ICFI (L-ICFI) and child anthropometric indices in downtown Shanghai, China.

Methods

The prospective cohort study included 180 infants aged 5-7 mo with their main caregivers who were visited 3 times every 6 months over 12 months. A CS-ICFI was constructed for each visit by using data on feeding practices based on 24-h and 7-d recalls. An L-ICFI was constructed with use of the 3 CS-ICFIs. The associations between ICFI and length-for-age z score (LAZ), weight-for-age z score (WAZ), and weight-for-length z score (WLZ) were examined. The stability of the CS-ICFI was assessed by using repeatability coefficient (RC).

Results

The L-ICFI was positively associated with LAZ and WAZ at Visit 3(beta = 0.151, P = 0.040 and beta = 0.173, P = 0.024, respectively). Moreover, the CS-ICFI at Visit 1 was positively associated with LAZ, WAZ and WLZ (beta = 0.160, P = 0.029; beta = 0.191, P = 0.009; beta = 0.176, P = 0.020) at Visit 3, and the CS-ICFI at Visit 3 was also positively associated with LAZ (beta = 0.176, P = 0.016). Stability of the CS-ICFI was shown by the value of 0.14 (95% CI: 0.07, 0.31) of the RC, which differed significantly from 0 (P < 0.05).

Conclusions

The ICFI constructed on brief recalls based on cross-sectional studies can be used to evaluate the effects of child feeding practice on child growth.
IL-3 and TNFα increase Thymic Stromal Lymphopoietin Receptor (TSLPR) expression on eosinophils and enhance TSLP-stimulated degranulation
Authors: Cook Ellen B , Stahl James L , Schwantes Elizabeth A , Fox Kristen E , Mathur Sameer K
Published: July 2012

Background

Thymic stromal lymphopoietin (TSLP) and eosinophils are prominent components of allergic inflammation. Therefore, we sought to determine whether TSLP could activate eosinophils, focusing on measuring the regulation of TSLPR expression on eosinophils and degranulation in response to TSLP, as well as other eosinophil activation responses.

Methods

Eosinophil mRNA expression of TSLPR and IL-7Rα was examined by real-time quantitative PCR of human eosinophils treated with TNFα and IL-5 family cytokines, and TSLPR surface expression on eosinophils was analyzed by flow cytometry. Eosinophils were stimulated with TSLP (with and without pre-activation with TNFα and IL-3) and evaluated for release of eosinophil derived neurotoxin (EDN), phosphorylation of STAT5, and survival by trypan blue exclusion. A blocking antibody for TSLPR was used to confirm the specificity of TSLP mediated signaling on eosinophil degranulation.

Results

Eosinophil expression of cell surface TSLPR and TSLPR mRNA was upregulated by stimulation with TNFα and IL-3. TSLP stimulation resulted in release of EDN, phosphorylation of STAT5 as well as promotion of viability and survival. TSLP-stimulated eosinophil degranulation was inhibited by a functional blocking antibody to TSLPR. Pre-activation of eosinophils with TNFα and IL-3 promoted eosinophil degranulation at lower concentrations of TSLP stimulation.

Conclusions

This study demonstrates that eosinophils are activated by TSLP and that eosinophil degranulation in response to TSLP may be enhanced on exposure to cytokines present in allergic inflammation, indicating that the eosinophil has the capacity to participate in TSLP-driven allergic responses.
Symptoms of depression in ICU physicians
Authors: Embriaco Nathalie , Hraiech Sami , Azoulay Elie , Baumstarck-Barrau Karine , Forel Jean-Marie , Kentish-Barnes Nancy , Pochard Frédéric , Loundou Anderson , Roch Antoine , Papazian Laurent
Published: July 2012

Background

Work and family are the two domains from which most adults develop satisfaction in life. They also are responsible for stressful experiences. There is a perception in the community that work is increasingly the source of much of our stress and distress. Depressive symptoms may be related to repeated stressful experiences. Intensive care unit (ICU) physicians are exposed to major stressors. However, the existence of depressive symptoms in these doctors has been poorly studied. This study was designed to evaluate the prevalence and associated risk factors of depressive symptoms in junior and senior ICU physicians.

Method

A one-day national survey was conducted in adult intensive care units (ICU) in French public hospitals. Symptoms of depression were assessed using the Centers of Epidemiologic Studies Depression Scale (CES-D).

