bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of ocular graft‐versus‐host disease on visual quality of life in patients after allogeneic stem cell transplantation: questionnaire study
Authors: Riemens Anjo , te Boome Liane C. J. , Kalinina Ayuso Viera , Kuiper Jonas J. W. , Imhof Saskia M. , Lokhorst Henk M. , Aniki Rothova
Published: April 2013

Purpose:  To determine the influence of ocular complications on quality of life (QoL) 3 years after allogeneic stem cell transplantation (allo‐SCT).

Methods:  All 54 adult patients that underwent and survived allo‐SCT in 2006/2007 in our centre received two questionnaires (VFQ‐25: visual function questionnaire‐25 and OSDI: ocular surface disease index). In addition, the following data were included: gender, age, underlying disease, presence of chronic and/or ocular graft‐versus‐host disease (GVHD), number of visits to an ophthalmologist, manifestations of dry eye disease, the duration of follow‐up and treatment for ocular GVHD.

Results:  Ocular GVHD developed in 26% (14 of 54) of patients and 71% (10 of 14) received treatment for ocular GVHD. The presence of ocular GVHD correlated with the severity of systemic GVHD (correlation coefficient: 0.52, p = 0.00). The Karnofsky scores were significantly lower in the patients with ocular GVHD compared to the patients with no ocular GVHD (p = 0.001). Karnofsky scores were weakly correlated with the severity of systemic GVHD (correlation coefficient: 0.25, p = 0.03. Three years after the all‐SCT, OSDI and VFQ‐25 scores were significantly impaired in patients with ocular GVHD [mean: 76.5; range (46.1–100) and mean: 31.1; range (0–72.9)] compared to patients with no ocular GVHD [mean: 89.4; range (45.2–100) and mean: 12.9; range (0–58.3); p = 0.02]. The scores of the VFQ‐25 were significantly lower in the domains of general health, ocular pain, social functioning and role difficulties.

Conclusion:  The long‐term vision‐related QoL measured by the OSDI and VFQ‐25 was impaired in patients with ocular GVHD.
Screening for coeliac disease in preschool Greek children: the feasibility study of a community‐based project
Authors: Karagiozoglou‐Lampoudi Thomai , Zellos Aglaia , Vlahavas George , Kafritsa Yota , Roma Eleftheria , Papadopoulou Alexandra , Fotoulaki Maria , Karyda Stavroula , Xinias Ioannis , Savvidou Afroditi
Published: April 2013

Aim

Evaluation of the prevalence of coeliac disease (CD) in Greek paediatric population.

Methods

The project consists of two parts: (i) a pilot study of preschool children aged 2–6 years to test the feasibility and diagnostic accuracy of community‐based screening and (ii) a CD prevalence study, by random clustered sampling and proportionate stratification of various geographical areas in Greece. Trained nonmedical staff performed a rapid immunochromatographic test to detect IgA antibodies to tTG‐IgA and IgA deficiency. Toddlers with positive results were referred to a paediatric gastroenterologist for further assessment with serum anti‐tTG IgA and EMA‐IgA. Children with positive serum anti‐tTG and anti‐EMA underwent upper gastrointestinal tract endoscopy and small bowel biopsy and were subsequently in gluten‐free diet.

Results

In this project participated 1136 toddlers, who were tested at school. The prevalence of positive rapid anti‐tTG screening was 1:154, of IgA deficiency 1:120 and of biopsy‐proven CD 1:154. The prevalence of CD from this pilot study served as expected prevalence value for sample size calculation for the main prevalence study.

Conclusion

This protocol using rapid immunochromatographic test for the detection of both IgA deficiency and CD is easy to be performed by nonmedical staff in a community setting, enabling the accurate identification of new CD cases among asymptomatic population.
Association of children's obesity with the quality of parental–child attachment and psychological variables
Authors: Bahrami Fatemeh , Kelishadi Roya , Jafari Nasim , Kaveh Zabihollah , Isanejad Omid
Published: April 2013

Aim

This study aimed to investigate the association of children's obesity with parental attachment and psychological variables as impulsivity, self‐control and efficiency of eating control.

Methods

This cross‐sectional study was conducted among 202 obese students aged 9–13 years selected by multistage cluster sampling from different areas of Isfahan, Iran. Three questionnaires were considered to be answered by the students and one for their parents. The students completed the following questionnaires: (i) Inventory of Parent and Peer Attachment‐Revised version for Children (IPPA‐R); (ii) Impulsivity Scale (IS); (iii) Efficiency of Eating Control; and (iv) Self‐control Rating Scale (SCRS).

Results

The quality of children's attachment had direct effects on self‐efficacy of eating management and on obesity by mediating of self‐efficacy of eating. Moreover, attachment had direct effect on self‐control and impulsivity, and in turn through these psychological variables, it had indirect effects on self‐efficacy of eating management.

