bluuebunny/crossref_metadata_2025 huggingface dataset:
Is extraction of Fe from iron based reference materials an appropriate method for determination of trace elements?
Authors: Taseska Milena , Makreski Petre , Stibilj Vekoslava , Jacimovic Radojko , Stafilov Trajče
Published: August 2011

Various trace elements in different types of iron based geological reference materials [JSS 804-1 (hematite), JSS 820-2 (limonite), SU-1 and SU-1a (iron-nickel-copper-cobalt ores)] were investigated using k
0-instrumental neutron activation analysis (k
0-INAA). To avoid the interference of iron as the matrix element, a liquid–liquid extraction procedure with diisopropyl ether (DIPE) in hydrochloric acid solution and determination of trace elements in the inorganic phase was undertaken prior to irradiation. The k
0-INAA method, applied to determine the content of the investigated elements, enabled the distribution of 39 elements to be followed through their corresponding intermediate/medium and long half-lived radionuclides. The possibility of determining the content of numerous trace elements after Fe separation is an important advantage of the proposed method. k
0-INAA used to determine element s in the powdered materials and in liquid form after iron extraction enabled us to follow the losses and potential contamination of some elements in the liquid–liquid extraction process. Additionally, elimination of the matrix element lowered the detection limit for some trace elements compared to their corresponding values obtained by k
0-INAA.
Transient anisotropy in degenerate systems: A semi-classical approach
Authors: Schalk Oliver , Unterreiner Andreas-Neil
Published: August 2011

A semi-classical model for transient anisotropy in degenerate excited states is developed on the basis of a more general ansatz presented recently (O. Schalk and A.-N. Unterreiner, Phys. Chem. Chem. Phys.12, 655 (2010)). This is the first model that can treat both rotational dephasing and the dynamics in degenerate systems, which is a prerequisite for a comprehensive theory to describe gas phase anisotropy experiments in small, highly symmetric systems. In the present contribution, it is shown that this model covers most of the features of the full quantum dynamical treatment and helps to give insights into the physical processes that are underlying these dynamics.
How long can fisheries management delay action in response to ecosystem and climate change?
Authors: Brown Christopher J. , Fulton Elizabeth A. , Possingham Hugh P. , Richardson Anthony J.
Published: August 2011

Sustainable management of fisheries is often compromised by management delaying implementation of regulations that reduce harvest, in order to maintain higher catches in the short term. Decreases or increases in fish population growth rate driven by environmental change, including ecosystem and climate change, affect the harvest that can be taken sustainably. If not acted on rapidly, environmental change could result in unsustainable fishing or missed opportunity for higher catches. Using simulation models of harvested fish populations influenced by environmental change, we explore how long fisheries managers can afford to wait before changing harvest regulations in response to changes in population growth. If environmental change causes population declines, delays greater than five years increase the probability of population collapse. Species with fast and highly variable population growth rates are more susceptible to collapse under delays and should be a priority for revised management where delays occur. Generally, the long‐term cost of delay, in terms of lost fishing opportunity, exceeds the short‐term benefits of overfishing. Lowering harvest limits and monitoring for environmental change can alleviate the impact of delays; however, these measures may be more costly than reducing delays. We recommend that management systems that allow rapid responses to population growth changes be enacted for fisheries management to adapt to ecosystem and climate change.
Expression of Immune‐Inflammatory Markers in Sites of Chronic Periodontitis in Patients With Type 2 Diabetes
Authors: Duarte Poliana Mendes , Szeremeske Miranda Tamires , Lima Jadson Almeida , Dias Gonçalves Tiago Eduardo , Santos Vanessa Renata , Bastos Marta Ferreira , Ribeiro Fernanda Vieira
Published: August 2011

Background: The aim of this study is to evaluate the gene expression of immune‐inflammatory markers in gingival biopsies of patients with type 2 diabetes with chronic periodontitis (CP).

Methods: Gingival biopsies were harvested from systemically and periodontally healthy patients (SPH), systemically healthy patients with CP (SHCP), and patients with better‐controlled and poorly controlled diabetes and CP. The levels of mRNA of interleukin (IL)‐17, IL‐6, IL‐23, IL‐10, IL‐4, interferon‐γ, toll‐like receptor (TLR)‐2, TLR‐4, osteoprotegerin, receptor activator of nuclear factor‐kappa B ligand (RANKL), tumor necrosis factor‐α, transforming growth factor‐β, transcription factor forkhead box p3, transcription factor orphan nuclear receptor C2 (RORC2), and receptor of advanced glycation end products (RAGE) were evaluated by quantitative real‐time polymerase chain reaction.

Results: All CP groups presented higher levels of mRNA of TLR‐2, TLR‐4, IL‐17, RANKL, and RAGE and a higher frequency of IL‐17 and TLR‐2 mRNA‐positive biopsies when compared to SPH (P <0.05). There was a higher frequency of detection of RORC2 in the biopsies from both groups with diabetes compared to the other groups (P <0.05). The frequency of IL‐4 mRNA‐positive tissues was lower in patients with diabetes compared to SHCP (P <0.05).