Results

A total of 189 ICUs participated, and 901 surveys were returned (75.8% response rate). Symptoms of depression were found in 23.8% of the respondents using the CES-D scale. Fifty-eight percent of these intensivists presenting symptoms of depression wished to leave their job compared with only 33% of those who did not exhibit signs of depression as assessed by the CES-D scale (p < 0.0001). Multiple logistic regression showed that organizational factors were associated with the presence of depressive symptoms. Workload (long interval since the last nonworking weekend, absence of relief of service until the next working day after a night shift) and impaired relationships with other intensivists were independently associated with the presence of depressive symptoms. A high level of burnout also was related to the presence of depressive symptoms. In contrast, no demographic factors regarding ICU physicians and no factor related to the severity of illness of patients were retained by the model. The quality of relationships with other physicians (from other departments) was associated with the absence of depressive symptoms (protective effect).

Conclusions

Approximately one of four intensivists presented symptoms of depression. The next step could be to test whether organization modification is associated with less depressive symptoms and less desire to leave the job.
Root anoxia effects on physiology and emissions of volatile organic compounds (VOC) under short-and long-term inundation of trees from Amazonian floodplains
Authors: Bracho-Nunez Araceli , Knothe Nina Maria , Costa Wallace R , Maria Astrid Liberato R , Kleiss Betina , Rottenberger Stefanie , Piedade Maria Teresa Fernandez , Kesselmeier Jürgen
Published: July 2012

Volatile organic compound (VOC) emissions are affected by a variety of biotic and abiotic factors such as light intensity, temperature, CO2and drought. Another stress factor, usually overlooked but very important for the Amazon region, is flooding. We studied the exchange of VOCs in relation to CO2exchange and transpiration of 8 common tree species from the Amazonian floodplain forest grown up from seeds using a dynamic enclosure system. Analysis of volatile organics was performed by PTR-MS fast online measurements. Our study confirmed emissions of ethanol and acetaldehyde at the beginning of root anoxia after inundation, especially in less anoxia adapted species such asVatairea guianensis, but not forHevea spruceanaprobably due to a better adapted metabolism. In contrast to short-term inundation, long-term flooding of the root system did not result in any emission of ethanol or/and acetaldehyde. Emission of other VOCs, such as isoprenoids, acetone, and methanol exhibited distinct behavior related to the origin (igapó or várzea type of floodplain) of the tree species. Also physiological activities exhibited different response patterns for trees from igapó or várzea. In general, isoprenoid emissions increased within the course of some days of short-term flooding. After a long period of waterlogging, VOC emissions decreased considerably, along with photosynthesis, transpiration and stomatal conductance. However, even under long-term testing conditions, two tree species did not show any significant decrease or increase in photosynthesis. In order to understand ecophysiological advantages of the different responses we need field investigations with adult tree species.
Monocyte populations as markers of response to adalimumab plus MTX in rheumatoid arthritis
Authors: Chara Luis , Sánchez-Atrio Ana , Pérez Ana , Cuende Eduardo , Albarrán Fernando , Turrión Ana , Chevarria Julio , Sánchez Miguel A , Monserrat Jorge , de la Hera Antonio , Prieto Alfredo , Sanz Ignacio , Diaz David , Alvarez-Mon Melchor
Published: July 2012

Introduction

The treatment of rheumatoid arthritis (RA) patients with anti-tumor necrosis factor alpha (TNFα) biological drugs has dramatically improved the prognosis of these patients. However, a third of the treated patients do not respond to this therapy. Thus, the search for biomarkers of clinical response to these agents is currently highly active. Our aim is to analyze the number and distribution of circulating monocytes, and of their CD14+highCD16-, CD14+highCD16+ and CD14+lowCD16+ subsets in methotrexate (MTX) non-responder patients with RA, and to determine their value in predicting the clinical response to adalimumab plus MTX treatment.

Methods

This prospective work investigated the number of circulating monocytes, and of their CD14+highCD16-, CD14+highCD16+ and CD14+lowCD16+ subsets, in 35 MTX non-responder patients with RA before and after three and six months of anti-TNFα treatment using multiparametric flow cytometry. The number of circulating monocytes in an age- and sex-matched healthy population was monitored as a control.

