bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Contributing to the Utilization of Adult Mental Health Services in Children and Adolescents Diagnosed with Hyperkinetic Disorder
Authors: Blasco-Fontecilla Hilario , Carballo Juan J. , Garcia-Nieto Rebeca , Lopez-Castroman Jorge , Alegria Analucia A. , Basurte-Villamor Ignacio , Sevilla-Vicente Juncal , Navarro-Jimenez Rocio , Legido-Gil Teresa , Morant-Ginestar Consuelo , Jimenez-Arriero Miguel Angel , Saiz-Ruiz Jeronimo , Baca-Garcia Enrique
Published: April 2012

Objectives. To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy) at Child and Adolescent Mental Health Services (CAMHS) moderate the risk of Adult Mental Health Services (AMHS) utilization in patients diagnosed with hyperkinetic disorder at CAMHS.Methods. Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities.Results. 7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS.Conclusions. Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS.
A Study on Methane and Nitrous Oxide Emissions Characteristics from Anthracite Circulating Fluidized Bed Power Plant in Korea
Authors: Lee Seehyung , Kim Jinsu , Lee Jeongwoo , Jeon Eui-Chan
Published: April 2012

In order to tackle climate change effectively, the greenhouse gas emissions produced in Korea should be assessed precisely. To do so, the nation needs to accumulate country-specific data reflecting the specific circumstances surrounding Korea’s emissions. This paper analyzed element contents of domestic anthracite, calorific value, and concentration of methane (CH4) and nitrous oxide (N2O) in the exhaust gases from circulating fluidized bed plant. The findings showed the concentration of CH4and N2O in the flue gas to be 1.85 and 3.25 ppm, respectively, and emission factors were 0.486 and 2.198 kg/TJ, respectively. The CH4emission factor in this paper was 52% lower than default emission factor presented by the IPCC. The N2O emission factor was estimated to be 46% higher than default emission factor presented by the IPCC. This discrepancy can be attributable to the different methods and conditions of combustion because the default emission factors suggested by IPCC take only fuel characteristics into consideration without combustion technologies. Therefore, Korea needs to facilitate research on a legion of fuel and energy consumption facilities to develop country-specific emission factors so that the nation can have a competitive edge in the international climate change convention in the years to come.
Aflatoxigenic Fungi and Aflatoxins in Portuguese Almonds
Authors: Rodrigues P. , Venâncio A. , Lima N.
Published: April 2012

Aflatoxin contamination of nuts is an increasing concern to the consumer’s health. Portugal is a big producer of almonds, but there is no scientific knowledge on the safety of those nuts, in terms of mycotoxins. The aim of this paper was to study the incidence of aflatoxigenic fungi and aflatoxin contamination of 21 samples of Portuguese almonds, and its evolution throughout the various stages of production. All fungi belonging toAspergillussectionFlaviwere identified and tested for their aflatoxigenic ability. Almond samples were tested for aflatoxin contamination by HPLC-fluorescence. In total, 352 fungi belonging toAspergillussectionFlaviwere isolated from Portuguese almonds: 127 were identified asA. flavus(of which 28% produced aflatoxins B), 196 as typical or atypicalA. parasiticus(all producing aflatoxins B and G), and 29 asA. tamarii(all nonaflatoxigenic). Aflatoxins were detected in only one sample at 4.97 μg/kg.
Galectin-10 Is Released in the Nasal Lavage Fluid of Patients with Aspirin-Sensitive Respiratory Disease
Authors: Negrete-Garcia Ma. Cristina , Jiménez-Torres Carla Yoneli , Alvarado-Vásquez Noe , Montes-Vizuet A. Rosalía , Velázquez-Rodriguez J. R. , Jimenez-Martinez M. Carmen , Teran-Juárez Luis Manuel
Published: April 2012

The aim of this work was to determine the presence of galectin-10 in nasal lavage fluid (NLF) of patients with aspirin-sensitive respiratory disease (ASRD) before and after challenge with L-ASA (aspirin) by ELISA. Fifteen ASRD patients, ten aspirin-tolerant asthmatics (ATA), and fifteen healthy controls (HC) were studied. The baseline presence of Galectin-10 in PBMC was determined using real time PCR. Galectin-10 was evaluated in tissue of nasal polyps by western blot. Our results showed a lower expression in PBMC of ASRD patients than in ATA and healthy controls. However, a higher concentration of galectin-10 in NLF was found in ASRD patients before and after L-ASA challenge; western blot confirmed a high expression of galectin-10 in tissue from nasal polyps obtained from ASRD patients. Our results suggest a probable role of galectin-10 in the inflammatory response observed in ASRD patients; however, confirmatory studies are needed.
Mechanical, Rheological, and Bioactivity Properties of Ultra High-Molecular-Weight Polyethylene Bioactive Composites Containing Polyethylene Glycol and Hydroxyapatite
Authors: Ahmad Mazatusziha , Wahit Mat Uzir , Abdul Kadir Mohammed Rafiq , Mohd Dahlan Khairul Zaman
Published: April 2012

