bluuebunny/crossref_metadata_2025 huggingface dataset:
Aripiprazole for the treatment of methamphetamine dependence: a randomized, double‐blind, placebo‐controlled trial
Authors: Coffin Phillip Oliver , Santos Glenn‐Milo , Das Moupali , Santos Deirdre M. , Huffaker Shannon , Matheson Tim , Gasper James , Vittinghoff Eric , Colfax Grant N.
Published: November 2012

Aims

To test aripiprazole for efficacy in decreasing use in methamphetamine‐dependent adults, compared to placebo.

Design

Participants were randomized to receive 12 weeks of aripiprazole or placebo, with a 3‐month follow‐up and a platform of weekly 30‐minute substance abuse counseling.

Setting

The trial was conducted from January 2009 to March 2012 at the San Francisco Department of Public Health.

Participants

Ninety actively using, methamphetamine‐dependent, sexually active adults were recruited from community venues.

Measurements

The primary outcome was regression estimated reductions in weekly methamphetamine‐positive urines. Secondary outcomes were study medication adherence [by self‐report and medication event monitoring systems (MEMS)], sexual risk behavior and abstinence from methamphetamine.

Findings

Participant mean age was 38.7 years, 87.8% were male, 50.0% white, 18.9% African American, and 16.7% Latino. Eighty‐three per cent of follow‐up visits and final visits were completed. By intent‐to‐treat, participants assigned to aripiprazole had similar reductions in methamphetamine‐positive urines as participants assigned to placebo [risk ratio (RR) 0.88, 95% confidence interval (CI): 0.66–1.19, P = 0.41]. Urine positivity declined from 73% (33 of 45 participants) to 45% (18 of 40) in the placebo arm and from 77% (34 of 44) to 44% (20 of 35) in the aripiprazole arm. Adherence by MEMS and self‐report was 42 and 74%, respectively, with no significant difference between arms (MEMS P = 0.31; self‐report P = 0.17). Most sexual risk behaviors declined similarly among participants in both arms (all P > 0.05). There were no serious adverse events related to study drug, although participants randomized to aripiprazole reported more akathisia, fatigue and drowsiness (P < 0.05).

Conclusion

Compared with placebo, aripiprazole did not reduce methamphetamine use significantly among actively using, dependent adults.
Improving operating theatre efficiency: an intervention to significantly reduce changeover time
Authors: Soliman Bishoy A. B. , Stanton Raymond , Sowter Steven , Rozen Warren Matthew , Shahbaz Shekib
Published: November 2012

Background

Operating theatre inefficiency and changeover delays are not only a significant source of wasted resources, but also a familiar source of frustration to patients and health‐care providers. This study aimed to prove that the surgical registrar through active involvement in patient changeover can significantly improve operating room efficiency and minimize delays.

Methods

A two‐phase prospective cohort study was undertaken, conducted over the course of 4 weeks at a single institution. The only inclusion criteria comprised patients to undertake endoscopic urological day surgery cases and require general anaesthesia. There were no exclusions. In the first phase (observational, with no intervention), changeover times between cases were documented. The second phase followed a structured intervention, involving the surgical registrar being actively involved in the patient's operative journey. Outcome measures were qualitative measures of operative efficiency. Statistical analysis was undertaken.

Results

There were 42 patients included in this study, with 21 patients in each of its arms. A 48% (P‐value < 0.01) reduction in overall case changeover times was demonstrated with the utilization of a structured intervention from 27.7 min (95% confidence interval (CI) 22.8–32.7%) to 15.7 min (95% CI 13.2–18.2%). The intervention results were statistically significant (P‐value < 0.05) for all markers of efficiency except for the waiting time in the anaesthetic holding bay (P‐value 0.13).

Conclusion

The surgical registrar can improve operating room efficiency by using a structured intervention, ultimately reducing patient changeover times.
Transurethral prostate resection for urinary retention: does age affect outcome?
Authors: Losco Giovanni , Mark Stephen , Jowitt Sharryn
Published: November 2012

Background

Patients presenting in urinary retention secondary to prostatic obstruction are offered transurethral resection of the prostate (TURP) to free them from long‐term catheterization. Short‐term success is well understood, but there is scarce data about effect of age on outcome, quality of life and catheter‐free rates.

Methods

One hundred consecutive patients who presented in urinary retention and underwent TURP were identified. Patients were followed up for 3 years to establish the rate of catheter dependence, incontinence, pad usage and quality of life using the International Prostate Symptom Score.

Results

Data were obtained from 95 patients with mean age of 75.6 years and mean follow‐up of 704 days. A total of 14 had died and 23 had prostate cancer. Eighty‐seven per cent was passing urine and 13% was catheter dependent. Mean age of catheter‐dependent patients was 84.9 years compared with 74.3 years in catheter‐free men (P < 0.0001). Twenty‐four per cent of patients 80 years and older were catheter dependent (P = 0.0039), 22% with prostate cancer were catheter dependent (P = 0.15). Fifty per cent of those who had died were catheter dependent (P = 0.0002). Thirty‐one per cent of patients reported leakage of urine but only 5% reported leakage requiring pad use. Overall, the mean quality of life score was 1.08.