Results

Non-responder patients with RA show an increased number of monocytes and of their CD14+highCD16-, CD14+highCD16+ and CD14+lowCD16+ subsets after three months of adalimumab plus MTX treatment that remained significantly increased at six months. In contrast, significant normalization of the numbers of circulating monocytes was found in responders at three months of adalimumab plus MTX treatment that lasts up to six months. CX3CR1 expression is increased in monocytes in non-responders. At three months of anti-TNFα treatment the number of circulating monocytes and their subsets was associated with at least 80% sensitivity, 84% specificity and an 86% positive predictive value (PPV) in terms of discriminating between eventual early responders and non-responders.

Conclusions

The absolute number of circulating monocytes and of their CD14+highCD16-, CD14+highCD16+ and CD14+lowCD16+ subsets at three months of adalimumab plus MTX treatment, have a predictive value (with high specificity and sensitivity) in terms of the clinical response after six months of anti-TNFα treatment in patients with RA.
Sustained low efficiency dialysis using a single-pass batch system in acute kidney injury - a randomized interventional trial: the REnal Replacement Therapy Study in Intensive Care Unit PatiEnts
Authors: Schwenger Vedat , Weigand Markus A , Hoffmann Oskar , Dikow Ralf , Kihm Lars P , Seckinger Jörg , Miftari Nexhat , Schaier Matthias , Hofer Stefan , Haar Caroline , Nawroth Peter P , Zeier Martin , Martin Eike , Morath Christian
Published: July 2012

Introduction

Acute kidney injury (AKI) is associated with a high mortality of up to 60%. The mode of renal replacement therapy (intermittent versus continuous) has no impact on patient survival. Sustained low efficiency dialysis using a single-pass batch dialysis system (SLED-BD) has recently been introduced for the treatment of dialysis-dependent AKI. To date, however, only limited evidence is available in the comparison of SLED-BD versus continuous veno-venous hemofiltration (CVVH) in intensive care unit (ICU) patients with AKI.

Methods

Prospective, randomized, interventional, clinical study at a surgical intensive care unit of a university hospital. Between 1 April 2006 and 31 January 2009, 232 AKI patients who underwent renal replacement therapy (RRT) were randomized in the study. Follow-up was assessed until 30 August 2009. Patients were either assigned to 12-h SLED-BD or to 24-h predilutional CVVH. Both therapies were performed at a blood flow of 100 to 120 ml/min.

Results

115 patients were treated with SLED-BD (total number of treatments n = 817) and 117 patients with CVVH (total number of treatments n = 877).The primary outcome measure, 90-day mortality, was similar between groups (SLED: 49.6% vs. CVVH: 55.6%, P = 0.43). Hemodynamic stability did not differ between SLED-BD and CVVH, whereas patients in the SLED-BD group had significantly fewer days of mechanical ventilation (17.7 ± 19.4 vs. 20.9 ± 19.8, P = 0.047) and fewer days in the ICU (19.6 ± 20.1 vs. 23.7 ± 21.9, P = 0.04). Patients treated with SLED needed fewer blood transfusions (1,375 ± 2,573 ml vs. 1,976 ± 3,316 ml, P = 0.02) and had a substantial reduction in nursing time spent for renal replacement therapy (P < 0.001) resulting in lower costs.

Conclusions

SLED-BD was associated with reduced nursing time and lower costs compared to CVVH at similar outcomes. In the light of limited health care resources, SLED-BD offers an attractive alternative for the treatment of AKI in ICU patients.

Trial registration

ClinicalTrials.gov NCT00322530
Prediction of severe community-acquired pneumonia: a systematic review and meta-analysis
Authors: Marti Christophe , Garin Nicolas , Grosgurin Olivier , Poncet Antoine , Combescure Christophe , Carballo Sebastian , Perrier Arnaud
Published: July 2012

Introduction

Severity assessment and site-of-care decisions for patients with community-acquired pneumonia (CAP) are pivotal for patients' safety and adequate allocation of resources. Late admission to the intensive care unit (ICU) has been associated with increased mortality in CAP. We aimed to review and meta-analyze systematically the performance of clinical prediction rules to identify CAP patients requiring ICU admission or intensive treatment.

Methods

We systematically searched Medline, Embase, and the Cochrane Controlled Trials registry for clinical trials evaluating the performance of prognostic rules to predict the need for ICU admission, intensive treatment, or the occurrence of early mortality in patients with CAP.

