bluuebunny/crossref_metadata_2025 huggingface dataset:
Clay mineral genesis and chemical evolution in the Miocene sediments of Somosaguas, Madrid Basin, Spain
Authors: Fesharaki O. , García-Romero E. , Cuevas-González J. , López-Martínez N.
Published: August 2007

A mineralogical and microtextural study of Somosaguas Miocene deposits, located in the Madrid Basin (western Madrid, Spain), was carried out using X-ray diffraction, scanning electron microscopy, transmission electron microscopy and optical microscopy, whereas crystal chemistry data were obtained by analytical electron microscopy-transmission electron microscopy and electron icroprobe analysis. Four stratigraphic sections were studied, compising detrital rocks representing intermediate and distal facies from alluvial fan deposits. The predominant source area of these sediments was the granitic rocks of the Spanish Central System with a lesser contribution of metamorphic rocks. Clayey arkoses are the most abundant rocks of these sections, typical of granite alteration under warm, semi-arid climates. The mineralogy is characterized by phyllosilicates, followed by feldspars and quartz. The data obtained reveal mineral mixtures of detrital (quartz, feldspars, kaolinite, micas and chlorite), transformed (illite and beidellite) and neoformed (montmorillonite) origin. Clay minerals resulted from interactions between detrital minerals and meteoric waters. Two trends of degradation of micas are detected. The first shows a transition from muscovites and dioctahedral illites, to beidellites. The other trend is defined by the biotite degradation to beidellites with different layer charge and octahedral Fe content. Montmorillonites were neoformed from the hydrolysis and weathering of primary minerals (feldspars and muscovite). Magnesian clay minerals such as sepiolite, palygorskite and trioctahedral smectites, extremely abundant in the centre of the basin, were not detected in Somosaguas sediments.
Synthesis of ZSM-5 on kaolin microspheres in the absence of an organic amine template
Authors: Sun S.-H. , Ma J.-T. , Gao X.-H.
Published: August 2007

Zeolite ZSM-5 was synthesized successfully, in situ, on pyrokaolin microspheres (PKM) under hydrothermal conditions, without the use of an organic amine template. The utility of alkali-modified pyrokaolin microspheres (AMKM) was also evaluated. The resulting products were characterized using X-ray diffraction, scanning electron microscopy (SEM) and N2-adsorption isotherm data. The material containing ZSM-5 synthesized from the system PKM-additional silica-water had a large surface area and pore volume with significant enhancements in the micropore surface area and micropore volume. The SEM images show that the synthesis of zeolite ZSM-5 from pyrokaolin microspheres (PKM) led to the formation of polycrystalline aggregates <2 μm in size. The purity of the zeolite ZSM-5 produced was affected by both the pH value of the reactant system and the reaction temperature. In the system containing AMKM-additional silica-water, very little of the synthesized zeolite resided on the kaolin microspheres.
A high-density SNP genome-wide linkage search of 206 families identifies susceptibility loci for chronic lymphocytic leukemia
Authors: Sellick Gabrielle S. , Goldin Lynn R. , Wild Ruth W. , Slager Susan L. , Ressenti Laura , Strom Sara S. , Dyer Martin J. S. , Mauro Francesca R. , Marti Gerald E. , Fuller Stephen , Lyttelton Matthew , Kipps Thomas J. , Keating Michael J. , Call Timothy G. , Catovsky Daniel , Caporaso Neil , Houlston Richard S.
Published: August 2007

Chronic lymphocytic leukemia (CLL) and other B-cell lymphoproliferative disorders display familial aggregation. To identify a susceptibility gene for CLL, we assembled families from the major European (ICLLC) and American (GEC) consortia to conduct a genome-wide linkage analysis of 101 new CLL pedigrees using a high-density single nucleotide polymorphism (SNP) array and combined the results with data from our previously reported analysis of 105 families. Here, we report on the combined analysis of the 206 families. Multipoint linkage analyses were undertaken using both nonparametric (model-free) and parametric (model-based) methods. After the removal of high linkage disequilibrium SNPs, we obtained a maximum nonparametric linkage (NPL) score of 3.02 (P = .001) on chromosome 2q21.2. The same genomic position also yielded the highest multipoint heterogeneity LOD (HLOD) score under a common recessive model of disease susceptibility (HLOD = 3.11; P = 7.7 × 10−5), which was significant at the genome-wide level. In addition, 2 other chromosomal positions, 6p22.1 (corresponding to the major histocompatibility locus) and 18q21.1, displayed HLOD scores higher than 2.1 (P < .002). None of the regions coincided with areas of common chromosomal abnormalities frequently observed in CLL. These findings provide direct evidence for Mendelian predisposition to CLL and evidence for the location of disease loci.
Grey scale enhancement by a new self-made contrast agent in early cirrhotic stage of rabbit liver
Authors: Zhang Li , Duan Yun-You , Yin Ji-Kai , Cui Ji-Hong , Zhang Yong , Cao Tie-Sheng
Published: August 2007

Background

The development of new ultrasound contrast agents (UCAs) has become one of the most promising fields in ultrasound medicine. This paper evaluates a new self-made contrast agent enhancement effect developed to study the fibrotic stages of the liver in perfusion models in vivo.