Conclusion

Outcome after TURP for urinary retention is satisfactory. Advanced age is associated with higher long‐term failure requiring catheterization, although it is still recommended in the elderly where an anaesthetic is safe. A high proportion of patients report urine leakage but the majority of this is clinically insignificant. Overall, patients report good quality of life.
Early colour Doppler duct diameter and symptomatic patent ductus arteriosus in a cyclo‐oxygenase inhibitor naïve population
Authors: Heuchan Anne Marie , Young David
Published: November 2012

Aims

To examine the relationship between early duct diameter and patent ductus arteriosus (PDA) symptoms.

Methods

A retrospective study of infants <29 weeks of gestation with early colour Doppler assessment of PDA diameter, in whom PDA was managed conservatively, without cyclo‐oxygenase inhibitor (COI) treatment.

Results

Gestation and birthweight, [median (range)], were 26 (23–28) weeks and 865 (500–1440) g, respectively. Symptomatic PDA developed in 20 (68.9%) infants, with 11 (37.9%) referred for PDA ligation at 24 (17–30) days. Symptoms resolved spontaneously in 7 infants (24.1%) at 19 (7–32) days. There were 6 (20.7%) deaths, including four early neonatal deaths with large PDA. Early colour Doppler PDA diameter >1.5 mm (n = 20) predicted development of symptomatic PDA (sensitivity 91%, specificity 100%), but symptoms resolved spontaneously without treatment in 30%. There was a significant linear correlation (p < 0.001) with increasing early PDA diameter and the development of more persistent PDA symptoms, early neonatal mortality and morbidity.

Conclusions

In our (COI)‐naïve population, the mortality and morbidity associated with prolonged exposure to unrestricted ducts are high. Not all infants with early PDA diameter >1.5 mm have persistent symptomatic PDA, but early PDA diameter could be utilized to identify those infants at greatest risk of adverse outcome associated with PDA.
Preterm birth and unintentional injuries: risks to children, adolescents and young adults show no consistent pattern
Authors: Calling Susanna , Palmér Karolina , Jönsson Lena , Sundquist Jan , Winkleby Marilyn , Sundquist Kristina
Published: November 2012

Aim

Preterm birth is associated with a number of physical and mental health issues. The aim of this study was to find out whether there was also any association between individuals born preterm in Sweden between 1984 and 2006 and the risk of unintentional injuries during childhood, adolescence and young adulthood.

Methods

The study followed 2 297 134 individuals, including 5.9% born preterm, from 1985 to 2007 for unintentional injuries leading to hospitalization or death (n = 244 021). The males and females were divided into four age groups: 1–5 years, 6–12 years, 13–18 years and 19–23 years. Hazard ratios were calculated for falls, transport injuries and other injuries.

Results

After adjusting for a comprehensive set of covariates, some of the preterm subgroups demonstrated slightly increased risks of unintentional injuries, while others showed slightly decreased risks. However, most of the estimates were borderline or non‐significant in both males and females. In addition, the absolute risk differences between individuals born preterm and full term were small.

Conclusion

Despite the association between preterm birth and a variety of physical and mental health consequences, this study shows that there is no consistent risk pattern between preterm birth and unintentional injuries in childhood, adolescence and young adulthood.
PPAR‐γ – a possible drug target for complicated pregnancies
Authors: McCarthy Fergus P , Delany Aoife C , Kenny Louise C , Walsh Sarah K
Published: November 2012

Peroxisome proliferator activated receptors (PPARs) are ligand‐activated transcription factors expressed in trophoblasts, which regulate both cell differentiation and proliferation. In recent years, evidence has linked PPARs to playing an integral role in pregnancy; specifically, PPAR‐β and PPAR‐γ have been shown to play an integral role in placentation, with PPAR‐γ additionally serving to regulate trophoblast differentiation. Recent evidence has shown that PPAR‐γ expression is altered in many complications of pregnancy such as intrauterine growth restriction (IUGR), preterm birth, pre‐clampsia and gestational diabetes. Thus, at present, accumulating evidence from the literature suggests both a pivotal role for PPAR‐γ in the progression of a healthy pregnancy and the possibility that PPAR‐γ may act as a therapeutic target in complicated pregnancies. This review aims to provide a succinct and comprehensive assessment of the role of PPAR‐γ in normal pregnancy and pregnancy complications, and finally its potential as a therapeutic target in the treatment and/or prevention of adverse pregnancy outcomes.
GABAB receptor subtypes differentially modulate synaptic inhibition in the dentate gyrus to enhance granule cell output
Authors: Foster Joshua D , Kitchen Ian , Bettler Bernhard , Chen Ying
Published: November 2012

Background and Purpose

Activation of GABAB receptors in the dentate gyrus (DG) enhances granule cell (GC) activity by reducing synaptic inhibition imposed by hilar interneurons. This disinhibitory action facilitates signal transfer from the perforant path to the hippocampus. However, as the two main molecular subtypes, GABAB(1a,2) and GABAB(1b,2) receptors, prefer axonal terminal and dendritic compartments, respectively, they may modulate the hilar pathways at different synaptic localizations. We examined their relative expression and functions in the DG.

Experimental Approach

The localization of GABAB subtypes was revealed immunohistochemically using subunit‐selective antibodies in GABAB1a–/– and GABAB1b–/– mice. Effects of subtype activation by the GABAB receptor agonist, baclofen, were examined on the perforant path‐stimulated GC population activities in brain slices.