Conclusion

The findings of this study underscore the importance of parent–child attachment quality. It can be suggested that childhood obesity can be prevented and managed with creating a secure attachment bond between children and parents and increasing perceived self‐efficacy eating management in children.
Laparoscopic resection for splenic artery aneurysm using the lateral approach: Report of two cases
Authors: Iida Atsushi , Katayama Kanji , Yamaguchi Akio
Published: April 2013

We report two cases of successful laparoscopic surgery for splenic artery aneurysm. In case 1, a 59‐year‐old man who had hypertension was admitted to the hospital with complaints of slight back pain. CT scan showed a winding splenic artery and an aneurysm behind the pancreas body. In case 2, a 71‐year‐old woman with hypertension consulted us and was diagnosed with splenic artery aneurysm. Her aneurysm increased from 1.2 mm to 20 mm at the 1‐year follow‐up. In both cases, we performed laparoscopic splenectomy, using the left lateral approach, to resect the aneurysm. Splenectomy was performed after the spleen had changed color. The operating times were 210 and 259 min, respectively and the bleeding was 60 and 100 mL, respectively. The postoperative course was uneventful. By using the lateral approach from the left side, we were able to precisely resect the splenic artery aneurysm under a stable laparoscopic view.
Simple technique to manage redundant skin after laparoscopic ventral hernia repair
Authors: Karim Muhammad Ali , Ali Abdulmajid
Published: April 2013

Introduction

The redundant skin left behind after laparoscopic ventral hernia repair overlies a dead space that is a potential site for seroma formation. This predisposes patients to surgical‐site infection and compromises the cosmetic outcome of the procedure, which is a key feature of the minimally invasive approach. We present a simple technique to deal with this problem.

Materials and Surgical Technique

This technique was used in six patients who underwent laparoscopic ventral hernia repair. Two patients were men and four were women. At the end of the procedure, glue (fibrin sealant) was injected in the dead space underneath the redundant skin and pressure was applied for some time; this attached the excessive skin to the underlying tissue. This obliterated the potential dead space, reducing the chances of seroma formation, and improved the cosmetic outcome of the procedure. Patients were reviewed 8 weeks after the procedure, and their body contours had returned to normal, with no skin redundancy.

Discussion

Minimally invasive surgery offers the advantage of a shorter hospital stay, faster recovery and improved cosmetic outcome, achieving better patient satisfaction as a result. This simple technique at the end of laparoscopic ventral hernia repair, in which the redundant skin is attached to the underlying tissue, improves the immediate postoperative cosmetic outcome and also obliterates any potential dead space for seroma formation.
Percutaneous endoscopic transforaminal approach to decompress the lateral recess in an elderly patient with spinal canal stenosis, herniated nucleus pulposus and pulmonary comorbidities
Authors: Kitahama Yoshihiro , Sairyo Koichi , Dezawa Akira
Published: April 2013

A 70‐year‐old man with severe pulmonary comorbidities was referred to our institution for treatment of a right L5 nerve impingement. He had suffered from spinal canal stenosis and herniated nucleus pulposus (HNP) at the level of L4‐L5 for more than a year and had been treated conservatively. However, the pain could not be alleviated, and his primary care physician scheduled posterior decompression surgery. During this procedure, the anesthesiologist refused to induce general anesthesia because of the patient's very poor pulmonary condition. Subsequently, the patient was referred to us. We used a transforaminal approach with percutaneous endoscopic discectomy, with the patient under local anesthesia. First, herniated nucleus pulposus fragments at the disc level were removed. With a trephine drill, the upper part of the L5 pedicle was removed, which allowed for the extraction of dorsally migrated fragments. Following complete removal of the herniated nucleus pulposus fragments, osseous decompression was performed. The osseous endplate of L5 (anterior part of the lateral recess) was removed to enlarge the lateral recess so that decompression of the L5 nerve root was possible. The patient's lower back pain and right leg pain subsided following surgery. Percutaneous endoscopic discectomy is useful for patients with severe comorbidities as it can be done with local anesthesia.
Cotyledonoid dissecting leiomyoma treated by laparoscopic surgery: A case report
Authors: Tanaka Hirohiko , Toriyabe Kuniaki , Senda Tokihiro , Sakakura Yasufumi , Yoshida Kayo , Asakura Tetsuo , Taniguchi Haruki , Nagao Kenji
Published: April 2013

A cotyledonoid dissecting leiomyoma is categorized as a leiomyoma with an unusual growth pattern, which is characterized by remarkable extrauterine bulbous growth in continuity with a dissecting myometrial component. A 36‐year‐old patient was preoperatively diagnosed with a mature cystic teratoma of the left ovary, and according to MRI, the tumor protruded from the uterus into the right broad ligament and was 10 cm in diameter. She underwent laparoscopic surgery to resect ovarian teratoma and the tumor under the right broad ligament. The tumor was almost completely resected and diagnosed as a cotyledonoid dissecting leiomyoma based on intraoperative and pathological findings. Recurrence was not seen for 26 months postoperatively in our case. Gross specimens are often mistaken for malignant lesions, but this was a benign disease. Even if some remnants of the leiomyoma remained postoperatively, recurrence has never been reported. When a cotyledonoid dissecting leiomyoma is resected laparoscopically, intrapelvic structures around it, such as the ureter, uterine artery, bladder, rectum and external iliac vessels, must be given careful attention.
Short‐term outcome of single‐incision laparoscopic totally extra‐peritoneal inguinal hernia repair
Authors: Wakasugi Masaki , Akamatsu Hiroki , Tori Masayuki , Ueshima Shigeyuki , Omori Takeshi , Tei Mitsuyoshi , Masuzawa Toru , Nishida Toshirou
Published: April 2013

We performed single‐incision laparoscopic surgery for totally extra‐peritoneal (SILS‐TEP) repair using a lightweight mesh fixed by absorbable tacks and without balloon dilation. Thirty‐four patients (mean age, 66.5 years) underwent SILS‐TEP repair in our hospital between September 2011 and April 2012; 30 patients had unilateral hernia and 4 had bilateral hernias. Mean operative time was 85.6 min for unilateral hernia and 137.7 min for bilateral hernias. All patients underwent successful SILS‐TEP repair. Mean hospital stay was 3.4 days. Mean duration of follow‐up was 7.1 months. Four seromas were observed, but no recurrences or major complications occurred. SILS‐TEP is an economical and useful method for decreasing postoperative complications, such as neuralgia and recurrence, and it could be an attractive approach for inguinal hernia.
Present and future advanced laparoscopic surgery
Authors: Rivas Homero , Díaz‐Calderón Daniela
Published: April 2013

