bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Oral Steroids in the Treatment of Phonotraumatic Vocal Fold Lesions in Women
Authors: Amin Milan R. , Achlatis Stratos , Gherson Shirley , Fang Yixin , Wang Binhuan , Born Hayley , Branski Ryan C. , Johnson Aaron M.
Published: October 2018

Objectives

(1) To determine the short‐term effectiveness of oral steroids in women with benign vocal fold lesions and (2) to determine the effectiveness of adjuvant oral steroids in women undergoing voice therapy for benign vocal fold lesions.

Study Design

Randomized, double‐blind, placebo‐controlled clinical trial.

Setting

Tertiary voice care center.

Subjects and Methods

Thirty‐six patients undergoing voice therapy for the treatment of phonotraumatic vocal fold lesions randomly received either a 4‐day course of oral steroids or a placebo prior to initiating voice therapy. Voice Handicap Index–10 (VHI‐10) scores, video and audioperceptual analyses, acoustic and aerodynamic analyses at baseline, and patient perception of improvement after a short course of steroids or a placebo and at the conclusion of voice therapy were collected.

Results

Thirty patients completed the study, of whom 27 (only female) were analyzed. The primary outcome measure, VHI‐10, did not improve after the 4‐day course of steroids or placebo. Secondary measures similarly showed no improvement with steroids relative to placebo. Voice therapy demonstrated a positive effect on both VHI‐10 and patient‐perceived improvement of voice in all subjects.

Conclusion

A short course of oral steroids did not benefit women with phonotraumatic vocal fold lesions. In addition, steroids had little beneficial effect when used adjunctively with voice therapy in this patient cohort.
Spectroscopic Analysis of Human Tracheal Tissue during Decellularization
Authors: Tint Derrick , Stabler Collin T. , Hanifi Arash , Yousefi Farzad , Linkov Gary , Hy Kenneth , Soliman Ahmed M. S. , Pleshko Nancy
Published: October 2018

Objective

To use mid‐infrared (IR) spectroscopy to assess changes in the cartilaginous framework of human trachea during decellularization.

Study Design

Laboratory‐based study.

Setting

Research laboratory.

Methods

Six cadaveric human tracheas were decellularized using a detergent enzymatic method (DEM). Tissue samples were obtained from each specimen after 0, 1, 10, and 25 DEM cycles for histologic and spectroscopic analysis. Decellularization was confirmed using hematoxylin and eosin (H&E) and 2‐(4‐amidinophenyl)‐1H‐indole‐6‐carboxamidine (DAPI) staining. Changes in cartilaginous framework were examined using Fourier transform infrared imaging spectroscopy (FT‐IRIS) and an attenuated total reflectance (ATR) probe in the mid‐IR frequencies. Results were statistically analyzed using 1‐way analysis of variance (ANOVA) and principal component analysis (PCA).

Results

Six decellularized tracheal scaffolds were successfully created using a DEM protocol. Histologic examination showed near‐complete nuclear loss following 25 DEM cycles. As observed with FT‐IRIS analysis, the collagen absorbance signal (1336 cm−1) was predominantly in the perichondria and remained stable after 25 DEM cycles (P =. 132), while the absorbance from sugar rings in proteoglycans and nucleic acids in hyaline cartilage (1080 cm−1) showed a significant decrease after 1 DEM cycle (P =. 0007). Examination of the luminal surface of the trachea with an ATR probe showed raw mid‐IR spectra consistent with cartilage. PCA showed significant separation of spectra corresponding to treatment cycle along the principal components 1 and 2.

Conclusion

Mid‐IR spectroscopy is a viable method of monitoring changes in extracellular matrix components during the decellularization of human trachea.
Standardizing Laryngeal Cleft Evaluations: Reliability of the Interarytenoid Assessment Protocol
Authors: Coppess Steven , Padia Reema , Horn David , Parikh Sanjay R. , Inglis Andrew , Bly Randall , Dahl John , Dudley Daniel , Johnson Kaalan
Published: October 2018

Objective

While the Benjamin‐Inglis classification system is widely used to categorize laryngeal clefts, it does not clearly differentiate a type 1 cleft from normal anatomy, and there is no widely accepted or validated protocol for systematically evaluating interarytenoid mucosal height. We sought to propose the interarytenoid assessment protocol as a method to standardize the description of the interarytenoid anatomy and to test its reliability.

Study Design

Retrospective review of endoscopic videos.

Setting

Pediatric academic center.

Subjects and Methods

The interarytenoid assessment protocol comprises 4 steps for evaluation of the interarytenoid region relative to known anatomic landmarks in the supraglottis, glottis, and subglottis. Thirty consecutively selected videos of the protocol were reviewed by 4 otolaryngologists. The raters were blinded to identifying information, and the video order was randomized for each review. We assessed protocol completion times and calculated Cohen's linear‐weighted κ coefficient between blinded expert raters and with the operating surgeon to evaluate interrater/intrarater reliability.

Results

Median age was 4.9 years (59 months; range, 1 month to 20 years). Median completion time was 144 seconds. Interrater and intrarater reliability showed substantial agreement (interrater κ = 0.71 [95% confidence interval (CI), 0.55‐0.87]; intrarater mean κ = 0.70 [95% CI, 0.59‐0.92/rater 1, 0.47‐0.85/rater 2]; P <. 001). Comparing raters to the operating surgeon demonstrated substantial agreement (mean κ = 0.62; 95% CI, 0.31‐0.79/rater 1, 0.48‐0.89/rater 2; P <. 001).