Key Results

GABAB(1a,2) receptors were concentrated in the inner molecular layer, the neuropil of the hilus and hilar neurons at the border zone; while GABAB(1b,2) receptors dominated the outer molecular layer and hilar neurons in the deep layer, showing their differential localization on GC dendrite and in the hilus. Baclofen enhanced the GC population spike to a larger extent in the GABAB1b–/– mice, demonstrating exclusively disinhibitory roles of the GABAB(1a,2) receptors. Conversely, in the GABAB1a–/– mice baclofen not only enhanced but also inhibited the population spike during GABAA blockade, revealing both disinhibitory and inhibitory effects of GABAB(1b,2) receptors.

Conclusions and Implications

The GABAB(1a,2) and GABAB(1b,2) receptor subtypes differentially modulate GC outputs via selective axonal terminal and dendritic locations in the hilar pathways. The GABAB(1a,2) receptors exclusively mediate disinhibition, thereby playing a greater role in gating signal transfer for hippocampal spatial and pattern learning.
Aberrant upregulation of ASCL2 by promoter demethylation promotes the growth and resistance to 5‐fluorouracil of gastric cancer cells
Authors: Kwon Oh‐Hyung , Park Jong‐Lyul , Baek Su‐Jin , Noh Seung‐Moo , Song Kyu‐Sang , Kim Seon‐Young , Kim Yong Sung
Published: November 2012

Achaete scute‐like 2 (ASCL2), a basic helix‐loop‐helix transcription factor, plays an essential role in the maintenance of adult intestinal stem cells. However, the function of ASCL2 in gastric cancer (GC) is poorly understood. Therefore, we investigated the roles and regulatory transcription mechanisms of ASCL2 in GC. Gene expression and methylation data analysis showed that ASCL2 was upregulated and hypomethylated in GC tissues. Using real‐time RT‐PCR and pyrosequencing analysis, we confirmed that ASCL2 was overexpressed and hypomethylated in GC tissues compared to adjacent normal tissues. We then investigated the mechanisms underlying the aberrant expression of ASCL2 in GC and found that treatment with a methylation inhibitor induced ASCL2 expression in GC cell lines. MBD‐sequencing assay also revealed hypermethylation of the promoter region of ASCL2 in GC cell lines, which barely expressed the ASCL2 gene. Furthermore, ASCL2 expression levels were inversely correlated with GC patient survival. Ectopic overexpression of ASCL2 showed that ASCL2 increased cell growth and promoted resistance to 5‐fluorouracil in GC cells. These results suggest that ASCL2 might play an important role in gastric tumor growth and chemoresistance, and could be a useful prognostic marker for GC patients.
Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico‐spongeous bone grafts – a prospective study of two cohorts
Authors: Wiltfang Jörg , Jätschmann Nadine , Hedderich Jürgen , Neukam Friedrich W. , Schlegel Karl Andreas , Gierloff Matthias
Published: November 2012

Objectives

The augmentation of the alveolar ridge using iliac cortico‐spongeous bone grafts is routinely used. However, bone grafts show a substantial degree of resorption, which may negatively affect the long‐term success of dental implants in the augmented area. The aim of this study was to evaluate the effect of a deproteinized bovine bone matrix coverage on the resorption of iliac bone grafts.

Material and methods

Two cohorts consisting of 40 patients who received a vertical augmentation of the alveolar ridge with onlay grafts from the iliac crest were prospectively investigated over a period of 2 years. In half of the patients (n = 40), the grafts were covered by a thin layer of deproteinized bovine bone matrix (DBBM cohort). The other 40 patients received the identical surgical procedure without a DBBM coverage (non‐DBBM cohort). The graft height/resorption was radiographically determined immediately after surgery, 6 months, 1 year, and 2 years postoperatively.

Results

The height of the bone graft 6 months after surgery accounted 92.15% of the initial value in the DBBM cohort and 87.76% in the non‐DBBM cohort. One year after augmentation, the height reduced to 83.95% in the DBBM cohort and 72.92% in the non‐DBBM cohort. Two years after surgery, the resorption slowed down and the height of the grafts accounted 81.27% in the DBBM cohort and 71.43% in the non‐DBBM cohort. The difference was statistically significant.

Conclusion

Deproteinized bovine bone matrix reduces the postoperative resorption of iliac bone block grafts and may therefore enhance the long‐term implant prognosis in the augmented area.
Effects of rectal administration of taurocholic acid on glucagon‐like peptide‐1 and peptide YY secretion in healthy humans
Authors: Wu T. , Bound M. J. , Standfield S. D. , Gedulin B. , Jones K. L. , Horowitz M. , Rayner C. K.
Published: November 2012

Glucagon‐like peptide‐1 (GLP‐1) and peptide YY (PYY), secreted by enteroendocrine L‐cells located most densely in the colon and rectum, are of fundamental importance in blood glucose and appetite regulation. In animal models, colonic administration of bile acids can stimulate GLP‐1 and PYY by TGR5 receptor activation. We evaluated the effects of taurocholic acid (TCA), administered as an enema, on plasma GLP‐1 and PYY, as well as gastrointestinal sensations in 10 healthy male subjects, and observed that rectal administration of TCA promptly stimulated secretion of both GLP‐1 and PYY, and increased fullness, in a dose‐dependent manner. These observations confirm that topical application of bile acids to the distal gut may have potential for the management of type 2 diabetes and obesity.
Utility and limitations of biochemical markers of vitamin B12 deficiency
Authors: Herrmann Wolfgang , Obeid Rima
Published: November 2012

Background

There is an urgent need for proper utilization of laboratory markers to diagnose vitamin B12 deficiency that should reduce false negative cases. We worked out a diagnostic algorithm that provides a two‐step detection of vitamin B12 deficiency using holotranscobalamin as a first line marker and methylmalonic acid (MMA) as a second line marker.