Methods

We constructed experimental models of hepatic fibrosis involving five stages from F0 to F4 via administration of CCL4 (0.01 ml/kg BW) every 3 days for 3 months. The intrahepatic circulatory time of the contrast agent was analyzed via an image and Cine-loop display. Calculations of the perfusion-related parameters including the peak signal intensity (PSI) and peak signal intensity time (PIT) of the portal vein and parenchyma were obtained from an analysis of the time-acoustic intensity curve.

Results

Hepatic artery to vein transmit time (HA-HVTT) was significantly shorter at F4 stage (mean 5.1 seconds) compared with those in other stages (mean 8.3 s, 7.5 s, 6.9 s, 6.6 s, P < 0.01). The average PSI difference of PV-parenchyma was 13.62 dB in F4 stage, demonstrating significant differences between F4 stage and other early stages (P < 0.001).

Conclusion

These results indicate that the new self-made contrast agent is capable of indicating intrahepatic hemodynamic changes. HA-HVTT and the PSI difference of the microbubble perfusion in liver parenchyma and PV were considered to differentiate the degree of hepatic fibrosis between F4 and other early stages.
High prevalence of extrapyramidal signs and symptoms in a group of Italian dental technicians
Authors: Fabrizio Edito , Vanacore Nicola , Valente Marcella , Rubino Alfonso , Meco Giuseppe
Published: August 2007

Background

Occupational and chronic exposure to solvents and metals is considered a possible risk factor for Parkinson's disease and essential tremor. While manufacturing dental prostheses, dental technicians are exposed to numerous chemicals that contain toxins known to affect the central nervous system, such as solvents (which contain n-hexane in particular) and metals (which contain mercury, iron, chromium, cobalt and nickel).

Methods

We performed an epidemiological and clinical study on all 27 dental technicians working in a school for dental technicians. We asked all the technicians to fill in a self-administered questionnaire on extrapyramidal symptoms, and the General Health Questionnaire (GHQ), a self-administered screening instrument, to detect any psychiatric disorders. Moreover, we invited all 27 dental technicians to undergo a neurological examination and provide a detailed occupational history in our clinic.

Results

Of the 14 subjects who underwent the neurological examination, four had postural tremor and one had a diagnosis of Parkinson's disease.

Conclusion

We found a high prevalence of extrapyramidal signs and symptoms in this group of male dental technicians working in a state technical high school in Rome. We believe that this finding may be due to the presence of toxins in the dental technician's work.
The use of the transition cost accounting system in health services research
Authors: Azoulay Arik , Doris Nadine M , Filion Kristian B , Caron Joanna , Pilote Louise , Eisenberg Mark J
Published: August 2007

The Transition cost accounting system integrates clinical, resource utilization, and financial information and is currently being used by several hospitals in Canada and the United States to calculate the costs of patient care. Our objectives were to review the use of hospital-based cost accounting systems to measure costs of treatment and discuss potential use of the Transition cost accounting system in health services research. Such systems provide internal reports to administrators for formulating major policies and strategic plans for future activities. Our review suggests that the Transition cost accounting information system may useful for estimating in-hospital costs of treatment.
Safety of rFVIIa in hemodynamically unstable polytrauma patients with traumatic brain injury: post hocanalysis of 30 patients from a prospective, randomized, placebo-controlled, double-blind clinical trial
Authors: Kluger Yoram , Riou Bruno , Rossaint Rolf , Rizoli Sandro B , Boffard Kenneth David , Choong Philip Iau Tsau , Warren Brian , Tillinger Michael
Published: August 2007

Background

Trauma is a leading cause of mortality and morbidity, with traumatic brain injury (TBI) and uncontrolled hemorrhage responsible for the majority of these deaths. Recombinant activated factor VIIa (rFVIIa) is being investigated as an adjunctive hemostatic treatment for bleeding refractory to conventional replacement therapy in trauma patients. TBI is a common component of polytrauma injuries. However, the combination of TBI with polytrauma injuries is associated with specific risk factors and treatment modalities somewhat different from those of polytrauma without TBI. Although rFVIIa treatment may offer added potential benefit for patients with combined TBI and polytrauma, its safety in this population has not yet been assessed. We conducted a post hoc sub analysis of patients with TBI and severe blunt polytrauma enrolled into a prospective, international, double-blind, randomized, placebo-controlled study.

Methods

A post hoc analysis of study data was performed for 143 patients with severe blunt trauma enrolled in a prospective, randomized, placebo-controlled study, evaluating the safety and efficacy of intravenous rFVIIa (200 + 100 + 100 μg/kg) or placebo, to identify patients with a computed tomography (CT) diagnosis of TBI. The incidences of ventilator-free days, intensive care unit-free days, and thromboembolic, serious, and adverse events within the 30-day study period were assessed in this cohort.

Results

Thirty polytrauma patients (placebo, n = 13; rFVIIa, n = 17) were identified as having TBI on CT. No significant differences in rates of mortality (placebo, n = 6, 46%, 90% confidence interval (CI): 22% to 71%; rFVIIa, n = 5, 29%, 90% CI: 12% to 56%; P = 0.19), in median numbers of intensive care unit-free days (placebo = 0, rFVIIa = 3; P = 0.26) or ventilator-free days (placebo = 0, rFVIIa = 10; P = 0.19), or in rates of thromboembolic adverse events (placebo, 15%, 90% CI: 3% to 51%; rFVIIa, 0%, 90% CI: 0% to 53%; P = 0.18) or serious adverse events (placebo, 92%, 90% CI: 68% to 98%; rFVIIa, 82%, 90% CI: 60% to 92%; P = 0.61) were observed between treatment groups.