Conclusion

The interarytenoid assessment protocol appears reliable in describing interarytenoid anatomy. Rapid completion times and substantial interrater/intrarater reliability were demonstrated. Incorporation of this protocol may provide important steps toward improved standardization in the anatomic description of the interarytenoid region in pediatric dysphagia.
Management of Rhinitis Medicamentosa: A Systematic Review
Authors: Zucker Shana M. , Barton Blair M. , McCoul Edward D.
Published: October 2018

Objective

Rhinitis medicamentosa (RM) is a common condition resulting from overuse of topical nasal decongestants. Despite the prevalence in otolaryngologic practice, a clear treatment protocol has not been established. Our objective was to review the current published literature pertaining to the treatment of RM with the possibility of finding data that support one treatment over another.

Data Sources

PubMed, Embase, Cochrane, and Web of Science databases were examined for patients diagnosed with RM resulting from chronic use of topical nasal decongestants.

Review Methods

The PRISMA standard (Preferred Reporting Items for Systematic Reviews and Meta‐analyses) was utilized to identify English‐language studies reporting treatment of patients with the primary diagnosis of RM after chronic use of a topical decongestant. Outcome measures of interest included patient‐reported symptom relief and objective parameters. MINORS criteria (methodological index for nonrandomized studies) were used to assess the quality of articles.

Results

A total of 350 articles were identified, 9 of which met final inclusion criteria for qualitative analysis. Outcomes defined in each publication were highly varied and relied on several unstandardized measures. The most commonly reported treatment option was topical nasal steroids, although overall there was limited evidence on which to base treatment recommendation.

Conclusions

There is not adequate evidence to develop a standardized treatment protocol for RM. The development of a uniform questionnaire, standard outcomes to be measured, and a method of assessing such outcomes is necessary. Prospective randomized controlled studies are warranted to determine the optimal treatment regimen following diagnosis of RM.
Brexit in Sunderland: The production of difference and division in the UK referendum on European Union membership
Authors: Bromley-Davenport Harry , MacLeavy Julie , Manley David
Published: October 2018

There is a growing narrative that the outcome of the UK referendum on European Union membership was the product of disenfranchisement and disillusionment wrought by the uneven consequences of economic restructuring in different UK regions, cities and communities. Those most likely to vote ‘leave’ were concentrated among those ‘left behind’ by globalisation, whilst those voting ‘remain’ were clustered within more affluent areas and social groups. These uneven geographies of leave and remain voting have been taken to reveal two diametrically opposed groups in British politics, obscuring the messy and contradictory ways in which votes are cast. In seeking to bring these complexities to light, this paper explores the motivating factors behind the Brexit vote amongst older working-class white men in Sunderland, England. The paper shows how economic stagnation and the experience of different forms of marginality led to a nostalgia for times past and a mistrust of political elites amongst this cohort. The paper documents how the feelings expressed by research participants became linked to the European Union project and its real and perceived impacts on the local area. In doing so, it shows that the referendum shaped and changed the electorate by asking them to align themselves with those either for or against Britain’s membership of the EU. The paper concludes by reflecting on the possibilities for creating an inclusive form of politics that treats different responses to the referendum question as the basis for an open conversation about democracy and democratic ideals.
Learning in the face of change: The Dutch National Collaboration Programme on Air Quality
Authors: Busscher Tim , Zuidema Christian , Tillema Taede , Arts Jos
Published: October 2018

Learning is essential in allowing policies and programmes to become adaptive to uncertain and changing circumstances. In this article, we use the case of the Dutch National Collaboration Programme on Air Quality (in Dutch: Nationaal Samenwerkingsprogramma Luchtkwaliteit (NSL)) to argue that the organisation of learning processes influences the extent to which policies and programmes can adapt. Learning is a diverse process that focuses both on improving knowledge of the effects of possible policy strategies and on bargaining and negotiation in which we interpret and make sense of such knowledge. Learning strategies can be organised by either focussing on exploring new ways to understand and approach problems or on exploiting existing knowledge, measures and capabilities by optimising and refining them. To be adaptive, it is important to balance both strategies, as otherwise two main risks might undermine the programmes’ adaptive capacity. First, there is the risk that the implementation of adaptive programmes is constrained by premature consensus, constraining the capacity to learn regarding the suitability of, and agreement on, existing problem definitions and programme goals during programme implementation. Second, there is also the risk of premature programming, constraining the capacity to learn regarding the suitability of the actions and approaches adopted. What makes the NSL such an interesting case study is that while the programme was designed to be adaptive on the basis of an on-going learning process, in practice, it largely failed to do so. On the basis of 67 interviews with stakeholders in the NSL and two focus group discussions, we show that the NSL failed to anticipate both risks. Processes of learning have become marginalised and focused predominantly on exploitation at the expense of exploration. As such, the NSL convincingly shows how a lack of organising learning is constraining the capacity to adapt to changing circumstances and also contributes to its possible failure.
Composing the social factory: An autonomist urban geography of Buenos Aires
Authors: Clare Nick
Published: October 2018

