bluuebunny/crossref_metadata_2025 huggingface dataset:
Major changes in trophic dynamics in large, deep sub‐alpine Lake Maggiore from 1940s to 2002: a high resolution comparative palaeo‐neolimnological study
Authors: MANCA MARINA , TORRETTA BARBARA , COMOLI PATRIZIA , AMSINCK SUSANNE L. , JEPPESEN ERIK
Published: June 2007

1. We describe the changes in trophic dynamics in Lake Maggiore from c. 1943 to 2002 using subfossil cladoceran data from a high resolution sediment record, long‐term contemporary data series and historical information. During this period the lake went through a eutrophication phase until 1980 followed by oligotrophication.

2. During the eutrophication period a major increase occurred in the abundance of Chydorus sphaericus, the proportion of planktonic cladocerans and total abundance of cladocerans in the sediment. Since 1980 the abundance declined again and subfossil Eubosmina mucro length and contemporary Daphnia body length increased, most probably as a result of higher abundance of invertebrate predators.

3. Changes in the fish stock composition caused by the introduction of exotic fish during the pre‐eutrophication period and a complete ban on fishing because of Dichloro‐diphenil‐ethanes (DDTs) pollution of the lake (during oligotrophication) could also be detected in the community assemblage and size structure of the sediment zooplankton.

4. We found good correspondence between trophic changes inferred from cladoceran subfossils (community composition, size and predation pressure) and contemporary data, suggesting that sediment samples can be used to infer past development in trophic dynamics, including predation by fish and pelagic invertebrates in lakes with scarce neolimnological data.

5. Furthermore, by combining palaeolimnological cladoceran data rarely obtained from contemporary samples (e.g. benthic and plant‐associated cladocerans, mucro length of bosminids) with contemporary data of organisms poorly represented in the sediment record (e.g. remains of Bythotrephes and fishes) a more complete understanding of changes in trophic dynamics was obtained.

6. The detection in the sediments of meteorological events whose effects on zooplankton had been recorded in the long‐term studies also provided evidence that eutrophication tends to override climate signals.

7. We conclude that a combined palaeo‐neolimnological approach can be a powerful tool for elucidating past changes in the trophic dynamics of lakes and the interaction with climate induced changes, not least when high resolution sediment records are available.
Haematuria in patients with haemophilia and its influence on renal function and proteinuria
Authors: BENEDIK‐DOLNIČAR M. , BENEDIK M.
Published: June 2007

Summary.  To investigate renal function in a group of patients with a history of haemophilia and haematuria. We reviewed 32 medical records of the patients with haemophilia and gross haematuria identified through a computerized haemophilia registry, from January 1993 to December 2004. In all patients but three (two refused to participate and one died) clinical and laboratory tests were performed by the nephrologist. One patient had chronic renal failure because of diabetic nephropathy. In two patients reduced renal function was detected by creatinine clearance measurements, and one of them had Duchenne muscular dystrophy. In four patients minimal proteinuria was diagnosed by the biuret method. Mild reduction in renal function of unknown cause was found in only one of the 29 patients tested.
International workshop on immune tolerance induction: consensus recommendations1
Authors: DIMICHELE D. M. , HOOTS W. K. , PIPE S. W. , RIVARD G. E. , SANTAGOSTINO E.
Published: June 2007

Summary.  Although immune tolerance induction (ITI) has been used for 30 years to eliminate inhibitors and restore normal factor pharmacokinetics in patients with hemophilia, there is a paucity of scientific evidence to guide therapeutic decision‐making. In an effort to provide direction for physicians and hemophilia treatment center staff members, an international panel of hemophilia opinion leaders met to develop consensus recommendations for ITI in patients with severe and mild hemophilia A and hemophilia B. These recommendations draw on the available published literature and the collective clinical experience of the group and are rated based on the level of supporting evidence .
The Serra da Mantiqueira, south‐eastern Brazil, as a biogeographical barrier for fishes
Authors: Ingenito Leonardo F. S. , Buckup Paulo A.
Published: June 2007

Aim  To present a fish fauna survey from rivers draining the south‐western region of the Serra da Mantiqueira, and to investigate the effectiveness of that mountain range as a biogeographical barrier isolating the fish faunas of the Paraíba do Sul basin and the upper Paraná river.

Location  Six drainages from the south‐western portion of the Serra da Mantiqueira in the region of Campos do Jordão, Brazil, were studied. They included three drainages belonging to the Paraíba do Sul basin (Piracuama, Grande and Buenos), and three belonging to the Sapucaí basin, Rio Paraná system (Sapucaí‐Mirim, upper Sapucaí and Santo Antônio).

Methods  The survey was conducted in two sampling trips supplemented by examination of specimens preserved in museum collections. Parsimony analysis of endemicity (PAE) was used to detect the hierarchy of relationships among the six drainages.

Results  A total of 47 species of fishes was recorded in the six drainages. The main watershed divide is an effective barrier between the two basins, with 28 species occurring exclusively in the Paraíba do Sul versant, and 15 occurring exclusively on the slope of the Sapucaí basin. The PAE of 18 species with cladistically informative distributions and unproblematic taxonomic diagnoses produced a single area cladogram, with complete congruence among 14 species.