Conclusion: CP, but not type 2 diabetes mellitus, significantly affected the expressions of the evaluated genes related to the innate and adaptive immune responses.
Results of the Heart Healthy and Ethnically Relevant Lifestyle Trial: A Cardiovascular Risk Reduction Intervention for African American Women Attending Community Health Centers
Authors: Parra-Medina Deborah , Wilcox Sara , Salinas Jennifer , Addy Cheryl , Fore Elizabeth , Poston Marybeth , Wilson Dawn K.
Published: August 2011

Objectives. We evaluated a theory-based lifestyle intervention targeting physical activity and dietary fat intake among African American women at high risk for cardiovascular disease.

Methods. The Heart Healthy and Ethnically Relevant Lifestyle trial (2005–2008) randomly assigned 266 low-income African American women aged 35 years and older who were patients of South Carolina community health care centers into comprehensive or standard care interventions. Comprehensive participants received standard care (stage-matched provider counseling and assisted goal setting) plus 12 months of telephone counseling and tailored newsletters. Primary outcomes were 6- and 12-month self-reported physical activity and dietary fat intake.

Results. Comprehensive participants were more likely than were standard care participants to decrease total physical activity (odds ratio [OR] = 3.13; 95% confidence interval [CI] = 1.18, 8.25) and increase leisure-time physical activity (OR = 3.82; 95% CI = 1.41, 10.3) at 6 months (no 12-month differences). Mean reductions in Dietary Risk Assessment score occurred in both groups but were greater among comprehensive participants than among standard care participants (6 months, −8.50 vs −5.34; 12 months, −7.16 vs −3.37; P < .001).

Conclusions. The comprehensive intervention improved women's leisure-time physical activity and dietary fat intake, highlighting a replicable model to help primary care providers implement lifestyle counseling.
Alcohol Advertising at Boston Subway Stations: An Assessment of Exposure by Race and Socioeconomic Status
Authors: Gentry Elisabeth , Poirier Katie , Wilkinson Tiana , Nhean Siphannay , Nyborn Justin , Siegel Michael
Published: August 2011

Objectives. We investigated the frequency of alcohol ads at all 113 subway and streetcar stations in Boston and the patterns of community exposure stratified by race, socioeconomic status, and age.

Methods. We assessed the extent of alcohol advertising at each station in May 2009. We measured gross impressions and gross rating points (GRPs) for the entire Greater Boston population and for Boston public school student commuters. We compared the frequency of alcohol advertising between neighborhoods with differing demographics.

Results. For the Greater Boston population, alcohol advertising at subway stations generated 109 GRPs on a typical day. For Boston public school students in grades 5 to 12, alcohol advertising at stations generated 134 GRPs. Advertising at stations in low-poverty neighborhoods generated 14.1 GRPs and at stations in high-poverty areas, 63.6 GRPs.

Conclusions. Alcohol ads reach the equivalent of every adult in the Greater Boston region and the equivalent of every 5th- to 12th-grade public school student each day. More alcohol ads were displayed in stations in neighborhoods with high poverty rates than in stations in neighborhoods with low poverty rates.
Trends in Smoking Among Adults From 1980 to 2009: The Minnesota Heart Survey
Authors: Filion Kristian B. , Steffen Lyn M. , Duval Sue , Jacobs David R. , Blackburn Henry , Luepker Russell V.
Published: August 2011

Objectives. We examined population-based smoking trends in Minnesota between 1980 and 2009.

Methods. The Minnesota Heart Survey (MHS) is a population-based, serial, cross-sectional study of cardiovascular risk factor trends among Minneapolis–Saint Paul metropolitan residents. The MHS recently completed its sixth survey (1980–1982 [n = 3799], 1985–1987 [n = 4641], 1990–1992 [n = 5159], 1995–1997 [n = 6690], 2000–2002 [n = 3281], and 2007–2009 [n = 3179]). We used MHS data to examine smoking trends among adults aged 25 to 74 years by means of age-adjusted generalized linear mixed models.

Results. Between 1980 and 2009, the prevalence of current smoking decreased from 32.8% to 15.5% for men and from 32.7% to 12.2% for women (P < .001 for each). Greater decreases occurred among those with higher income and those with more education. Among currently smoking men, the number of cigarettes smoked per day decreased from 26.0 in the 1980–1982 survey to 16.0 in the 2007–2009 survey (P < .001). Similar trends were observed among women.

Conclusions. Although the prevalence of smoking and cigarette consumption decreased from the 1980–1982 period to the 2007–2009 period, interventions specifically designed for those of lower socioeconomic status are needed.
Low-Risk Lifestyle Behaviors and All-Cause Mortality: Findings From the National Health and Nutrition Examination Survey III Mortality Study
Authors: Ford Earl S. , Zhao Guixiang , Tsai James , Li Chaoyang
Published: August 2011

Objectives. We examined the relationship between 4 low-risk behaviors—never smoked, healthy diet, adequate physical activity, and moderate alcohol consumption—and mortality in a representative sample of people in the United States.

Methods. We used data from 16958 participants aged 17 years and older in the National Health and Nutrition Examination Survey III Mortality Study from 1988 to 2006.

Results. The number of low-risk behaviors was inversely related to the risk for mortality. Compared with participants who had no low-risk behaviors, those who had all 4 experienced reduced all-cause mortality (adjusted hazard ratio [AHR]=0.37; 95% confidence interval [CI]=0.28, 0.49), mortality from malignant neoplasms (AHR=0.34; 95% CI=0.20, 0.56), major cardiovascular disease (AHR=0.35; 95% CI=0.24, 0.50), and other causes (AHR=0.43; 95% CI=0.25, 0.74). The rate advancement periods, representing the equivalent risk from a certain number of years of chronological age, for participants who had all 4 high-risk behaviors compared with those who had none were 11.1 years for all-cause mortality, 14.4 years for malignant neoplasms, 9.9 years for major cardiovascular disease, and 10.6 years for other causes.