Conclusion

The use of a total dose of 400 (200 + 100 + 100) μg/kg rFVIIa in this group of hemodynamically unstable polytrauma patients with TBI was not associated with an increased risk of mortality or with thromboembolic or adverse events.
Human immature monocyte-derived dendritic cells produce and secrete α-defensins 1–3
Authors: Rodríguez-García Marta , Oliva Harold , Climent Núria , García Felipe , Gatell José M , Gallart Teresa
Published: August 2007

Defensins are effector molecules of the innate immunity with a broad antimicrobial spectrum, including HIV. They also link innate and adaptive immunity, displaying chemotactic activity for monocytes, T cells, and dendritic cells (DCs). α-Defensins 1–3 are mainly produced by neutrophils, but their production by other leukocyte subsets has also been reported. Herein, we studied whether monocyte-derived DCs (MDDCs), which are regarded as a model for myeloid DCs, produce α-defensins 1–3. We found that immature MDDCs (imMDDCs) produce α-defensins 1–3 mRNA, but this production is undetectable or barely detectable following 48 h of maturation with the proinflammatory cytokine cocktail (IL-1β+IL-6+TNF-α) or LPS. It is surprising that α-defensins 1–3 production was up-regulated when exposed to each one of the proinflammatory cytokines alone, especially IL-1β. α-Defensins 1–3 produced by imMDDCs were mainly secreted peptides. Production and secretion of α-defensins 1–3 by imMDDCs can have biological relevance for the antigen processing of pathogens and can contribute to understanding differences in susceptibility to infections, an issue of special interest in the field of HIV infection.
Time-Dependent Prognostic Scoring System for Predicting Survival and Leukemic Evolution in Myelodysplastic Syndromes
Authors: Malcovati Luca , Germing Ulrich , Kuendgen Andrea , Della Porta Matteo G. , Pascutto Cristiana , Invernizzi Rosangela , Giagounidis Aristoteles , Hildebrandt Barbara , Bernasconi Paolo , Knipp Sabine , Strupp Corinna , Lazzarino Mario , Aul Carlo , Cazzola Mario
Published: August 2007

Purpose

The aims of this study were to identify the most significant prognostic factors in myelodysplastic syndromes (MDS) taking into account both their values at clinical onset and their changes in time and to develop a dynamic model for predicting survival and leukemic evolution that can be applied at any time during the course of the disease.

Patients and Methods

We studied a learning cohort of 426 MDS patients diagnosed at the Department of Hematology, San Matteo Hospital, Pavia, Italy, between 1992 and 2004, and a validation cohort of 739 patients diagnosed at the Heinrich-Heine-University Hospital, Düsseldorf, Germany, between 1982 and 2003. All patients were reclassified according to WHO criteria. Univariable and multivariable analyses were performed using Cox models with time-dependent covariates.

Results

The most important variables for the prognostic model were WHO subgroups, karyotype, and transfusion requirement. We defined a WHO classification–based prognostic scoring system (WPSS) that was able to classify patients into five risk groups showing different survivals (median survival from 12 to 103 months) and probabilities of leukemic evolution (P < .001). WPSS was shown to predict survival and leukemia progression at any time during follow-up (P < .001), and its prognostic value was confirmed in the validation cohort.

Conclusion

WPSS is a dynamic prognostic scoring system that provides an accurate prediction of survival and risk of leukemic evolution in MDS patients at any time during the course of their disease. This time-dependent system seems particularly useful in lower risk patients and may be used for implementing risk-adapted treatment strategies.
Impact of Complete Response to Chemotherapy on Overall Survival in Advanced Colorectal Cancer: Results From Intergroup N9741
Authors: Dy Grace K. , Krook James E. , Green Erin M. , Sargent Daniel J. , Delaunoit Thierry , Morton Roscoe F. , Fuchs Charles S. , Ramanathan Ramesh K. , Williamson Stephen K. , Findlay Brian P. , Pockaj Barbara A. , Sticca Robert P. , Alberts Steven R. , Pitot Henry C. , Goldberg Richard M.
Published: August 2007

Purpose

To evaluate clinical characteristics and survival outcomes among patients with locally advanced or metastatic colorectal cancer who achieve a complete response (CR) to systemic treatment either alone or with multimodality approach.

Patients and Methods

Data were collected retrospectively from CRC patients enrolled onto the phase III trial N9741, a National Cancer Institute–funded and Gastrointestinal Cancer Intergroup–sponsored study coordinated by the North Central Cancer Treatment Group. Patients were randomly assigned to combinations of oxaliplatin, fluorouracil (FU)/leucovorin (LV) and irinotecan. The three treatment arms consist of IFL (irinotecan + FU/LV), FOLFOX4 (oxaliplatin + FU/LV), and IROX (irinotecan + oxaliplatin). Median follow-up was 42.6 months.