Results

Sufficient data were available to perform a meta-analysis on eight scores: PSI, CURB-65, CRB-65, CURB, ATS 2001, ATS/IDSA 2007, SCAP score, and SMART-COP. The estimated AUC of PSI and CURB-65 scores to predict ICU admission was 0.69. Among scores proposed for prediction of ICU admission, ATS-2001 and ATS/IDSA 2007 scores had better operative characteristics, with a sensitivity of 70% (CI, 61 to 77) and 84% (48 to 97) and a specificity of 90% (CI, 82 to 95) and 78% (46 to 93), but their clinical utility is limited by the use of major criteria.

ATS/IDSA 2007 minor criteria have good specificity (91% CI, 84 to 95) and moderate sensitivity (57% CI, 46 to 68). SMART-COP and SCAP score have good sensitivity (79% CI, 69 to 97, and 94% CI, 88 to 97) and moderate specificity (64% CI, 30 to 66, and 46% CI, 27 to 66). Major differences in populations, prognostic factor measurement, and outcome definition limit comparison. Our analysis also highlights a high degree of heterogeneity among the studies.

Conclusions

New severity scores for predicting the need for ICU or intensive treatment in patients with CAP, such as ATS/IDSA 2007 minor criteria, SCAP score, and SMART-COP, have better discriminative performances compared with PSI and CURB-65. High negative predictive value is the most consistent finding among the different prediction rules. These rules should be considered an aid to clinical judgment to guide ICU admission in CAP patients.
SNX5 is essential for efficient macropinocytosis and antigen processing in primary macrophages
Authors: Lim Jet Phey , Teasdale Rohan D. , Gleeson Paul A.
Published: July 2012

Macropinocytosis mediates the bulk endocytosis of solute molecules, nutrients and antigens. As this endocytic pathway is considered important in functions associated with immune responses, the molecular mechanisms regulating this pathway in immune cells is of particular significance. However, the regulators of macropinocytosis in primary cells remain poorly defined. Members of the sorting nexin (SNX) family have been implicated in macropinosome biogenesis in cultured cells and here we have analyzed the role of two SNX family members, SNX1 and its binding partner SNX5, in macropinocytosis of mouse primary macrophages. We show that endogenous SNX1 and SNX5 are localised to newly-formed macropinosomes in primary mouse macrophages and, moreover, demonstrate that SNX5 plays an essential role in macropinosome biogenesis. Depletion of SNX5 in bone marrow-derived macrophages dramatically decreased both the number and size of macropinosomes. Depletion of SNX5 also resulted in dramatic reduction in uptake and processing of soluble ovalbumin in macrophages, indicating that the majority of antigen uptake and delivery to late endosomes is via macropinocytosis. By contrast, the absence of SNX1 had no effect on endogenous SNX5 localisation and macropinosome biogenesis using macrophages from SNX1 knockout mice. Therefore, SNX5 can function independently of SNX1 and is a modulator of macropinocytosis that influences the uptake and processing of soluble antigen in primary mouse macrophages.
Social support mediates the relationship between HIV stigma and depression/quality of life among people living with HIV in Beijing, China
Authors: Rao D , Chen W T , Pearson C R , Simoni J M , Fredriksen-Goldsen K , Nelson K , Zhao H , Zhang F
Published: July 2012

Stigma towards people living with HIV is pervasive in China and related to poor service utilization, psychosocial distress and diminished quality of life (QOL). In an effort to identify mechanisms to reduce HIV stigma and its negative consequences, we examined whether social support mediates the relation between enacted stigma and both depressive symptoms and QOL among 120 HIV outpatients in Beijing, China. Generally, perceived social support was associated with less stigma, less depressive symptomatology and better QOL. Using multivariable regression models, we found that social support was a full mediator of the impact of stigma on both depressive symptomatology and QOL. The findings suggest social support may be an important target of interventions to reduce the impact of stigma on poor psychosocial health outcomes.
A case of hepatitis a vaccination failure in an HIV-positive man who had sex with men in Israel
Authors: Mor Z , Lurie Y , Katchman E
Published: July 2012