Materials and Methods

We tested 1359 serum samples sent to our laboratory for total vitamin B12 assay. Serum samples were used for the determination of holotranscobalamin, MMA and creatinine.

Results

Compared with total B12, holotranscobalamin showed a higher area under the receiver operating characteristic curve for detecting MMA levels > 300 nM. However, the distribution of holotranscobalamin in individuals with elevated creatinine irrespective of MMA and in individuals with elevated MMA irrespective of creatinine was shifted into the higher ranges. In the grey zone of holotranscobalamin between 23 and 75 pM (the range extending from the 90% diagnostic sensitivity to the 90% diagnostic specificity), MMA testing as a second line marker would help detecting 18% of deficient cases. Lowering MMA after vitamin B12 treatment may help setting the diagnosis of B12 deficiency in individuals with elevated creatinine.

Discussion

Testing for vitamin B12 deficiency should start with holotranscobalamin measurement. Holotranscobalamin between 23 and 75 pM should be followed by MMA testing that can filter substantial number of deficient cases in the grey range in individuals with normal renal function. This diagnostic strategy may significantly improve assessing vitamin B12 deficiency.
Renal impairment and all‐cause mortality in cardiovascular disease: effect modification by type 2 diabetes mellitus
Authors: Selvarajah Sharmini , Uiterwaal Cuno S. P. M. , Haniff Jamaiyah , van der Graaf Yolanda , Visseren Frank L. J. , Bots Michiel L. ,   on behalf of the SMART study group
Published: November 2012

Background

Renal impairment and type 2 diabetes mellitus (DM) are well‐known independent risk factors for mortality. The evidence of their combined effects on mortality is unclear, but of importance because it may determine aggressiveness of treatment. This study sought to assess and quantify the effect modification of diabetes on renal impairment in its association with mortality.

Materials and methods

Patients with cardiovascular disease or at high risk, recruited in the Second Manifestations of ARTerial disease cohort study, were selected. A total of 7135 patients were enrolled with 33 198 person‐years of follow‐up. Renal impairment was defined by albuminuria status and estimated glomerular filtration rate (eGFR). Outcome was all‐cause mortality.

Results

Mortality increased progressively with each stage of renal impairment, for both albuminuria status and eGFR, for diabetics and non‐diabetics. There was no effect modification by diabetes on mortality risk due to renal impairment. The relative excess risk due to interaction (RERI) for DM and microalbuminuria was 0·21 (−0·11, 0·52), for overt proteinuria −1·12 (−2·83, 0·59) and for end‐stage renal failure (ESRF) 0·32 (−3·65, 4·29). The RERI for DM with eGFR of 60–89 mL/min/1·73 m2 was −0·31(−0·92, 0·32), for eGFR of 30–59 mL/min/1·73 m2 −0·07 (−0·76, 0·62) and for eGFR of < 30 mL/min/1·73 m2 0·38 (−0·85, 1·61).

Conclusions

Type 2 diabetes mellitus does not modify nor increase the risk relation between all‐cause mortality and renal impairment. These findings suggest that the hallmark for survival is the prevention and delay in progression of renal impairment in patients with cardiovascular disease.
Type 2 diabetes and 1‐year mortality in intensive care unit patients
Authors: Christiansen Christian F. , Johansen Martin B. , Christensen Steffen , O'Brien James M. , Tønnesen Else , Sørensen Henrik T.
Published: November 2012

Background

Data on the prognostic impact of diabetes and diabetic complications in intensive care unit (ICU) patients are limited and inconsistent. We, therefore, examined mortality in ICU patients with type 2 diabetes with and without pre‐existing heart and kidney diseases compared with nondiabetic patients.

Design

We conducted this population‐based cohort study in Northern Denmark during 2005–2011. We included all ICU patients aged 40 years or older from the 17 ICUs in the area and identified type 2 diabetes by either a filled prescription for an antidiabetic drug, a previous diagnosis of diabetes, or an elevated glycosylated haemoglobin level. Diabetic patients were disaggregated according to pre‐existing diagnoses of heart disease (myocardial infarction or heart failure) and kidney disease.

We estimated 1‐year mortality by the Kaplan–Meier method and hazard ratios of death (HRs) during follow‐up using Cox regression, controlling for confounding factors and stratified by relevant subgroups.

Results

Among 45 018 ICU patients, 7219 (16·0%) had type 2 diabetes. Overall, 1‐year mortality was 36·0% in ICU patients with type 2 diabetes, rising to 54·6% in patients with pre‐existing heart and kidney diseases, compared with 29·1% in nondiabetic patients. Comparing diabetic with nondiabetic patients, the adjusted 0‐ to 30‐day HR was 1·20 (95% confidence interval (CI): 1·13–1·26) and 1·19 (95% CI: 1·10–1·28) during the 31‐ to 365‐day follow‐up period. Pre‐existing kidney disease further increased the impact of diabetes, while heart disease alone had no such effect.

