bluuebunny/crossref_metadata_2025 huggingface dataset:
Level and Change in Cognitive Test Scores Predict Risk of First Stroke
Authors: DeFries Triveni , Avendaño Mauricio , Glymour M. Maria
Published: January 2009

OBJECTIVES: To determine whether cognitive test scores and cognitive decline predict incidence of first diagnosed stroke.

DESIGN: Stroke‐free Health and Retirement Study participants were followed on average 7.6 years for self‐ or proxy‐reported first stroke (1,483 events). Predictors included baseline performance on a modified Telephone Interview for Cognitive Status (Mental Status) and Word Recall test and decline between baseline and second assessment in either measure. Hazard ratios (HRs) were estimated using Cox proportional hazards models for the whole sample and stratified according to five major cardiovascular risk factors.

SETTING: National cohort study of noninstitutionalized adults with a mean baseline age of 64±9.9.

PARTICIPANTS: Health and Retirement Study participants (n=19,699) aged 50 and older.

RESULTS: Word Recall (HR for 1 standard deviation difference=0.92, 95% confidence interval (CI)=0.86–0.97)) and Mental Status (HR=0.89, 95% CI=0.84–0.95) predicted incident stroke. Mental Status predicted stroke risk in those with (HR=0.93, 95%=0.87–0.99) and without (HR=0.81, 95% CI=0.72–.91) one or more vascular risk factors. Word Recall declines predicted a 16% elevation in subsequent stroke risk (95% CI=1.01–1.34). Declines in Mental Status predicted a 37% elevation in stroke risk (95% CI=1.11–1.70).

CONCLUSION: Cognitive test scores predict future stroke risk, independent of other major vascular risk factors.
A Brief, Intensive, Clinically Focused Geriatrics Course During the Third Year of Medical School
Authors: Fisher Alfred L. , O'Keefe Elizabeth A. , Hanlon Joseph T. , Studenski Stephanie A. , Hennon John G. , Resnick Neil M.
Published: January 2009

During the next several decades, the aging of the “baby boom” generation in the United States will result in a dramatic increase in the number of patients aged 65 and older seeking medical care, but current projections suggest that the shortage of geriatrics‐trained specialists will only worsen during this time period. As a result, the care of elderly patients will largely fall to other types of physicians. Consequently, it is imperative that medical school training include exposure to the basic skills needed to care safely for older adults. This goal is challenging, because the number of geriatric medicine faculty in most academic medical centers is small, and multiple other medical specialties are also vying for time in a busy medical school curriculum. Whether a 3‐day course conducted during the third year of medical school could teach basic principles of geriatric medicine in a time‐ and manpower‐effective manner was explored. It was found that even this brief exposure to geriatrics could have meaningful effects on student knowledge of and comfort with geriatrics.
Body Mass Index and Risk of Adverse Cardiac Events in Elderly Patients with Hip Fracture: A Population‐Based Study
Authors: Batsis John A. , Huddleston Jeanne M. , Melton, IIII L. Joseph , Huddleston Paul M. , Lopez‐Jimenez Francisco , Larson Dirk R. , Gullerud Rachel E. , McMahon M. Molly
Published: January 2009

OBJECTIVES:To determine whether obesity affects cardiac complications after hip fracture repair.

DESIGN:A population‐based historical study using data from the Rochester Epidemiology Project.

SETTING:Olmsted County, Minnesota.

PARTICIPANTS:All urgent hip fracture repairs between 1988 and 2002.

MEASUREMENTS:Body mass index (BMI) was categorized as underweight (<18.5 kg/m2), normal‐weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30 kg/m2). Postoperative cardiac complications were defined as myocardial infarction, angina pectoris, congestive heart failure, or new‐onset arrhythmias within 1‐year of surgery. Incidence rates were estimated for each outcome, and overall cardiac complications were assessed using Cox proportional hazards models adjusted for age, sex, year of surgery, use of beta‐blockers, and the Revised Cardiac Risk Index.