Ultrahigh-molecular-weight polyethylene/high-density polyethylene (UHMWPE/HDPE) blends prepared using polyethylene glycol PEG as the processing aid and hydroxyapatite (HA) as the reinforcing filler were found to be highly processable using conventional melt blending technique. It was demonstrated that PEG reduced the melt viscosity of UHMWPE/HDPE blend significantly, thus improving the extrudability. The mechanical and bioactive properties were improved with incorporation of HA. Inclusion of HA from 10 to 50 phr resulted in a progressive increase in flexural strength and modulus of the composites. The strength increment is due to the improvement on surface contact between the irregular shape of HA and polymer matrix by formation of mechanical interlock. The HA particles were homogenously distributed even at higher percentage showed improvement in wetting ability between the polymer matrix and HA. The inclusion of HA enhanced the bioactivity properties of the composite by the formation of calcium phosphate (Ca-P) precipitates on the composite surface as proven from SEM and XRD analysis.
Effect of Irrigation to Winter Wheat on the Radiation Use Efficiency and Yield of Summer Maize in a Double Cropping System
Authors: Quanqi Li , Yuhai Chen , Xunbo Zhou , Songlie Yu , Changcheng Guo
Published: April 2012

In north China, double cropping of winter wheat and summer maize is a widely adopted agricultural practice, and irrigation is required to obtain a high yield from winter wheat, which results in rapid aquifer depletion. In this experiment conducted in 2001-2002, 2002-2003, and 2004-2005, we studied the effects of irrigation regimes during specific winter wheat growing stage with winter wheat and summer maize double cropping systems; we measured soil moisture before sowing (SMBS), the photosynthetic active radiation (PAR) capture ratio, grain yield, and the radiation use efficiency (RUE) of summer maize. During the winter wheat growing season, irrigation was applied at the jointing, heading, or milking stage, respectively. The results showed that increased amounts of irrigation and irrigation later in the winter wheat growing season improved SMBS for summer maize. The PAR capture ratio significantly (LSD,P<0.05) increased with increased SMBS, primarily in the 3 spikes leaves. With improved SMBS, both the grain yield and RUE increased in all the treatments. These results indicate that winter wheat should be irrigated in later stages to achieve reasonable grain yield for both crops.
Standard Enucleation with Aluminium Oxide Implant (Bioceramic) Covered with Patient's Sclera
Authors: Zigiotti Gian Luigi , Cavarretta Sonia , Morara Mariachiara , Nam Sang Min , Ranno Stefano , Pichi Francesco , Lembo Andrea , Lupo Stefano , Nucci Paolo , Meduri Alessandro
Published: April 2012

Purpose. We describe in our study a modified standard enucleation, using sclera harvested from the enucleated eye to cover the prosthesis in order to insert a large porous implant and to reduce postoperative complication rates in a phthisis globe.Methods. We perform initially a standard enucleation. The porous implant (Bioceramic) is then covered only partially by the patient's sclera. The implant is inserted in the posterior Tenon's space with the scleral covering looking at front. All patients were followed at least for twelve months (average followup 16 months).Results. We performed nineteen primary procedures (19 patients, 19 eyes,xM;xF) and secondary, to fill the orbital cavity in patients already operated by standard evisceration (7 patients, 7 eyes). There were no cases of implant extrusion. The orbital volume was well reintegrated.Conclusion. Our procedure was safe and effective. All patients had a good cosmetic result after final prosthetic fitting and we also achieved good prothesis mobility.
Emotion and relatedness as aspects of the identities of adolescents with severe learning disabilities: contributions from ‘practice‐near’ social work research
Authors: Hingley‐Jones Helen
Published: April 2012

This paper considers social and personal/individual approaches to researching identities of adolescents with severe learning disabilities; suggesting that vital components of emotionality and relatedness are largely missing from research and consequently from literature informing social care professionals. This leaves untapped, rich information and communication resources for research which may improve understandings of the experiences of a socially excluded group of young people. A psychosocial view of adolescent identity development, ‘subjectivation’, offers a way forward and a case study on ‘Billy’, drawn from a ‘practice‐near’ observational study, helps to illustrate this. Observation allows the researcher to be sensitive to the subtle ways in which identities of young people with severe learning disabilities are constructed, often with a sense of fragility and uncertainty. Continuities of experience between the young people and the rest of the adolescent community may be seen, but also the impact of living with impairment can be thought about in relation to the particular psychosocial circumstances of each young person. Knowledge of these processes enhances social work practice by encouraging workers to be sensitive to, and healthily curious about, the multiple ways in which identities of young people with severe learning disabilities are shaped in relationship with those around them and the wider social field.
The LINA cohort: indoor chemical exposure, circulating eosinophil/basophil (Eo/B) progenitors and early life skin manifestations
Authors: Weisse K. , Lehmann I. , Heroux D. , Kohajda T. , Herberth G. , Röder S. , von Bergen M. , Borte M. , Denburg J.
Published: April 2012

Background

Hematopoietic progenitor cells, especially those committed to the Eo/B lineage, are known to contribute to allergic inflammation.

Objective

The aim of the present study was to investigate whether environmental factors are associated with changes in numbers of circulating Eo/B progenitors at 1 year of age.

Methods

Peripheral blood from 60 1‐year‐old children enrolled in the LINA (Lifestyle and environmental factors and their Influence on Newborns Allergy risk) birth cohort was assessed for Eo/B progenitor cells (Eo/B CFU) using standardized and validated methylcellulose assays. Frozen peripheral blood mononuclear cells (PBMC) were cultured in the presence of IL‐3, IL‐5 or GM‐CSF, and Eo/B CFUs enumerated. Clinical outcomes and exposure to environmental tobacco smoke (ETS) were documented by standardized questionnaires, and indoor volatile organic compound (VOC) concentrations were assessed by passive sampling.