Conclusions

ICU patients with type 2 diabetes had higher 1‐year mortality compared with nondiabetic ICU patients, particularly those with pre‐existing kidney disease.
Advanced systemic mastocytosis: the impact of KIT mutations in diagnosis, treatment, and progression
Authors: Verstovsek Srdan
Published: November 2012

Apart from indolent systemic mastocytosis (SM), which is associated with a favorable prognosis, other subtypes of SM (SM with associated clonal hematologic non–mast cell lineage disease, aggressive SM, and mast cell leukemia – collectively referred to in this review as advanced SM) can be debilitating. The complexity of SM makes both the diagnosis and design of response criteria challenging for clinical studies. The tyrosine kinase KIT has been shown to play a crucial role in the pathogenesis of SM and has been a focal point in the development of targeted therapy. Mutations within various domains of the KIT receptor that lead to constitutive activation have been identified in patients, and those involving the activation loop of the KIT receptor are the mutations most frequently detected in patients with mastocytosis. Aberrant activation of the KIT receptor results in increased production of mast cells in extracutaneous organs that may lead to organ failure or early death. This review discusses the diagnosis and management of patients with advanced SM, including the relevance of KIT in this disease, potential therapies targeting this kinase, and criteria for measuring responses to these therapies.
Wound‐associated macrophages control collagen 1α2 transcription during the early stages of skin wound healing
Authors: Rodero Mathieu P. , Legrand Julien M. D. , Bou‐Gharios George , Khosrotehrani Kiarash
Published: November 2012

Wound‐associated fibrosis is important to provide tensile strength upon wound healing but at the same time is detrimental to proper tissue regeneration. To date, there is no clear evidence of the role of macrophages and their subpopulations in the control of the kinetics of collagen production during wound healing. To evaluate in vivo the contribution of macrophages in collagen transcription, we depleted macrophages after wounding luciferase reporter mice of the collagen 1 alpha 2 (Col 1α2) promoter activity. Our data reveal that Col 1α2 starts to be transcribed at D2 after wounding, reaching a plateau after 7 days. Sustained macrophage depletion significantly reduced collagen 1α2 transcription from D4, indicating that the control of fibrosis by macrophages occurs during the early stages of the wound healing process. In conclusion, our results demonstrate an important role of wound macrophages in the control of collagen production during wound healing.
Papillary fibroblasts differentiate into reticular fibroblasts after prolonged in vitro culture
Authors: Janson David , Saintigny Gaëlle , Mahé Christian , Ghalbzouri Abdoelwaheb El
Published: November 2012

The dermis can be divided into two morphologically different layers: the papillary and reticular dermis. Fibroblasts isolated from these layers behave differently when cultured in vitro. During skin ageing, the papillary dermis decreases in volume. Based on the functional differences in vitro, it is hypothesized that the loss of papillary fibroblasts contributes to skin ageing. In this study, we aimed to mimic certain aspects of skin ageing by using high‐passage cultures of reticular and papillary fibroblasts and investigated the effect of these cells on skin morphogenesis in reconstructed human skin equivalents. Skin equivalents generated with reticular fibroblasts showed a reduced terminal differentiation and fewer proliferating basal keratinocytes. Aged in vitro papillary fibroblasts had increased expression of biomarkers specific to reticular fibroblasts. The phenotype and morphology of skin equivalents generated with high‐passage papillary fibroblasts resembled that of reticular fibroblasts. This demonstrates that papillary fibroblasts can differentiate into reticular fibroblasts in vitro. Therefore, we hypothesize that papillary fibroblasts represent an undifferentiated phenotype, while reticular fibroblasts represent a more differentiated population. The differentiation process could be a new target for anti‐skin‐ageing strategies.
Proteomic analysis of immediate‐early response plasma proteins after 70% and 90% partial hepatectomy
Authors: Kumar Sudhanshu , Zou Yuhong , Bao Qi , Wang Mu , Dai Guoli
Published: November 2012

Aim

Partial hepatectomy (PH) induces robust hepatic regenerative and metabolic responses that are considered to be triggered by humoral factors. The aim of the study was to identify plasma protein factors that potentially trigger or reflect the body's immediate‐early responses to liver mass reduction.

Methods

Male C57BL/6 mice were subjected to sham operation, 70% PH or 90% PH. Blood was collected from the inferior vena cava at 20, 60 and 180 min after surgery.

Results

Using a label‐free quantitative mass spectrometry‐based proteomics approach, we identified 399 proteins exhibiting significant changes in plasma expression between any two groups. Of the 399 proteins, 167 proteins had multiple unique sequences and high peptide ID confidence (>90%) and were defined as priority 1 proteins. A group of plasma proteins largely associated with metabolism is enriched after 70% PH. Among the plasma proteins that respond to 90% PH are a dominant group of proteins that are also associated with metabolism and one known cytokine (platelet factor 4). Ninety percent PH and 70% PH induces similar changes in plasma protein profile.