Modern laparoscopy, starting with Kurt Semm's insufflators and the first successful appendectomies, has only been around for approximately 30 years. Since those early successes, the technology has grown from the inception of basic laparoscopy to endoscopic surgery through natural orifices, and it continues to evolve by leaps and bounds with computer‐assisted surgery and improved robotics in surgery. Without question, laparoscopy has revolutionized the way we perform standard surgery, especially relative to the techniques that had been used for hundreds of years. Despite the development of multiple novel technologies since the 1980s, very little has changed with regard to basic conceptualizations and practice of laparoscopy. In this review article, we will describe the highlights of recent advanced laparoscopic surgery procedures, their potential applications within the field of surgery, and how these advances may impact and improve future quality and patient outcomes.
Endo‐laparoscopic approach versus conventional open surgery in the treatment of obstructing left‐sided colon cancer: Long‐term follow‐up of a randomized trial
Authors: Tung Karen Lok Man , Cheung Hester Yui Shan , Ng Lawrence Wing Chiu , Chung Cliff Chi Chiu , Li Michael Ka Wah
Published: April 2013

Introduction

We previously conducted a randomized trial comparing the endo‐laparoscopic approach (i.e. placing self‐expanding metallic stents followed by laparoscopic resection) and conventional open surgery in the treatment of obstructing left‐sided colon cancer. This study is a follow‐up of the previous randomized trial and aims to report the long‐term outcomes of the two groups.

Methods

Forty‐eight patients from the randomized trial were followed up in an outpatient clinic with regular monitoring. Patients were compared for clinicopathological variables, disease recurrence and survival rates.

Results

Clinicopathological details were comparable between the two groups. During the median follow‐up periods of 32 months for the open group and 65 months endo‐laparoscopic group, no statistically significant difference was observed between the groups in disease recurrence rate, 5‐year overall survival (27% vs 48%, P = 0.076) and 5‐year disease‐free survival rates (48% vs 52%, P = 0.63).

Conclusion

Besides being a safe bridge to subsequent elective laparoscopic surgery, preoperative self‐expanding metallic stents insertion does not adversely affect oncological outcomes and patient survival. Based on our data, the endo‐laparoscopic approach is the treatment of choice for patients presenting with malignant left‐sided colonic obstruction.
Reduction of Hippocampal Apoptosis by Intracerebroventricular Administration of Extracellular Signal‐Regulated Protein Kinase and/or p38 Inhibitors in Amyloid Beta Rat Model of Alzheimer's Disease: Involvement of Nuclear‐Related Factor‐2 and Nuclear Factor‐κB
Authors: Ashabi Ghorbangol , Alamdary Shabnam Zeighamy , Ramin Mahmoudreza , Khodagholi Fariba
Published: April 2013

In the present study, we examined the effects of intracerebroventricular administration of extracellular signal‐regulated protein kinase‐ (ERK) and p38‐specific inhibitors, U0126 and PD169316, respectively, on apoptosis induced by amyloid beta (Aβ) in rats. To investigate the effects of these compounds, we evaluated intracellular signalling pathways of apoptosis, as well as inflammatory and antioxidant pathways, 7 and 20 days after Aβ injection. We found that caspase‐3 and Bax/Bcl‐2 ratio, two hallmarks of apoptosis, were significantly decreased in the rats pre‐treated with U0126 and PD169316, 7 days after Aβ injection. This observation was in agreement with the results of immunostaining analysis of the hippocampus that showed decreased levels of terminal transferase dUTP nick end labelling positive cells in the hippocampus of U0126 and PD169316 pre‐treated rats, compared with the Aβ‐injected group. We also chased the changes in the levels of calpain‐2 and caspase‐12, two ER factors, in the Aβ‐injected and treatment groups. Decreased levels of calpain‐2 and caspase‐12 in U0126 and PD169316 pre‐treated rats confirmed the protective effects of these inhibitors. Furthermore, we studied the effect of two stress‐sensing transcription factors, nuclear‐related factor‐2 (Nrf2) and nuclear factor‐кB (NF‐кB), in Aβ‐injected as wells as U0126 and PD169316 pre‐treated rats. U0126 and PD169316 activated Nrf2 and suppressed NF‐кB pathways, 7 days after Aβ injection. These antioxidant and inflammatory pathways restored to the vehicle level within 20 days. Taken together, our findings reinforce and extend the notion of the potential neuroprotective role of ERK and/or p38 inhibitors against the neuronal toxicity induced by Aβ.
Beneficial Pharmacological Effects of Levosimendan on Antioxidant Status of Acute Inflammation Induced in Paw of Rat: Involvement in Inflammatory Mediators
Authors: Karakus Emre , Halici Zekai , Albayrak Abdulmecit , Bayir Yasin , Aydin Ali , Unal Deniz , Cadirci Elif , Ferah Irmak , Odaci Ersan
Published: April 2013