Results

Sixty-two (4%) of 1,508 patients had a CR to chemotherapy alone, and an additional 32 (2%) had a CR after multimodality treatment. Factors associated with achieving CR with systemic chemotherapy alone included FOLFOX4 treatment, patients with assessable disease, or a single site of metastasis. Continuing protocol treatment beyond two cycles after documentation of CR was not associated with improved survival. The rate of curative intent resection was significantly higher for patients treated with oxaliplatin-containing regimens (P = .02). Median survival was similar between patients with CR after chemotherapy alone (44.3 months) or after multimodality approach (47.4 months; P = .81).

Conclusion

FOLFOX4 was more likely to produce a CR than were IFL or IROX. Oxaliplatin regimens were more likely to result in successful surgical resections. Patients who have CR to systemic chemotherapy alone can achieve impressive survival outcomes similar to those seen among patients who attained a CR status after multimodality treatment.
Donepezil for Cancer Fatigue: A Double-Blind, Randomized, Placebo-Controlled Trial
Authors: Bruera Eduardo , El Osta Badi , Valero Vicente , Driver Larry C. , Pei Be-Lian , Shen Loren , Poulter Valerie A. , Palmer J. Lynn
Published: August 2007

Purpose

To evaluate the effectiveness of donepezil compared with placebo in cancer patients with fatigue as measured by the Functional Assessment for Chronic Illness Therapy–Fatigue (FACIT-F).

Patients and Methods

Patients with fatigue score ≥ 4 on a scale of 0 to 10 (0 = no fatigue, 10 = worst possible fatigue) for more than 1 week were included. Patients were randomly assigned to receive donepezil 5 mg or placebo orally every morning for 7 days. A research nurse contacted the patients by telephone daily to assess toxicity and fatigue level. All patients were offered open-label donepezil during the second week. FACIT-F and/or the Edmonton Symptom Assessment System (ESAS) were assessed at baseline, and days 8, 11, and 15. The FACIT-F fatigue subscale score on day 8 was considered the primary end point.

Results

Of 142 patients randomly assigned to treatment, 47 patients in the donepezil group and 56 in the placebo group were assessable for final analysis. Fatigue intensity improved significantly on day 8 in both donepezil and placebo groups. However, there was no significant difference in fatigue improvement by FACIT-F (P = .57) or ESAS (P = .18) between groups. In the open-label phase, fatigue intensity continued to be low as compared with baseline. No significant toxicities were observed.

Conclusion

Donepezil was not significantly superior to placebo in the treatment of cancer-related fatigue.
Tyramine-Mediated Activation of Sympathetic Nerves Inhibits Insulin Secretion in Humans
Authors: Gilliam Lisa K. , Palmer Jerry P. , Taborsky Gerald J.
Published: August 2007

Context: Older studies have shown that high doses of norepinephrine infused into human subjects can inhibit insulin secretion. Similar inhibition during electrical stimulation of sympathetic nerves in animals raises the possibility that the suppression of insulin secretion seen in humans could reflect a physiological effect of sympathetic nerves on islet β-cells. However, a direct test of the hypothesis that moderate and selective activation of these nerves is sufficient to inhibit insulin secretion in humans is lacking.

Objective: We sought to test this hypothesis by releasing moderate amounts of endogenous norepinephrine selectively from the sympathetic nerves of normal human subjects by infusing them with low doses of the indirect sympathomimetic agent tyramine.

Methods: During a single study visit, 11 healthy subjects received iv injections of arginine either alone or in combination with a low-dose tyramine infusion. Physiological (blood pressure) and biochemical (insulin, glucose, and norepinephrine) parameters were measured.

Results: The acute insulin response to arginine was significantly reduced during tyramine compared with that seen in the absence of tyramine (P = 0.036).

Conclusions: These data suggest that moderate and selective activation of sympathetic nerves inhibits insulin release in humans.
The RhoA effector mDiaphanous regulates MyoD expression and cell cycle progression via SRF-dependent and SRF-independent pathways
Authors: Gopinath Suchitra Devi , Narumiya Shuh , Dhawan Jyotsna
Published: August 2007

Expression of the key muscle transcription factor MyoD is regulated by RhoA GTPase, which is an important regulator of adhesion-dependent signaling. We show that mDiaphanous (mDia) – an adaptor protein that mediates the effects of RhoA on cell motility and the cytoskeleton – is an upstream regulator of MyoD in C2C12 mouse myoblasts. Knockdown of mDia1 reduced MyoD expression and proliferation via a serum-response factor (SRF)-dependent pathway. Surprisingly, overexpression of a Rho-independent form of mDia1 (mDiaΔN3), despite activating SRF, also suppressed MyoD and the cell cycle, suggesting the presence of a second pathway downstream of mDia1. We present evidence that the alternative pathway by which mDia1 regulates MyoD involves T-cell factor (TCF)/lymphoid enhancer factor (LEF) and its co-activator, β-catenin. TCF activity was suppressed by mDiaΔN3 and induced by silencing mDia. mDiaΔN3 disrupted the signal-dependent nuclear localization of β-catenin and suppressed MyoD expression. Co-expression of a degradation-resistant form of β-catenin with mDiaΔN3 restored MyoD expression, suggesting a mechanistic link between the two signaling proteins. We also implicate a region encompassing the FH1 domain of mDia1 in β-catenin-TCF regulation. Taken together, our results suggest that a balance between two pathways downstream of mDia regulates MyoD expression and cell cycle progression.
Calcineurin is essential for depolarization-induced nuclear translocation and tyrosine phosphorylation of PYK2 in neurons
Authors: Faure Camille , Corvol Jean-Christophe , Toutant Madeleine , Valjent Emmanuel , Hvalby Øivind , Jensen Vidar , El Messari Said , Corsi Jean-Marc , Kadaré Gress , Girault Jean-Antoine
Published: August 2007