Conclusion

Our findings enable us to gain insight into the immediate‐early response of plasma proteins to liver mass loss. Our data support the notion that increased metabolic demands of the body after massive liver mass loss may function as a sensor that calibrates hepatic regenerative response.
Eocene volcanism during the incipient stage of Izu–Ogasawara Arc: Geology and petrology of the Mukojima Island Group, the Ogasawara Islands
Authors: Kanayama Kyoko , Umino Susumu , Ishizuka Osamu
Published: November 2012

The Ogasawara Islands mainly comprise Eocene volcanic strata formed when the Izu–Ogasawara–Mariana Arc began. We present the first detailed volcanic geology, petrography and geochemistry of the Mukojima Island Group, northernmost of the Ogasawara Islands, and show that the volcanic stratigraphy consists of arc tholeiitic rocks, ultra‐depleted boninite‐series rocks, and less‐depleted boninitic andesites, which are correlatable to the Maruberiwan, Asahiyama and Mikazukiyama Formations on the Chichijima Island Group to the south. On Chichijima, a short hiatus is identified between the Maruberiwan (boninite, bronzite andesite, and dacite) and Asahiyama Formation (quartz dacite and rhyolite). In contrast, these lithologies are interbedded on Nakodojima of the Mukojima Island Group. The stratigraphically lower portion of Mukojima is mainly composed of pillow lava, which is overlain by reworked volcaniclastic rocks in the middle, whereas the upper portion is dominated by pyroclastic rocks. This suggests that volcanic activity now preserved in the Mukojima Island Group records growth of one or more volcanoes, beginning with quiet extrusion of lava under relatively deep water followed by volcaniclastic deposition. These then changed into moderately explosive eruptions that took place in shallow water or above sea level. This is consistent with the uplift of the entire Ogasawara Ridge during the Eocene. Boninites from the Mukojima Island Group are divided into three types on the basis of geochemistry. Type 1 boninites have high SiO2 (>57.0 wt.%) and Zr/Ti (>0.022) and are the most abundant type in both Mukojima and Chichijima Island Groups. Type 2 boninites have low SiO2 (<57.1 wt.%) and Zr/Ti (<0.014). Type 3 boninites have 57.6–60.7 wt.% SiO2 and are characterized by high CaO/Al2O3 (0.9–1.1). Both type 2 and 3 boninites are common on Mukojima but are rare in the Chichijima Island Group.
Geochemistry and Sr–Nd–Pb isotopic constraints on the petrogenesis of Cenozoic lavas from the Pali Aike and Morro Chico area (52°S), southern Patagonia, South America
Authors: Choo Mi Kyung , Lee Mi Jung , Lee Jong Ik , Kim Kyu Han , Park Kye‐Hun
Published: November 2012

Geochemical and isotopic analyses (Sr–Nd–Pb) of late Miocene to Quaternary plateau lavas from the Pali Aike and Morro Chico areas (52°S) were undertaken to constrain the melting processes and mantle sources that contributed to magma generation and the geodynamic evolution of southernmost Patagonia, South America. The Pali Aike and Morro Chico lavas are alkaline (Pali Aike, 45–49 wt.% SiO2; 4.3–5.9 wt.% Na2O+K2O) and subalkaline (Morro Chico, 50.5–50.8 wt.% SiO2; 4.0–4.4 wt.% Na2O+K2O), relatively primitive (Pali Aike, 9.5–13.7 wt.% MgO; Morro Chico, 7.6–8.8 wt.% MgO) mafic volcanic rocks that have typical intraplate ocean island basalt‐like signatures. Incompatible trace element ratios and isotopic ratios of the Pali Aike and Morro Chico lavas differ from those of the majority of Neogene southern Patagonian slab window lavas in showing more enriched characteristics and are similar to high‐μ (HIMU)‐like basalts. The rare earth element (REE) modeling to constrain mantle melting percentages suggests that these lavas were produced by low degrees of partial melting (1.0–2.0% for Pali Aike lavas and about 2.6–2.7% for Morro Chico lavas) of a garnet lherzolite mantle source. The major systematic variations of Sr–Nd–Pb isotopes in southern Patagonian lavas are related to geographic location. The Pali Aike and Morro Chico lavas from the southernmost part of Patagonia have lower 87Sr/86Sr and higher 143Nd/144Nd and 206Pb/204Pb ratios, relative to most of the southern Patagonian lavas erupted north of 49.5°S, pointing to a HIMU‐like signature. An isotopically depleted and HIMU‐like asthenospheric domain may have been the main source of magmas in the southernmost part of Patagonia (e.g. Pali Aike, Morro Chico, and Camusu Aike volcanic field), suggesting the presence of a major discontinuity in the isotopic composition of the asthenosphere in southern Patagonia. On the basis of geochemical and isotope data and the available geological and geotectonic reconstructions, a link between the HIMU asthenospheric mantle domain beneath southernmost Patagonia and the HIMU mega‐province of the southwestern Pacific Ocean is proposed.
The effect of calcium hydroxide on the antibiotic component of Odontopaste® and Ledermix® paste
Authors: Athanassiadis M. , Jacobsen N. , Nassery K. , Parashos P.
Published: November 2012

Aim

To investigate the chemical interaction of calcium hydroxide with the antibiotics demeclocycline calcium in Ledermix® Paste and clindamycin hydrochloride in Odontopaste®.

Methodology

Validated methods were developed to analyse the interaction of calcium hydroxide in two forms, Pulpdent® and calcium hydroxide powder, with the two antibiotics. High‐performance liquid chromatography (HPLC) was used to analyse the mixed samples of the pastes and calcium hydroxide. The concentration of demeclocycline calcium over 0‐, 1‐, 18‐, 24‐, 72‐h and 7‐day time‐points was determined. The concentration of clindamycin hydrochloride over 1‐, 6‐, 24‐, 72‐h and 7‐day time‐points was determined. All tests with HPLC involved testing of the standard in duplicate alongside the samples. Linearity, precision and specificity of the testing procedures and apparatus were validated. Descriptive statistics are provided.