RESULTS:Hip fracture repairs were performed in 184 (15.6%) underweight, 640 (54.2%) normal‐weight, 251 (21.3%) overweight, and 105 (8.9%) obese subjects (mean age 84.2 ± 7.5; 80% female). Baseline American Society of Anesthesiologists (ASA) status was similar in all groups (ASA I/II vs III–V,P=.14). Underweight patients had a significantly higher risk of developing myocardial infarction (odds ratio (OR) 1.44, 95% confidence interval (CI)=1.0–2.1;P=.05) and arrhythmias (OR=1.59, 95% CI=1.0–2.4;P=.04) than normal‐weight patients. Multivariate analysis demonstrated that underweight patients had a higher risk of developing an adverse cardiac event of any type (OR=1.56, 95% CI=1.22–1.98;P<.001). Overweight and obese patients with hip fracture had no excess risk of any cardiac complication.

CONCLUSION:The obesity paradox and low functional reserve in underweight patients may influence the development of postoperative cardiac events in elderly people with hip fracture.
Blood donor deferral in Minas Gerais State, Brazil: blood centers as sentinels of urban population health
Authors: Di Lorenzo Oliveira Cláudia , Loureiro Flávia , De Bastos Maria R.D. , Proietti Fernando A. , Carneiro‐Proietti Anna B.F.
Published: January 2009

BACKGROUND: Shortage of safe blood donors is frequent and it is important to understand the causes of deferral of potential donors, who reside mainly in urban areas, to improve recruitment campaigns aiming at the quality/availability of donors.

STUDY DESIGN AND METHODS: In Minas Gerais State, Brazil, Hemominas Foundation collects, analyzes, and distributes more than 90 percent of blood. Blood is collected in 19 centers in cities. In 2006, data from 335,109 attempts to donate were analyzed.

RESULTS: Seventy‐seven percent of donor candidates were less than 40 years old, with 57.1 percent nonwhite and 66 percent male. A total of 21.6 percent were deferred at the interview. Women were more clinically deferred than men (25.5% vs. 19.6%). In larger cities, the proportion of first‐time donors (FTs) was higher (67.8%). The main causes of permanent deferral among FTs were neurologic diseases (37.5%), chronic hypertension (22.2%), and endocrinologic diseases (9.9%). The main causes of temporary clinical deferral in this group were risky behavior for sexually transmitted diseases (32.6%), anemia (8.5%), and hypertension (6%). The main causes of permanent deferral in repeat donors (RTs) were chronic hypertension (31.6%) and neurologic diseases (22.1%); for temporary deferral it was anemia (22.6%). A total of 2.9% of the collected blood bags were discarded due to reactive tests (FTs = 34.82/1000; RTs = 3.51/1000).

CONCLUSION: A deferral study in blood donor candidates may shed light on regional diversity, highlighting how social inequalities and health status of the general population may affect the blood supply. Risk factors and marker rates derived from the donor pool may be useful to gain insights regarding public health issues.
Human platelet antigen typing of neonatal alloimmune thrombocytopenia patients using whole genome amplified DNA and a 5′‐nuclease assay
Authors: Lemnrau Alina G. , Cardoso Sandra , Creary Lisa E. , Brown Colin , Miretti Marcos , Girdlestone John , Navarrete Cristina V.
Published: January 2009

BACKGROUND: A serious constraint in the investigation of the human platelet antigen (HPA) status of potential neonatal alloimmune thrombocytopenia (NAIT) cases is the limited amount of DNA available from the neonates. Whole genome amplification (WGA) of these DNA samples could overcome this problem, but requires validation to ensure that it is sufficiently sensitive and accurate before its application in a clinical diagnostic setting.

STUDY DESIGN AND METHODS: This study has validated the use of WGA DNA for HPA‐1, ‐2, ‐3, ‐4, ‐5, and ‐15 genotyping with a panel of six controls and 13 previously HPA‐typed samples from neonates together with parental DNA, using a 5′‐nuclease (TaqMan) assay. WGA was performed using titrated amounts of genomic and WGA DNA template. HPA typing was performed on genomic and amplified DNA using a 5′‐nuclease assay or polymerase chain reaction with sequence‐specific primers (PCR‐SSP).

RESULTS: WGA DNA yields were in the suggested range of 400× to 800×, as assessed by spectrophotometry and gel analysis, and did not require further purification. HPA genotyping showed 100 percent concordance when using down to 5 ng of genomic or WGA template.