Levosimendan (LEVO) is a new calcium sensitizer with positive inotropic and vasodilating properties that represents a new pharmacological class of inotropic drugs that stimulate elevated cardiac output. The purpose of this study was to examine anti‐inflammatory effect and antioxidant activity of LEVO in a carrageenan (CAR)‐induced inflammatory paw oedema rat model. The CAR‐induced rat groups received LEVO 1, 2 and 3 mg/kg by intraperitonally and indomethacin (IND) 25 mg/kg by oral gavage. LEVO inhibited CAR‐induced paw oedema and suppressed the production of TNF‐α, IL‐1 and IL‐6 at doses of 2 and 3 mg/kg. In contrast to CAR‐injected paws, 2 and 3 mg/kg doses of LEVO and IND increased superoxide dismutase (SOD) activity and also both doses of LEVO, and IND decreased the 8‐isoprostaglandin F2α (8‐ISO) level. A 2 mg/kg dose of LEVO produced 39%, 46%, 61% and 64.7% anti‐inflammatory effects (p < 0.0001) for the 1st, 2nd, 3rd and 4th hours, respectively. Other results of our current study have shown that SOD and glutathione for CAR‐injected groups were lower, and 8‐ISO level was higher than those for the healthy rat group. LEVO may be provided as a pharmacological agent in the prevention or treatment of diseases in which acute or chronic inflammation occurs based on a pathogenic factor.
The Effects of Lidocaine Used in Sciatic Nerve on the Pharmacodynamics and Pharmacokinetics of Ropivacaine in Sciatic Nerve Combined with Lumbar Plexus Blockade: A Double‐Blind, Randomized Study
Authors: Chen Limei , Wang Quanguang , Shi Kejian , Liu Fuli , Liu Le , Ni Jianwu , Fang Xiangyu , Xu Xuzhong
Published: April 2013

In this controlled, randomized, double‐blind study, we compared the pharmacodynamics and pharmacokinetics of ropivacaine and staged injection of lidocaine and ropivacaine in a combined lumbar plexus–sciatic nerve block. The experiment was performed in two parts: pharmacodynamics study (Group r, n = 20; Group lr, n = 20) and pharmacokinetics study (Group R, n = 10; Group LR, n = 10). The sciatic nerve blockade was performed using either (1) 10 mL of 2% lidocaine and then 10 mL of 0.75% ropivacaine (Group lr and Group LR) or (2) 10 mL of normal saline (N.S.) and then 10 mL of 0.75% ropivacaine (Group r and Group R). Two kinds of solutions were ‘staged’ injection. The sensory onset time and sensory recovery time were assessed in the pharmacodynamics study. Arterial blood samples were collected for the pharmacokinetics study. Sciatic sensory block onset times were reduced, and the sensory recovery times were decreased in Group lr. Cmax of ropivacaine in Group LR was significantly higher than that in Group R. A significant increase in AUC(0–t) and AUC(0–∞) was observed in Group LR compared with Group R. When 2% lidocaine and 0.75% ropivacaine are used for a combined sciatic nerve–lumbar plexus block by ‘staged’ injection, lidocaine induced faster onset times, decreased the block duration and increased the AUC and Cmax of ropivacaine.
Protective Effects of d‐Limonene on Lipid Peroxidation and Antioxidant Enzymes in Streptozotocin‐Induced Diabetic Rats
Authors: Murali Ramakrishnan , Karthikeyan Arumugam , Saravanan Ramalingam
Published: April 2013

The aim of this study was to evaluate the protective effects of d‐limonene on the levels of lipid peroxidation by‐products and antioxidant defence systems in the plasma and tissues of normal and streptozotocin (STZ)‐induced diabetes rats. The experimental diabetes was induced in rats by a single dose of STZ (40 mg/kg i.p.) injection, and treatment with d‐limonene was continued for 45 days. After the treatment period, oxidative stress parameters such as lipid peroxidation by‐products; enzymatic antioxidants such as superoxide dismutase, catalase, glutathione peroxidase and glutathione‐S‐transferase; non‐enzymic antioxidants including reduced glutathione, Vitamins C and E were measured in the plasma and tissues of experimental rats. An increase in the levels of lipid peroxidation by‐products and significant decrease in antioxidant enzymes were observed in untreated diabetic rats. Administration of d‐limonene to diabetic rats for 45 days caused a significant reduction in the levels of lipid peroxidation by‐products and an increase in the activities of antioxidant enzymes, when compared with the untreated diabetic group. There was no significant difference in normal treated groups, when compared with normal rats. Biochemical observations were substantiated with the help of histopathological examinations through its antioxidant properties and thereby conferred protection against STZ‐induced diabetic rats. The result of this study indicates that d‐limonene has antioxidant potential in addition to its antidiabetic effect in experimental diabetes.
Up‐regulated GLT‐1 Resists Glutamate Toxicity and Attenuates Glutamate‐induced Calcium Loading in Cultured Neurocytes
Authors: Liu Chun‐hua , Jiao Hong , Guo Zhao‐hui , Peng Ying , Wang Wei‐zhi
Published: April 2013

Glutamate transporter‐1 (GLT‐1) plays a dual role in glutamate transportation: both normally devotion to the clearance of glutamate and during some pathological conditions extruding glutamate to the extracellular space. Therefore, it is uncertain whether increased expression of GLT‐1 will actually be helpful against glutamate excitotoxicity. In this study, GLT‐1 up‐regulation was induced by ceftriaxone, and L‐glutamate was added to induce glutamate toxicity in primary cultured rat cortical cells. The results showed that up‐regulated GLT‐1 induced by 1 μM ceftriaxone for 2 days markedly increased cell viability, decreased apoptotic cell death and alleviated ultrastructural damage induced by 50 μM glutamate 15 min. as well as promoted L‐[3H]‐glutamate uptake in cultured cells. GLT‐1 up‐regulation had no effect on the intracellular free calcium concentration ([Ca2+]i) in the resting situation, while relieved intracellular calcium overloading by reducing the elevation and promoting the recovery of [Ca2+]i following stimulation of 50 μM glutamate for 2 min. Applying 100 μM dihydrokainic acid (GLT‐1 antagonist) 30 sec. before glutamate eliminated the above effect of GLT‐1 up‐regulation on [Ca2+]i. In conclusion, GLT‐1 up‐regulation induced by ceftriaxone plays a positive glutamate transporting role against glutamate toxicity in primary cultured rat cortical cells.
Antihyperalgesic Effect of the GABAA Ligand Clobazam in a Neuropathic Pain Model in Mice: A Pharmacokinetic–Pharmacodynamic Study
Authors: Besson Marie , Daali Youssef , Di Lio Alessandra , Dayer Pierre , Zeilhofer Hanns Ulrich , Desmeules Jules
Published: April 2013