Results

Children with skin manifestations (atopic dermatitis or cradle cap) within the first year of life had higher numbers of circulating IL‐3‐, IL‐5‐ or GM‐CSF‐stimulated Eo/B CFUs (P < 0.05) at 1 year. In children with cradle cap, a positive correlation was found between Eo/B CFUs and exposure to ETS‐related VOCs during pregnancy or at 1 year of age (P < 0.05).

Conclusions and Clinical Relevance

This is the first demonstration that environmental exposures are positively associated with levels of circulating Eo/B progenitors. The recruitment and differentiation of Eo/B progenitors in response to environmental triggers may play a role in the development of skin manifestations during the first year of life.
High‐Performance Liquid Chromatography Under Partially Denaturing Conditions (dHPLC) is a Fast and Cost‐Effective Method for Screening Molecular Defects: Four Novel Mutations Found in X‐Linked Chronic Granulomatous Disease
Authors: de Oliveira‐Junior E. B. , Prando C. , Lopez J. A. , Arango J. C. , Buzolin M. , Rehder J. , Pedroza L. A. , Frazão J. B. , Dantas V. M. , Roxo‐Junior P. , Grumach A. S. , Costa‐Carvalho B. T. , Bustamante J. , Condino‐Neto A.
Published: April 2012

Implementing precise techniques in routine diagnosis of chronic granulomatous disease (CGD), which expedite the screening of molecular defects, may be critical for a quick assumption of patient prognosis. This study compared the efficacy of single‐strand conformation polymorphism analysis (SSCP) and high‐performance liquid chromatography under partially denaturing conditions (dHPLC) for screening mutations in CGD patients. We selected 10 male CGD patients with a clinical history of severe recurrent infections and abnormal respiratory burst function. gDNA, mRNA and cDNA samples were prepared by standard methods. CYBB exons were amplified by PCR and screened by SSCP or dHPLC. Abnormal DNA fragments were sequenced to reveal the nature of the mutations. The SSCP and dHPLC methods showed DNA abnormalities, respectively, in 55% and 100% of the cases. Sequencing of the abnormal DNA samples confirmed mutations in all cases. Four novel mutations in CYBB were identified which were picked up only by the dHPLC screening (c.904 insC, c.141+5 g>t, c.553 T>C, and c.665 A>T). This work highlights the relevance of dHPLC, a sensitive, fast, reliable and cost‐effective method for screening mutations in CGD, which in combination with functional assays assessing the phagocyte respiratory burst will contribute to expedite the definitive diagnosis of X‐linked CGD, direct treatment, genetic counselling and to have a clear assumption of the prognosis. This strategy is especially suitable for developing countries.
The rs150311303 Polymorphism in FcγRIIa Enhances IgG Binding Capacity
Authors: Omar A. H. , Shibata H. , Yasunami M. , Yamazaki A. , Ofori M. F. , Akanmori B. D. , Shuaibu M. N. , Kikuchi M. , Hirayama K.
Published: April 2012

Fc gamma receptor (FcγR) provides an important link between humoral and cellular immune responses. FcγRIIa‐H131R polymorphism has been associated with differential binding to IgG subclasses and susceptibility to severe malaria phenotypes among different populations in the malaria endemic world. In this study, the effect of FCGR2A gene polymorphisms on susceptibility to symptomatic malaria among Ghanaian cohort children was investigated. Blood samples from four hundred and 29 (429) healthy Ghanaian children were genotyped for FCGR2A polymorphisms by direct DNA sequencing. Attributable and relative risks to symptomatic malaria were calculated for the polymorphic variants. Two major FCGR2A polymorphisms, rs1801274A/G (FcγRIIa‐H131R) and rs150311303 (FcγRIIa‐ins170L), were identified in the study population, and assessment of their risks did not show significant association with susceptibility to symptomatic malaria. The functional significance of these polymorphisms was also examined by evaluating their binding abilities to IgG subclasses using flow cytometric analysis of HEK cells transfected with the FcγRIIa haplotype variants. The binding assay revealed the rs150311303, which was observed only among carriers of the FcγRIIa‐131RR genotype for the rs1801274 to consistently enhance binding capacities to all IgG subclasses. Thus, of the three FcγRIIa haplotype variants observed in this study population, the FcγRIIaRL haplotype variant was observed to have the highest binding ability to IgG1, IgG3 and IgG4.
An update on treatment of onychomycosis
Authors: Grover Chander , Khurana Ananta
Published: April 2012

Onychomycosis (OM) is a fungal infection of the nail plate or nail bed which is highly prevalent in the general population and also responsible for significant morbidity. The condition needs to be treated in view of the physical and emotional handicap it produces. The peculiarities of the nail apparatus in health and disease lead to difficulties in being able to successfully treat this condition. Hence, the very same antifungals which produce high cure rates in skin infections are rendered less efficacious in nail disease. Low cure rates and high relapse rates even with highly efficacious antifungals have lead to an increasing interest in exploring newer treatment options which can ensure drug penetration, drug persistence, mycological cure and effective prevention of relapse. The current review aims to summarize our current status of knowledge about the treatment options for OM. It also summarizes the newer areas of research especially with respect to devices related therapies; physical measures to enhance penetration through nail; and development and evaluation of synergistic combinations.
Rodent motor and neuropsychological behaviour measured in home cages using the integrated modular platform SmartCage™
Authors: Khroyan Taline V , Zhang Jingxi , Yang Liya , Zou Bende , Xie James , Pascual Conrado , Malik Adam , Xie Julian , Zaveri Nurulain T , Vazquez Jacqueline , Polgar Willma , Toll Lawrence , Fang Jidong , Xie Xinmin
Published: April 2012