CONCLUSION: This study demonstrates that WGA can be used for HPA typing using PCR‐SSP or plate‐based 5′‐nuclease assays. The use of WGA for HPA typing in clinical samples from NAIT patients was validated with 100 percent concordance, and it is suggested that this technology can be used for other analyses where DNA amounts are limited.
When Race Becomes Even More Complex: Toward Understanding the Landscape of Multiracial Identity and Experiences
Authors: Shih Margaret , Sanchez Diana T.
Published: January 2009

The explosion in the number of people coming from a multiracial heritage has generated an increased need for understanding the experiences and consequences associated with coming from a multiracial background. In addition, the emergence of a multiracial identity challenges current thinking about race, forcing scholars to generate new ideas about intergroup relations, racial stigmatization, social identity, social perception, discrimination, and the intersectionality of race with other social categories such as social class. The present issue brings together research and theory in psychology, sociology, education, culture studies, and public policy surrounding multiracial identity and introduces new advances in thinking about race, intergroup relations, and racial identity. In exploring multiracial identity, the issue will reexamine conceptualization of race and racial identification by examining the social experiences of multiracial individuals.
The Interpretation of Multiracial Status and Its Relation to Social Engagement and Psychological Well‐Being
Authors: Binning Kevin R. , Unzueta Miguel M. , Huo Yuen J. , Molina Ludwin E.
Published: January 2009

This research examines how multiracial individuals chose to identify themselves with respect to their racial identity and how this choice relates to their self‐reported psychological well‐being (e.g., self‐esteem, positive affect) and level of social engagement (e.g., citizenship behaviors, group alienation). High school students who belong to multiple racial/ethnic groups (N = 182) were asked to indicate the group with which they primarily identify. Participants were then classified as identifying with a low‐status group (i.e., Black or Latino), a high‐status group (i.e., Asian or White), or multiple groups (e.g., Black and White, etc.). Results showed that, compared with multiracial individuals who identified primarily with a low‐ or high‐status group, those who identified with multiple groups tended to report either equal or higher psychological well‐being and social engagement. Potential explanations and implications for understanding multiracial identity are discussed.
Exploring Multiracial Individuals’ Comfort with Intimate Interracial Relationships
Authors: Bonam Courtney M. , Shih Margaret
Published: January 2009

This article explores the relationship between a heightened awareness of race as a social construct and comfort in interracial relationships across varying levels of intimacy among multiracial and monoracial individuals. Study 1 finds that multiracial individuals express higher levels of comfort in intimate interracial relationships than monoracial White and minority individuals. Study 2 finds that belief in race as a social construction mediates the differences between monoracial and multiracial individuals in their comfort in intimate interracial relationships. Implications of these findings for interracial relationships are discussed.
To Disclose or Not to Disclose Biracial Identity: The Effect of Biracial Disclosure on Perceiver Evaluations and Target Responses
Authors: Sanchez Diana T. , Bonam Courtney M.
Published: January 2009

Are biracial people perceived more negatively than their monoracial counterparts? Across two studies, we compared ratings of warmth, competence, and minority scholarship worthiness for biracial (Study 1: Black/White, Study 2: Asian/White), White, and minority (Study 1: Black, Study 2: Asian) college applicants. Findings suggest that both biracial applicants were perceived as colder and sometimes less competent than both White and corresponding minority applicants. Moreover, biracial people were also perceived as less qualified for minority scholarships than other racial minorities, which is partially explained by penalties to warmth and competence. Study 3 shows that disclosing one's biracial identity makes biracial people vulnerable to negative feedback. Taken together, these studies suggest that biracial people who disclose their biracial identity experience bias from perceivers and may be more vulnerable to that bias because of the personal nature of racial disclosure. Findings are discussed considering the stereotype content model (Cuddy, Fiske, & Glick, 2007), cultural stereotypes about biracial people (Jackman, Wagner, & Johnson, 2001), and the costs of disclosing devalued identities.
Transcatheter Intracardiac Echocardiography‐Assisted Closure of Interatrial Shunts: Complications and Midterm Follow‐Up
Authors: Rigatelli Gianluca , Cardaioli Paolo , Giordan Massimo , Dell'Avvocata Fabio , Braggion Gabriele , Piergentili Christian , Roncon Loris , Faggian Giuseppe
Published: January 2009