Facilitation of spinal GABAergic inhibition with benzodiazepines (BZDs) reverses pain sensitization in animals; however, the use of BZDs in man is limited by their sedative effect. The antihyperalgesic effects of GABAA agonists are mediated by GABAA receptors containing α2 subunits, whereas sedation is linked to α1 subunit‐containing receptors. α2 and α3 selective GABAA receptor modulators have been tested in animals but are not yet available for use in human beings. Clobazam is a 1,5‐BZD, which exhibits less cognitive side effects than other benzodiazepines. Here, we studied its antihyperalgesic effects in a mouse model of neuropathic pain. Clobazam showed a dose‐dependent antihyperalgesic effect in the chronic constriction injury (CCI) model of neuropathic pain, peaking at 1 hr after administration and lasting for 4 hr with no relevant sedation at a dose of 3 mg/kg. At higher doses, the antihyperalgesic effect was stronger, but sedation became significant. The blood and brain kinetics of clobazam were linear over the range of doses tested with a short half‐life of the parent compound and a ready penetration of the blood–brain barrier. Clobazam blood concentrations decreased rapidly, falling below the limit of detection at 120 min. after drug application. Its main metabolite, N‐desmethyl‐clobazam, showed more delayed and prolonged pharmacokinetics, partly explaining why antihyperalgesia persisted when clobazam was no longer detectable in the blood. Considering its therapeutic margin and its pharmacokinetic properties, clobazam would be a valuable compound to assess the role of the GABAergic pathway in pain transmission in human beings.
Impact of Genetic Factors (CYP2C9,VKORC1 and CYP4F2) on Warfarin Dose Requirement in the Turkish Population
Authors: Özer Mahmut , Demirci Yeliz , Hızel Candan , Sarıkaya Sabit , Karaltı İskender , Kaspar Çiğdem , Alpan Serdar , Genç Ece
Published: April 2013

Warfarin has a narrow therapeutic index and displays marked person‐to‐person variation in dose requirement. Functional polymorphisms at candidate genes can therefore offer utility as biomarkers to individualize warfarin treatment. The main objective of this study was to determine whether and to what extent variability in warfarin dose requirements was determined by polymorphisms in CYP2C9, VKORC1, CYP4F2 (rs2108622) and EPHX1 (rs2292566) in the Turkish population. Patients (n = 107) who had stable doses and international normalized ratio (INRs) at their last three consecutive visits were registered. Their demographic factors, concurrent medications, warfarin‐related bleedings or thromboembolisms, smoking, alcohol intake and weekly green vegetable consumption were recorded. From a blood sample, DNA was isolated and genotyped by real‐time PCR for polymorphisms of CYP2C9, VKORC1, CYP4F2 and EPHX1. A regression analysis was used to determine the independent effects of genetic and non‐genetic factors on warfarin dose optimization. In our study, in addition to age, genetic variants of CYP2C9, VKORC1 and CYP4F2 were found to be significant predictor variables for the maintenance dose for warfarin, explaining 39.3% of dose variability. VKORC1 and CYP2C9 genotypes remain predictor variables of the warfarin dose, and we first found that CYP4F2 (rs2108622) contributes to dose variability in the Turkish population as well. These observations may be of benefit to future translation research with a view to global personalized medicine in regions hitherto understudied such as the Turkish population so as to rationalize initial warfarin dose and reduce the burden of frequent INR measurements.
Thrombospondins, Potential Drug Targets for Cardiovascular Diseases
Authors: Mustonen Erja , Ruskoaho Heikki , Rysä Jaana
Published: April 2013

The thrombospondin (TSP) family consists of five multimeric, multidomain calcium‐binding glycoproteins that act as regulators of cell–cell and cell–matrix associations as well as interact with other extracellular matrix molecules affecting their function. Increasing interest on cardiac TSP‐1, TSP‐2 and TSP‐4 has emerged, and they have been studied in cardiac hypertrophy, myocardial infarction, heart failure, atherosclerosis and aortic valve stenosis. The aim of this MiniReview is to summarize the current knowledge on each TSP in various cardiovascular pathologies. We specifically emphasize the role of TSPs in cardiac remodelling and evaluate TSPs as potential cardiovascular drug targets. Thrombospondin‐1 (TSP‐1) is the most studied TSP, being antiangiogenic and able to activate transforming growth factor‐β. The functions of TSP‐2 and TSP‐4 are linked in maintaining the composition of the matrix of the hypertrophied heart, whereas there is very little knowledge on cardiac TSP‐3 and TSP‐5. TSP‐1, TSP‐2 and TSP‐4 have been shown to affect cardiac remodelling in vivo, for example, by modulating matrix metalloproteinase and transforming growth factor‐β activity, collagen synthesis, myofibroblast differentiation, cell death and stretch‐mediated augmentation of cardiac contractility. The detrimental role for TSPs in cardiovascular pathophysiology has been clearly demonstrated in knockout mouse models, and augmentation of TSP signalling in the heart during stress and haemodynamic overload might be beneficial. In conclusion, the role of TSP‐1, TSP‐2 and TSP‐4 in cardiac hypertrophy, remodelling after myocardial infarction, heart failure, atherosclerosis and aortic valve stenosis encourages further investigation to validate them as potential drug targets.
Religiosity, mood symptoms, and quality of life in bipolar disorder
Authors: Stroppa André , Moreira‐Almeida Alexander
Published: April 2013

Objectives

The aim of the present study was to investigate the relationship between religiosity and mood, quality of life, number of hospitalizations, and number of severe suicide attempts among bipolar disorder patients.