Main conclusions  The main Mantiqueira watershed divide is an effective biogeographical barrier isolating the fish faunas of the Paraíba do Sul and the Sapucaí basin (upper Paraná system). Previous hypotheses of a past connection between the upper Paraná and the Paraíba do Sul are not supported by extant species distributions in the Serra da Mantiqueira region. Within‐basin drainage differentiation, however, is relatively low.
Phylogeographic structuring and volant mammals: the case of the pallid bat (Antrozous pallidus)
Authors: Weyandt Sarah E. , Van Den Bussche Ronald A.
Published: June 2007

Aim To examine the phylogeographic pattern of a volant mammal at the continental scale. The pallid bat (Antrozous pallidus) was chosen because it ranges across a zone of well‐studied biotic assemblages, namely the warm deserts of North America.

Location The western half of North America, with sites in Mexico, the United States, and Canada.

Methods PCR amplification and sequencing of the mitochondrial control region was performed on 194 pallid bats from 36 localities. Additional sequences at the cytochrome‐blocus were generated for representatives of each control‐region haplotype.modeltestwas used to determine the best set of parameters to describe each data set, which were incorporated into analyses usingpaup*. Statistical parsimony and measurements of population differentiation (amova,FST) were also used to examine patterns of genetic diversity in pallid bats.

Results We detected three major lineages in the mitochondrial DNA of pallid bats collected across the species range. These three major clades have completely non‐overlapping geographic ranges. Only 6 of 80 control‐region haplotypes were found at more than a single locality, and sequences at the more conserved cytochrome‐blocus revealed 37 haplotypes. Statistical parsimony generated three unlinked networks that correspond exactly to clades defined by the distance‐based analysis. On average there wasc. 2% divergence for the combined mitochondrial sequences within each of the three major clades andc. 7% divergence between each pair of clades. Molecular clocks date divergence between the major clades at more than one million years, on average, using the faster rates, and at more than three million years using more conservative rates of evolution.

Main conclusions Divergent haplotypic lineages with allopatric distributions suggest that the pallid bat has responded to evolutionary pressures in a manner consistent with other taxa of the American southwest. These results extend the conclusions of earlier studies that found the genetic structuring of populations of some bat species to show that a widespread volant species may comprise a set of geographically replacing monophyletic lineages. Haplotypes were usually restricted to single localities, and the clade showing geographic affinities to the Sonoran Desert contained greater diversity than did clades to the east and west. While faster molecular clocks would allow for glacial cycles of the Pleistocene as plausible agents of diversification of pallid bats, evidence from co‐distributed taxa suggests support for older events being responsible for the initial divergence among clades.
Genetic and morphometric differentiation among island populations of two Norops lizards (Reptilia: Sauria: Polychrotidae) on independently colonized islands of the Islas de Bahia (Honduras)
Authors: Klütsch C. F. C. , Misof B. , Grosse W.‐R. , Moritz R. F. A.
Published: June 2007

Aim  Anole lizards (Reptilia: Sauria: Polychrotidae) display remarkable morphological and genetic differentiation between island populations. Morphological differences between islands are probably due to both adaptive (e.g. differential resource exploitation and intra‐ or interspecific competition) and non‐adaptive differentiation in allopatry. Anoles are well known for their extreme diversity and rapid adaptive speciation on islands. The main aim of this study was to use tests of morphological and genetic differentiation to investigate the population structure and colonization history of islands of the Islas de Bahia, off the coast of Honduras.

Location  Five populations of Norops bicaorum and Norops lemurinus were sampled, four from islands of the Islas de Bahia and one from the mainland of Honduras.

Methods  Body size and weight differentiation were measured in order to test for significant differences between sexes and populations. In addition, individuals were genotyped using the amplified fragment length polymorphism technique. Bayesian model‐based and assignment/exclusion methods were used to study genetic differentiation between island and mainland populations and to test colonization hypotheses.

Results  Assignment tests suggested migration from the mainland to the Cayos Cochinos, and from there independently to both Utila and Roatán, whereas migration between Utila and Roatán was lacking. Migration from the mainland to Utila was inferred, but was much less frequent. Morphologically, individuals from Utila appeared to be significantly different in comparison with all other localities. Significant differentiation between males of Roatán and the mainland was found in body size, whereas no significant difference was detected between the mainland and the Cayos Cochinos.

Main conclusions  Significant genetic and morphological differentiation was found among populations. A stepping‐stone model for colonization, in combination with an independent migration to Utila and Roatán, was suggested by assignment tests and was compatible with the observed morphological differentiation.
PRECLINICAL STUDY: Perinatal exposure to delta‐9‐tetrahydrocannabinol causes enduring cognitive deficits associated with alteration of cortical gene expression and neurotransmission in rats
Authors: Campolongo Patrizia , Trezza Viviana , Cassano Tommaso , Gaetani Silvana , Morgese Maria Grazia , Ubaldi Massimo , Soverchia Laura , Antonelli Tiziana , Ferraro Luca , Massi Maurizio , Ciccocioppo Roberto , Cuomo Vincenzo
Published: June 2007