Objective: It has been suggested that intracardiac echocardiography (ICE) improves the safety and effectiveness of transcatheter device‐based closure of interatrial shunts, but the impact of this technique on midterm follow‐up is unknown. We sought to prospectively evaluate midterm follow‐up results of ICE‐aided transcatheter closure of interatrial shunts in adults. Methods: Over a 48‐month period, we prospectively enrolled 140 consecutive patients (mean age 43 ± 15. 5 years, 98 females) who had been referred to our center for catheter‐based closure of interatrial shunts. All patients were screened with transesophageal echocardiography (TEE) before the operation. Patients who met the inclusion criteria underwent ICE study and attempted closure. Immediate success rates, predischarge occlusion rates, complication rates, as well as fluoroscopy and procedural times, patients' radiological exposure, midterm complication rates, and midterm occlusion rates were evaluated. Results: One hundred patients out of 140 (71.4%) underwent an attempt at transcatheter closure. After ICE study and measurements, the TEE‐planned device type and size was changed in 31 patients with patent foramen ovale whereas the TEE‐planned device size was changed in 41 patients with atrial septal defect (globally 72%). Procedural success rate, predischarge occlusion rate, and complication rate were 99, 90.7, and 12%, respectively. On mean follow‐up of 36.6 ± 14.8 months the follow‐up occlusion rate was 96.5%. No aortic erosion or device thrombosis was observed. Conclusions: ICE‐guided interatrial shunt transcatheter closure is safe and effective and appears to have excellent midterm results thus avoiding the complications caused by device oversizing, such as aortic erosion and device thrombosis.
Can a Novel Echocardiographic Score Better Predict Outcome after Percutaneous Balloon Mitral Valvuloplasty?
Authors: Rifaie Osama , Esmat Iman , Abdel‐Rahman Mohamed , Nammas Wail
Published: January 2009

Objective: The assessment of patients with mitral stenosis before percutaneous balloon mitral valvuloplasty (PBMV) is crucial to predict outcome after the procedure. We tried to explore the prognostic power of a novel echocardiographic score to predict immediate postprocedural outcome in comparison to the standard score. Methods: We enrolled 50 consecutive patients with moderate to severe mitral stenosis admitted to undergo PBMV. For all patients, we assessed both the standard Massachusetts General Hospital (MGH) score and a novel score based on calcification (especially commissural) and subvalvular involvement. Patients underwent PBMV with the double balloon technique. Thereafter, patients were classified into two groups: group 1 (poor outcome) defined as no procedural success and/or increase of MR by more than 1 grade and group 2 (optimal outcome) defined as procedural success with increase of MR by 1 grade or less. Results: The total MGH score did not differ significantly between the two groups. However, among the individual parameters of the score, both calcification and subvalvular affection were significantly higher in group 1 versus group 2 (2.8 ± 0.4 versus 1.7 ± 0.8, and 2.4 ± 0.5 versus 1.6 ± 0.4, respectively, P < 0.01 for both). The total novel score and its two individual parameters (calcification and subvalvular involvement) were all significantly higher in group 1 versus group 2 (6 ± 1.5 versus 2.9 ± 1.9, 4.9 ± 1.2 versus 2.4 ± 1.5, 1.5 ± 1.6 versus 0.5 ± 0.9, respectively, P < 0.01 for all). Multivariate analysis demonstrated the novel score to be the only independent predictor of poor outcome. Conclusion: The novel score is more reliable and correlates with outcome better than the standard score.
Evaluation of Left Atrial Appendage Functions According to Different Etiologies of Atrial Fibrillation with a Tissue Doppler Imaging Technique by Using Transesophageal Echocardiography
Authors: Sahin Tayfun , Ural Dilek , Kilic Teoman , Bildirici Ulas , Kozdag Güliz , Agacdiken Aysen , Ural Ertan
Published: January 2009