Through the creation of an original theoretical framework, this paper demonstrates the value of a deeper engagement between autonomist Marxism and (urban) geography. By spatialising arguably the autonomists’ key theoretical contribution – class composition – the paper develops the ideas of technical and political spatial compositions. These dialectically intertwined concepts provide a framework with which to analyse the relationships between shifting urban spaces and struggles, and clarity is therefore added to another key autonomist concept, the evocative yet nebulous ‘social factory’. Applying these to Buenos Aires, the paper focuses on various spatial conjunctures, exploring their emergence and the immanent potentials for radical spatial politics they afford and preclude. In particular, the paper provides a detailed reading of the complex role Buenos Aires’ ‘informal’ settlements play in both perpetuating and resisting a neoliberal, financially extractive economy. The benefit of a ‘spatial composition’ framework is twofold: it provides a periodising heuristic with which to originally and usefully approach urban struggles, and, in unpacking the ‘social factory’, it can be applied widely as a form of radical geographical praxis. The paper thus makes important theoretical and empirical contributions to an exciting, emerging autonomist (urban) geography, as well as to studies of Buenos Aires.
Effect of Phenobarbital on Cyclophosphamide Cytotoxic Activity and Pharmacokinetics in Mice
Authors: Donelli Maria Grazia , Vecchi Annunciata , Bossi Adriana , Colombo Tina , Sironi Marina , Pantarotto Claudio , Garattini Silvio , Spreafico Federico
Published: October 2018

The interaction between cyclophosphamide (CPA) and phenobarbital (PB) was investigated in B6D2F, mice, checking both the antileukemic and immunosuppressive activity together with the serum levels of CPA and its metabolites. A reduced cytotoxic activity of CPA has been observed when PB is given for 2 days before CPA and an interval of at least 6 hours elapses between the last treatment of PB and the administration of CPA. On the contrary, when PB is given simultaneously with CPA for 2 or 4 consecutive days, an increased antileukemic activity of CPA occurs. In the experimental condition where PB decreases the activity of CPA, serum levels of CPA, assayed by means of a new specific gas-chromatographic method, and of its NBP-alkylating metabolites, indicate that this effect may be explained on a pure pharmacokinetic basis. However, for the situation where an increased effect of CPA was observed under the influence of PB, pharmacokinetic data did not provide a clear explanation.
Effects of High Doses of Peptichemio upon the Humoral Response to Sheep Erythrocytes and Delayed Hypersensitivity Reactions to Oxazolone in Cba Mice
Authors: Caruso Calogero , Bellavia Angelo , Cillari Enrico , Ascoli Riccardo , Pavone-Macaluso Michele
Published: October 2018

A study has been carried out on the immunosuppressive activity of high doses of peptichemio (PTC) in CBA mice. Humoral response to sheep erythrocytes, delayed hypersensitivity to oxazolone, and cellular proliferation in lymph nodes and spleen of animals sensitized with oxazolone have been investigated. The results demonstrated that PTC had a definite immunosuppressive action, as shown by the inhibition of primary response to inoculation of sheep erythrocytes, by depression of delayed hypersensitivity to oxazolone, and by marked inhibition of 125IUdr incorporation in lymph nodes of sensitized animals. It is suggested that the inhibitory action is mediated by an effect on actively proliferating B or T lymphoid cells, although involvement of macrophages cannot be ruled out.
Allelic Structural Genes for the Expression of Mature or Immature Endogenous Type-C Virus in C57Bl/He and C57BL/6J MICE
Authors: Boiocchi Mauro , Torre Gabriella Della , Porta Giuseppe Della
Published: October 2018

Type C particles produced in a great amount by the exocrine pancreas of normal C57BL mice have been found by electron microscopy to retain their immature morphology in C57BL/6J mice and to develop into the mature form in C57BL/He mice. Examining F1, F2 and Bc1 hybrids between the 2 strains, evidence of a dominant allelism for the immature phenotype was found.
Angiosarcoma of the Breast
Authors: Migliori Elena
Published: October 2018

Two cases of angiosarcoma of the breast are presented. In spite of the often differentiated histologic pattern, this neoplasm is highly malignant and has a very poor prognosis due to its proclivity for hematogenous metastases. A short review of the recent literature corroborates this.
A Double-Labeling Assay for Simultaneous Estimation and Characterization of Estrogen and Progesterone Receptors using Radioiodinated Estradiol and Tritiated Org 2058
Authors: Ronchi Enrico , Granata Giovanna , Brivio Moreno , Coradini Danila , Miodini Patrizia , Di Fronzo Giovanni
Published: October 2018