Methods

In a cross‐sectional study of bipolar disorder outpatients (N = 168), we assessed symptoms of mania [Young Mania Rating Scale (YMRS)], depression [Montgomery–Åsberg Depression Rating Scale (MADRS)], religiosity (Duke Religious Index), religious coping (Brief RCOPE), and quality of life [World Health Organization Quality of Life–Brief Version (WHOQOL‐BREF)]. Sociodemographic data, number of suicide attempts, and number of hospitalizations were obtained through an interview with the individual and analysis of the patient's medical records. Logistical and linear regressions of the association between the religious indicators and clinical variables were conducted, controlling for sociodemographic variables.

Results

A total of 148 (88.1%) individuals reported some type of religious affiliation. Intrinsic religiosity [odds ratio (OR) = 0.19, 95% confidence interval (CI): 0.06–0.57, p = 0.003] and positive religious coping strategies (OR = 0.25, CI: 0.09–0.71, p = 0.01) were associated with fewer depressive symptoms. All four domains of quality of life were directly and significantly correlated with intrinsic religiosity. Positive religious coping was correlated with higher levels of the psychological (β = 0.216, p = 0.002) and environmental (β = 0.178, p = 0.028) quality‐of‐life domains. Negative religious coping was associated with lower scores on the psychological domain of quality of life (β = −0.182, p = 0.025).

Conclusions

Intrinsic religiosity and positive religious coping are strongly associated with fewer depressive symptoms and improved quality of life. Negative religious coping is associated with worse quality of life. Religiosity is a relevant aspect of patients' lives and should be taken into consideration by physicians when assessing and managing bipolar disorder patients. Further longitudinal studies are needed to determine the causality and therapeutic implications of our findings.
HOME MARKET EFFECTS IN THE CHAMBERLINIAN–RICARDIAN WORLD
Authors: Huang Yo‐Yi , Lee Cheng‐Te , Huang Deng‐Shing
Published: April 2013

According to conventional home market effects, free trade tends to shrink the market share for a smaller economy in differentiated manufacturing goods, and in the extreme, leads to a complete hollowing out of the industry. Departing from the original Helpman–Krugman modelling assumptions behind the home market effects, we introduce a technology advantage in terms of the difference in fixed cost and/or marginal cost between trading partners and prove that home market effects will be offset and even reverse if a small economy has better technology than another country. With a higher elasticity of substitution, the marginal cost advantage becomes more important if it is to dominate the home market effect. We also show that even with an identical country size, the intra‐industry trade addressed in the existing literature may not occur; it will occur only if the technology differential lies within a certain range that is positively affected by the level of transport cost.
What do parents know about their children's comprehension of emotions? Accuracy of parental estimates in a community sample of pre‐schoolers
Authors: Kårstad S. B. , Kvello Ø. , Wichstrøm L. , Berg‐Nielsen T. S.
Published: April 2013

Background

Parents' ability to correctly perceive their child's skills has implications for how the child develops. In some studies, parents have shown to overestimate their child's abilities in areas such as IQ, memory and language. Emotion Comprehension (EC) is a skill central to children's emotion regulation, initially learned from their parents. In this cross‐sectional study we first tested children's EC and then asked parents to estimate the child's performance. Thus, a measure of accuracy between child performance and parents' estimates was obtained. Subsequently, we obtained information on child and parent factors that might predict parents' accuracy in estimating their child's EC.

Methods

Child EC and parental accuracy of estimation was tested by studying a community sample of 882 4‐year‐olds who completed the Test of Emotion Comprehension (TEC). The parents were instructed to guess their children's responses on the TEC. Predictors of parental accuracy of estimation were child actual performance on the TEC, child language comprehension, observed parent–child interaction, the education level of the parent, and child mental health.

Results

Ninety‐one per cent of the parents overestimated their children's EC. On average, parents estimated that their 4‐year‐old children would display the level of EC corresponding to a 7‐year‐old. Accuracy of parental estimation was predicted by child high performance on the TEC, child advanced language comprehension, and more optimal parent–child interaction.