Background: Atrial fibrillation (AF) occurs due to various etiologies that carry different risks for thromboembolism. However, the effect of different etiologies on left atrial appendage (LAA) function has not been investigated. This study aimed to examine the LAA function in AF that occurred under various etiologies and to compare the findings with a novel tissue Doppler imaging (TDI) technique by using transesophageal echocardiography (TEE). Methods: LAA function was assessed in 84 patients with permanent AF according to various etiologies [mitral stenosis in 20 (24%), hypertension in 44 (52%), and hyperthyroidism in 20 (24%) patients] and in 23 controls with sinus rhythm. LAA area change, PW‐Doppler and tissue velocities of LAA were measured. The presence of SEC or thrombus and their relation to LAA function was evaluated. Results: LAA velocities were lowest in mitral stenosis and highest in hyperthyroidism. Moderate–severe LAA SEC was detected in 61 and thrombi in 23 patients. Factors associated with the severity of SEC were the percentage of the LAA area change, PW‐Doppler peak emptying velocity, and TDI septal wall downward velocity. The percent of the LAA area change and PW‐Doppler peak emptying velocity were the significantly related factors for the presence of thrombi (OR = 0.84, 95% CI = 0.74–0.95, P = 0.005 and OR = 0.85, 95% CI = 0.74–0.98, P = 0.02, respectively). Conclusion: LAA function deteriorated most severely in mitral stenosis and least in hyperthyroidism. The LAA area change and PW‐Doppler emptying velocity were important predictors for SEC or thrombi. Although TDI was not superior to classical methods, it provided complementary data to PW‐Doppler velocities for predicting SEC and thrombi.
Usefulness of Live/Real Time Three‐Dimensional Transthoracic Echocardiography in Diagnosing Acquired Left Ventricular‐Right Atrial Communication Misdiagnosed as Severe Pulmonary Hypertension by Two‐Dimensional Transthoracic Echocardiography
Authors: Hansalia Sachin , Manda Jayaprakash , Pothineni Koteswara Rao , Nanda Navin C.
Published: January 2009

We describe an adult patient with an acquired left ventricular‐right atrial communication that was misdiagnosed as severe pulmonary hypertension (PH) by two‐dimensional (2D) transthoracic echocardiography, but accurately detected on three‐dimensional (3D) transthoracic echocardiography. Open heart surgery confirmed the defect.
Waist Circumference, Body Mass Index, and Their Association With Cardiometabolic and Global Risk
Authors: Christian Allison H. , Mochari Heidi , Mosca Lori J.
Published: January 2009

Total body fat and adipose tissue distribution are associated with cardiometabolic risk, yet there are conflicting data as to whether waist circumference (WC) or body mass index (BMI) is a better predictor of cardiovascular risk. To determine whether WC or BMI was more strongly associated with cardiometabolic risk, family members of patients with cardiac disease were studied (N=501; mean age, 48 years; 66% female; 36% nonwhite). Height, weight, WC, BMI, blood pressure, high‐density lipoprotein cholesterol, triglycerides, glucose, high‐sensitivity C‐reactive protein, and lipoprotein‐associated phospholipase A2 were systematically measured. Global risk was calculated using the Framingham function. Increased WC and BMI were equally strong predictors of cardiometabolic and global risk. The prevalence of cardiometabolic risk factors and their correlation with WC and BMI varied by race/ethnicity. Our data support inclusion of WC and BMI in screening guidelines for diverse populations to identify individuals at increased cardiometabolic risk.
The Role of Adiponectin in Obesity, Diabetes, and Cardiovascular Disease
Authors: Kawano Jordan , Arora Rohit
Published: January 2009

Nearly 1 in 4 adults in the United States is obese. The connection between obesity and insulin resistance, type 2 diabetes, and cardiovascular disease is a well researched one. The increasing prevalence of each of these diseases has become a growing concern for the medical community. Adiponectin is a collagen‐like plasma protein secreted by adipocytes that has been suggested to play a causal role in the development of insulin resistance and cardiovascular disease. The protein has been found to be decreased in cases of insulin resistance, diabetes, atherosclerosis, and coronary artery disease. Up‐regulation of adiponectin and its receptor, through the use of thiazolidinediones, has been found to be partially related to insulin sensitization and thus antidiabetic effects. In this review, we discuss adiponectin’s antiatherogenic effects, its association with insulin resistance and obesity, and the possibility of using adiponectin and its receptor as a therapeutic target.
Drugs Are Not Enough: The Metabolic Syndrome—A Call for Intensive Therapeutic Lifestyle Change
Authors: Brown Todd M. , Sanderson Bonnie K. , Bittner Vera
Published: January 2009