To facilitate investigation of diverse rodent behaviours in rodents’ home cages, we have developed an integrated modular platform, the SmartCage™ system (AfaSci, Inc. Burlingame, CA, USA), which enables automated neurobehavioural phenotypic analysis and in vivo drug screening in a relatively higher‐throughput and more objective manner.

The individual platform consists of an infrared array, a vibration floor sensor and a variety of modular devices. One computer can simultaneously operate up to 16 platforms via USB cables.

The SmartCage™ detects drug‐induced increases and decreases in activity levels, as well as changes in movement patterns. Wake and sleep states of mice can be detected using the vibration floor sensor. The arousal state classification achieved up to 98% accuracy compared with results obtained by electroencephalography and electromyography. More complex behaviours, including motor coordination, anxiety‐related behaviours and social approach behaviour, can be assessed using appropriate modular devices and the results obtained are comparable with results obtained using conventional methods.

In conclusion, the SmartCage™ system provides an automated and accurate tool to quantify various rodent behaviours in a ‘stress‐free’ environment. This system, combined with the validated testing protocols, offers powerful a tool kit for transgenic phenotyping and in vivo drug screening.
Pregnancy complicated by uterine sacculation due to a huge myoma
Authors: Shima Eiri , Serikawa Takehiro , Itsukaichi Mina , Haino Kazufumi , Ooki Izumi , Takakuwa Koichi , Tanaka Kenichi
Published: April 2012

Uterine sacculation is rare complication affecting the pregnant uterus, and is difficult to diagnose. Sacculation consists of a transitory pouch or sac‐like structure caused by inverted uterine polarity. Vaginal delivery is difficult, and even cesarean section can be difficult because of peculiar risks associated with uterine sacculation. We report a pregnant patient with posterior sacculation due to a huge myoma in the lower anterior uterine segment. Sacculation, especially that complicated by a huge myoma, is very difficult to accurately diagnose and makes cesarean section surgery challenging. Because of the myoma in our present case, opening the lower uterine segment was impossible with cesarean section. The uterus was instead opened by corporeal vertical cesarean section. Myomectomy was not performed and the giant myoma thus remained. Postoperative assessment revealed the uterus to still be retroverted. The giant myoma was the cause of sacculation in this case.
Physical, psychological and sexual effects in multi‐ethnic Malaysian women who have undergone hysterectomy
Authors: Wong Li Ping , Arumugam Kulenthran
Published: April 2012

Aim:  The postoperative effects on Asian women after hysterectomy have not been fully explored. This study was undertaken to investigate the physical, psychological and sexual functioning effects in multi‐ethnic Malaysian women who have undergone hysterectomy.

Material and Methods:  A cross‐sectional questionnaire‐based study was conducted on women who underwent hysterectomy at the Gynecological Outpatient Clinic, University of Malaya Medical Center between November 2008 and October 2009.

Results:  Postoperative physical and psychological effects were common. Participants with higher household income had a significantly lower number of physical and psychological problems. Young women were more likely to experience psychological effects. There were significant differences between ethnic groups in physical and psychological symptoms. A multivariate model to determine factors associated with sexual functioning identified the importance of sexual relationship, spouse or partner's attitudes, and ethnic groups as significant covariates.

Conclusion:  The findings underscore the importance of ethnic‐based approaches to counseling to mitigate the psychological effects of hysterectomy and to focus on young women with low socioeconomic status.
Bladder drainage during labor: A randomized controlled trial
Authors: Rivard Colleen , Awad Michael , Liebermann Maike , DeJong Megan , Massey Sarita M. , Sinacore Jim , Brubaker Linda
Published: April 2012

Aim:  To compare two bladder draining methods during labor on time to delivery, cost and nursing preference.

Material and Methods:  This trial randomized 139 women with singleton pregnancies in active labor or undergoing induction of labor. Eligibility required an anticipated vaginal delivery with a clinical indication for bladder catheterization (epidural). Participants were randomly assigned to either indwelling or intermittent catheterization. The primary outcome was time to delivery; secondary outcomes were nurse preference, cost and route of delivery. A sample size of 138 women would be needed for 80% power to detect a 30 min difference in the time to delivery interval with a 0.05 alpha error.

Results:  Outcome data was available for 138 patients (72 indwelling and 66 intermittent). The time to delivery was similar among the two groups (13.8 h for indwelling and 14.4 h for intermittent). Route of delivery and cost estimate was similar in both groups; however, nurses preferred the indwelling method.