Conclusions. Low-risk lifestyle factors exert a powerful and beneficial effect on mortality.
Relations of Meeting National Public Health Recommendations for Muscular Strengthening Activities With Strength, Body Composition, and Obesity: The Women's Injury Study
Authors: Trudelle-Jackson Elaine , Jackson Allen W. , Morrow James R.
Published: August 2011

Objectives. We examined the relations of meeting or not meeting the 2008 Physical Activity Guidelines for Americans recommendations for muscular strengthening activities with percentage of body fat, body mass index (BMI; defined as weight in kilograms divided by height in meters, squared), muscular strength, and obesity classification in women.

Methods. We analyzed data on 918 women aged 20 to 83 years in the Women's Injury Study from 2007 to 2009. A baseline orthopedic examination included measurement of height, body weight, skinfolds, and muscle strength.

Results. Women who met muscle strengthening activity recommendations had significantly lower BMI and percentage of body fat and higher muscle strength. Women not meeting those recommendations were more likely to be obese (BMI ≥ 30) compared with women who met the recommendations after we adjusted for age, race, and aerobic physical activity (odds ratio = 2.28; 95% confidence interval = 1.61, 3.23).

Conclusions. There was a small but significant positive association between meeting muscle strengthening activity recommendations and muscular strength, a moderate inverse association with body fat percentage, and a strong inverse association with obesity classification, providing preliminary support for the muscle strengthening activity recommendation for women.
Aligning Community Engagement With Traditional Authority Structures in Global Health Research: A Case Study From Northern Ghana
Authors: Tindana Paulina O. , Rozmovits Linda , Boulanger Renaud F. , Bandewar Sunita V. S. , Aborigo Raymond A. , Hodgson Abraham V. O. , Kolopack Pamela , Lavery James V.
Published: August 2011

Despite the recognition of its importance, guidance on community engagement practices for researchers remains underdeveloped, and there is little empirical evidence of what makes community engagement effective in biomedical research.

We chose to study the Navrongo Health Research Centre in northern Ghana because of its well-established community engagement practices and because of the opportunity it afforded to examine community engagement in a traditional African setting.

Our findings suggest that specific preexisting features of the community have greatly facilitated community engagement and that using traditional community engagement mechanisms limits the social disruption associated with research conducted by outsiders. Finally, even in seemingly ideal, small, and homogeneous communities, cultural issues exist, such as gender inequities, that may not be effectively addressed by traditional practices alone.
Seven-Year Patterns in US Cigar Use Epidemiology Among Young Adults Aged 18–25 Years: A Focus on Race/Ethnicity and Brand
Authors: Cullen Jennifer , Mowery Paul , Delnevo Cristine , Allen Jane A. , Sokol Natasha , Byron M. Justin , Thornton-Bullock Amber
Published: August 2011

Objectives. We examined patterns in cigar use among young adults, aged 18–25 years, focusing on race/ethnicity and brand.

Methods. We conducted a secondary data analysis of cross-sectional waves of the National Survey on Drug Use and Health, 2002–2008, using multivariate logistic regression to assess time trends in past 30 days cigar use, past 30 days use of a “top 5” cigar brand, cigar use intensity, and age at first cigar use.

Results. Cigar use has increased among White non-Hispanic men aged 18 to 25 years, from 12.0% in 2002 to 12.7% in 2008. Common predictors of all outcomes included male gender and past 30 days use of cigarettes, marijuana, and blunts. Additional predictors of past 30 days cigar and “top 5” brand use included younger age, non-Hispanic Black or White race, lower income, and highest level of risk behavior. College enrollment predicted intensity of use and “top 5” brand use.

Conclusions. Recent legislative initiatives have changed how cigars are marketed and may affect consumption. National surveys should include measures of cigar brand and little cigar and cigarillo use to improve cigar use estimates.
Social Gradients in Oral Health in Older Adults: Findings From the English Longitudinal Survey of Aging
Authors: Tsakos Georgios , Demakakos Panayotes , Breeze Elizabeth , Watt Richard G.
Published: August 2011

Objectives. We examined prospective associations between socioeconomic position (SEP) markers and oral health outcomes in a national sample of older adults in England.

Methods. Data were from the English Longitudinal Survey of Aging, a national cohort study of community-dwelling people aged 50 years and older. SEP markers (education, occupation, household income, household wealth, subjective social status, and childhood SEP) and sociodemographic confounders (age, gender, and marital status) were from wave 1. We collected 3 self-reported oral health outcomes at wave 3: having natural teeth (dentate vs edentate), self-rated oral health, and oral impacts on daily life. Using multivariate logistic regression models, we estimated associations between each SEP indicator and each oral health outcome, adjusted for confounders.

Results. Irrespective of SEP marker, there were inverse graded associations between SEP and edentulousness, with proportionately more edentate participants at each lower SEP level. Lower SEP was also associated with worse self-rated oral health and oral impacts among dentate, but not among edentate, participants.