Whether intensive pharmacologic cardiovascular risk factor management reduces metabolic syndrome (MetS) prevalence is unknown. The authors compared the number of secondary prevention medications and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)–defined MetS prevalence in coronary artery disease patients entering cardiac rehabilitation from 1996 to 2001 (period 1, n=516) with those entering from 2002 to 2006 (period 2, n=609). Age, sex, and ethnicity were similar in both periods. From period 1 to period 2, participants took more secondary prevention medications (2.8±1.3 vs 3.5±1.0, P<.001). Prevalence of low high‐density lipoprotein cholesterol (66% vs 66%), diabetes (37% vs 38%), and hypertension (81% vs 81%) were unchanged. The prevalence of hypertriglyceridemia decreased (48% vs 36%, P<.001), but the proportion meeting criteria for elevated waist circumference increased (51% vs 58%, P<.05), resulting in no change in overall MetS prevalence (60% vs 59%, P=NS). More emphasis on therapeutic lifestyle change in addition to intensive pharmacologic therapy is needed to reduce MetS prevalence in patients with coronary artery disease.
Comparison Between Turkish Cardiovascular Risk Platform and United States National Cholesterol Education Program Adult Treatment Panel III Definitions of the Metabolic Syndrome in Turkish Adults
Authors: Can Ahmet Selçuk , Özbayrakçı Sinan , Palaoğlu K. Erhan , Bersot Thomas P
Published: January 2009

The Turkish Cardiovascular Risk Platform (TCRP) calls for the diagnosis of the metabolic syndrome (MS) if insulin resistance, impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus and ≥2 other established criteria are present. TCRP defines insulin resistance as a homeostasis model assessment >2.7. The aim of this cross‐sectional study was to compare TCRP guidelines with the United States National Cholesterol Education Program Adult Treatment Panel III (NCEP) definition of MS in Turkish adults (N=1690). The age‐ and sex‐adjusted prevalence of MS was 25% with the TCRP and 40% for the NCEP definition. Patients with MS identified by the NCEP definition but not by the TCRP definition had lower body mass index and less insulin resistance, but had a similarly adverse cardiovascular risk factor profile to those with TCRP‐identified MS, with high blood pressure, waist circumference, triglycerides, and total cholesterol/high‐density lipoprotein cholesterol ratio. Other national health organizations should avoid using homeostasis model assessment as a prerequisite for diagnosing MS. Modification of the NCEP definition would be more appropriate for ethnic groups with different body sizes.
Coronary Artery Calcification and Inflammation According to Various Metabolic Syndrome Definitions
Authors: Narla Venkata , Santos Raul D. , Campbell Catherine Y. , Carvalho Jose A.M. , Nasir Khurram , Budoff Matthew J. , Blumenthal Roger S. , Michos Erin D.
Published: January 2009

A number of metabolic syndrome (MS) definitions exist, and one’s cardiovascular disease risk may depend on the definition used. The authors compared the association of subclinical atherosclerosis (coronary artery calcification [CAC] score >0] and inflammation (white blood cell [WBC] count greater than or equal to the highest quartile) with 3 definitions of MS (those of the National Cholesterol Education Program Adult Treatment Panel III [NCEP ATP III], the American Heart Association/National Heart, Lung and Blood Institute [AHA/NHLBI], and the International Diabetes Federation [IDF]) in 458 asymptomatic men (mean age, 46±7 years). MS was present in 28%, 29%, and 34% according to NCEP ATP III, AHA/NHLBI, and IDF criteria, respectively. CAC was observed in 40% and high WBC count in 24%. After adjustment for age, smoking, and low‐density lipoprotein cholesterol, the odds ratios for CAC scores >0 with MS by NCEP ATP III, AHA/NHLBI, and IDF definitions were 1.67 (95% confidence interval [CI], 1.02–2.72), 1.67 (95% CI, 1.03–2.70), and 1.63 (95% CI, 1.03–2.57), respectively. The multivariate odds ratios for high WBC count with MS by NCEP ATP III, AHA/NHLBI, and IDF definitions were 1.69 (95% CI, 1.04–2.73), 1.84 (95% CI, 1.14–2.95), and 1.66 (95% CI, 1.05–2.62), respectively. MS is associated with increased subclinical atherosclerosis and inflammation irrespective of various definitions.
Docking, virtual high throughput screening and in silico fragment‐based drug design
Authors: Zoete Vincent , Grosdidier Aurélien , Michielin Olivier
Published: January 2009