Conclusion:  Indwelling catheterization is recommended as the standard method for bladder drainage in laboring women with epidural.
Obstetric and gynecological outcome in a patient with traumatic pelvic fracture and perineal injuries
Authors: Goswami Deepti , Kochhar Puneet Kaur , Suri Tarun , Zutshi Vijay , Batra Swaraj
Published: April 2012

A 19‐year‐old woman presented with pelvic trauma following a road accident. She was hemodynamically stable. Examination revealed perineal injuries and type C pelvic fracture, which was stabilized with an external fixator. The broken ends of the pubic bone were brought together by an orthopedic wire. The detached vaginal wall and torn anal sphincter were surgically repaired after making a diverting colostomy. The postoperative period was uneventful. Colostomy was reversed after 3 months. Postoperatively the patient developed a cystocele, dyspareunia and vaginal pain. She conceived spontaneously and was planned for an elective cesarean at 37 weeks gestation; however, she presented in labor at 36 weeks and had a normal vaginal delivery. Pelvic fractures may be associated with genitourinary and anal sphincter injuries, which require management by a multidisciplinary team. On recovery the patient may develop prolapse, dyspareunia and persistent local pain. Spontaneous conception and normal vaginal delivery are nevertheless possible.
Metformin sensitizes endometrial cancer cells to chemotherapy by repressing glyoxalase I expression
Authors: Dong Lingling , Zhou Qian , Zhang Zhenbo , Zhu Yaping , Duan Tao , Feng Youji
Published: April 2012

Aim:  Metformin plays an important role in the inhibition of cancer cell growth and prolongs remission durations. It reverses progestin‐resistance in endometrial cancer cells by downregulating glyoxalase I (GloI) expression. This study aimed to investigate the effect of metformin on endometrial cancer cell chemotherapeutic sensitivity and explore the underlying molecular mechanisms.

Material and Methods:  MTT assay was performed to determine the rate of cell death after cisplatin and paclitaxel with or without metformin. Western blot was carried out to analyze GloI expression. SiRNA‐targeting of GloI was used to knockdown GloI expression before further treatment with chemotherapeutic agents to examine the effect of GloI downregulation on chemotherapy‐induced cell killing. In addition, plasmid transfection was used to overexpress GloI and determine whether high GloI levels blocked metformin‐enhanced cell sensitivity to chemotherapy. PCR was used to analyze the efficiency of RNA interference and plasmid transfection.

Results:  The addition of metformin enhanced the sensitivity of endometrial cells to cisplatin and paclitaxel, which was associated with reduced levels of GloI expression. Moreover, low‐dose chemotherapeutic drugs alone could not significantly reduce GloI expression, whereas the addition of metformin potently downregulated GloI protein levels. Cisplatin and paclitaxel markedly inhibited the proliferative ability of GloI‐depleted endometrial cancer cells. However, the overexpression of GloI abolished the effect of metformin‐enhanced cell sensitivity to chemotherapeutic drugs.

Conclusion:  Metformin enhances the rate of cell‐killing induced by chemotherapeutic agents by repressing GloI expression.
Oxidative stress measured by carbonyl groups level in postmenopausal women after oral and transdermal hormone therapy
Authors: Polac Ireneusz , Borowiecka Marta , Wilamowska Agnieszka , Nowak Pawel
Published: April 2012

Aim:  Menopause is associated with an increased risk of cardiovascular disorders, which are accompanied by oxidative stress. Our study was undertaken to determine whether oxidative stress in menopausal women could be reduced after six months of oral or transdermal hormonal therapy.

Material and Methods:  Carbonyl groups of proteins in blood plasma were estimated by sensitive ELISA method with anti‐DNP antibodies. In this method, protein samples diluted in phosphate‐buffered saline were adsorbed to wells of an ELISA plate and then reacted with dinitrophenylhydrazine (DNPH).

Results:  Plasma protein carbonyl levels of postmenopausal women treated with o‐HT and t‐HT for six months (o‐HT: 1.785 ± 0.31 nmol/mg; t‐HT: 1.838 ± 0.33 nmol/mg) were lower when compared with the control group (2.232 ± 0.28 nmol/mg). There was no statistically significant difference in carbonyl levels between women after oral and transdermal HT (P = 0.149).

Conclusion:  Hormonal therapy reduces the level of carbonyl protein, a marker of oxidative stress, suggesting potential protective effect.
Uterine tamponade using condom catheter balloon in the management of non‐traumatic postpartum hemorrhage
Authors: Rathore Asmita Muthal , Gupta Sonali , Manaktala Usha , Gupta Sangeeta , Dubey Chandan , Khan Mumtaz
Published: April 2012

Aim:  To study the efficacy and complications of uterine tamponade using condom catheter balloon in non‐traumatic postpartum hemorrhage (PPH).

Material and Methods:  This prospective study was conducted in a tertiary care teaching hospital in India. Eighteen patients with non‐traumatic PPH not responding to medical management were included in the study. Uterine tamponade was achieved by a condom catheter balloon filled with saline and kept in situ for 8–48 h. The main outcome measures were success rate in controlling hemorrhage, time required to stop bleeding, subsequent morbidity and technical difficulties. Data was analyzed using appropriate statistical methods.

Results:  The success rate of condom catheter balloon in controlling hemorrhage was 94%. The mean amount of fluid filled in the condom catheter balloon was 409 mL. The average time taken to control bleeding was 6.2 min. The mean duration for which condom catheter balloon was left in situ was 27.5 h. The average amount of blood loss was 1330 mL. Five patients (28%) had infective morbidity.