Proline-rich tyrosine kinase 2 (PYK2) is a non-receptor tyrosine kinase expressed in many cell types and enriched in neurons. PYK2 is a cytoplasmic enzyme activated by increases in cytosolic free Ca2+ through an unknown mechanism. We report that depolarization or electrical stimulation of hippocampal slices induced a rapid and transient nuclear accumulation of PYK2. Depolarization of cultured neurons or PC12 cells also triggered a Ca2+-dependent nuclear accumulation of PYK2, much more pronounced than that induced by blockade of nuclear export with leptomycin B. Src-family kinase activity, PYK2 autophosphorylation and kinase activity were not required for its nuclear translocation. Depolarization induced a slight decrease in PYK2 apparent molecular mass, compatible with a Ca2+-activated dephosphorylation. Pretreatment of PC12 cells with inhibitors of calcineurin (protein phosphatase 2B), cyclosporin A and FK506, prevented depolarization-induced nuclear translocation and tyrosine phosphorylation of PYK2. Transfection with dominant-negative and constitutively active calcineurin-A confirmed the role of calcineurin in the regulation of PYK2 tyrosine phosphorylation and nuclear accumulation. Our results show that depolarization independently induces nuclear translocation and tyrosine phosphorylation of PYK2, and that both responses require calcineurin activation. We suggest that PYK2 exerts some of its actions in the nucleus and that the effects of calcineurin inhibitors may involve PYK2 inhibition.
Current management of popliteal fossa incompetent superficial venous systems
Authors: Kambal A , Bicknell C , Najem M , Renton S , Hussain S T
Published: August 2007

Objectives: Controversy exists regarding the management of varicose veins at the level of the popliteal fossa. This questionnaire reviews the current practice of vascular surgeons.

Methods: A postal questionnaire was sent to 440 consultant surgeon members of the Vascular Society of Great Britain and Ireland. Recipients were asked to indicate their current practice of investigation and management of small saphenous (SSV), gastrocnemius and Giacomini varicosities.

Results: We have received 296 (67%) responses to the questionnaire. Duplex scanning is utilized by 275 (93%) for the initial assessment of patients. Preoperatively, 188 (64%) reuse duplex scanning to mark the saphenopopliteal junction (SPJ) site, 53 (18%) mark with handheld Doppler only and 24 (8%) do not mark the SPJ. At operation, 198 (67%) flush ligate the SPJ and 87 (29%) tie the SSV 2–3 cm from the junction. A total of 101 (34%) usually strip the SSV to various levels. In symptomatic patients, 158 (53%) ligate the SPJ when an incompetent segment of SSV with a competent SPJ exists. One hundred and sixty-nine (57%) disconnect incompetent gastrocnemius veins during SPJ surgery and 172 (58%) regularly look for the Giacomini vein. Routine follow-up after surgery is practised by 172 (58%), most commonly at six weeks. This is mostly (88%) by clinical examination, with 14 (8.1%) using duplex scanning and six (4.7%) using a nurse-run clinic for the follow-up.

Conclusions: This review suggests marked variation in the management of popliteal fossa venous incompetence. There is a clear need for further research to clarify the role of ablation in the management of symptoms and skin changes.
Restless legs syndrome in patients with chronic venous disorders: an untold story
Authors: McDonagh B , King T , Guptan R C
Published: August 2007

Objectives: To prospectively study the profile of restless leg syndrome (RLS) in patients presenting to a phlebology practice.

Methods: The study uses prospective questionnaire and clinical observation study. In all, 174 consecutive patients and 174 matched controls were evaluated in detail. The diagnosis of restless legs syndrome (RLS) was established by the International RLS study group (IRLSSG) criteria. Detailed clinical, systemic and Duplex ultrasound evaluations were done to establish the presence of chronic venous disorders (CVD) (reflux > 0.5s on augmentation manoeuvers and revised clinical, aetiological, anatomical and pathological [CEAP] criteria).

Results: Of the 174 consecutive subjects studied (22M: 152F), 63 (36%) had evidence of RLS compared with only 34 of 174 of the controls (19%, P <0.05). Sixty-two (98%) of these RLS-positive study subjects were subsequently diagnosed with CVD. In comparison, 31 (91%) of the RLS-positive control subjects ( n = 34) were found to have CVD. This prevalence of CVD was comparable with RLS-positive study subjects, but was significantly higher than the prevalence in CVD in RLS-negative controls ( P <0.01). Only three (9%) of the controls had RLS without CVD. RLS-positive subjects were typically women above the age of 40 years ( P <0.01 vs. men, P <0.01 vs. below 40 years). A significant difference in clinical presentation in the study subjects was the high prevalence of leg cramps in the RLS-positive subjects ( P <0.01). None of the patients with RLS in this series gave history of anaemia, chronic renal failure or an established psychiatric or neurological disease as found pathognomic for RLS by others.