Introduction

Docking

Virtual high throughput screening

In silico fragment‐based drug design

Conclusion

The drug discovery process has been profoundly changed recently by the adoption of computational methods helping the design of new drug candidates more rapidly and at lower costs. In silico drug design consists of a collection of tools helping to make rational decisions at the different steps of the drug discovery process, such as the identification of a biomolecular target of therapeutical interest, the selection or the design of new lead compounds and their modification to obtain better affinities, as well as pharmacokinetic and pharmacodynamic properties. Among the different tools available, a particular emphasis is placed in this review on molecular docking, virtual high‐throughput screening and fragment‐based ligand design.
A type‐specific study of human papillomavirus prevalence in cervicovaginal samples in three different Spanish regions
Authors: GOMEZ‐ROMAN JOSE JAVIER , ECHEVARRIA CELINA , SALAS SANTOS , GONZÁLEZ‐MORÁN MARÍA ASUNCIÓN , PEREZ‐MIES BELEN , GARCÍA‐HIGUERA ISABEL , NICOLÁS MARTÍNEZ MONTSERRAT , VAL‐BERNAL JOSE FERNANDO
Published: January 2009

Human papillomavirus (HPV) is the most frequent sexually transmitted viral infection. It is necessary to know HPV genotype distribution to identify how many women will be protected by HPV vaccines. During a period of 18 months, we have analyzed 2362 HPV positive reporting data from a secondary demand screening program in three regions in Spain (Cantabria, Leon and Burgos). The study has been conducted using polymerase chain reaction and tube array hybridization covering the 35 HPV genotypes described as affecting anogenital mucosa. There were no significant differences between the three regions according to genotype distribution. The most frequent were HPV16 (19.18%), HPV53 (11.26%) and HPV58 (7.66%). HPV18 was the source of 4.02% of infections. High‐risk HPVs were found in 1863/2362 cases. HPV16 was present in 24.3% of high‐risk infections and HPV18 was found in 5.1%. Uncommon genotypes (<5% of the total prevalence each) were found in 17,9% of the total high‐risk infections (334/1863). Multiple infections were diagnosed in 22% of the cases. The HPV genotype distribution is different from previously published data when multiple types are included in the screening. Both HPV16/18 account for 30% of high‐risk infections in a clinical setting in Spain. The presence of multiple genotypes is very common among the population.
Cyclooxygenase‐2 expression on urothelial and inflammatory cells of cystoscopic biopsies and urine cytology as a possible predictive marker for bladder carcinoma
Authors: MOUSSA MONA , OMRAN ZEINAB , NOSSEIR MONA , LOTFY ABEYA , SWELLAM TAREK
Published: January 2009