Results

The antibiotics in both Odontopaste® and Ledermix® Paste were affected by the addition of calcium hydroxide. When mixed with calcium hydroxide powder, Odontopaste® had a 2% loss of clindamycin hydrochloride over 7 days, but when mixed with Pulpdent®, there was a 36% loss over 7 days. Ledermix® Paste showed an 80% loss of demeclocycline calcium over 7 days when mixed with calcium hydroxide powder and a 19% loss when mixed with Pulpdent® over the 7‐day period.

Conclusion

The addition of calcium hydroxide to Odontopaste® or Ledermix® Paste results in reductions of the respective antibiotic over a 7‐day time period.
Intrarenal reflux in primary vesicoureteral reflux
Authors: Fukui Shinji , Watanabe Masato , Yoshino Kaoru
Published: November 2012

Objectives

To elucidate the significance of intrarenal reflux.

Methods

We retrospectively analyzed 276 patients (age <5 years) with grade III to V vesicoureteral reflux. They were divided into two groups: 55 patients with intrarenal reflux and 221 patients without intrarenal reflux (control group). All patients received low‐dose antibiotic prophylaxis.

Results

The most common initial presentation in both groups was febrile urinary tract infection. On dimercaptosuccinic acid scan, the rate of decreased differential renal function (<40%) was significantly higher in the intrarenal reflux group than in the control group (51% vs 33%, P < 0.05). Breakthrough urinary tract infections were observed in 26 patients (47%) in the intrarenal reflux group and 61 patients (28%) in the control group (P < 0.01). There was no statistically significant difference regarding spontaneous resolution of reflux, which occurred in nine patients (16%) in the intrarenal reflux group and 32 patients (14%) in the control group. Surgical treatment was selected more often in the intrarenal reflux group (P < 0.05) because of the high incidence of breakthrough urinary tract infection.

Conclusions

The rate of spontaneous resolution of high‐grade vesicoureteral reflux is similar between patients with and without intrarenal reflux. However, those with intrarenal reflux present are more likely to present a decreased differential renal function and breakthrough urinary tract infections. Consequently, surgical treatment is considered more frequently in cases with intrarenal reflux. Although high‐grade vesicoureteral reflux with intrarenal reflux can be treated conservatively, physicians should take into account the higher risk of breakthrough urinary tract infections.
Risk factors for chronic kidney disease after chemotherapy for testicular cancer
Authors: Inai Hiromu , Kawai Koji , Ikeda Atsushi , Ando Satoshi , Kimura Tomokazu , Oikawa Takehiro , Onozawa Mizuki , Miyazaki Jun , Uchida Katsunori , Nishiyama Hiroyuki
Published: November 2012

Objective

To elucidate the patterns of and risk factors for deterioration of renal function after chemotherapy in metastatic testicular cancer survivors using the estimated glomerular filtration rate.

Methods

A total of 96 patients who were treated with cisplatin‐based chemotherapy for metastatic testicular cancer between January 1981 and December 2010 were enrolled in this study. The estimated glomerular filtration rate was based on the serum creatinine concentration using the formula of the Japanese Society of Nephrology. Risk factors for chronic kidney disease were examined by multivariate logistic‐regression analysis.

Results

The median follow‐up period was 70 months (range 15–342). The median pretreatment estimated glomerular filtration rate was 98 mL/min/1.73 m2 (range 44–216), and it gradually decreased for 1 year after the end of chemotherapy, although there was no significant change in estimated glomerular filtration rate beyond 1 year. One year after chemotherapy, 22 of 96 patients (23%) showed chronic kidney disease (less than 60 mL/min/1.73 m2 estimated glomerular filtration rate). The multivariate analysis showed that the patients with mild renal damage (estimated glomerular filtration rate 60–89 mL/min/1.73 m2) and elevated blood pressure (higher than 130/80 mmHg) before treatment had a significant risk with odds ratios of 2.63 (95% confidence interval 1.09–6.73) and 4.22 (95% confidence interval 1.45–12.6), respectively.

Conclusions

Close monitoring of renal function is important for at least 1 year after chemotherapy for testicular cancer, especially in patients having elevated blood pressure and/or mild renal damage before chemotherapy.
Vancomycin therapeutics and monitoring: a contemporary approach
Authors: Avent M. L. , Vaska V. L. , Rogers B. A. , Cheng A. C. , van Hal S. J. , Holmes N. E. , Howden B. P. , Paterson D. L.
Published: November 2012

Vancomycin remains a clinically useful antibiotic despite the advent of several alternative drugs. Optimising vancomycin therapy with therapeutic drug monitoring is widely recommended. The aim of therapeutic drug monitoring is to help the clinician to achieve target pharmacodynamic parameters in the case of vancomycin, an area under the concentration time curve/minimum inhibitory concentration ratio of ≥400. Vancomycin monitoring methods can be categorised into four categories: empiric trough concentrations; linear regression analysis (one‐compartment model), population methods and Bayesian estimation procedures. Although the empiric trough concentrations and population methods are easy to use and require minimal resources, there are large differences in the published vancomycin model parameters. This demonstrates that there is great variance in pharmacokinetic parameters between the models and a single vancomycin model cannot be applied to all patient populations. The linear regression and Bayesian methods recommended more accurate dosage regimens; however, they require additional resources such as information technology and healthcare personnel with background training in pharmacokinetics. The Bayesian methods offered additional advantages such as calculation of doses based on a single‐serum concentration and optimisation of the patient's previous pharmacokinetic data to determine subsequent dosage regimens. Computerised programs, utilising the Bayesian estimation procedures, are able to achieve target concentrations in a greater percentage of patients earlier in the course of therapy than the empiric trough concentrations and population methods. We recommend the use of these programs providing there is appropriate expertise available to make appropriate recommendations.
Validity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients
Authors: Cil Akinci Ayse , Pinar Rukiye
Published: November 2012

Aims and objectives. To investigate the validity and reliability of the Caregiver Burden Scale in family members who provide primary care for haemodialysis patients.