Conclusions. There are consistent and clear social gradients in the oral health of older adults in England, with disparities evident throughout the SEP hierarchy.
The Influence of Changes in Dental Care Coverage on Dental Care Utilization Among Retirees and Near-Retirees in the United States, 2004–2006
Authors: Manski Richard J. , Moeller John F. , St Clair Patricia A. , Schimmel Jody , Chen Haiyan , Pepper John V.
Published: August 2011

Objectives. We examined dental care utilization transition dynamics between 2004 and 2006 in the context of changing dental coverage status.

Methods. We used data from the Health and Retirement Study for persons aged 51 years and older to estimate a multivariable model of dental care use transitions with controls for dental coverage and retirement transitions and other potentially confounding covariates.

Results. We found that Americans aged 51 years and older who lost dental coverage between the 2004 and 2006 survey periods were more likely to stop dental care use between periods, and those who gained coverage were more likely to start dental care use between periods, than those without coverage in both periods.

Conclusions. Dental coverage transitions and status have a strong effect on transitions in dental care use. Given that retirement is a time when many experience a loss of dental coverage, older adults may be at risk for sporadic dental care and even stopping use, leading to worse dental and potentially overall health.
Causes of the Decline in Cigarette Smoking Among African American Youths From the 1970s to the 1990s
Authors: Oredein Tyree , Foulds Jonathan
Published: August 2011

Adult cigarette smoking prevalence trends among African Americans (AAs) and Whites are similar. However, during the decline in youth smoking that occurred between the mid-1970s and the early 1990s, the drop in smoking rates among AA adolescents was more than double that among Whites. We examined the evidence for potential explanations for this phenomenon. On the basis of our findings, we propose that racial differences in parental attitudes, religious ties, negative perceptions and experiences of the health effects of smoking, worsening poverty, increased use of food stamps, and price sensitivity were major factors contributing to the more rapid decrease in and continued lower rates of smoking among AA youths.
Cultural Context in the Effort to Improve Oral Health Among Alaska Native People: The Dental Health Aide Therapist Model
Authors: Wetterhall Scott , Burrus Barri , Shugars Daniel , Bader James
Published: August 2011

The Alaska Native people in rural Alaska face serious challenges in obtaining dental care. Itinerant care models have failed to meet their needs for more than 50 years.

The dental health aide therapist (DHAT) model, which entails training midlevel care providers to perform limited restorative, surgical, and preventive procedures, was adopted to address some of the limitations of the itinerant model. We used quantitative and qualitative methods to assess residents’ satisfaction with the model and the role of DHATs in the cultural context in which they operate.

Our findings suggest that the DHAT model can provide much-needed access to urgent care and is beneficial from a comprehensive cultural perspective.
A Clinical Study Comparing the Efficacy and Sensitivity of Home vs Combined Whitening
Authors: Dawson PFL , Sharif MO , Smith AB , Brunton PA
Published: August 2011

This randomized clinical study assessed efficacy in terms of color change and production of sensitivity after home whitening alone and home whitening supplemented with in-office bleaching. Thirty-six subjects (aged 19 to 58 years) were randomly assigned to one of three different treatment groups: (A) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays; (B) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 9% hydrogen peroxide (in the same trays); or (C) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 27% hydrogen peroxide (in the same trays). The efficacy of tooth whitening was assessed by determining the color change associated with the six upper anterior teeth using a value-ordered shade guide. Sensitivity was self-assessed with the use of a visual analog scale (VAS). Tooth shade and sensitivity were assessed at the following points: pretreatment; immediately after the home whitening phase; immediately after the in-office phase (groups B and C); and one week post active treatment. At the one week follow-up visit, subjects in group A had a mean (SD) color change of 5.9 (1.83) (teeth were lighter) immediately after cessation of treatment (p<0.01). Subjects in groups B and C experienced a greater change in mean (SD) shade immediately following their respective in-office treatments of 5.1 (1.53) and 5.4 (1.55). However, within one week, the shade of these teeth regressed to a similar degree to that achieved by subjects treated in group A. Overall, no significant difference in shade change or sensitivity was produced between the three groups. Investigators concluded that the in-office element of combined whitening produced no significant difference in tooth color or sensitivity when compared with home whitening alone.
An In Vitro Assessment of the Effects of Three Surface Treatments on Repair Bond Strength of Aged Composites
Authors: Kashi TS Jafarzadeh , Erfan M , Rakhshan V , Aghabaigi N , Tabatabaei FS
Published: August 2011

Clinical Relevance

To achieve a durable composite-composite bond, it is highly recommended that besides selective grinding of the surface to be repaired, specific combinations of silane primer and bonding agent should be used, without the need for acid etching of the composite surface.
Clinical Profile and Outcome of Patients with Dengue Syndrome in Hospital Care
Authors: Mohammad Hanif , Sarkar Devendra Nath , Amin M Robed , Basher A , Ahmed T
Published: August 2011