Estrogen (ER) and progesterone receptors (PgR) appear to be a prerequisite to elicit a biologic response by a hormone-target organ. Current methodologies for analysis of these proteins (e.g., dextran-coated charcoal, DCC) in single-label assay (SLA) require relatively large amounts of tissue material, time and laboriousness. Therefore, we have developed for breast cancer tissue an improved dual-label assay (DLA) for simultaneous titration (by DCC) and/or characterization (by sedimentation properties) of ER and PgR on the same sample, using 125I-E2 and 3H-Org 2058 as tracers. The interaction of 125I-E2 with ER and plasma proteins in comparison to 3H-E2 was studied in terms of specificity, time course, affinity binding and sedimentation pattern. 125I-E2 bound the same molecular forms displayed by 3H-E2 (9 and 3S) but with lower titers (about 1.3-fold), irrespective of the technique used, and did not bind to sex hormone-binding globulin. Simultaneous detection of 125I and 3H was achieved by use of a gamma counter plus a beta counter sequentially. ER and PgR titrations with DCC in DLA were in good agreement with those obtained with SLA, in terms of titers and Ka values. An analogous result was obtained with sucrose density gradient (SDG) analysis. Both the DLA methods were highly reproducible (CV < 8.0 %). Between the rotors available for SDG, the vertical one was preferable because of the larger number of samples processed and of less purturbation of sedimenting receptor molecules. Furthermore, a biochemical application of the method is described. In conclusion, the DLA procedure, by simplifying ER and PgR estimation, makes it possible to study, even on small tumor biopsies, the molecular properties of these proteins in relation to the clinical response of the disease.
Results of a Multicenter Retrospective Study on Pediatric Brain Tumors in Italy
Authors: Madon Enrico , Besenzon Luigi , del Prever Adalberto Brach , di Montezemolo Luca Cordero , Cucchi Beniamino , Iannacci Lisa , Mosso Maria Luisa , Pession Andrea , Paolucci Guido
Published: October 2018

This retrospective study was undertaken to evaluate the clinical characteristics, course and treatment of children (0–14 years of age) diagnosed with a primary CNS tumor during the period 1976–1982 in Italy. Four hundred and sixty-two patients (263 males and 199 females) were followed by 18 various neurosurgical and pediatric oncology centers. The histologic types most frequently reported were: medulloblastoma (23 %), astrocytoma (16 %), ependymoma (11 %) and spongioblastoma (11 %). Of the 388 patients who underwent surgery, radical excision was reported in 42 %, partial excision in 32 %, biopsy only in 6 %, and unqualified surgery in 4 %; 19 % had no surgery. Radiotherapy and chemotherapy combined were administered in 61 % of the 143 patients followed at pediatric oncology centers; 19 % received radiotherapy alone, 3 % chemotherapy alone, and 17 % neither treatment. Forty-six percent of the patients were reported alive, 40 % dead, and 14 % lost to follow-up. Performance status was identified for 62 patients. The investigation revealed marked differences in the therapeutic treatment administered, thus precluding valid data analysis. This emphasizes the need to coordinate efforts among the institutions and the disciplines involved in the treatment of this form of childhood cancer.
Ovarian Granulocytic Sarcoma with Central Nervous System Involvement
Authors: Marra Roberto , Pagano Livio , Storti Sergio , Rabitti Carla , Tartaglione Raffaele , Leone Giuseppe
Published: October 2018

The authors describe 2 cases of acute myeloid leukemia (AML) with ovarian granulocytic sarcoma (GS) and central nervous system (CNS) involvement. The patients had an unfavorable clinical course in a short period of time. It has been reported that GS or CNS involvement does not have a bad prognostic significance. We suggest that the association of these two complications worsens the prognosis of AML.
Analysis of Breslow Tumor Thickness Distribution of Skin Melanoma in the Italian Region of Romagna, 1986–1991
Authors: Stanganelli Ignazio , Raccagni Antonio Ascari , Baldassari Laura , Calista Donato , Serafini Monica , Bucchi Lauro
Published: October 2018

Aims and Background

In southern European countries, the availability of epidemiologic data on cutaneous malignant melanoma is limited. A descriptive analysis was performed on melanoma cases diagnosed in the Italian region of Romagna (population 600,000), 1986-91.

Methods

The main end point was the proportion of cases less than 1.5 mm thick by sex, age, and site.

Results

A total of 297 incident cases was evaluated. The average annual age-standardized (World) incidence rates were 6.2 (95% CI 5.2–7.2) per 100,000 females and 4.5 (95% CI 3.6–5.3) per 100,000 males. Females presented with significantly thinner melanomas than males. The proportion of cases less than 1.5 mm thick decreased significantly with increasing age in both sexes, with the most pronounced decrease (approximately from 2/3 to 1/3) being observed above 60 years for females and above 40 for males. Comparing sexes by 10-year age groups, a significant F:M advantage in thickness distribution was found only at age 40–49 and 50–59 years. Among females under 60, melanomas of the legs and those of the trunk showed no difference in thickness distribution, in both sexes, incidence appeared to increase progressively with age. No apparent elevation in incidence rates was observed in the age groups with the highest frequency of thin melanomas.

Conclusions

The major implication of these data is that in public education programs specific messages should be aimed at those subgroups that show the poorest levels of self-surveillance.
An Intensive Treatment with Mitoxantrone and Ifosfamide in Second-Line Therapy of Epithelial Ovarian Cancer
Authors: Di Leo Angelo , Biganzoli Laura , Bohm Silvia , Lupi Giovanni , Oriana Saro , Riboldi Gianluca , Spatti Giovanbattista , Vicario Giovanni , Di Re Francesco , Bajetta Emilio
Published: October 2018

Aims and background

Both mitoxantrone (DHAD) and ifosfamide (IFO) have given promising results when administered as single agents in advanced ovarian cancer pretreated with platinum compounds. The aim of this I.T.M.O. group pilot trial was to evaluate, in a selected population of ovarian cancer patients, the efficacy and tolerability of the following intensive second-line regimen: DHAD, 12 mg/m2 i.v., day 1; IFO, 4,000 mg/m2 i.v., days 1 and 2; Mesna, 800 mg/m2 i.v. t.i.d., days 1 and 2. Filgrastim (5 μg/kg/day i.m.) was given from day 6 to day 19 to reduce the expected neutropenia. Cycles were repeated every 21 days.