The aim of the present study was to investigate whether perinatal exposure to a moderate dose of delta‐9‐tetrahydrocannabinol (THC) alters cortical gene expression and neurotransmission, leading to enduring cognitive dysfunctions in rat offspring. To this purpose, rat dams were treated, from gestational day 15 to postnatal day 9, with THC at a daily dose (5 mg/kg,per os) devoid of overt signs of toxicity. THC did not influence reproduction parameters, whereas it caused subtle neurofunctional deficits in the adult offspring. Particularly, perinatal THC induced long‐lasting alterations of cortical genes related to glutamatergic and noradrenergic systems, associated with a decrease in the cortical extracellular levels of both neurotransmitters. These alterations may account, at least in part, for the enduring cognitive impairment displayed by THC‐exposed offspring. Taken together, the present results highlight how exposure to cannabinoids during early stages of brain development can lead to irreversible, subtle dysfunctions in the offspring.
Differences between allergic and nonallergic rhinitis in a large sample of adolescents and adults
Authors: Mølgaard E. , Thomsen S. F. , Lund T. , Pedersen L. , Nolte H. , Backer V.
Published: June 2007

Background:  The aim of this study was to describe differences between allergic rhinitis (AR) and nonallergic rhinitis (NAR) in a large community‐based sample of Danish adolescents and adults.

Methods:  A total of 1186 subjects, 14–44 years of age, who in a screening questionnaire had reported a history of airway symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms and furthermore skin test reactivity, lung function and airway responsiveness were measured using standard techniques.

Results:  A total of 77% of the subjects with rhinitis had AR, whereas 23% had NAR. Subjects with NAR were more likely to be females, OR = 2.05 (1.31–3.20), P = 0.002, to have persistent symptoms within the last 4 weeks, OR = 1.88 (1.23–2.89), P = 0.003, and to have recurring headaches, OR = 1.94, (1.12–3.37), P = 0.019. On the other hand, subjects with NAR were less likely to have airway hyperresponsiveness, OR = 0.40, (0.24–0.66), P < 0.001, food allergy, OR = 0.40, (0.19–0.36), P = 0.009 and to have been treated with antihistamines in the last 4 weeks, OR = 0.22, (0.13–0.38), P < 0.001 compared with subjects with AR. Subjects with AR were symptomatically worse within their season in terms of sneezing (P < 0.001) and itchy eyes (P < 0.001), compared to subjects with NAR, whereas nasal congestion and rhinorrhea were equally frequent in the two groups (P = 0.901 and P = 0.278, respectively).

Conclusions:  The proportion of subjects with NAR in an adolescent and adult population with rhinitis is around one‐fourth. Women have NAR twice as often as men. In general, subjects with NAR have more persistent but equally severe symptoms compared to subjects with AR. However, subjects with AR have more sneezing and itchy eyes within their particular season of allergy compared to subjects with NAR.
Comparison of sirolimus and everolimus in their effects on blood lipid profiles and haematological parameters in heart transplant recipients
Authors: Tenderich Gero , Fuchs Uwe , Zittermann Armin , Muckelbauer Rebecca , Berthold Heiner K. , Koerfer Reiner
Published: June 2007

Abstract:  The mTOR (mammalian target of rapamycin) inhibitors sirolimus (SRL) and everolimus (EVL) are potent immunosuppressive agents, which allow reducing the dose of the nephrotoxic calcineurin inhibitors cyclosporin and tacrolimus (TAC) in solid organ transplant recipients. However, there is evidence that mTOR inhibitors may lead to myelosuppression and dyslipidemia/hyperlipidemia. We therefore performed a retrospective analysis in heart transplant recipients with renal insufficiency, who received 3.0 mg/d SRL (SRL group; n = 28) or 1.5 mg/d EVL (EVL group; n = 27) each in combination with a reduced TAC dose for at least one yr. Fewer cardiac rejections, but a similar rate of infections occurred in the EVL group compared with the SRL group indicating that the administered EVL dose resulted in a potent immunosuppression. Serum triglyceride and total cholesterol concentrations rose significantly in the SRL group but not in the EVL group. In the SRL group only, the frequency of statin use increased significantly during follow‐up. The EVL group showed a significant rise in HDL cholesterol levels during follow‐up. There was a slight transient fall in haemoglobin concentrations in the SRL group but not in the EVL group. Leucocyte counts fell significantly in both study groups. However, no cases of leucopenia and also no cases of thrombopenia occurred. In summary, we could demonstrate that in heart transplant recipients with renal insufficiency the introduction of 1.5 mg/d EVL in combination with a reduced TAC dose is effective in preventing cardiac rejections and has less adverse effects on lipid metabolism than the usually prescribed SRL dose, whereas both therapy regimens are not associated with major haematological side‐effects.
Simultaneous pancreas–kidney transplantation: to anticoagulate or not? Is that a question?
Authors: Vaidya Anil , Muthusamy A.S. , Hadjianastassiou V.G. , Roy D. , Elker D.E. , Moustafellos P. , Muktadir A. , Sinha S. , Friend P.J.
Published: June 2007

Abstract:  Pancreas graft loss due to venous thrombosis is the leading non‐immunological cause for graft failure following kidney–pancreas transplantation. Thromboelastography (TEG)‐directed anticoagulation protocol has shown that approximately one‐third of the patients undergoing pancreas transplantation require therapeutic anticoagulation to prevent the occurrence of graft thrombosis. This article presents the argument for individualised anticoagulation in these patients based on their TEG tracings and suggests the use of TEG in patients undergoing pancreas transplantation.
Follow‐up interviews of 12 living kidney donors one yr after open donor nephrectomy
Authors: Andersen Marit Helen , Bruserud Fanny , Mathisen Lars , Wahl Astrid Klopstad , Hanestad Berit Rokne , Fosse Erik
Published: June 2007