Dengue is a viral febrile illness, which has become a major international public health concern including Bangladesh, spectrum of illness ranging from dengue fever (DF) to life threatening dengue haemorrhagic fever (DHF), dengue shock syndrome (DSS) and ultimately death. The clinical profiling and outcome during epidemic dengue outbreak was observed in Dhaka Medical College Hospital in 2000 to 2001. One hundred and fifty patients were systematically observed. Male female ratio was 5:1 with severity of illness in younger patients. Hundred percent patients had fever with 83% having generalized weakness. The severe cases(DHF) were having sudden sustained temperature of 103 degree farenheight. Majority have abdominal symptoms(>80%) while 10% had respiratory only. Sixty percent have hepatomegaly while 40 % spleenomealy while 80% of DHF had ascites. Above 75% cases of Dengue haemorhagic fever had positive tourniquet test while melaena was the commonest mucosal bleeds. No fatality was observed in this study although variability of discharge was seen in different groups. Keyword: Clinical, Profile, Outcome, Dengue, Hospital DOI: http://dx.doi.org/10.3329/jom.v12i2.6733 JOM 2011; 12(2): 131-138
Diabetic Foot Care - A Public Health Problem
Authors: Somroo Jamil Ahmed , Hashmi Anjum , Iqbal Zafar , Ghori Aslam
Published: August 2011

Background: Diabetes is global epidemic with devastating human, social and economic consequences. The disease claims as many lives per year as HIV/AIDS and places a severe burden on healthcare systems and economies everywhere, with the heaviest burden falling on low- and middle-income countries. Despite this, awareness of the global scale of the diabetes threat remains pitifully low, inappropriate diabetic foot care affects, feet health leading to callosities, cracks, fissures, fungal infections, ingrown toe nails and patients end up in ulcers and amputations. Objectives: To assess diabetic patients taking proper foot care according to International Guidelines and its impact on their foot health. Methods: A cross sectional study was conducted at outdoor patients department of Medicine, Liaquat University of Medical Sciences Hospital Hyderabad from 17th January 2008 to 16th January 2009. 100 diabetic patients were selected by non probability convenience sampling according to Performa having questions regarding diabetic foot care derived from American Diabetic Association Guidelines for Diabetic Foot care. Results: Diabetic patients taking proper foot care was only 6%. There were 45(45%) males and 55(55%) females. Mean age was 51.57+10.72 years. 38% patients knew about foot care. 17% used to inspect their feet daily, 20% washed their feet daily, while 73% washed their feet more than once. 23% patients dried their feet after every foot wash, 27% applied emollients, 25% checked shoes before wearing, 24% used to wear correct shoes, 8% used to wear cotton socks and 36% used to walk bare feet. Foot care practices on foot health has statistically highly significant association (p<0.01) e.g. number of foot washes with foot hygiene, fungal infections with proper foot drying, emollient application with skin texture, cracks and fissures. Associations of proper foot care were statistically significant with literacy status of patients and foot care teachings (p<0.05). Conclusion: Few diabetic patients are taking proper foot care. Proper Foot care practices were associated with provision of education of foot care and literacy status of patients. Community health education programs regarding diabetic foot care will likely to reduce diabetic foot complications. Keyword: Diabetes, Foot care education, Diabetic foot care, Diabetic foot, Ulceration; Prevention. DOI: http://dx.doi.org/10.3329/jom.v12i2.7604 JOM 2011; 12(2): 109-114
Pharmacotherapy for Osteoarthritis: A Review
Authors: Ara Rowsan , Alam MD Zahid
Published: August 2011

Osteoarthritis (OA) is a leading cause of disability in the elderly. The goal of OA treatment is to control symptoms, prevent disease progression, minimize disability, and improve quality of life. The management can be divided into non pharmacologic interventions, pharmacologic interventions, and surgical options. Pharmacologic interventions can be further subdivided into symptomatic therapy and potential structureor disease-modifying therapy. There are, at present, no specific pharmacologic therapies that can prevent the progression of joint damage due to OA. Acetaminophen is the first line of therapy, although most of the patient requires NSAIDs. Risk of gastrointestinal (GI) bleeding and cardiovascular risk need to be considered, especially for elderly. With inflammatory components, intra-articular glucocorticoid injection gives short term benefit. Compared with corticosteroid injections, hyaluronan injections have similar clinical effects. But it is more costly. So far research with potential structure- and disease-modifying drugs in osteoarthritis includes tetracyclines, glycosaminoglycan polysulfuric acid, pentosan polysulfate, diacerein, glucosamine and others. Scientists are looking for new therapeutic targets like IL-1 receptor antagonist (IL-1Ra), mitogen-activated protein (MAP) kinases inhibitors, NF-kappaB inhibitors. Gene therapy, Chondrocyte and stem cell transplants showed some promise in animal models. Keyword: Osteoarthritis, pharmacologic therapy, disease modifying therapy DOI: http://dx.doi.org/10.3329/jom.v12i2.7690 JOM 2011; 12(2): 142-148
Health Risks of Nuclear-Power-Plant Accidents
Authors: Chowdhury MA Jalil
Published: August 2011

DOI: http://dx.doi.org/10.3329/jom.v12i2.8415 JOM 2011; 12(2): 99-102
Cerebral Venous Sinus Thrombosis- An Update
Authors: Chowdhury Rajib Nayan , Rahman Kazi Mohibur , Khan Sharif Uddin , Habib MD Ahsan , Miah Titu , Ayaz KFM , Deb Sudip Ranjan , Islam Nazrul , Patwary Samsul Arefin
Published: August 2011

DOI: http://dx.doi.org/10.3329/jom.v12i2.8421 JOM 2011; 12(2): 149-152
Large Cell Carcinoma Mimicking Non Resolving Pneumonia
Authors: Imran Khan Mohammad Ashik , Miah MD Titu , Mahbub MD Shahriar , Das Gupta Ratan , Ahasan HAM Nazmul , Alamgir Khan MD Munawwar , Patwary Shamsul Arefin , Hossain Homayra Tahseen
Published: August 2011