Background. In Turkey, there is a need for a multi‐dimensional instrument to evaluate the caregiver burden in people who provide care for patients with chronic diseases.

Design. A methodological study.

Methods. The study sample consisted of 161 family members who provide primary care for haemodialysis patients. The forward‐backward translation method was used to develop the Turkish Caregiver Burden Scale. The reliability was based on internal consistency investigated by Cronbach’s alpha and item–total correlation. The factorial construct validity of the scale was tested with confirmatory factor analysis. By means of convergent and divergent validity, correlation between Caregiver Burden Scale and 36‐Item Short Form Health Survey (SF‐36) and correlation between Caregiver Burden Scale and the Maslach Burnout Scale were investigated.

Results. Cronbach’s alpha and item–total correlations results suggested that there was good internal reliability. We found five underlying factors similar to original Scale’s five‐factor solution. The confirmatory factor analysis five‐factor model represented an acceptable fit. Factor loadings were significant, with standardised loadings ranging from 0·43–0·81. By means of divergent validity, all sub‐dimension scores and the total score of the Caregiver Burden Scale were negatively correlated with the SF‐36, whereas there was a positive correlation with the emotional exhaustion and depersonalisation subscales of the Maslach Burnout Scale as expected.

Conclusion. These results suggest that the Caregiver Burden Scale is a reliable and valid instrument which can be used with confidence in Turkish caregivers for haemodialysis patients to screen caregiver burden.

Relevance to clinical practice. The burden experienced by people who provide care for patients with chronic diseases can be evaluated with the Caregiver Burden Scale. Additionally, the Caregiver Burden Scale can be used in the evaluation of the effectiveness of attempts to decrease caregiver burden.
Resuscitation in general medical wards: who decides?
Authors: Ganz Freda DeKeyser , Kaufman Nechama , Israel Sima , Einav Sharon
Published: November 2012

Aims and objectives.  To investigate nurse experiences and attitudes regarding resuscitation while focusing on intentional avoidance of action during a futile cardiac arrest.

Background.  Nurses often lack the legal and clinical authority to make resuscitation decisions; however, in cases where they believe that resuscitation would be futile, they may elect to delay/avoid the initiation of resuscitation as a non‐confrontational method of achieving the desired endpoint, thus essentially transferring the final resuscitation decision from the physician to the nurse.

Design and methods.  An anonymous questionnaire survey conducted among a convenience sample of 122/142 nurses from five medical wards in two Jerusalem hospitals.

Results.  Nearly one‐fifth (19/117) of participants reported non‐initiation of a futile resuscitation. Nurses who chose not to initiate futile resuscitations were those who scored higher on the Support Do Not Attempt Resuscitation Questionnaire, those that had previously been consulted by a doctor regarding the initiation of resuscitation and those that expressed a desire to be a part of a multidisciplinary team focused on resuscitation decision‐making. No other variables seemed to affect this outcome.

Conclusions.  Nurses are often excluded from the resuscitation decision‐making process despite their desire to participate. Delayed initiation/avoidance of resuscitation is being actively practiced by some nurses.

Relevance to clinical practice.  Nurses should be given the opportunity to become an essential component of resuscitation decision‐making to avoid the pre‐emption of medical resuscitation decisions.
Living an unstable everyday life while attempting to perform normality – the meaning of living as an alcohol‐dependent woman
Authors: Thurang Anna , Bengtsson Tops Anita
Published: November 2012

Aims and objectives

To illuminate the meaning of living with alcohol dependency as a woman.

Background

The number of women suffering from alcohol dependency is increasing. Today there are shortcomings in knowledge about the lived experiences of being a woman with alcohol dependency; knowledge which might be of importance for meeting these women's specific needs of care.

Design

The study has a qualitative design. Fourteen women with alcohol dependency participated in open in‐depth interviews.

Method

Data were analysed according to a phenomenological‐hermeneutic method, and interpreted by help from gender and caring perspectives as well as results from previous research of alcohol dependency.

Results

In relation to the women's senses of well‐being, four main gender formations were found; An unstable self involving continual and rapid swings between emotional and bodily reactions. Ambivalence – meaning ambiguous feelings towards themselves as human beings and how they lead their lives. Introspectiveness – involving reflections, pondering and being introverted. Attempts to perform normality – covering – dealing with life through various strategies and facades to live up to the expectations of how to behave as a woman.

Conclusion

Living with alcohol dependency as a woman constitutes of a rapid shifting everyday life resulting in senses of alienation as well as private introspection leading to self‐degradation, and to a lesser extent meaningfulness and hope. It also constitutes of managing to perform normality.

Relevance to clinical practice

When supporting women with alcohol dependency towards wellbeing, professionals need to work towards approaching the woman's inner thoughts, share them and reflect over them together. To support these women to find balance in life, caregivers need to cooperate with the women to find out how best to live a life adjusted to the woman's abilities and wishes.