Conclusions: RLS appears to be a common overlapping clinical syndrome in patients with CVD. Prospective blinded therapeutic trials are planned to study the influence of definitive treatments for CVD on sequential RLS scores.
Development of a consultation and teaching concept for leg wound treatment in home health care
Authors: Jönsson Ann-Marie , Willman Ania
Published: August 2007

We developed a consultation and teaching concept about leg wounds and their care, for use by patients and caregivers in a home health-care setting. Descriptive data were gathered through a survey distributed to three groups, comprising 21 individuals (18 nurses and 3 health administrators). These participants provided answers regarding group activities, meeting frequency, meeting notes and meeting content, as well as responses to questions regarding the Website, Web materials, film and a pamphlet. Seventeen people answered the survey (81% response rate). They made predominantly positive comments. The combined total average score was 3.6 (1=very bad to 4=very good). The concept was implemented in one municipality in a health-care region in southern Sweden using high bandwidth videophones (640 kbit/s). The results showed that elderly persons at home and nurses working in home health care were interested in using the concept and communicating via videophone. A strength of the Web-based information and communication material is its adaptability to suit both patients and care givers.
An economic evaluation of a telehealth network in British Columbia
Authors: Schaafsma Joseph , Pantazi Stefan V , Moehr Jochen R , Anglin Christine R , Grimm Nicole A
Published: August 2007

We carried out an economic evaluation of the northernmost five sites of the British Columbia telehealth network. The videoconferencing network links health-care facilities in 12 communities with Vancouver, for clinical consultations, administrative meetings and educational sessions. The economic evaluation was based on the netcost criterion (i.e. cost of telehealth minus travel costs avoided). Cost and utilization data were obtained from client interviews and log data compiled between September 2001 and January 2003. The results showed that the subnetwork of five sites was not only cost reducing, but also cost-effective. Travel costs for administrative meetings were reduced by $724,457/annum and were greater than the annual fixed and variable costs of all the telehealth sessions ($553,740). A sensitivity analysis was conducted on six parameters: amortization period, opportunity cost of capital, operating cost of a telehealth session (by type of session), number of telehealth sessions, travel time and the opportunity cost of travel time. The study suggests that the cost-effectiveness of telehealth to remote areas will increase over time as the cost of equipment continues to fall, as network connections become cheaper and as utilization rates rise.
Physical rehabilitation using telemedicine
Authors: Russell Trevor G
Published: August 2007

Telerehabilitation is the provision at a distance of rehabilitation services such as physiotherapy, speech pathology or occupational therapy. The primary aim is to provide equitable access to rehabilitation services. Broadly speaking, the technologies used for telemedicine-based physical rehabilitation can be classified as: (1) image-based telerehabilitation; (2) sensor-based telerehabilitation; and (3) virtual environments and virtual reality telerehabilitation. To date, much of the research has been technology focused, and has consisted of single case or small sample research designs. The next step is to demonstrate viable telerehabilitation services in real world environments using well controlled research methodologies with large patient cohorts. In addition, the broader issues of cost-benefit and cost-effectiveness require investigation. If this can be done, then the undoubted potential benefits of telerehabilitation, for both the patient and health-care systems, can be realized.
Audiology telemedicine
Authors: Krumm Mark
Published: August 2007

Various real-time telemedicine applications have been investigated in audiology, including pure tone audiometry, otoacoustic emission testing, auditory brainstem response recordings, hearing aid fitting and video-otoscopy. Store-and-forward applications have usually been used to transmit basic patient data including case history information and hearing screening results, although both video-nystagmography and video-otoscopy have been piloted. Remote access to computerized equipment is relevant to audiology telemedicine, although there have been few reports of the use of application sharing using computerized audiology equipment. In a pilot trial of real-time telemedicine, both pure tone and speech audiometry measures were provided remotely through application sharing. Audiology telemedicine appears promising, but it is at an early stage of development and many areas such as its cost effectiveness, patient acceptance and test efficacy require systematic investigation.
An analysis of business issues in a telestroke project
Authors: Cho Sunyoung , Khasanshina Elena V , Mathiassen Lars , Hess David C , Wang Sam , Stachura Max E
Published: August 2007

A telehealth network based at the Medical College of Georgia was established in 2003 to treat stroke patients in remote hospitals. In the first three years, more than 400 patients were evaluated at nine rural hospitals. A total of 65 patients (16%) were treated with tissue plasminogen activator (approximately half of them in less than 2 h). Although clinically successful, the system reached the point at which it would either further diffuse or die out. We examined the roles played by internal and external factors in the development of the system. We interviewed 25 individuals in five hospitals (the hub hospital and four rural hospitals). Important business issues were identified that would need to be addressed in order to expand the project and make it self-sustaining. The external factors were economic, legal and market issues. The internal factors were organizational, technical and educational issues. Early identification and negotiation of business issues related to project implementation are likely to be important in diffusion and sustainability.
The STARPAHC collection: part of an archive of the history of telemedicine
Authors: Freiburger Gary , Holcomb Mary , Piper Dave
Published: August 2007