Fever, chest pain, cough in a young lady usually does not ring any alarm bell. We present here a case of a young lady who had typical symptoms of community acquired pneumonia who initially responded to regular antibiotics but later was investigated to have large cell carcinoma. Presentation of lung cancer as non-resolving pneumonia is not a very common phenomenon and diagnosis can present a diagnostic challenge to the clinician. Keyword: Non-resolving pneumonia, Young lady, Chest pain, fever, Large cell Carcinoma, Bangladesh. DOI: http://dx.doi.org/10.3329/jom.v12i2.8423 JOM 2011; 12(2): 166-169
A Young Man with Left Renal Mass  A Case of Primary Renal Lymphoma
Authors: Miah MD Titu , Tarafder Binoy Krishna , Amiruzzaman MD , Lutfur Rahman Dosth Mohammad , Uddin Khan Muhammad Ehasun
Published: August 2011

Renal involvement in lymphoma is not very uncommon but primary renal lymphoma is very rare and prognosis is poor. A 20 years male presented with localized, dull, constant pain and progressive swelling in left upper abdomen. He also gave history of significant weight loss. Examination findings revealed that he was anaemic, left kidney was hugely enlarged and hepatomegaly. Initially it seemed to be a case of renal cell carcinoma. But after doing invasive investigations it was proved to be a case of lymphoma, which considering all clinical and laboratory findings was diagnosed as a case of primary renal lymphoma. Keywords: Young man, Primary, Renal mass, Lymphoma DOI: http://dx.doi.org/10.3329/jom.v12i2.8424 JOM 2011; 12(2): 174-176
An Unusual Cause of Seizure in Clinical Practice
Authors: Hossain A , Islam QT , Siddiqui MMR , Rahman YU , Shipa RA
Published: August 2011

Neurocysticercosis (NCC), the infection caused by the larval stage of the tapeworm Taenia solium, is the most common parasitic disease of the nervous system (NS) in humans, where it is the leading cause of late-onset seizures in the endemic areas. Fortunately it is still rare in Bangladesh due to some religious binding in eating pork. Here we present a young man who came to us with Neurocysticercosis as the cause of recurrent seizure and various neurological manifestations. Keyword: Neurocysticercosis, Taenia solium, seizure. DOI: http://dx.doi.org/10.3329/jom.v12i2.8425 JOM 2011; 12(2): 177-179
Dengue Fever as A Cause of Acute Disseminated Encephalomyelitis (ADEM)
Authors: Chowdhury RN , Siddiqui MR , Mahbub MS , Hasan OSI , Talukder A , Nabi S , Miah T
Published: August 2011

Dengue fever is very common in Bangladesh. Every year a large number of urban populations suffer from this viral infection. Various presentations of dengue fever have been documented. Neurological complications in dengue fever are relatively uncommon. Among these, Acute Disseminated Encephalomyelitis (ADEM) has been observed in very few cases. Here we present a case of 13 year old girl suffering from ADEM following dengue fever. Keyword: Acute Disseminated Encephalomyelitis, Dengue fever, Neurological complication.DOI: http://dx.doi.org/10.3329/jom.v12i2.8428 JOM 2011; 12(2): 185-187
LD Body in Epitrochliar Lymphnode in a Bone Marrow and Splenic Aspiration Negative Indian Kala Azar
Authors: Das Gupta Ratan , Das Aparna , Miah Titu , Imran Khan Mohammad Ashik , Hasnain Muntasir , Alam Billal , Kabir Ahamedul
Published: August 2011

Kala Azar is a parasitic disease cause by Leishmania Donovani, transmitted by sand fly phlebotomus. Lymphadenopathy is not a common presentation in Indian Kala azar. We present an adult male from endemic zone of kalaazar presented with epitrochlear lymphadenopathy and hepato-splenomegaly and diagnosed by presence LD in lymphnode biopsy. Keyword: Kala Azar, Lymphadenopathy, Leishmania Donovani (LD) body, Bangladesh DOI: http://dx.doi.org/10.3329/jom.v12i2.8429 JOM 2011; 12(2): 188-190
A Young Lady with Headache and Abnormal Behavior
Authors: Mahbub MD Shahriar , Imran Khan Mohammad Ashik , Siddiqui MMR , Ahasan HAM Nazmul
Published: August 2011

DOI: http://dx.doi.org/10.3329/jom.v12i2.8430 JOM 2011; 12(2): 192
Evaluation of a commercial packed bed flow hydrogenator for reaction screening, optimization, and synthesis
Authors: Bryan Marian C , Wernick David , Hein Christopher D , Petersen James V , Eschelbach John W , Doherty Elizabeth M
Published: August 2011

The performance of the ThalesNano H-Cube®, a commercial packed bed flow hydrogenator, was evaluated in the context of small scale reaction screening and optimization. A model reaction, the reduction of styrene to ethylbenzene through a 10% Pd/C catalyst bed, was used to examine performance at various pressure settings, over sequential runs, and with commercial catalyst cartridges. In addition, the consistency of the hydrogen flow was indirectly measured by in-line UV spectroscopy. Finally, system contamination due to catalyst leaching, and the resolution of this issue, is described. The impact of these factors on the run-to-run reproducibility of the H-Cube® reactor for screening and reaction optimization is discussed.
Cutting Edge: Crohn’s Disease-Associated Nod2 Mutation Limits Production of Proinflammatory Cytokines To Protect the Host from Enterococcus faecalis-Induced Lethality
Authors: Kim Yun-Gi , Shaw Michael H. , Warner Neil , Park Jong-Hwan , Chen Felicia , Ogura Yasunori , Núñez Gabriel
Published: August 2011