Conclusion:  Condom catheter balloon is effective in controlling non‐traumatic PPH in 94% cases. It is effective, simple to use, easily available and is a cheap modality to manage non‐traumatic postpartum hemorrhage, especially in limited resource settings.
5′‐Ectonucleotidase‐knockout mice lack non‐REM sleep responses to sleep deprivation
Authors: Zielinski Mark R. , Taishi Ping , Clinton James M. , Krueger James M.
Published: April 2012

Adenosine and extracellular adenosine triphosphate (ATP) have multiple physiological central nervous system actions including regulation of cerebral blood flow, inflammation and sleep. However, their exact sleep regulatory mechanisms remain unknown. Extracellular ATP and adenosine diphosphate are converted to adenosine monophosphate (AMP) by the enzyme ectonucleoside triphosphate diphosphohydrolase 1, also known as CD39, and extracellular AMP is in turn converted to adenosine by the 5′‐ectonuleotidase enzyme CD73. We investigated the role of CD73 in sleep regulation. Duration of spontaneous non‐rapid eye movement sleep (NREMS) was greater in CD73‐knockout (KO) mice than in C57BL/6 controls whether determined in our laboratory or by others. After sleep deprivation (SD), NREMS was enhanced in controls but not CD73‐KO mice. Interleukin‐1 beta (IL1β) enhanced NREMS in both strains, indicating that the CD73‐KO mice were capable of sleep responses. Electroencephalographic power spectra during NREMS in the 1.0–2.5 Hz frequency range was significantly enhanced after SD in both CD73‐KO and WT mice; the increases were significantly greater in the WT mice than in the CD73‐KO mice. Rapid eye movement sleep did not differ between strains in any of the experimental conditions. With the exception of CD73 mRNA, the effects of SD on various adenosine‐related mRNAs were small and similar in the two strains. These data suggest that sleep is regulated, in part, by extracellular adenosine derived from the actions of CD73.
The absence of voiding symptoms in men with a prostate‐specific antigen (PSA) concentration of ≥3.0 ng/mL is an independent risk factor for prostate cancer: results from the Gothenburg Randomized Screening Trial
Authors: Frånlund Maria , Carlsson Sigrid , Stranne Johan , Aus Gunnar , Hugosson Jonas
Published: April 2012

Study Type – Prognostic (RCT)

Level of Evidence 1b

What's known on the subject? and What does the study add?

There are only a few studies and no consensus concerning the relationship between LUTS and prostate cancer. This paper focuses on 2353 men with an elevated PSA level within the Gothenburg Randomized Screening Trial who underwent biopsy and answered questions regarding LUTS. The main conclusion was that the absence of voiding symptoms is an independent risk factor for prostate cancer detection.

OBJECTIVE

To investigate whether men with obstructive voiding symptoms are at increased risk for being diagnosed with prostate cancer within the Gothenburg randomized population‐based prostate cancer screening trial.

SUBJECTS AND METHODS

In 1995, 20 000 men born between 1930 and 1944 were randomly selected from the population register and randomized to either a screening group (10 000), invited for total prostate‐specific antigen (tPSA) testing every second year until they reached an upper age‐limit pending between 67 and 71 years, or to a control group not invited (10 000).

Men with a PSA concentration of ≥3.0 ng/mL were offered further examination with prostate biopsies. Immediately before the physician's examination a self‐administered, study‐specific questionnaire was completed including one question concerning obstructive voiding symptoms.

Multivariate logistic regression modelling was used to estimate odds ratios (ORs) for associations of age, tPSA, free/total PSA (f/tPSA) ratio, prostate volume and the presence of voiding symptoms in prostate cancer risk. A P < 0.05 was considered statistically significant.

RESULTS

Between 1995 and 2010 there were 2590 men who had an elevated PSA concentration (≥3.0 ng/mL) at least once during the study. Of these, 2353 men (91%) accepted further clinical examination with transrectal ultrasonography (TRUS) and prostate biopsies. In all, 633/2353 men had prostate cancer (27%) on biopsy and 1720/2353 men (73%) had a benign pathology.

Men with prostate cancer reported a lower frequency of voiding symptoms (24% vs 31%, P < 0.001), independent of age and locally advanced tumours (T2b–T4). In the multivariate logistic regression model increasing age and tPSA were positively associated with prostate cancer while prostate volume, f/tPSA ratio and the presence of voiding symptoms were all inversely associated with the risk of detecting prostate cancer in a screening setting. This inverse association of voiding symptoms and prostate cancer detection was restricted to men with large prostates (>37.8 mL); 15% in men with voiding symptoms vs 22% in asymptomatic men (P < 0.001).

CONCLUSION

The presence of voiding symptoms should not be a decision tool for deciding which men with an elevated PSA concentration should be offered biopsies of the prostate.
Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption
Authors: Ayyathurai Rajinikanth , Garcia‐Roig Michael , Gorin Michael A. , González Javier , Manoharan Murugesan , Kava Bruce R. , Soloway Mark S. , Ciancio Gaetano
Published: April 2012

Study Type – Therapy (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

The surgical implications of renal cell carcinoma with coexisting bland and tumour thrombi of the inferior vena cava is not well described. In this study we review our experience managing these tumours. On multivariate analysis, we found that the presence of bland thrombus was associated with an increased need for surgical interruption of the inferior vena cava.

OBJECTIVE

To study the role of interruption of the inferior vena cava (IVC) in patients with renal cell carcinoma (RCC) and associated bland and tumour thrombi.