Abstract:  Very few studies have prospectively followed living kidney donors the first year after donor surgery. In 2003, we in‐depth interviewed living kidney donors one wk after donation to explore their immediate experiences of going through nephrectomy. The aim of the current investigation was to explore experiences regarding physical and psychosocial health during the first year after donor surgery. Twelve donors going through open donor nephrectomy were interviewed by telephone at one yr after donation. The analysis was carried out with an empirical phenomenological method. All participants expressed an overall positive experience about being a donor a year after transplantation. However, several participants experienced physical disincentives longer than expected post‐donation. Emotional distress, such as mild depression and a feeling of loss, was also part of the donor experiences. Donors experiencing unsuccessful recipient outcome reported severe physical and mental reactions. This study provides insights on the physical and mental cost to living kidney donation. Awareness of how donors may experience their situations can help transplantation professionals in their efforts to understand and provide support.
Psychological factors associated with medication adherence following renal transplantation
Authors: Gremigni Paola , Bacchi Francesca , Turrini Chiara , Cappelli Gianni , Albertazzi Alberto , Bitti Pio Enrico Ricci
Published: June 2007

Abstract:  Background:  A relationship exists between non‐adherence and clinical outcomes in health care, including renal transplantation. The aim of this study was to identify the psychological variables associated with non‐adherence to medication after renal transplantation.

Methods:  This cross‐sectional study involved 34 patients, 38% male, with a mean age of 49 yr (range 26–70) and a mean of six yr post‐transplantation. Adherence to medication was measured by two items: (i) the frequency of not taking medications and (ii) the frequency of not taking medications exactly as prescribed. The psychological variables were: dispositional coping style (COPE) and five items measuring barriers and perceived characteristics of the medication regimen. Descriptive and multivariate analyses were utilized to examine the data.

Results:  Twenty‐four per cent of patients reported less than perfect adherence. Individuals who were younger, who perceived less autonomy in the management of treatment and who were characterized by an active coping style were less likely to adhere to medication. Individuals who perceived less autonomy and a higher level of interference of treatment with their life patterns were less likely to take medication exactly as prescribed.

Conclusions:  The finding of this study suggests that adherence to medications after renal transplant is associated with psychological variables, such as coping style and perceived autonomy in the management of treatment. Understanding of the patient’s perspective may help to develop effective interventions to increase the levels of adherence to medications that may result in better clinical outcomes.
Management of portal vein thrombosis in liver transplantation: influence on morbidity and mortality
Authors: Lladó Laura , Fabregat Juan , Castellote José , Ramos Emilio , Torras Jaume , Jorba Rosa , Garcia‐Borobia Francisco , Busquets Juli , Figueras Juan , Rafecas Antoni
Published: June 2007

Abstract: Background: Splanchnic thrombosis is a surgical challenge in liver transplantation (LT). The aim of this study was to analyze our experience in the management of portal vein thrombosis, and its influence on evolution.

Aim: The aim of this study was to analyze our experience in the management of portal vein thrombosis, and its influence on evolution.

Patients and methods: Between 1999 and 2004, 366 liver transplants were performed in 335 patients. Forty‐two patients [12.5%: portal vein thrombosis (PVT) group] had portal thrombosis at the time of LT. We analyzed the technical aspects and compared their evolution with a group of patients without portal thrombosis (n = 293; no‐PVT group). Retransplantations were excluded.

Results: Of the 42 patients with thrombosis, 18 had partial thrombosis and 16 complete thrombosis [six included the proximal superior mesenteric vein (SMV) and in two the whole splanchnic system]. In 12 cases, usual T‐T anastomosis was performed and in 16 cases a thrombectomy was carried out; there were five cases of anastomosis at confluence of the SMV, five cases of anastomosis to a collateral vein, three cases of venous graft, and one case of cavoportal hemitransposition. The operative time was higher in PVT group (417 ± 103 min vs. 363 ± 83; p = 0.0005), as RBC transfusion (2.4 ± 3.1 vs. 1.9 ± 2.3; p = 0.04), and hospital stay (20.9 ± 14.9 d vs. 15.1 ± 10.6; p = 0.002). However, there were no differences in hospital mortality (4% vs. 7.8%; p = 0.98), primary dysfunction (4.8% vs. 7.8%; p = 0.44), or three‐yr‐actuarial survival (75% vs. 77%; p = 0.95). The incidence of post‐transplant thrombosis was higher in the PVT group (15% vs. 2.4%; p = 0.0005).

Conclusions: Portal thrombosis is associated with greater operative complexity and rethrombosis, but has no influence on overall morbidity and mortality.
Single time point measurement by C2 or C3 is highly predictive in cyclosporine area under the curve estimation immediately after lung transplantation
Authors: Hangler Herbert B. , Ruttmann Elfriede , Geltner Christian , Bucher Brigitte , Nagiller Johann , Laufer Guenther , Mueller Ludwig C.
Published: June 2007

Abstract:  Background:  The two h post‐dose cyclosporine (CsA) concentration has been advocated as the optimal time point measurement for CsA area under the curve (AUC) estimation after solid organ transplantation. The aim of the study was to investigate whether intensified CsA monitoring is necessary, or if a single time point measurement is accurate to estimate the AUC in the very early period following lung transplantation (LuTX).