An early telemedicine project involving NASA, the Papago Tribe (now the Tohono O'odham Indian Nation), the Lockheed Missile and Space Company, the Indian Health Service and the Department of Health, Education and Welfare explored the possibilities of using technology to provide improved health care to a remote population in southern Arizona. The project, called STARPAHC (Space Technology Applied to Rural Papago Advanced Health Care), took place in the 1970s and demonstrated the feasibility of a consortium of public and private partners working together to provide medical care to remote populations via telecommunication. In 2001 the Arizona Health Sciences Library acquired important archival materials documenting the STARPAHC project and in collaboration with the Arizona Telemedicine Program established the Arizona Archive of Telemedicine. The material is likely to interest those studying early attempts to use technology to deliver health care at a distance, as well as those studying the sociological ramifications of technical and scientific projects among indigenous populations.
Care coordination and telemedicine improves glycaemic control in ethnically diverse veterans with diabetes
Authors: Dang Stuti , Ma Fangchao , Nedd Nicole , Florez Hermes , Aguilar Enrique , Roos Bernard A
Published: August 2007

We conducted a pilot study of a care-coordination programme involving daily monitoring and education of elderly diabetic veterans from different racial/ethnic groups. A telephone-based, in-home messaging device was used for patient monitoring and education. Sixty-nine patients were enrolled in the study and HbA1c values were obtained both before and after the telemedicine intervention in 41 of them. The mean HbA1c before enrolment was 7.6% and the mean value 9 months later was 7.3% ( P = 0.09). The greatest fall in HbA1c occurred in African-Americans (0.65%, P = 0.05). The total number of hospital admissions decreased from 31 pre-enrolment to 25 post-enrolment ( P = 0.0002). Bed days of care decreased from 368 to 149 ( P = 0.0002). Care coordination, facilitated by telemedicine, appeared to improve glycaemic control in veterans with diabetes from diverse ethnic backgrounds, particularly African-Americans. This may reduce health-care resource utilization.
A systematic review of research methodology in telemedicine studies
Authors: Whitten Pamela , Johannessen Liv Karen , Soerensen Tove , Gammon Deede , Mackert Michael
Published: August 2007

We conducted a systematic review of 15 relevant databases for articles about telemedicine. After eliminating articles that did not meet the inclusion criteria, 1615 remained for analysis. Three raters coded the articles to assess various theoretical and methodological variables. Only 5% ( n = 85) of the telemedicine articles made mention of any theory or paradigmatic approach. Studies commonly reported the objectives (96%) but rarely stated a research question or hypothesis (11%). Randomized selection of the subjects was reported in 11% of patient studies and 4% of studies where providers were the subject. There was a wide range in the number of subjects employed, although the majority of studies were based on sample sizes of less than 100. Only 26% of the studies reported a time frame. Until the telemedicine field adheres to agreed standards of reporting methodological details it will be difficult to draw firm conclusions from review studies.
Risk Factors for Developing Gadolinium-Induced Nephrogenic Systemic Fibrosis
Authors: Peak Amy S , Sheller Amy
Published: August 2007

Objective:

To identify medications and other potential risk factors, in addition to renal dysfunction, for developing gadolinium-induced nephrogenic systemic fibrosis (NSF).

Data Sources:

Information was obtained from PubMed, International Pharmaceutical Abstracts, Iowa Drug Information Service, and Google Scholar, using the unlimited search terms nephrogenic systemic fibrosis, NSF, nephrogenic fibrosing dermopathy, NFD, gadolinium, gadodiamide, gadoversetamide, gadopentetate, gadobenate, and gadoteridol. Information was also obtained from the Food and Drug Administration, as well as the manufacturers of the above-mentioned products. Data were collected during April and May 2007.

Study Selection and Data Extraction:

All identified articles and information were evaluated. Articles and other information that included data regarding concurrent medications, disease states, and other risk factors for developing gadolinium-induced NSF were included in this review, as were clinical practice guidelines.

Data Synthesis:

NSF is a mysterious and severe disorder that occurs in individuals with severe renal impairment. Virtually all cases of NSF have been associated with the administration of gadolinium-containing contrast media. However, not all renally impaired patients who receive gadolinium develop NSF. Thus, additional risk factors for the development of NSF have been suggested. These risk factors include medications that could cause transmetallation of gadolinium, medications that could cause acidosis, and high doses of erythropoietin. Concomitant medical conditions, including hyperphosphatemia, acidosis, recent surgery, hepatic disease, hypercoagulability, and proinflammatory processes may also predispose patients to NSF.

Conclusions:

Gadolinium-based contrast agents should be avoided in patients with significant renal impairment unless the benefits clearly outweigh the risks. If gadolinium is required, nonionic linear chelates (eg, gadodiamide, gadoversetamide) should not be used. Renally impaired individuals who require gadolinium should be screened proactively for underlying disease states and concomitant drugs that may increase their risk of developing NSF; therapy should be adjusted accordingly.
Sex differences in help‐seeking appear in early childhood
Authors: Benenson Joyce F. , Koulnazarian Manouchak
Published: August 2007

This study tested the hypothesis that sex differences in help‐seeking, which have been obtained consistently with adults and adolescents, would appear in early childhood. To this end, 32 girls and 32 boys aged 3 and 6 years from lower and upper‐middle socio‐economic class schools were asked to perform four tasks (drawing an animal, building a house with blocks, piecing together a puzzle, and matching sounds) in the presence of a male or female adult. After explaining each task, the adult offered help to the child. Latencies to request help were significantly lower for girls than boys across both age and socio‐economic levels. The implications of sex differences in latencies to obtain help are discussed.
Toward a Description of Deaf College Students' Written English: Overuse, Avoidance, and Mastery of Function Words
Authors: Channon Rachel , Sayers Edna Edith
Published: August 2007