METHODS

We reviewed 129 consecutive patients with the preoperative diagnosis of RCC with tumour thrombus who underwent radical nephrectomy and tumour thrombectomy in one academic institution between May 1997 and February 2011.

RESULTS

Percentages of patients with levels I, II, III and IV tumour thrombus were 29%, 13%, 48% and 9%, respectively.

The perioperative mortality rate was 2.3%. There were 29 (22%) perioperative complications recorded.

In all, 19 patients underwent surgical interruption of the IVC by ligation or segmental resection, including one level II, 14 level III and four level IV thrombi.

A total of 15 patients (12%) had bland thrombus associated with the tumour thrombus; four of these underwent intraoperative IVC filter placement and eight underwent surgical IVC interruption.

Advanced level of tumour thrombus was the only significant factor predicting association of bland thrombus (odds ratio [OR]= 2.09, 95% confidence interval [CI]: 1.082–4.037, P= 0.028).

On multivariate analysis, level of thrombus (OR = 3.1, 95% CI: 1.30–7.74, P= 0.011) and association of bland thrombus (OR = 9.07, 95% CI: 2.42–34.01, P= 0.001) were significant factors for IVC interruption.

CONCLUSIONS

Surgical interruption of the IVC is a feasible option in selected patients with chronic IVC obstruction. Association of bland thrombus with tumour thrombus should alert the surgical team to the potential for a challenging surgery.

Precise preoperative imaging to assess the degree of venous obstruction and to help with differentiation between bland and tumour thrombus is key to achieving a surgical outcome with minimal morbidity.
The correlation between size of renal cell carcinoma and its histopathological characteristics: a single center study of 1867 renal cell carcinoma cases
Authors: Zhang Cuijian , Li Xuesong , Hao Han , Yu Wei , He Zhisong , Zhou Liqun
Published: April 2012

Study Type – Prognosis (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

We had known from former studies of RCC that the risks of high grade tumours increased with tumour size and probability of localized tumour decreased with tumour size increasing. Our study had provided large and detailed data about pathologic features of RCC. We also examined the exactly changing of probabilities of different subtypes with diameter increasing and evaluated the effects of hemorrhage, necrosis and cystic degeneration on pathologic subtypes.

OBJECTIVE

To investigate the correlation between tumour size and histopathological characteristics of renal cell carcinoma (RCC).

PATIENTS AND METHODS

A total of 1867 patients who underwent surgical operation between January 2002 and March 2010 due to RCC were included. According to 1997 WHO recommendation about Fuhrman nuclear grading of RCC which criteria we used, tumours were stratified by the largest pathologic diameter into 5 groups, the discrepancy of tumour grade between different groups and whether tumour size could predict histological subtype were analyzed.

RESULTS

The largest diameter (mean ±sd) of G1, G2, and G3 tumours were 3.27 ± 1.46 cm,4.87 ± 2.23 cm, and 7.39 ± 3.11 cm, respectively. The percentage of extracapsular extension tumours in 2 cm or less, 2.1 and 4.0 cm, 4.1 to 7 cm, 7.1 to 10 cm, and more than 10 cm group were 0.5%, 4.3%, 19.8%, 57.9%, and 91.9%, respectively. The distribution of G1 tumours shows a decreasing trend with the diameter becoming larger, while the G3 tumours shows an opposite trend (P < 0.05). Logistic regression analysis predicted that the odds of papillary, chromophobe, and other types vs clear cell decreased with increase in tumour size. If the tumour was complicated with hemorrhage or necrosis, the chance of being chromophobe was higher, while the probability of being papillary and chromophobe decreased when a tumour with cystic degeneration.

CONCLUSION

There was a significant correlation between tumour size and tumour grade and stage; Larger tumours were prone to have higher grade and stage, and the probability of being clear cell carcinoma grew higher as the tumour size increased.
Transient receptor potential vanilloid 1 mediates nerve growth factor‐induced bladder hyperactivity and noxious input
Authors: Frias Barbara , Charrua Ana , Avelino Antonio , Michel Martin C. , Cruz Francisco , Cruz Celia D.
Published: April 2012

What's known on the subject? and What does the study add?

The interaction between the TRPV1 and NGF systems has been addressed only in the context of acute somatic pain. The present study expands this view and indicates that this interaction remains operative and is important as a mechanism for chronic visceral pain and dysfunction. Moreover, it further stresses the need to develop more specific and effective TRPV1 antagonists for clinical use.

OBJECTIVES

To explore the role of transient receptor potential vanilloid 1 (TRPV1) in the excitatory effects of chronic administration of nerve growth factor (NGF) on bladder‐generated sensory input and reflex activity.

To explore new therapeutic targets for bladder dysfunction.

MATERIALS AND METHODS

Wild‐type (WT) and TRPV1 knockout (KO) mice received daily intraperitoneal injections of NGF (1 µg/10 g) or saline for a period of 4 days, during which time thermal sensitivity was evaluated daily. On the 5th day, mice were anaesthetized and cystometries were performed. The frequency, amplitude and area under the curve (AUC) of bladder reflex contractions were determined.

c‐Fos expression was evaluated on L6 spinal cord sections of WT and TRPV1 KO mice treated with saline or chronic NGF by immunohistochemistry.

TrkA receptor staining intensity was determined in L6 spinal cord sections and respective dorsal root ganglia of WT and TRPV1 KO mice.