Methods:  Within the first two wk following transplantation, daily AUCs were calculated by serial CsA measurements at zero, one, two, three, four, and six h (C0–C6) in 12 consecutive lung transplant recipients. Correlation of single CsA measurements and AUC as well as linear regression analysis was performed to evaluate the most predictive single CsA blood level regarding the AUC.

Results:  A total of 606 CsA concentration measurements were performed and the 101 corresponding AUCs were calculated for each patient. Mean AUC was 3443 ± 1451 μg/L. C0: 361 ± 118 μg/L, C1: 481 ± 231 μg/L, C2: 682 ± 314 μg/L, C3: 715 ± 347 μg/L, C4: 658 ± 271 μg/L, C6: 571 ± 260 μg/L. The correlation of CsA serum levels with AUC was the lowest at trough levels (C0) with a correlation coefficient (r = 0.31) and highest at three h (C3: r = 0.89) and two h (C2: r = 0.88).

Conclusions:  Similar to a stable post‐transplant period, CsA trough levels turned out to have poor correlation with the corresponding AUC early after LuTX. The highest correlation of C3 with the AUC may be explained by delayed intestinal resorption immediately post‐operative, however C2 is a peer parameter. Optimum AUCs and corresponding C2 or C3 levels in the immediate post‐operative phase however remain to be determined.
Pre‐medication with intravenous clonidine suppresses fentanyl‐induced cough
Authors: Horng H.‐C. , Wong C.‐S. , Hsiao K.‐N. , Huh B. K. , Kuo C.‐P. , Cherng C.‐H. , Wu C.‐T.
Published: June 2007

Background:  A reflex cough is often observed after an intravenous bolus of fentanyl. This study was conducted to determine whether pre‐treatment with intravenous clonidine could effectively attenuate fentanyl‐induced cough.

Methods:  Three hundred ASA I–II patients, aged between 18 and 80 years, undergoing various elective surgeries, were enrolled in this study. All patients were randomly assigned to one of two groups treated with intravenous clonidine 2 μg/kg (clonidine group) or the same volume of normal saline (control group). Intravenous fentanyl (2 μg/kg in 2 s) was injected 2 min after the clonidine or normal saline injection. Changes in the hemodynamics, auditory evoked potentials (AEPs) and Observer Assessment of Alertness/Sedation (OAA/S) rating scale were recorded before and 2 min after the clonidine or normal saline injection and 1 min after the fentanyl injection. The number of coughs 1 min after the fentanyl injection was also recorded.

Results:  Patients in the clonidine group showed a significantly lower incidence of cough than those in the control group (17.3% vs. 38.7%, respectively; P < 0.01). The blood pressure was lower in the clonidine group than in the control group. There were no significant differences in AEP or OAA/S rating scale.

Conclusions:  Pre‐treatment with intravenous clonidine (2 μg/kg) suppressed the reflex cough induced by fentanyl, with mild hemodynamic changes. Therefore, intravenous clonidine may be a clinically useful method of suppressing fentanyl‐induced cough.
Parental presence during induction enhances the effect of oral midazolam on emergence behavior of children undergoing general anesthesia
Authors: Arai Y.‐C. P. , Ito H. , Kandatsu N. , Kurokawa S. , Kinugasa S. , Komatsu T.
Published: June 2007

Background:  Pre‐anesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, sedative premedication and parental presence during induction of anesthesia (PPIA) are used to treat pre‐anesthetic anxiety in children. The aim of the present study was to test if a combination of mother presence and midazolam premedication is effective for improving emergence condition in children undergoing general anesthesia.

Methods:  Sixty children were allocated to one of three groups: a sedative group (0.5 mg/kg oral midazolam), a PPIA group or a sedative and PPIA group. When anesthesia was induced with 7% sevoflurane in 100% oxygen, qualities of mask induction were rated. Anesthesia was maintained with sevoflurane (1.5–2.5%) in 60% oxygen and intravenous fentanyl 4 μg/kg. During emergence from anesthesia, the score of the child’s emergence behavior was rated.

Results:  The children in the midazolam group showed a better quality of mask induction compared with those in the PPIA group, the addition of parental presence to oral midazolam did not provide additional improvement of mask induction. In contrast, the children in the midazolam + PPIA group were less agitated than those in the other groups at emergence from anesthesia.

Conclusion:  Parental presence during induction of anesthesia enhanced the effect of oral midazolam on emergence behavior of children undergoing general anesthesia.
Ultrasound controlled nerve stimulation in the elbow region: high currents and short distances needed to obtain motor responses
Authors: Sauter A. R. , Dodgson M. S. , Stubhaug A. , Cvancarova M. , Klaastad Ø.
Published: June 2007

Background:  Electrical nerve stimulation is commonly used to perform peripheral nerve blocks. The purpose of this study was to investigate the relation between stimulating currents and the distance between the needle‐tip and stimulated nerves.

Methods:  In 18 volunteers the radial and ulnar nerves were stimulated in the elbow region from opposite directions. Needle‐to‐nerve distances were measured by high‐frequency ultrasound when motor responses to electrical stimulation were elicited with currents of 5, 2, 1 and 0.5 mA and impulse widths of 0.1 ms. Additionally, current thresholds for nerve stimulation were identified when the needle‐tip was in contact with the nerve.