Methods

Nineteen platinum-pre-treated patients were enrolled and 14 were evaluated for tumor response; the disease of 5 patients was not measurable clinically or radiologically.

Results

Seven responses were observed (3 CRs), with a median response duration of 5 months. The median time to treatment failure and overall survival for all 19 patients was respectively 8 and 13 months. Anemia was observed in all of the treated patients (grade 3–4 in 9 cases). Only 6 of the 19 patients ended the five planned cycles of chemotherapy without any delay.

Conclusions

Although DHAD plus IFO induced a considerable number of objective responses, the limited response duration time to treatment failure, and overall survival as well as the reported side effects suggest that this is not a recommended regimen for the palliative treatment of ovarian cancer patients undergoing second-line chemotherapy.
Are Lipid Abnormalities Reliable Cardiovascular Risk Factors in Dialysis Patients?
Authors: Bergesio F. , Ciuti R. , Salvadori M. , Galli G.A. , Monzani G. , Bertoni E. , Salerno A. , Frizzi V.
Published: October 2018

Patients on chronic hemodialysis often present both hyperlipidemia and a high incidence of cardiovascular disease (CVD). Uremic hyperlipidemia has usually been regarded as one of the most important cardiovascular risk factors (CVRF) in these patients. In order to study whether the “uremia-induced” lipid abnormalities are actually associated with evidence of uremic CVD, and consequently may be considered reliable CVRF, 123 patients on chronic dialysis were reviewed for the presence of CVD and, at the same time, examined for their lipoprotein pattern and other clinical and biochemical variables.

Lipids and lipoproteins did not prove helpful in our study in identifying patients with CVD. Despite the fact that they had been on dialysis for a shorter time, CVD patients were significantly older and had higher blood pressure than patients without CVD. Our data suggest that the uremia-induced lipid abnormalities are not reliable markers of CVD in dialysis patients, and support the hypothesis that dialysis per se does not accelerate the atherosclerotic process in uremic patients
Transmembranous Transport and Adsorption of Beta-2-microglobulin during Hemodialysis using Polysulfone, polyacrylonitrile, polymethylmethacrylate and Cuprammonium Rayon Membranes
Authors: Klinke B. , Röckel A. , Abdelhamid S. , Fiegel P. , Walb D.
Published: October 2018

Beta-2-microglobulin (b2M) was identified as a causative agent of amyloidosis associated with long-term hemodialysis (HD). Therefore, we examined handling of b2M during a 4-hour hemodialysis session. We compared b2M adsoprtion and diffusive/convective elimination between high-flux membranes such as polysulfone (PS; F 60®, Fresenius), polyacrylonitrile (AN 69; FiltralR, Hospal) and polyacrylonitrile (PAN, PAN 12CX2R, Asahi) and less permeable membranes such as cuprammonium rayon (CR; AM 160 HR, Asahi) and polymethylmethacrylate (PMMA; BK-1.6 UR, Toray). To calculate total elimination, arterio-venous differences of b2M were measured at 0, 5, 20, 60 and 240 minutes; dialysate concentration was analyzed to evaluate diffusive/convective transport. Differences between recovery in dialysate and total removal were regarded as amount removed by adsorption. Total elimination per 4-hour hemodialysis session and per m2 membrane surface was 154.7 ± 12.3 mg for the PS, 137.8 ± 28.4 mg for the AN 69, 179.8 ± 47.5 mg for the PAN, 130.8 ± 11.8 mg for the PMMA and 14.4 ± 16.0 mg for the CR membrane. Diffusive/convective transport was 128.0 ± 18.1 mg for PS, 54.7 ± 8.1 mg for AN 69 and 106.5 ± 20.8 mg for PAN and insignificant for PMMA and CR. Adsorption was 26.7 ± 4.3 mg for PS, 83.1 ± 29.0 mg for AN 69 and 59.8 ± 17.2 mg for PAN. Besides transmembranous transport sorption is an important mode of elimination. Weekly endogenous generation rate is about twice as high as b2M elimination
Are Changes in Intracranial Pressure during Intermittent Machine Haemofiltration Dependent upon Membrane Biocompatibility?
Authors: Davenport A. , Davison A.M. , Will E.J.
Published: October 2018

We measured the intracranial pressure, using a subdural catheter in three patients admitted with grade 4 hepatic encephalopathy following paracetamol (aminocetaphen) self poisoning. Acute oliguric renal failure was present in all cases and was treated with daily intermittent machine haemofiltration. Hypovolaemia prior to treatment was corrected and a total of 14 isovolaemic 17 litre exchanges carried out using either a Gambro FH77 (8) or Hospal 3600 (6) haemofilter. Intracranial pressure (ICP) increased during treatment with both types of filter, but the increase was greater in the Gambro FH77 treated group, mean ICP increased from 7.6 ± 2 mmHg to 12 ± 3 mmHg at 3 hours (p< 0.05), this was associated with a greater fall in the percentage change from the pretreatment value of both arterial oxygen tension and total peripheral white blood cell count during the first hour of treatment compared to the Hospal 3600 treated group, 8 ± 2% vs 1 ± 2% (p< 0.05) and 5 ± 2% vs 3 ± 2% (p< 0.05).