Hepatitis A virus (HAV) vaccination is recommended for men who have sex with men (MSM) and other susceptible populations, who are at increased risk for HAV infection, such as HIV-positive persons. Vaccines failures are uncommon, and in HIV-positive individuals whose CD4 count is ≥500 cells/mm2, seroconversion is achieved in 73–94% of vaccinees following the second dose. Data were retrieved from the patient's file at the sexually transmitted disease clinic and the AIDS clinic describing this rare case of vaccine failure. A 35-year-old, HIV-positive MSM was vaccinated against HAV on 2007, while his CD4 count was 551 cells/mm2. Two years later, he was hospitalized due to acute HAV. The patient's serum drawn two months prior to the onset of acute HAV was retrospectively tested and showed no response to the vaccine. The source of the HAV infection was not identified. The patient's partner who was HIV-negative and had been vaccinated simultaneously with the same batch developed protective antibodies. In conclusion, HIV-positive patients and their providers should be informed about HAV vaccine failure, and post-immunization serologies to hepatitis should be considered to evaluate immunization response. Alternative approaches to develop immunity are needed for non-responders.
HIV-1 discordant couples in Karnataka, South India: is the sex ratio of index cases changing?
Authors: Shastri S , Shet A , Rewari B , De Costa A
Published: July 2012

India has an estimated 2.5 million HIV infections, most of which are heterosexually transmitted. Women comprise 40% of infected adults. In India, 90% of women between the ages of 15 and 45 years are married. Previous literature has suggested that sexual intercourse with an HIV-infected husband represents a married woman's greatest risk for being infected. However, a recent meta-analysis of discordant couples from sub-Saharan Africa reported that women were the index case in half of all couples. Similar data are not available from India. This cross-sectional study describes the epidemiology of 925 discordant couples from five districts in Karnataka province, one of the high HIV prevalence provinces in India. Men were the index case in 74% of couples. However, in young couples (where the index case was aged <30 years), women were more likely to be the infected partner (64% of couples). Condom use was reported by 46% of these discordant couples. These results suggest an emerging predominance of female index case infections among younger discordant couples in India, and point to the need for focusing HIV preventive messages on youth and couples before marriage.
SMS for disease control in developing countries: a systematic review of mobile health applications
Authors: Déglise Carole , Suggs L Suzanne , Odermatt Peter
Published: July 2012

Mobile phones provide a low cost method of addressing certain health system needs in developing countries. We examined SMS-supported interventions for prevention, surveillance, management and treatment compliance of communicable and non-communicable diseases in developing countries. We searched both peer-reviewed and grey literature reporting the use of SMS messages for disease prevention, surveillance, self-management and compliance in developing countries. A total of 98 applications fulfilled the inclusion criteria (33 prevention, 19 surveillance, 29 disease management and 17 patient compliance applications). In 31 projects, the SMS applications were evaluated. The majority of applications focused on HIV/AIDS and were located in India, South Africa and Kenya. Most used bulk (push) messaging. In general, they were well accepted by the population. The review provides further evidence that mobile phones are an appropriate and promising tool for disease control interventions in developing countries.
Correction of dorsally-malunited extra-articular distal radial fractures using volar locked plates without bone grafting
Authors: Mahmoud M. , El Shafie S. , Kamal M.
Published: July 2012

Malunion is the most common complication of the distal radius with many modalities of treatment available for such a problem. The use of bone grafting after an osteotomy is still recommended by most authors. We hypothesised that bone grafting is not required; fixing the corrected construct with a volar locked plate helps maintain the alignment, while metaphyseal defect fills by itself. Prospectively, we performed the procedure on 30 malunited dorsally-angulated radii using fixed angle volar locked plates without bone grafting. At the final follow-up, 22 wrists were available. Radiological evidence of union, correction of the deformity, clinical and functional improvement was achieved in all cases. Without the use of bone grafting, corrective open wedge osteotomy fixed by a volar locked plate provides a high rate of union and satisfactory functional outcomes.
Oxford phase 3 unicompartmental knee replacement in Korean patients
Authors: Lim H-C. , Bae J-H. , Song S-H. , Kim S-J.
Published: July 2012