RESULTS

Repeated administration of NGF induced thermal hypersensitivity in WT but not in TRPV1 KO mice.

The frequency of bladder contractions of saline‐treated WT and TRPV1 KO mice was similar, the values respectively being 0.45 ± 0.12/min and 0.46 ± 0.16/min. Treatment with NGF enhanced bladder reflex activity in WT mice to 1.23 ± 0.41/min (P < 0.05). In NGF‐treated KO mice, the frequency of bladder contractions was 0.60 ± 0.05/min. Irrespective of treatment, no differences were observed in the amplitude of bladder contractions of WT and TRPV1 KO mice. The AUC was significantly increased in NGF‐treated WT‐mice, when compared with saline‐treated WT‐mice. No changes were found in AUC of saline‐treated and NGF‐treated TRPV1 KO mice.

Chronic administration of NGF resulted in a significant increase of spinal c‐Fos expression in WT mice (P < 0.05 vs KO animals), but not in TRPV1 KO animals.

TrkA expression was similar in WT and TRPV1 KO mice.

CONCLUSIONS

NGF‐induced bladder overactivity and noxious input depend on the interaction of NGF with TRPV1.

The lack of bladder overactivity in TRPV1 KO mice treated with NGF does not represent loss of TrkA expression.

TRPV1 is essential for NGF‐driven bladder dysfunction and represents a bottleneck target in bladder pathologies associated with NGF up‐regulation.
Exenatide plus metformin compared with metformin alone on β‐cell function in patients with Type 2 diabetes
Authors: Derosa G. , Franzetti I. G. , Querci F. , Carbone A. , Ciccarelli L. , Piccinni M. N. , Fogari E. , Maffioli P.
Published: April 2012

Diabet. Med. 29, 1515–1523 (2012)

Aim  To quantify how much exenatide added to metformin improves β‐cell function, and to evaluate the impact on glycaemic control, insulin resistance and inflammation compared with metformin alone.

Methods  A total of 174 patients with Type 2 diabetes with poor glycaemic control were instructed to take metformin for 8 ± 2 months, then they were randomly assigned to exenatide (5 μg twice a day for the first 4 weeks and forced titration to 10 μg twice a day thereafter) or placebo for 12 months. At 12 months we evaluated anthropometric measurements, glycaemic control, insulin resistance and β‐cell function variables, glucagon, adiponectin, high sensitivity‐C reactive protein and tumour necrosis factor‐α. Before and after 12 months, patients underwent a combined euglycaemic hyperinsulinaemic and hyperglycaemic clamp, with subsequent arginine stimulation.

Results  Exenatide + metformin gave a greater decrease in body weight, glycaemic control, fasting plasma proinsulin and insulin and their ratio, homeostasis model assessment for insulin resistance (HOMA‐IR), and glucagon values and a greater increase in C‐peptide levels, homeostasis model assessment β‐cell function index (HOMA‐β) and adiponectin compared with placebo + metformin. Exenatide + metformin decreased waist and hip circumference, and reduced concentrations of high sensitivity‐C reactive protein and tumour necrosis factor‐α. Exenatide + metformin gave a greater increase in M value (+34%), and disposition index (+55%) compared with placebo + metformin; first (+21%) and second phase (+34%) C‐peptide response to glucose and C‐peptide response to arginine (+25%) were also improved by exenatide + metformin treatment, but not by placebo + metformin.

Conclusion  Exenatide is effective not only on glycaemic control, but also in protecting β‐cells and in reducing inflammation.
Why are defensive toxins so variable? An evolutionary perspective
Authors: Speed Michael P. , Ruxton Graeme D. , Mappes Johanna , Sherratt Thomas N.
Published: April 2012

Defensive toxins are widely used by animals, plants and micro‐organisms to deter natural enemies. An important characteristic of such defences is diversity both in the quantity of toxins and the profile of specific defensive chemicals present. Here we evaluate evolutionary and ecological explanations for the persistence of toxin diversity within prey populations, drawing together a range of explanations from the literature, and adding new hypotheses. We consider toxin diversity in three ways: (1) the absence of toxicity in a proportion of individuals in an otherwise toxic prey population (automimicry); (2) broad variation in quantities of toxin within individuals in the same population; (3) variation in the chemical constituents of chemical defence. For each of these phenomena we identify alternative evolutionary explanations for the persistence of variation. One important general explanation is diversifying (frequency‐ or density‐dependent) selection in which either costs of toxicity increase or their benefits decrease with increases in the absolute or relative abundance of toxicity in a prey population. A second major class of explanation is that variation in toxicity profiles is itself nonadaptive. One application of this explanation requires that predator behaviour is not affected by variation in levels or profiles of chemical defence within a prey population, and that there are no cost differences between different quantities or forms of toxins found within a population. Finally, the ecology and life history of the animal may enable some general predictions about toxin variation. For example, in animals which only gain their toxins in their immature forms (e.g. caterpillars on host plants) we may expect a decline in toxicity during adult life (or at least no change). By contrast, when toxins are also acquired during the adult form, we may for example expect the converse, in which young adults have less time to acquire toxicity than older adults. One major conclusion that we draw is that there are good reasons to consider within‐species variation in defensive toxins as more than mere ecological noise. Rather there are a number of compelling evolutionary hypotheses which can explain and predict variation in prey toxicity.