Nucleotide-binding oligomerization domain 2 (Nod2) mutations including L1007fsinsC are associated with the development of Crohn’s disease (CD). These CD-associated Nod2 mutations are common in healthy white populations, suggesting that they may confer some protective function, but experimental evidence is lacking. Using a mouse strain that expresses Nod22939iCstop, the equivalent of the L1007fsinsC mutation, we found that macrophages homozygous for Nod22939iCstop are impaired in the recognition of muramyl dipeptide and Enterococcus faecalis, a commensal bacterium that is a common cause of sepsis-associated lethality in humans. Notably, Nod2 deficiency and homozygocity for Nod22939iCstop were associated with reduced production of TNF-α and IL-6 and lethality after systemic infection with E. faecalis despite normal bacteria loads. Consistently, inhibition of TNF-α signaling protected wild-type mice from E. faecalis-induced lethality. These results suggest that the same Nod2 mutation can increase the susceptibility to CD, but also protect the host from systemic infection by a common enteric bacterium.
Activated Protein C Attenuates Systemic Lupus Erythematosus and Lupus Nephritis in MRL-Fas(lpr) Mice
Authors: Lichtnekert Julia , Rupanagudi Khader Valli , Kulkarni Onkar P. , Darisipudi Murthy Narayana , Allam Ramanjaneyulu , Anders Hans-Joachim
Published: August 2011

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease leading to inflammatory tissue damage in multiple organs (e.g., lupus nephritis). Current treatments including steroids, antimalarials, and immunosuppressive drugs have significant side effects. Activated protein C is a natural protein with anticoagulant and immunomodulatory effects, and its recombinant version has been approved by the U.S. Food and Drug Administration to treat severe sepsis. Given the similarities between overshooting immune activation in sepsis and autoimmunity, we hypothesized that recombinant activated protein C would also suppress SLE and lupus nephritis. To test this concept, autoimmune female MRL-Fas(lpr) mice were injected with either vehicle or recombinant human activated protein C from week 14–18 of age. Activated protein C treatment significantly suppressed lupus nephritis as evidenced by decrease in activity index, glomerular IgG and complement C3 deposits, macrophage counts, as well as intrarenal IL-12 expression. Further, activated protein C attenuated cutaneous lupus and lung disease as compared with vehicle-treated MRL-Fas(lpr) mice. In addition, parameters of systemic autoimmunity, such as plasma cytokine levels of IL-12p40, IL-6, and CCL2/MCP-1, and numbers of B cells and plasma cells in spleen were suppressed by activated protein C. The latter was associated with lower total plasma IgM and IgG levels as well as lower titers of anti-dsDNA IgG and rheumatoid factor. Together, recombinant activated protein C suppresses the abnormal systemic immune activation in SLE of MRL-Fas(lpr) mice, which prevents subsequent kidney, lung, and skin disease. These results implicate that recombinant activated protein C might be useful for the treatment of human SLE.
A randomized controlled trial to compare pregabalin with gabapentin for postoperative pain in abdominal hysterectomy
Authors: Ghai Anju , Gupta Monika , Hooda Sarla , Singla Dinesh , Wadhera Raman
Published: August 2011

Background:

Pregabalin is a potent ligand for alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which exhibits potent anticonvulsant, analgesic and anxiolytic activity. The pharmacological activity of pregabalin is similar to that of gabapentin and shows possible advantages. Although it shows analgesic efficacy against neuropathic pain, very limited evidence supports its postoperative analgesic efficacy. We investigated its analgesic efficacy in patients experiencing acute pain after abdominal hysterectomy and compared it with gabapentin and placebo.

Methods:

A randomized, double-blind, placebo-controlled study was conducted in 90 women undergoing abdominal hysterectomy who were anaesthetized in a standardized fashion. Patients received 300 mg pregabalin, 900 mg gabapentin or placebo, 1–2 hours prior to surgery. Postoperative analgesia was administered at visual analogue scale (VAS) ≥3. The primary outcome was analgesic consumption over 24 hours and patients were followed for pain scores, time to rescue analgesia and side effects as secondary outcomes.

Results:

The diclofenac consumption was statistically significant between pregabalin and control groups, and gabapentin and control groups; however, pregabalin and gabapentin groups were comparable. Moreover, the consumption of tramadol was statistically significant among all the groups. Patients in pregabalin and gabapentin groups had lower pain scores in the initial hour of recovery. However, pain scores were subsequently similar in all the groups. Time to first request for analgesia was longer in pregabalin group followed by gabapentin and control groups.

Conclusion:

A single dose of 300 mg pregabalin given 1–2 hours prior to surgery is superior to 900 mg gabapentin and placebo after abdominal hysterectomy. Both the drugs are better than placebo.
A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy
Authors: Safavi Mohammadreza , Honarmand Azim , Zare Narges
Published: August 2011

Background:

The aim of the present study was to compare the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT).

Methods:

We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all three factors before surgery. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive value, Receiver operating characteristic (ROC) Curve and the area under ROC curve (AUC) for each airway predictor in isolation and in combination were determined.