Medium-term survivorship of the Oxford phase 3 unicompartmental knee replacement (UKR) has not yet been established in an Asian population. We prospectively evaluated the outcome of 400 phase 3 Oxford UKRs in 320 Korean patients with a mean age at the time of operation of 69 years (48 to 82). The mean follow-up was 5.2 years (1 to 10). Clinical and radiological assessment was carried out pre- and post-operatively. At five years, the mean Knee Society knee and functional scores had increased significantly from 56.2 (30 to 91) pre-operatively to 87.2 (59 to 98) (p = 0.034) and from 59.2 (30 to 93) to 88.3 (50 to 100) (p = 0.021), respectively. The Oxford knee score increased from a mean of 25.8 (12 to 39) pre-operatively to 39.8 (25 to 58) at five years (p = 0.038). The ten-year survival rate was 94% (95% confidence interval 90.1 to 98.0). A total of 14 UKRs (3.5%) required revision. The most common reason for revision was dislocation of the bearing in 12 (3%). Conversion to a total knee replacement was required in two patients who developed osteoarthritis of the lateral compartment.

This is the largest published series of UKR in Korean patients. It shows that the mid-term results after a minimally invasive Oxford phase 3 UKR can yield satisfactory clinical and functional results in this group of patients.
Association Between CASP8 and CASP10 Polymorphisms and Toxicity Outcomes With Platinum-Based Chemotherapy in Chinese Patients With Non-Small Cell Lung Cancer
Authors: Qian Ji , Qu Hui-Qi , Yang Lixin , Yin Ming , Wang Qiming , Gu Shaohua , Wu Qihan , Zhao Xueying , Wu Wenting , Wu Junjie , Tan Xiaoming , Chen Wenqing , Wang Haijian , Wang Jiucun , Fan Weiwei , Chen Hongyan , Han Baohui , Lu Daru , Wei Qingyi , Jin Li
Published: July 2012

Caspase-8 and caspase-10 play crucial roles in both cancer development and chemotherapy efficacy. In this study, we aimed to comprehensively assess single nucleotide polymorphisms (SNPs) of the caspase-8 (CASP8) and caspase-10 (CASP10) genes in relation to toxicity outcomes with first-line platinum-based chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). We genotyped 13 tag SNPs of CASP8 and CASP10 in 663 patients with advanced NSCLC treated with platinum-based chemotherapy regimens. Associations between SNPs and chemotherapy toxicity outcomes were identified in a discovery set of 279 patients and then validated in an independent set of 384 patients. In both the discovery and validation sets, variant homozygotes of CASP8 rs12990906 and heterozygotes of CASP8 rs3769827 and CASP10 rs11674246 and rs3731714 had a significantly lower risk for severe toxicity overall. However, only the association with the rs12990906 variant was replicated in the validation set for hematological toxicity risk. In a stratified analysis, we found that some other SNPs, including rs3769821, rs3769825, rs7608692, and rs12613347, were significantly associated with severe toxicity risk in some subgroups, such as in nonsmoking patients, patients with adenocarcinoma, and patients treated with cisplatin combinations. Consistent results were also found in haplotype analyses. Our results provide novel evidence that polymorphisms in CASP8 and CASP10 may modulate toxicity outcomes in patients with advanced NSCLC treated with platinum-based chemotherapy. If validated, the findings will facilitate the genotype-based selection of platinum-based chemotherapy regimens.
Torsadogenic Cardiotoxicity of Antipsychotic Drugs: a Structural Feature, Potentially Involved in the Interaction with Cardiac HERG Potassium Channels
Authors: Testai L. , Bianucci A. M. , Massarelli I. , Breschi M. C. , Martinotti E. , Calderone V.
Published: July 2012