This suggests that membrane biocompatibility may also play a role in the development of increased intracranial pressure during intermittent machine haemofiltration.
Beta 2-microglobulin Removal by Synthetic Dialysis Membranes. Mechanisms and Kinetics of the Molecule
Authors: Ronco C. , Heifetz A. , Fox K. , Curtin C. , Brendolan A. , Gastaldon F. , Crepaldi C. , Fortunato A. , Pietribasi G. , Caberlotto A. , Brunello A. , Manani S. Milan , Zanella M. , La Greca G.
Published: October 2018

Beta 2-microglobulin (ß2-m) accumulation represents a possible complication of long term dialysis. It is therefore important to evaluate the capacity of removal of this molecule from the patient by different dialysis membranes. The present study is aimed at evaluating the mechanisms involved in ß2-m removal by three different synthetic membranes: a) highly asymmetric hydrophobic polysulfone (Biosulfane, NMC), b) moderately asymmetric and hydrophobic polysulfone (PS600, Fresenius), c) Polyacylonitrile (AN69HF, Hospal). The adsorption capacity and sieving coefficients of the three membranes for native and labeled ß2-m were studied in vitro utilizing human blood. The amount adsorbed by the membrane was measured by the elution of the molecule obtained with a detergent solution. Clearances, total removal and membrane adsorption were studied in six patients treated in a randomized sequence with the three membranes. For this purpose, plasma and dialysate measurements as well as total collection of spent dialysate and ß2-m elution from the used dialyzers were carried out. Ex novo generation of ß2-m did not take place during in vitro circulation. The molecule was removed by the studied membranes both by filtration and adsorption. The Biosulfane membrane removed ß2-m mostly by adsorption while the PS600 membrane removed ß2-m almost entirely by filtration. Intermediate behaviour was shown by AN69 membrane. Similar quantities of ß2-m were removed from the patients with the three membranes. Total removal could only be precisely measured by adding the quantity of ß2-m eluted from the membrane to the amount recovered in the spent dialysate. Out of total removal, adsorption was more than 90% with Biosulfane, while only 5% with the PS600. These findings contribute to the understanding of the discrepancy found between the clearance measured from the plasma side and that measured from the dialysate side. In conclusion, clearance and sieving measurements for ß2-m cannot be correctly performed unless the capacity of adsorption of the membrane is taken into account.
Coagulation Activation in Extracorporeal Hemodialysis
Authors: Camici M. , Evangelisti L. , Balestri P. , Cioni L. , Fundi P. , Sagripanti A. , Meriggioli M. , Giordani R.
Published: October 2018

The Authors evaluated the behavior of protein C activity, factor X and factor VII coagulant activity and serum lipoprotein(a) before and after dialytic treatment in patients on maintenance hemodialysis. They observed depressed protein C activity that significantly (p<0.005) increased and became normal immediately after hemodialysis while factor X and factor VII increased (p<0.01; p<0.05) despite heparinization together with amount of serum lipoprotein(a). In vitro incubation (30 'at 37°C) of uremic and healthy blood showed a decrease in serum lipoprotein(a) concentration. After heparin addition (final concentration 0.5 U/ml) lipoprotein(a) increased in the uremic blood only. The clinical and physiopathological implications of these results are discussed.
The Use of a Heparin Removal Device: A Valid Alternative to Protamine
Authors: Hendrikx M. , Leunens V. , Vandezande E. , Wallyn A. , Flameng W.
Published: October 2018

Purpose

Experiments were carried out to test the efficacy and safety of the heparin removal device, a plasmapheresis filter that binds and eliminates heparin, in the context of extracorporeal circulation.

Procedures and Findings

Six dogs were put on cardiopulmonary bypass after heparinization. Upon weaning, additional heparin was administered to obtain an activated clotting time above 900s. The animals were connected to the heparin removal device and with flows of 500 ml/min, activated clotting time, activated partial thromboplastin time and plasma heparin concentrations were normalised to baseline after 30 min. Hemodynamic parameters remained unaffected. A slight decrease in red and white blood cell count and in platelets was observed which however recovered spontaneously two hours after the filter procedure. No damage to blood components could be observed.

Conclusions

The use of a heparin removal device is as efficient as systemic administration of protamine to reverse the effects of heparinization. It may prevent the adverse reactions linked to protamine administration and therefore be indicated in certain subgroups of patients undergoing cardiopulmonary bypass.
On the Basement Membrane of the Nephron
Authors: Paalanen Antti
Published: October 2018

This study comprises some observations about the structure of the connective tissue of the basement membrane and interstitium in some normal, post-natal human kidneys. The basis of the basement membrane is mainly a reticular, homogeneous membrane that belongs uniformly to both Bowman's capsule and the wall of the renal tubule. Outside it in the capsule is a durable collagenic membrane whose development must be considered and evincement of functional adaptation under the pressure conditions of the cavity. In renal tubules there is no such well-defined outer membrane, but in them the basement membrane has in addition collagenic traits to some extent and is thus reticular-collagenic when examined as a whole. The renal tubules are surrounded by a dense, spiraling reticular network of fibres which attaches to the connective tissue of the interstitium where fibrocytes are scarce. The network extends all the way around the renal corpuscle. There is no elastic tissue at all in the basement membranes.
Experimental Studies on the Removal of Paraffin from the Urinary Bladder with the Aid of Chemical Solvents
Authors: Lenko Jan , Panasiewicz Kazimierz , Waniewski Edward
Published: October 2018