Results:  The ulnar nerves responded to electrical stimulation from a significantly greater distance than the radial nerves. Threshold levels at needle‐to‐nerve contact ranged from 0.4 to 4.5 mA for the radial nerve and from 0.32 to 2.0 mA for the ulnar nerve. They were significantly lower for the ulnar nerve than for the radial nerve. Currents required to obtain neuromuscular responses often exceeded the recommended current levels for nerve stimulation.

Conclusions:  Our results show significant differences in the ease of stimulation between the radial and ulnar nerves. High current thresholds and short nerve‐to‐needle distances were often needed to obtain neuromuscular responses in two nerves in the elbow region.
Physiological restitution after night‐call duty in anaesthesiologists: impact on metabolic factors
Authors: Malmberg B , Persson R , Jönsson B. A. G. , Erfurth E.‐M , Flisberg P , Ranklev E , ØRbaek P
Published: June 2007

Background: Several studies have shown impaired mental well‐being and performance in physicians work on call, but knowledge of the physiological effects is scarce. The aims of the present study were to investigate if there was a metabolic stress response in the restitutional phase after night‐call duty, indicating potential negative health effects, and determine whether there were differences between physician specialities.

Methods: Anaesthesiologists (n= 19) were compared with paediatricians/ear, nose and throat (ENT) surgeons (n= 18). On an ordinary workday, 1 and 3 days after work on night call, blood samples were taken for analysis of glucose, thyroid‐stimulating hormone (TSH), free thyroxine, testosterone, insulin growth factor‐1 (IGF‐1), high‐ and low‐density lipoprotein cholesterol (HDL and LDL), triglycerids (TG) and insulin. Saliva cortisol was sampled on an ordinary working day, a day including 16‐h night call, the third day following, and for anaesthesiologists also on a day off work.

Results: TSH differed significantly between days in both groups, with a 26% lower level 1 day after on‐call duty (P< 0.001). A 48% cortisol rise in the morning preceding night duty was found for paediatricians/ENT surgeons (P< 0.01).

Conclusion: The significant dip in TSH level 24 h after night‐call duty indicates a metabolic effect of working on night call and should be studied further. However, the levels were within the normal range and the overall results do not imply any serious metabolic changes and only minor differences were seen between specialist groups.
OESTROGEN AND NIGROSTRIATAL DOPAMINERGIC NEURODEGENERATION: ANIMAL MODELS AND CLINICAL REPORTS OF PARKINSON'S DISEASE
Authors: Liu Bin , Dluzen Dean E
Published: June 2007

The exact nature of oestrogen (positive, negative or no effect) in the dopaminergic neurodegenerative disorder Parkinson's disease is controversial.

In the present review, we summarize the data on oestrogen and nigrostriatal dopaminergic neurodegeneration in animal models and clinical reports of Parkinson's disease.

Most animal studies support the ability of oestrogen to function as a neuroprotectant against neurotoxins that target the nigrostriatal dopaminergic system.

Retrospective and prospective clinical studies generally support the findings from animal studies that oestrogen exerts a positive, or, at worst, no effect, in Parkinson's disease.

Oestrogen was chosen as one of the 12 neuroprotective compounds to be attractive candidates for further clinical trials (Phase II or III) in 2003.
CAN NITRIC OXIDE‐GENERATING COMPOUNDS IMPROVE THE OXIDATIVE STRESS RESPONSE IN EXPERIMENTALLY DIABETIC RATS?
Authors: Mohamadin Ahmed MA , Hammad Lamiaa NA , El‐Bab Mohamed Fath , Gawad Hala S Abdel
Published: June 2007

The present study was designed to evaluate the protective effects of the nitric oxide (NO)‐generating compounds l‐arginine (l‐Arg) and sodium nitroprusside (SNP) on oxidative stress markers in streptozotocin (STZ)‐diabetic rats.

Diabetes was induced after a single intraperitoneal injection of STZ (60 mg/kg). Rats were divided into non‐diabetic (control), diabetic and treated diabetic groups. The treated diabetic groups were supplemented with l‐Arg (300 mg/kg), SNP (3 mg/kg per day) or glibenclamide (0.6 mg/kg per day) orally for 4 weeks.

At the end of the experiment, fasted rats were killed by cervical decapitation. Blood was collected for estimation of glucose, haemoglobin, glycosylated haemoglobin (HbA1c), total cholesterol, high‐density lipoprotein–cholesterol and triglycerides. Thiobarbituric acid‐reactive substances (TBARS; an index of lipid peroxidation), superoxide dismutase, glutathione peroxidase, catalase, nitrate/nitrite (NOx) and reduced glutathione (GSH) were estimated in liver and kidney homogenates.

A significant increase was observed in plasma glucose levels and HbA1c, with a concomitant decrease in haemoglobin levels, in diabetic rats. These alterations reverted back to near normal after treatment with the NO‐generating compounds. A loss of bodyweight, polydipsia, polyphagia and elevated levels of serum cholesterol and triglycerides were observed in diabetic rats. Hyperglycaemia was accompanied by a significant increase in tissue TBARS and a decrease in NOx, GSH and anti‐oxidant enzymes, whereas, supplementation with l‐Arg and SNP significantly reduced TBARS levels and increased GSH and anti‐oxidant enzyme activities. Linear regression analysis indicated that blood glucose and TBARS were had a significant positive correlation with HbA1c, whereas a negative correlation was observed between GSH and NOx.