Many non-cardiovascular drugs of common clinical use cause, as an unwanted accessory property, the prolongation of the cardiac repolarisation process, due to the block of the HERG (Human Ether-a-go-go Related Gene) potassium channel, responsible for the repolarising IKr current. This delayed cardiac repolarisation process can be often unmasked by a prolongation of the QT interval of the ECG. In these conditions, premature action potentials can generate morphologically anomalous after-polarisations, and trigger a dangerous kind of polymorphic ventricular tachyarrhythmia, known as torsade de pointes, which can evolve in ventricular fibrillation and death. The risk associated with the torsadogenic cardiotoxicity of drugs, which prolong the QT interval has been the topic of documents produced by many health authorities, giving important issues about the preclinical and clinical evaluation of cardiac safety. Besides, public and private research laboratories developed several experimental in vitro or in vivo strategies, aimed to an early recognition of the influence of a drug (or of a drugcandidate) on the HERG channel and / or on the cardiac repolarisation process. Also the identification of a possible pharmacophore model, common in all or at least in numerous torsadogenic drugs, could represent a first step for the development of useful in silico approaches, allowing a preliminary indication about the potential torsadogenic property of a given molecule. In this work, we described the electrophysiological basis of torsade de pointes and listed several pharmacological classes of torsadogenic drugs. Among them, we focused our attention on antipsychotics, with an accurate overview on the experimental and clinical reports about their torsadogenic properties. Moreover, a common structural feature exhibited by these drugs, despite of their remarkable chemical differences, is evidenced by a computational approach and is indicated as a possible “facilitating” requirement for their torsadogenic properties. Together with other remarks, coming from different computational studies, the individuation of a satisfactory “toxicophore” model could be greatly useful, for the theoretical prediction of torsadogenic properties of a given chemical moiety and for the design of new drugs devoid of such an undesired and potentially lethal side-effect.
Improved, High Yield Synthesis of 3H-Quinazolin-4-ones, the Key Intermediates of Recently Developed Drugs
Authors: Orfi Laszlo , Waczek Frigyes , Pato Janos , Varga Istvan , Hegymegi-Barakonyi Balint , Houghten Richard A. , Ker Gyorgy
Published: July 2012

Purine bases and their bioisosteric analogs are widely used as building blocks in combinatorial chemistry. Recently a great number of fused pyrimidine derivatives became known as potential drug molecules against various types of proliferative diseases, caused by over-expression of protein kinases [1]. One of the most important compound
Social Class, Politics, and the Spirit Level: Why Income Inequality Remains Unexplained and Unsolved
Authors: Muntaner Carles , Rai Nanky , Ng Edwin , Chung Haejoo
Published: July 2012

Richard Wilkinson and Kate Pickett's latest book, The Spirit Level: Why Equality is Best for Everyone, has caught the attention of academics and policymakers and stimulated debate across the left-right political spectrum. Interest in income inequality has remained unabated since the publication of Wilkinson's previous volume, Unhealthy Societies: The Afflictions of Inequality. While both books detail the negative health effects of income inequality, The Spirit Level expands the scope of its argument to also include social issues. The book, however, deals extensively with the explanation of how income inequality affects individual health. Little attention is given to political and economic explanations on how income inequality is generated in the first place. The volume ends with political solutions that carefully avoid state interventions such as limiting the private sector's role in the production of goods and services (e.g., non-profit sector, employee-ownership schemes). Although well-intentioned, these alternatives are insufficient to significantly reduce the health inequalities generated by contemporary capitalism in wealthy countries, let alone around the world.
Employer-Sponsored Health Insurance Erosion Accelerates in the Recession
Authors: Gould Elise
Published: July 2012

From 2000 to 2009, the share of non-elderly Americans covered by employer-sponsored health insurance (ESI) fell 9.4 percentage points. Although the economy was already in a recession in 2008, it continued to dramatically deteriorate in 2009. From 2008 to 2009, the unemployment rate rose 3.5 percentage points, the largest one-year increase on record. As most Americans under age 65 rely on health insurance obtained through the workplace, it is no surprise that ESI fell sharply from 2008 to 2009 at a rate three times as high as in the first year of the recession. Over the 2000s, no demographic or socioeconomic group has been spared from the erosion of job-based insurance. Both genders and people of all ages, races, education, and income levels have suffered declines in coverage. Workers across the wage distribution, in small and large firms alike, and even those working full-time and in white-collar jobs have experienced losses. Along with sharp declines in ESI, the share of those under age 65 without any insurance increased 3.3 percentage points from 2000 to 2009. Increasing public insurance coverage, particularly among children, is the only reason the uninsured rate did not rise one-for-one with losses in ESI.
Response to the Institute of Medicine's Recommendation That Cost Determine Insurance Policies' “Essential Benefits”
Authors: Himmelstein David
Published: July 2012

An open letter to U.S. Secretary of Health and Human Services Kathleen Sebelius, signed by 2,425 individuals, including 1,280 U.S. physicians, protests the recommendations of an Institute of Medicine committee on the “essential benefits package” to be offered by health plans under the 2010 federal health reform act. The letter also criticizes conflicts of interest in the Institute of Medicine committee, which includes executives from two of the nation's largest health insurance firms and a major donor to the Institute.
Detection of Differential Levels of Proteins in the Urine of Patients with Endometrial Cancer: Analysis Using Two-Dimensional Gel Electrophoresis and O-Glycan Binding Lectin
Authors: Mu Alan Kang-Wai , Lim Boon-Kiong , Hashim Onn Haji , Shuib Adawiyah Suriza
Published: July 2012