The experimental studies in vitro and in vivo concerning the solubility of paraffin in the urinary bladder with the aid of chemical solvents such as: benzine, benzene, xylene, toluene, kerosene and turpentine were performed, It was found that a 3-gram lump of paraffin could be dissolved in 25 ml. of a solvent in 25 minutes. Kerosene and turpentine dissolved paraffin in 90 and 120 minutes, and so they were excluded from the experiments in vivo. On macro - and microscopic examination after 24 hours a severe suppurative cystitis with inflammatory peritoneal reaction could be found as a result of the application of solvent for 25 minutes. The use of the above method for clinical purposes in therefore inadvisable.
Les Cytostatiques de Groupe SP-I Pour le Traitement Local Des Έpithéliomes de la Vessie
Authors: Petkovic S. , Tomic M. , Petronio VI.
Published: October 2018

Nous présenton un essai du traitement locale des tumeurs papillaires de la vessie, par instillations dans la vessie de cytostatiques. Ce traitement doit être limité aux tumeurs superficielles, à la papillomatose ou carcinose surtout. Nous n'avons pas réussi à faire disparaître les tumeurs plus volumineuses qu'un petit pois. Mais le problème n'est pas là. Il s'agit d'arrêter une forte tendance de la muqueuse vésicale à la proliferation papillomateuse. Cette idée nous vient parce que dans certains cas il nous paraît impossible d'arrêter cette tendence soit par le traitement opératoire soit par les rayons X. Sur 41 séries du traitement, en laissant à côté les malades avec des larges tumeurs proliferatives ou infiltratives (aucun succès), il nous paraît que les cytostatiques doivent être recommandés juste dans le traitement de la papillomatose ou carcinose en les associant avec l'étincelage transuréthrale, qui à lui seul est impuissant à arrêter la tendance de la muqueuse vésicale vers la prolifération récidivante.
A well-being of their own: Children’s perspectives of well-being from the capabilities approach
Authors: Domínguez-Serrano Mónica , del Moral-Espín Lucía , Gálvez Muñoz Lina
Published: October 2018

Although children’s well-being is an increasingly important area of interest for policy and research, it is still an under-theorized concept. This article proposes a theoretical framework regarding children’s well-being that combines a capabilities approach with a social provisioning approach. The methodology used involved children in the conceptualization of their well-being and in validating a list of relevant capabilities necessary to have a good life. The data show how children express a multidimensional understanding of well-being and propose an agenda of priorities and concerns of their own different from that of adults.
Vibration isolation analysis of tubular sandwiched structure used for trackless rubber-tyred vehicles
Authors: Yan Bijuan , Han Binhui , Wang Jun , Sun Dagang
Published: October 2018

In this article, a kind of tubular sandwiched engine mount (TSEM) was first used in the trackless rubber-tyred vehicles (TRTVs). TRTV have been playing an important role in underground mining. However, during the working of TRTV, the vibrations are always violent and these vibrations are very harmful. Therefore, reducing the vibration of TRTV has become an urgent and important matter. The TSEM was made of three layers, that is, the external layer, the internal layer and the middle layer. The finite element analysis (FEA) was carried out to find out whether the deformation of TSEM could meet the design requirements. To grasp the vibration isolation feature of the TSEM, the tests were performed under two working conditions of TRTVs. The results show that the rear engine mounts could always get good vibration-reducing performance, whereas the performance of the front mounts is sometimes poor in a certain direction, that is, perhaps owing to the vibration energy coupling in different directions. In addition, the vibration of the seat was measured. The test results show that the vertical acceleration is reduced when the vehicle is installed with the TSEM, compared with that of the seat when the vehicle is equipped with the existing old mounts. The results in this article could provide a good reference for the application of the tubular sandwiched structure in different rubber-tyred vehicles.
Charting a roadmap towards membership and formal voice in global bioethics standard- setting: Health research and the case of the International Council on Harmonisation
Authors: Flear Mark
Published: October 2018

The United Kingdom’s (UK’s) imminent departure from the European Union (EU) has a further but usually overlooked consequence: The UK will also be leaving the various global fora where it has been represented with other Member States of the EU. In many cases, the UK will still have to comply with the global regulatory tools, including norms and standards, made by these fora. The UK’s departure from the EU thus raises the more general question of how those formally outside the fora that set global norms and standards can navigate membership procedures in order to become involved in setting them. This article focuses on the example of the International Council on Harmonisation (ICH) and its work in harmonizing good clinical practice (GCP) in relation to clinical trials for pharmaceuticals. By reference to this example, the article underlines the importance of the ICH to global standard-setting for GCP and the importance of engagement in this forum by those that do not have a formal role in setting the standards, but that must abide by them nonetheless if they are to trade globally. Subsequently, the article explains the formal procedures for membership and involvement in standard-setting. In doing so, the article aims to provide a roadmap towards membership and a say in global standard-setting.
Effectiveness of a Weight Management Program Applying Mobile Health Technology as a Supporting Tool for Overweight and Obese Working Women
Authors: Siriwoen Roscharin , Chongsuwat Rewadee , Tansakul Supreya , Siri Sukhontha
Published: October 2018