Conclusion

Parents' ability to estimate the level of their child's EC was characterized by a substantial overestimation. The more competent the child, and the more sensitive and structuring the parent was interacting with the child, the more accurate the parent was in the estimation of their child's EC.
The oxidative stress induced in vivo by Shiga toxin-2 contributes to the pathogenicity of haemolytic uraemic syndrome
Authors: Gomez S A , Abrey-Recalde M J , Panek C A , Ferrarotti N F , Repetto M G , Mejías M P , Fernández G C , Vanzulli S , Isturiz M A , Palermo M S
Published: April 2013

Typical haemolytic uraemic syndrome (HUS) is caused by Shiga toxin (Stx)-producing Escherichia coli infections and is characterized by thrombotic microangiopathy that leads to haemolytic anaemia, thrombocytopenia and acute renal failure. Renal or neurological sequelae are consequences of irreversible tissue damage during the acute phase. Stx toxicity and the acute inflammatory response raised by the host determine the development of HUS. At present there is no specific therapy to control Stx damage. The pathogenic role of reactive oxygen species (ROS) on endothelial injury has been largely documented. In this study, we investigated the in-vivo effects of Stx on the oxidative balance and its contribution to the development of HUS in mice. In addition, we analysed the effect of anti-oxidant agents as therapeutic tools to counteract Stx toxicity. We demonstrated that Stx induced an oxidative imbalance, evidenced by renal glutathione depletion and increased lipid membrane peroxidation. The increased ROS production by neutrophils may be one of the major sources of oxidative stress during Stx intoxication. All these parameters were ameliorated by anti-oxidants reducing platelet activation, renal damage and increasing survival. To conclude, Stx generates a pro-oxidative state that contributes to kidney failure, and exogenous anti-oxidants could be beneficial to counteract this pathogenic pathway.
Miltefosine and polyhexamethylene biguanide: a new drug combination for the treatment of Acanthamoeba keratitis
Authors: Polat Zubeyde A , Walochnik Julia , Obwaller Andreas , Vural Ayse , Dursun Ayhan , Arici Mustafa K
Published: April 2013

Background

In this study, a series of compounds – miltefosine, polyhexamethylene biguanide, chlorhexidine and propamidine isethionate – and combinations of the latter three agents with miltefosine were prepared and used in a rat model for the topical treatment of Acanthamoeba keratitis.

Methods

The corneas of rats were infected with Acanthamoeba hatchetti. On the fifth day, all corneas were microscopically examined in order to determine the grade of infections. Nine groups were then prepared: miltefosine (65.12 μg/mL); chlorhexidine (0.02%); polyhexamethylene biguanide (0.02%), propamidine isethionate (0.1%), miltefosine plus chlorhexidine, miltefosine plus polyhexamethylene biguanide; miltefosine plus propamidine isethionate; infected control; and a non‐infected control group. The treatment was continued for 28 days. After the treatment, the corneas were excised and used for Acanthamoeba culture to investigate the presence of Acanthamoeba growth. For the determination of cytotoxicity of the drugs on L929 cells, colorimetric assays were performed.

Results

The best treatment results were obtained from the polyhexamethylene biguanide plus miltefosine group; the ratio of fully recovered eyes was 28.4%. It was proven that the miltefosine–polyhexamethylene biguanide combination yielded the highest anti‐acanthamoebal activity in that approximately 86% of the eyes were cleared from amoebae. The cytotoxicity values of the miltefosine and the control groups were compared with other groups and found to be statistically different (P < 0.05).

Conclusion

This in vivo study demonstrates that a miltefosine–polyhexamethylene biguanide combination is highly effective for the treatment of Acanthamoeba keratitis.
Outcomes of combined lens extraction and goniosynechialysis in angle closure
Authors: White Andrew JR , Orros Justo Manuel A , Healey Paul R
Published: April 2013

Background

The aim of this study was to assess the effect of goniosynechialysis on intraocular pressure and medication requirement in patients with angle closure.

Design

A retrospective chart review.

Participants

51 eyes from 42 patients were included in the study. 17 had documented evidence of acute angle closure while 34 had chronic angle closure.

Methods

Examination of the medical records of patients with synechial primary angle closure who underwent combined phacoemulsification and goniosynechialysis from 2003–2011 at 3 centres.

Main Outcome Measures

Intraocular pressure and requirement for drops were the main outcome measures.

Results

Mean follow‐up was 25.9 months for the acute group and 25.4 months for the chronic group. Mean preoperative intraocular pressure was 23.33 ± 14.41 mmHg on an average of 2.51 ± 1.3 medications. Mean postoperative intraocular pressure was lowered to 13.67 ± 2.41 (p ≤ 0.01) and medication usage was significantly lowered to 0.65 ± 0.87 (p ≤ 0.01). Subjects with documented acute symptomatic angle closure had higher preoperative intraocular pressure and a larger intraocular pressure fall post goniosynechialysis (from 30.41 mmHg ± 23 mmHg to 12.12 mmHg ± 2.32 mmHg) compared to those without such a documented episode (19.79 mmHg ± 4.37 mmHg to 14.44 mmHg ± 2.08 mmHg, p = 0.007). Both groups have similar postoperative need for glaucoma medication, 0.65 ± 0.93 vs 0.65 ± 0.85.

Conclusions

Combined phacoemulsififcation and goniosynechialysis reduces intraocular pressure, medication requirements and need for further surgery in subjects with angle closure. The procedure is more effective in eyes with a previously documented acute symptomatic presentation of angle closure.
Analysis of fine structure and biochemical changes of retina during aging of Wistar albino rats
Authors: El‐Sayyad Hassan IH , Khalifa Soad A , El‐Sayyad Fawkia I , Mousa Shaker A , Mohammed Ezaldin AM
Published: April 2013

Background

Aging is a biological phenomenon that involves an increase of oxidative stress associated with gradual degradation of the structure and function of the retina. Gender differences and subsequent deterioration of retinal cell layers is an interesting topic, especially because there is no published work concerning it.

Methods

One hundred and twenty male and female Wistar albino rats ages 1, 6, 18, 30 and 42 months (n = 20 equal for male and female) were used. At the time interval, retinae were investigated by light and transmission electron microscopy, assessments of neurotransmitters, anti‐oxidant enzymes (catalase, superoxide dismustase and glutathione S transferase), caspase‐3 and ‐7, malonadialdhyde, and DNA fragmentation.