Cancers can cause some proteins to be aberrantly excreted or released in the urine, which can be used as biomarkers. To screen for potential biomarkers for endometrial cancer (ECa), the urinary proteins from patients who were newly diagnosed with early stage ECa and untreated controls were separated using two-dimensional gel electrophoresis (2-DE) and followed by image analysis. The altered levels of zinc alpha-2 glycoprotein, alpha 1-acid glycoprotein, and CD59 were detected in the patients compared to the controls. In addition, the urine of the ECa patients was also found to contain relatively lower levels of a fragment of nebulin when the 2-DE separated urinary proteins were probed using champedak galactose binding (CGB) lectin. The different levels of the nebulin fragment were further validated by subjecting the urinary protein samples to CGB lectin affinity chromatography and analysis of the bound fractions by LC-MS/MS. Our data is suggestive of the potential use of the differentially expressed urinary proteins as biomarkers for ECa although this requires further extensive validation on clinically representative populations.
Evaluation of Polyphenolic Profile and Nutritional Value of Non-Traditional Fruit Species in the Czech Republic — A Comparative Study
Authors: Jurikova Tunde , Sochor Jiri , Rop Otakar , Mlček Jiří , Balla Štefan , Szekeres Ladislav , Žitný Rastislav , Zitka Ondrej , Adam Vojtech , Kizek Rene
Published: July 2012

Dry matter, organic acids, ascorbic acid, minerals (nitrogen, phosphorus, potassium, calcium, magnesium, sodium) and polyphenolic profile of a number of non-traditional fruit species and their genotypes, namely blue honeysuckle (Lonicera spp.), Saskatoon berry (Amelanchier alnifolia), black mulberry (Morus nigra), Tomentosa cherry (Prunus tomentosa Thunb.) and jostaberry (Ribes nigrum x Grossularia uva-crispa) were investigated. The results showed that Lonicera genotypes displayed high levels of ascorbic acid and they were rich in minerals, with the cultivar ‘Amfora’ achieving the leading position in nitrogen, phosphorus and potassium content among all lesser known fruit species. Amelanchier cultivars represented a valuable source of ascorbic acid and calcium, ‘Tišňovský’ and ‘Smoky’ together with Morus nigra ‘Jugoslavska’ accumulated the highest level of examined polyphenolic compounds. Regular consumption of studied less common fruit species can bring health benefits so they can represent a high potential value for fruit growers and in addition they can be utilised as functional foods.
Anammox and denitrification in the oxygen minimum zone of the eastern South Pacific
Authors: Dalsgaard Tage , Thamdrup Bo , Farías Laura , Revsbech Niels Peter
Published: July 2012

We quantified the removal of fixed nitrogen as N2 production by anammox and N2 and N2O production by denitrification over a distance of 1900 km along the coasts of Chile and Peru, using short‐term incubations with 15N‐labeled substrates. The eastern South Pacific contains an oxygen minimum zone (OMZ) characterized by an anoxic, nitrate‐ and nitrite‐rich layer of ∼ 200‐m thickness below 30–90 m of oxic water. Anammox and denitrification were almost exclusively recorded when the in situ O2 concentration was below detection, indicating that the induction of these processes is highly oxygen sensitive. Anammox was detected in 70% of the samples from anoxic depths. Denitrification was detected in fewer samples, but maximum rates were an order of magnitude higher than those of anammox. In our incubations denitrification was responsible for 72% of the total N2 production and 77% of the total removal of fixed nitrogen including N2O production. However, at the individual depths it could be one or the other process that was responsible for all of the nitrogen removal. Anammox activity was highest just below the oxic‐anoxic interface and declined exponentially with depth, whereas no depth dependence was discerned for denitrification. Denitrification resulted in net production of N2O in some of the samples and consumption of added 15N2O in others. Together with the accumulation of this indicates that denitrification must be seen as a sequence of individually regulated reactions, each of which may start and stop depending on the electron donor input, while anammox is much less variable. The highly patchy distribution of denitrification contributes to explain the apparent imbalances between ammonium sources and sinks suggested by previous 15N‐based studies in OMZs.