It is concluded that NO‐generating compounds improve most of the biochemical abnormalities and anti‐oxidant levels in diabetic rats. The beneficial effects of NO‐generating compounds can be attributed to the generation of NO and/or enhanced anti‐oxidant enzyme activities.
CHRONIC SALT LOADING AND CARDIOVASCULAR‐ASSOCIATED CHANGES IN EXPERIMENTAL DIABETES IN RATS
Authors: Maeda CY , Schaan BD , Oliveira EM , Oliveira VL , De Angelis K , Irigoyen MC
Published: June 2007

High‐sodium intake may increase blood pressure and diabetes is a salt‐sensitive condition. In the present study, we evaluated cardiovascular changes and their neurohumoral mechanisms in streptozotocin (STZ)‐diabetic rats that underwent chronic salt loading.

We studied male Wistar rats (150–280 g) 14 days after the injection of either STZ (50 mg/kg, i.v.; D; n = 18) or citrate buffer (C; n = 16). After the induction of diabetes, animals were maintained for 14 days with free access to standard rat chow and tap water (C and D groups) or 1% NaCl solution (C‐S and D‐S groups). We conducted two experiments. Experiment 1 consisted of basal arterial pressure (AP) measurement (30 min) followed by the evaluation of AP responsiveness to phenylephrine and sodium nitroprusside. One day later, with the rats anaesthetized, a blood sample was collected to test for glycaemia, plasma angiotensin‐converting enzyme (ACE) activity and renin. Kidneys were removed for the determination of tissue ACE activity. Experiment 2 comprised 24 h urine collection followed by 3 days of cardiovascular records, which consisted of a 30 min basal AP measurement, followed by injection of blockers of the vasopressin system, the renin–angiotensin system (RAS) and the sympathetic system. Basal haemodynamic data, baroreflex evaluation and AP responses to blockade of the vasopressin system with vasopressin V1 receptor antagonist (aAVP; 10 mg/kg, i.v.), the RAS by losartan (10 mg/kg, i.v.) and the sympathetic system by hexamethonium (20 mg/kg, i.v.) were determined.

Glycaemia was similar between C and C‐S (P = 0.612) and between D and D‐S (P = 0.552), but higher in diabetic compared with non‐diabetic rats (P < 0.0001). The D‐S rats had an increment of 24% in mean AP compared with D (120 ± 4 vs 97 ± 2 mmHg, respectively; P = 0.0001), which was not seen in C‐S compared with C rats. A positive association was noted between urinary sodium and mean AP (r = 0.37; P = 0.04). Plasma renin was undetectable in D‐S rats. The response to acute drug blockade of vasopressin and the RAS was similar among groups, but hexamethonium elicited a more pronounced decrease in AP in D‐S compared with D rats (P = 0.001).

The main neurohumoral mechanisms of salt‐induced cardiovascular changes in STZ‐diabetes are increased sodium and vascular sensitivity to adrenergic stimuli, which act in combination to produce a final result of higher AP levels, a finding not observed in control rats. Baroreflex derangements induced by diabetes were not affected by salt overload.
ARTERIAL STIFFNESS AND CARDIOVASCULAR OUTCOME
Authors: Zoungas Sophia , Asmar Roland P
Published: June 2007

Studies have reported an association between arterial function indices and cardiovascular risk factors, as well as the risk of incident cardiovascular events, including coronary heart disease and stroke.

The data are overwhelmingly in favour of an independent role for aortic pulse wave velocity in predicting fatal and non‐fatal cardiovascular events in healthy and diseased populations and in the evaluation of cardiovascular risk.

Augmentation index may independently predict all‐cause mortality and cardiovascular events in coronary and end‐stage renal disease patients, but some outcome studies have questioned its usefulness in hypertensive subjects and dialysis patients.

Systemic arterial compliance, to this time, has not been shown to independently predict cardiovascular outcome.

Future cardiovascular risk is greatly modified by prior disease and risk factors; the greatest additional value in measuring arterial stiffness and compliance may be in those with little or no end‐organ disease.
HEREDITARY AND ENVIRONMENTAL INFLUENCES ON ARTERIAL FUNCTION
Authors: Hayward CS , Benetos A
Published: June 2007

With the ageing population and increasing heart failure, arterial function has been shown to contribute to cardiovascular risk because of its adverse effects on ventriculovascular coupling. Population studies have confirmed independent prognostic information of arterial stiffening on cardiovascular survival.

The term ‘arterial function’ encompasses a range of phenotypes, including measures of arterial structure/remodelling, measures of arterial wall mechanics, surrogate measures of stiffness and of wave reflection. There exists significant interaction between these measures and none is truly independent of the others. Added to this complexity is the recognition that, although arterial function has a strong genetic component, quantification requires a range of techniques from twin to family and population studies.

The contribution of heritability is often derived from statistical models with input from genomic scanning and candidate gene studies. Studies to date confirm a significant heritable component for the majority of phenotypes examined. However, it has also been recognized that the factors involved in blood pressure maintenance are likely to be separate to those in arterial structural degeneration with ageing. Candidate genes for arterial function go beyond those of the sympathetic and renin–angiotensin systems and include genes involved in signalling pathways and extracellular matrix modulation.