Results

Light and transmission electron microscopy observations of the older specimens (30 and 42 months) revealed apparent deterioration of retinal cell layers, especially ganglion and nerve fibres, nuclear, pigmented epithelium and stacked membranes of the photoreceptor's outer segments. Males were highly susceptible to aging processes. Retinal DNA fragmentation was remarked parallel with increase of apoptic markers caspase 3 and 7. Concomitantly, there was a marked reduction of neurotransmitters and anti‐oxidant enzymes, and an increase of lipid peroxidation.

Conclusions

Aging contributed to an increase of oxidative stress resulting from damage of mitochondria in retinal cells, a decrease of the anti‐oxidant enzyme system and an increase of markers of retinal cell death.
Inflammatory reaction – communication of cells
Authors: Terheyden Hendrik , Stadlinger Bernd , Sanz Mariano , Garbe Annette I. , Meyle Jörg
Published: April 2013

This article presents scientific background information on the animated 3D film “Inflammatory Reactions – Communication of Cells” (Quintessence Publications, ISBN 978‐1‐85097‐231‐0). Gingivitis and periodontitis are understood as the result of a coordinated action of a few clearly identified cellular players who communicate with each other via cytokines. For didactic reasons, the course of a periodontal infection is described here in four phases: (1) bacterial biofilm formation and development of a host response in the marginal periodontium, (2) innate immune response leading to gingivitis, (3) role of the adaptive immune system in attachment loss and pocket formation, and (4) down‐regulation of inflammation and periodontal regeneration and repair following biofilm removal. The control of the cells is discussed as a cytokine network, which can be modulated in pro‐ or anti‐inflammatory direction depending on the control of the bacterial infection. Degradation of soft tissue structural proteins like collagen and proteoglycans by matrix metalloproteinases and degradation of hard tissue matrix by osteoclasts are explained as an interference of the immune system with the natural equilibrium of tissue remodeling. Five mechanisms of promotion of bone loss through the influence of the immune system are described. One example is bone resorption as a consequence of the shift of the RANKL/osteoprotegerin balance by soluble RANKL synthesized by CD4+Th1 cells as well as the interference with the coupling of osteoclasts and osteoblasts through dedifferentiation of osteoblasts by TNFα. Finally, the signaling required for down‐regulation of inflammatory reactions and the reasons for the incomplete regeneration after periodontal bone loss are discussed.
The effect of local simvastatin application on critical size defects in the diabetic rats
Authors: Ezirganlı Şeref , Kazancıoğlu Hakkı O. , Mihmanlı Ahmet , Aydın Mehmet Ş. , Sharifov Rasul , Alkan Alpay
Published: April 2013

Objectives

To evaluate bone‐healing effects of local simvastatin application to critical size defects (CSDs) in the experimental diabetes mellitus (DM) rat model.

Materials and Methods

A total of 35 male Sprague–Dawley rats with an average weight of 350 g and aged 3 months were used in this study. The rats were divided into five groups of seven animals each: passive control (group A), active control (group B), 0.5 mg simvastatin (group C), 1.0 mg simvastatin (group D), and 1.5 mg simvastatin (group E). Streptozotocin was used to induce Type 1 diabetes in all rats. Eight mmCSDs were created under anesthesia in each rat calvarium.CSDs were left empty in group A. Defects in group B were grafted alone with a gelatin sponge mixed with normal saline. Defects in the experimental groups (groups A, B, and C) were grafted with gelatin sponge mixed saline solutions contain 0.5, 1.0, 1.5 mg simvastatin. Rats were sacrificed after 1 month, and the defects were prepared for radiologic and histomorphometric assessment of regenerated bone.

Results

None of the specimens exhibited complete closure of new bone across the 8‐mm defect. A correlation between computed tomography and histomorphometric analysis was not determined. Both amount of volume and area of regenerated bone were found higher in the experimental groups than in the control groups. However, these values were not found statistically significant degree (P < 0.05) for each groups. The density of regenerated bone in the region of interest was higher in the control groups in contrast to in the experimental groups. However, statistical significance was just found between groups C and A and between groups C and B (P < 0.05).

Conclusion

The local simvastatin application enhanced healing of the bone defects in the diabetic rat modelCSDs.
Sensitization patterns in Compositae‐allergic patients with current or past atopic dermatitis
Authors: Paulsen Evy , Andersen Klaus E.
Published: April 2013

Background. An association between Compositae sensitization and atopic dermatitis has been suggested on the basis of case reports and clinical studies.

Objectives. To describe the characteristics of sensitization in Compositae‐allergic patients with current and/or past atopic dermatitis.

Patients/materials/methods. Consecutive Compositae‐sensitive patients were selected for analysis if they had a history of (i) present and/or past atopic dermatitis or (ii) childhood flexural eczema or (iii) childhood eczema of any kind and a positive prick test result.

Results. Fifty‐one persons (35 females and 16 males) were included. The mean age was lower and the percentage of males was slightly higher than in non‐atopics. Testing with sesquiterpene lactone mix, parthenolide and Compositae mix 6% or 5% detected 96% of the patients. Occupational sensitization occurred in 22%. The sensitizing pattern did not differ much from that of non‐atopics, except that dandelion was an important allergen in children. Cobalt allergy was the most frequent other contact allergy, occurring in 37%.

Conclusions. Persons with current or past atopic dermatitis may become sensitized to Compositae at any age, both occupationally and non‐occupationally. They should be screened for Compositae allergy on equal terms with non‐atopics, except that dandelion extract should always be tested in children. Co‐sensitization to cobalt was frequent, but probably not related to the plant allergy.