The use of function words in 135 essays written by deaf college underclassmen in developmental and credit-bearing English composition classes is described and compared with Standard English (SE) versions of the same essay. If student and SE versions were the same, this was considered mastery; if the student omitted a word, this was considered avoidance; and if the student added a word, this was considered overuse. The deaf students varied from SE more for function than for content words. They demonstrated low mastery of independent clause markers, demonstratives, third-person singular neuter pronouns, and modals related to possibility, but had relatively high mastery of the first-person singular, and some punctuation. These students strongly avoided some dependent clause markers, some demonstratives, the indefinite article, punctuation except for periods and commas, and the modal verbs may, might and should, but greatly overused other dependent clause markers, the second person and third-person neuter pronouns, quantifiers, the verb do, and the modals could and will. They were also more likely to produce run-ons than fragments.
Post-release Case Management Services and Health-Seeking Behavior Among HIV-Infected Ex-Offenders
Authors: Jacob Arriola Kimberly R , Braithwaite Ronald L. , Holmes Elizabeth , Fortenberry Renata M
Published: August 2007

This study explores whether being met at the gate by a case manager is associated with more health-seeking behavior during the six months post-release among HIV-infected inmates transitioning from the facility to the community. Case managers documented whether clients were met at the gate upon release. Clients (N=226) underwent a structured interview at approximately six months post-release. One hundred and four clients were met at the gate upon release (46%). Results indicate that clients who were met at the gate were more likely to participate in drug or alcohol treatment (p≤.01) and not engage in sex exchange during the subsequent six months (p≤.05). Health-seeking behavior prior to incarceration, facility type, and state were controlled for. Being met at the gate was not significantly associated with reduced emergency room use or using street drugs. Findings offer support for the importance of establishing early post-release contact with a case manager among HIV-infected ex-offenders.
HIV-infected Injection Drug Users: Health Care Utilization and Morbidity
Authors: Barash Elizabeth Tesh , Hanson Debra L , Buskin Susan E , Teshale Eyasu
Published: August 2007

Background. About one-third of HIV-infected people in the U.S. have a history of injection drug use (IDU). To examine disparities in health care, we compared health care utilization and morbidity of IDUs and non-IDUs. Methods. A large national cohort of people receiving HIV care was used to compare IDU and non-IDU inpatient, outpatient, and emergency room (ER) visits and other standards of care. We also compared prevalence of HIV-related illnesses. Results. Injection drug users were older and more frequently female, non-White, and publicly insured than non-IDUs. Injection drug users were more than twice as likely to have one or more ER visits annually and almost twice as likely to be hospitalized. CD4 and viral load testing was half as likely to be performed for IDUs in a six-month period. Injection drug users were significantly more likely to have HIV-related morbidity. Conclusions. Health care associated with injection drug use may not be adequately addressed in the outpatient setting. The benefits of broadening the scope of primary HIV care should be examined.
Leaving Medicaid without Health Insurance: TANF Policies and Recipients' Vulnerabilities
Authors: Cheng Tyrone
Published: August 2007

This study identifies factors predicting health insurance coverage of TANF recipients leaving Medicaid programs. A sample of 785 Medicaid spells of enrollment by able-bodied, non-elderly adults is drawn from a national survey. Employing event history analysis and multinomial logistic regression, the study finds that those who left Medicaid were three times more likely to become uninsured than to become privately insured. Recipients leaving TANF were 24 times more likely to leave Medicaid than to remain on Medicaid. The impact of leaving TANF upon becoming uninsured was moderated by restrictive TANF policies. Recipients who were White and employed part-time were 41–42% more likely to become uninsured than were their counterparts. A high unemployment rate increased a recipient's chance of becoming uninsured by 27.5%. Married people, African Americans, those with full-time jobs, and those with earnings above the poverty line were at least 32% more likely to acquire private coverage than their respective counterparts.
Recently Released with HIV/AIDS: Primary Care Treatment Needs and Experiences
Authors: Fontana Leonard , Beckerman Adela
Published: August 2007

The research objectives of this study are to describe the re-entry experiences of people recently released from jail who were living with HIV/AIDS, and to identify factors that influence their access to primary care and adherence to a treatment regimen. The research used a mixed-method, qualitative and quantitative research design. The findings indicate that the overall instability in the lives of many of the former inmates studied hampered their ability to attend to their HIV/AIDS-related health care needs. Most former inmates returned to the community with co-occurring problems related to housing and substance abuse. Complicating their access to health care were fragmented health care and correctional systems. The study highlights the need for coordination and collaboration between correctional facilities and community-based health care and human service providers that leads to a deliberative and planned transition from jail to service systems in the community.
Outreach to Immigrant Communities: Teaching Pediatric Residents about Access to Health Care
Authors: Karp Robert J , Rhee David , Feldman David , Bouchkouj Najat
Published: August 2007

Twenty-seven pediatric residents were assessed for knowledge, attitudes, and behaviors regarding rights of immigrant families. A program documenting immigrant rights was reinforced in the clinic with posters and individual consultations on immigrant children's needs. This brief program was effective in instructing residents on health and nutritional services for immigrant patients.