The present review examines the evidence for heritability of the major arterial function phenotypes with environmental and ageing modulation. A brief overview of the impact of atherosclerotic risk factors on arterial function is included.
AGE, HYPERTENSION AND ARTERIAL FUNCTION
Authors: McEniery Carmel M , Wilkinson Ian B , Avolio Albert P
Published: June 2007

Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross‐sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age‐related changes observed in peripheral arteries appear to be less marked.

The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices.

Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear.

Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end‐product cross‐links between proteins, such as collagen and elastin, hold substantial promise.
SEX HORMONES AND THE CARDIOVASCULAR SYSTEM: EFFECTS ON ARTERIAL FUNCTION IN WOMEN
Authors: Teede HJ
Published: June 2007

It has long been hypothesized that oestrogen may be cardioprotective. This hypothesis is supported by diverse and comprehensive mechanistic studies in animals and humans. Consistently, in observational studies, oestrogen use in post‐menopausal women significantly reduced cardiovascular disease. Contrastingly, large interventional trials focusing on chronic disease prevention in older post‐menopausal women have suggested neutral (oestrogen alone) or adverse (combined oestrogen/progestin preparations) cardiovascular effects.

The negative initial interpretation and extrapolation of the early randomized, controlled interventional trials, primarily the Women's Health Initiative, has recently been theoretically reconciled with the positive mechanistic and observational studies. As a new interventional literature emerges, it has been suggested that if oestrogen is used from menopause onwards it is likely to be protective, but if instituted after endothelial damage has occurred in an oestrogen‐deficient post‐menopausal state, the beneficial vessel wall effects are not observed and the procoagulant effects result in overall increased cardiovascular risk.

The present article reviews the literature on arterial function and oestrogen use in the setting of the early endothelial protection theory. This theory is generally supported by the data on oestrogen effects on arterial function. In general, in studies of premenopausal women the effects of oestrogen were positive, with similar benefits noted if oestrogen was used early after menopause. However, where hormone therapy was commenced some years after menopause, the beneficial effects on arterial function were not observed. In clinical practice, hormone therapy is primarily used at menopause for the treatment of menopausal symptoms. The data on arterial function reviewed herein, along with emerging interventional human studies, suggest that the cardiovascular effects of this practice are not adverse.
High intraspecific recombination rate in a native population of Candidatus Pelagibacter ubique (SAR11)
Authors: Vergin Kevin L. , Tripp H. James , Wilhelm Larry J. , Denver Dee R. , Rappé Michael S. , Giovannoni Stephen J.
Published: June 2007

Recombination is an important process in microbial evolution. Rates of recombination with extracellular DNA matter because models of microbial population structure are profoundly influenced by the degree to which recombination is occurring within the population. Low rates of recombination may be sufficient to ensure the lateral propagation of genes that have a high selective advantage without disrupting the clonal pattern of inheritance for other genes. High rates of recombination potentially can obscure clonal patterns, leading to linkage equilibrium, and give microbial populations a population genetic structure more akin to sexually interbreeding eukaryotic populations. We examined eight loci from nine strains of candidatus Pelagibacter ubique (SAR11), isolated from a single 2L niskin sample of natural seawater, for evidence of genetic recombination between strains. The Shimodaira–Hasegawa test revealed significant phylogenetic incongruence in seven of the genes, indicating that frequent recombination obscures phylogenetic signals from the linear inheritance of genes in this population. Statistical evidence for intragenic recombination was found for six loci. An informative sites matrix showed extensive evidence for a widespread breakdown of linkage disequilibrium. Although the mechanisms of genetic transfer in native SAR11 populations are unknown, we measured recombination rates, ρ, that are much higher than point mutation rates, θ, as a source of genetic diversity in this clade. The eukaryotic model of species sharing a common pool of alleles is more apt for this SAR11 population than a strictly clonal model of inheritance in which allelic diversity is controlled by periodic selection.
Initial clinical evaluation of a new pneumatic intracorporeal lithotripter
Authors: Rané Abhay , Kommu Sashi S. , Kandaswamy S.V. , Rao Pradeep , Aron Monish , Kumar Rajeev , Gupta Narmada
Published: June 2007

OBJECTIVE

To test the clinical efficacy of the StoneBreakerTM (LMA Urology, Gland, Switzerland), a novel device which is much more compact and ergonomic than other current intracorporeal pneumatic lithotripters, and more powerful, generating contact pressures of up to 2.9 MPa, thereby enabling better pneumatic fragmentation and removal of stones during percutaneous nephrostolithotomy (PCNL), ureteroscopic stone fragmentation (USF) and vesical stone lithotripsy (VL).

PATIENTS AND METHODS

We prospectively evaluated 102 patients, comprising 49 PCNLs, 48 USFs and 5 VLs, treated using the StoneBreaker. The stone size, position, number of shocks required to fragment the stone to effect complete clearance, and degree of retropulsion were documented in each case; any evidence of urothelial trauma was noted.

RESULTS

All stones were satisfactorily fragmented and all patients rendered stone‐free. Very few shocks were required, and documented retropulsion was minor. There was no evidence of consequential urothelial trauma at the end of any procedure.

CONCLUSION

The StoneBreaker appears to be a safe, effective, robust and compact device for intracorporeal lithotripsy.