Results:

Difficult laryngoscopy (Grade 3 or 4) occurred in 41 (6.8%) patients. The main endpoint of the present study, the AUC of the ROC, was significantly lower for the MMT (AUC, 0.511; 95% CI, 0.470–0.552) than the ULBT (AUC, 0.709; 95% CI, 0.671–0.745, P=0.002) and the RHTMD score (AUC, 0.711; 95% CI, 0.673–0.747, P=0.001). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score. By using discrimination analysis, the optimal cutoff point for the RHTMD for predicting difficult laryngoscopy was 21.06 (sensitivity, 75.6%; specificity, 58.5%).

Conclusion:

The RHTMD is comparable with ULBT for prediction of difficult laryngoscopy in general population.
Start time delays in operating room
Authors: Gupta Babita , Agrawal Pramendra , D'souza Nita , Soni Kapil Dev
Published: August 2011

Background:

Healthcare expenditure is a serious concern, with escalating costs failing to meet the expectations of quality care. The treatment capacities are limited in a hospital setting and the operating rooms (ORs). Their optimal utilization is vital in efficient hospital management. Starting late means considerable wait time for staff, patients and waste of resources. We planned an audit to assess different perspectives of the residents in surgical specialities and anesthesia and OR staff nurses so as to know the causative factors of operative delay. This can help develop a practical model to decrease start time delays in operating room (ORs).

Aims:

An audit to assess different perspectives of the Operating room (OR) staff with respect to the varied causative factors of operative delay in the OR. To aid in the development of a practical model to decrease start time delays in ORs and facilitate on-time starts at Jai Prakash Narayan Apex Trauma centre (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi.

Methods:

We prepared a questionnaire seeking the five main reasons of delay as per their perspective.

Results:

The available data was analysed. Analysis of the data demonstrated the common causative factors in start time operative delays as: a lack of proper planning, deficiencies in team work, communication gap and limited availability of trained supporting staff.

Conclusions:

The preparation of the equipment and required material for the OR cases must be done well in advance. Utilization of newer technology enables timely booking and scheduling of cases. Improved inter-departmental coordination and compliance with preanesthetic instructions needs to be ensured. It is essential that the anesthesiologists perform their work promptly, well in time . and supervise the proceedings as the OR manager. This audit is a step forward in defining the need of effective OR planning for continuous quality improvement.
Intra and postoperative outcome of adding clonidine to bupivacaine in infraorbital nerve block for young children undergoing cleft lip surgery
Authors: Jindal Parul , Khurana Gurjeet , Dvivedi Sanjay , Sharma J. P.
Published: August 2011

Aims and Context:

To evaluate the efficacy of adding clonidine to bupivacaine in bilateral infraorbital nerve block for hemodynamic changes, requirement of opioids, volatile agent, and muscle relaxants intraoperatively and relief of pain postoperatively

Setting and Design:

Prospective, randomized, double-blind study.

Methods:

Fifty pediatric patients aged less than 24 months undergoing elective cleft lip repair were randomly allocated to two groups of 25 each. After tracheal intubation, group A received bilateral infraorbital nerve block with 1 ml solution of clonidine (1 μg/kg) and bupivacaine 0.25%, and group B received 1 ml of 0.25% bupivacaine. Hemodynamic parameters, intraoperative requirement of volatile anesthetic agent, muscle relaxant, and analgesic were recorded. Pain was assessed postoperatively using the Face, Legs, Activity, Cry, Consolability scale till the first rescue drug was given.

Statistical Analysis:

Two sample unpaired t-test and the correlation r test.

Results:

The duration of analgesia from the time of administration of block in group A was 667.72 ± 210.74 min compared to 558.48 ± 150.28 min in group B (P<0.05).

Conclusion:

Addition of clonidine as an adjunct to local anesthetic significantly decreased the requirement of other anesthetic drugs and significantly prolonged the duration of postoperative analgesia without any adverse effects.
Percutaneous tracheotomy
Authors: Alzahrani T. , Nawaz S. , Delvi B. , Hajjar W.
Published: August 2011

Background:

Percutanoeous tracheotomy (PT) is a minimal invasive procedure alternative to surgical tracheotomy. PT offers an added advantage of enormous decrease of time interval between decision of doing tracheotomy and actually doing it. Moreover hazards of patient transport can be avoided as it can be safely performed at the bedside. We started doing PT in 2003 and performed 100 cases using forceps dilatation. Later we switched over to cone dilatation where we performed 215 cases. This study aims to compare two techniques of forceps vs. cone dilatation methods for PT.

Methods:

A total of 100 cases of PT were performed starting from December 2003 to August 2005 using the forceps dilatation method (group A). Further 215 cases were conducted (group B) from September 2003 to July 2008 using the cone dilatation method. Time of performing both procedures was recorded. Also incidence of complications was also recorded in both groups.

Results:

The incidence of minor bleeding in group A was 9%, whereas in group B was 5.58%. Major bleeding occurred in two patients in group B. Both cases suffered of pneumothorax and emphysema. One patient developed life-threatening tension pneumothorax and required cardio pulmonary resuscitation. This was one case in this series, in which the procedure has contributed to patient's morbidity. Guide wire-related technical difficulties were seen in 2% of the cases in group A, and 3.7% of cases in group B.

Conclusion:

forceps dilatation PT is superior to the cone dilatation technique in terms of safety. Further studies are needed to confirm our results.