This study aimed to evaluate the effectiveness of a weight management program applying mobile health (mHealth) technology as a supporting tool. A quasi-experimental research with a 1-group pretest and posttest design was conducted. Thirty-eight overweight and obese working women, aged 25 to 52 years, who were ready to take action on weight loss participated in a 12-week weight management program. Repeated-measures analysis of variance was used to examine the mean differences in related variables. The results showed that the mean weight and waist circumference of the participants significantly decreased from baseline to post-intervention (week 6) and follow-up (week 12; 72.2 ± 10.4, 71.6 ± 10.8, 71.4 ± 11.0 kg, P = .008, and 92.1 ± 10.1, 89.9 ± 9.9, 87.8 ± 10.7 cm, P < .001, respectively). Moreover, they had significantly improved self-efficacy for healthy eating and physical activity, eating behaviors, dietary intake patterns, and frequency of taking stairs. This weight management program was effective for the prevention and control of overweight and obesity.
Preoperative incipient osteoarthritis predicts failure after periacetabular osteotomy: 69 hips operated through the anterior intrapelvic approach
Authors: Isaksen Kjetil F , Roscher Elin K , Iversen Kjetil S , Eitzen Ingrid , Clarke-Jenssen John , Nordsletten Lars , Madsen Jan E
Published: October 2018

Background:

Untreated developmental hip dysplasia may result in pain, loss of function and is a common cause of osteoarthritis (OA). The periacetabular osteotomy (PAO) was developed to relieve symptoms and postpone further degeneration of the hip. We aimed to assess preoperative clinical and radiographic prognostic factors and evaluate survivorship of PAO after medium-term follow-up of 7.4 (2–15) years.

Methods:

59 patients (69 hips) operated with a PAO through an anterior intrapelvic approach from 1999 to 2011 were retrospectively identified. The patients were evaluated radiographically and clinically with Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index and 15D quality of life questionnaires. Survival analyses identified native hip joint survival predictors.

Results:

9 hips (9 patients) were converted to a total hip arthroplasty (THA). Of the 50 remaining patients (60 hips), 44 patients (54 hips) were examined at medium-term follow-up. 3 patients were lost to follow-up or declined participation and 3 were interviewed by telephone. Patient age at time of surgery was 32 (14–44) years. Survival analyses showed 84.3% (95% confidence interval [CI], 68.7–92.5%) survival of the native hip at 8 years follow-up (number at risk 32) (worst case scenario 80% survival at 8 years, 95% CI, 63.9–89.2%, number at risk 32). Cox regression with presence of preoperative OA (Tönnis ⩾1), showed a crude hazard ratio for conversion to THA with preoperative OA of 13.73, p < 0.001.

Conclusions:

Periacetabular osteotomy through the anterior intrapelvic approach can be performed safely and with satisfactory results at medium-term follow-up. The presence of preoperative incipient OA (Tönnis ⩾1) is the most important predictor for poor hip joint survival.
Resilience pathways, childhood escape routes, and mentors reported by gay and bisexual men affected by syndemic conditions
Authors: Adam Barry D , Hart Trevor A , Mohr Jack , Coleman Todd , Vernon Julia
Published: October 2018

Investigation of the social and psychological antecedents of the HIV epidemic has identified a syndemic of conditions associated with risk behavior and seroconversion. This study inquires into the resilient practices and developmental processes of gay and bisexual men at the nexus of syndemic conditions to understand the pathways that lead to health problems or well-being. Interviews with 40 men identified branching pathways from home environments into schools that either offer refuge or a regime of gender discipline and bullying. Some found escape routes from hostile environments in worlds of books, pop culture, or internet chat. In adolescence, one set of men identified the development of sexual relationships with older men as a lifeline that brought a measure of emotional growth. This study points to resilience pathways and social resources that could make a difference in the lives of those deemed to be “high risk.”
Three-dimensional bimetallic layered beams with interface compliance: Analytical solution
Authors: Schnabl Simon , Planinc Igor
Published: October 2018

This paper focuses on the development of a new mathematical model and its analytical solution for the analysis of the mechanical behavior of geometrically and materially linear three-dimensional two-layer bimetallic beams with interface compliance. Consequently, the analytical solution of bending of elastic three-dimensional two-layer composite beams with interface compliance is derived for the first time. In the illustrative example, a three-dimensional two-layer cantilever composite beam made of 6061-T6 aluminum and C83400 red brass is analyzed. It is shown that interface compliance could have a significant influence on the mechanical behavior of such a structure. Finally, the results for different mechanical quantities are tabulated and as such the analytical solution presented can be used as a benchmark solution of three-dimensional bimetallic composite beams.
When is brand content shared on Facebook? A field study on online Word-of-Mouth
Authors: Haikel-Elsabeh Marie , Zhao Zhenzhen , Ivens Björn , Brem Alexander
Published: October 2018

When implementing social media strategies on Facebook brand pages, companies focus on factors that prompt electronic Word-of-Mouth (eWoM) about brand contents. This study examines individual and collective factors that lead to brand content sharing behaviors. The research conducts a field study of a real brand on its Facebook fan page to gather actual behavioral data. Both declarative and behavioral data are used to explain brand eWoM, based on 250 participants. Empirical results show that the Facebook activity has a positive influence on brand content sharing for active users (posters) but not for nonactive users (lurkers), while brand engagement positively affects brand content sharing for both active and nonactive users. Furthermore, brand community involvement does not have an influence on brand content sharing. Findings offer companies useful recommendations for using the determinants included in our research design to understand and analyze the sharing behaviors of users.