Cyclooxygenase‐2 (COX‐2) is a key inducible enzyme involved in the production of prostaglandins. It contributes to human carcinogenesis by various mechanisms. The aim of the current study was to elucidate the possible involvement of COX‐2 in human bladder carcinoma by examining its expression on both urothelial and inflammatory cells in tissue biopsies and urine cytology samples of different urinary bladder lesions. A total of 65 patients were included in the study and were selected from cases admitted to Urology Department, Theodor Bilharz Research Institute (TBRI), Giza, Egypt. They represented seven control cases with almost normal‐looking bladder tissue; pure chronic cystitis (n=12); premalignant lesions (18) in the form of squamous metaplasia (n=8) or urothelial dysplasia (n=10) as well as transitional cell carcinoma (TCC) (n=18), and squamous cell carcinoma (SqCC) (n=10). Immunohistochemistry of formalin‐fixed, paraffin‐embedded tissue sections and urine cytology samples was performed for all cases using COX‐2 (H‐62): sc‐7951, a rabbit polyclonal antibody. The study revealed positive COX‐2 expression on the urothelial and inflammatory cells of cystoscopic biopsies from all cases of pure chronic cystitis, squamous metaplasia and SqCC compared with 42.8% and 71.4% of normal controls, respectively. The score of urothelial COX‐2 expression was sequentially up‐regulated from normal to chronic cystitis (either pure or associated with premalignant changes) (p<0.05) to malignant changes (p<0.05). However, the inflammatory cellular expression was down‐regulated with malignant transformation compared with chronic cystitis (p<0.05). In TCC, COX‐2 was over‐expressed on both urothelial and inflammatory cells in advanced tumors. Urine cytology samples were positive for COX‐2 in a comparable manner to that observed in cystoscopic biopsies. Accordingly, the results of the current study have provided new information in two aspects: First, is the possibility of using the differential COX‐2 expression on both inflammatory and urothelial cells as markers for premalignant or malignant transformation; second, besides cystoscopy, urine cytology was found to have a high sensitivity for COX‐2 expression and hence proved to be valuable in malignancy as a non‐invasive substitute for cystoscopy.
Eosinophil granulocytes: functional differences of a new isolation kit compared to the isolation with anti‐CD16‐conjugated MicroBeads
Authors: Schefzyk Matthias , Bruder Manuela , Schmiedl Andreas , Stephan Michael , Kapp Alexander , Wedi Bettina , Raap Ulrike
Published: January 2009

Background/purpose:  Using a new eosinophil isolation kit, we were not able to confirm our previous findings of a delayed apoptosis of eosinophils in atopic dermatitis. Thus, we investigated whether this new isolation kit modulates the functional activity of eosinophils.

Methods:  Peripheral blood eosinophils were isolated with the new isolation kit as well as conventionally with anti‐CD16‐conjugated MicroBeads. We analysed viability, apoptosis, CD69 and CD95 expression, streptavidin binding and superoxide anion release.

Results:  Purity of eosinophils was higher using the new isolation kit (P < 0.05). However, these eosinophils had a decreased survival (P < 0.05–0.01), presented morphological features of apoptosis, showed an increased percentage of apoptotic nuclei (P < 0.01), an increased release of superoxide anions (P < 0.05), a higher expression of CD69 and CD95 (P < 0.05) and an increased binding to streptavidin compared to eosinophils isolated with anti‐CD16 conjugated MicroBeads.

Conclusion:  The new eosinophil isolation kit should not be used for the investigation of eosinophils as it potently affects their functional activity.
Illumination influences the ability of migrating juvenile salmonids to pass a submerged experimental weir
Authors: Kemp P. S. , Williams J. G.
Published: January 2009

Abstract –  The downstream migration of juvenile salmonids has previously been considered predominantly passive. It has been argued that passive displacement during periods of darkness is, partially at least, a result of an inability to maintain a fixed position in the absence of visual cues. In this study, behaviour of juvenile Pacific salmonids was assessed under conditions of light and dark as they passed through an artificial channel and encountered a submerged weir. Results indicated that when light, fish formed schools and actively explored the channel. Conversely, when dark (infrared illumination only) they did not form schools, but maintained randomly distributed positions holding station against the flow. As a consequence, more fish approached and either passed, or rejected, the weir when light. The majority of fish that passed the weir did so within the first minute of each trial. Fish predominantly passed through the channel facing downstream and changed orientation prior to passing tail first over the weir crest in the presence and absence of visual cues. The orientation switch was less common when dark. This study shows, at a fine‐resolution scale, that downstream movement of juvenile salmonids can be inhibited as fish exhibit alternative behaviours in the absence of visual cues. Downstream movement was not predominantly passive. Fish passage design should not be based on the assumption that downstream migration is passive.
Bone replacement following dental trauma prior to implant surgery – present status
Authors: Hallman Mats , Mordenfeld Arne , Strandkvist Tomas
Published: January 2009

Abstract –  Dento‐alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the ‘gold standard’, this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has increased. Today, a substantial number of biomaterials are available on the market, but only a few are well documented. The user should be aware that these biomaterials have different properties: resorbable or non‐resorbable, time of resorption and resorption mechanism. The purpose of this review is to describe the function of various bone substitutes and indications for their use in reconstructive implant surgery and to give an overview of the current situation.
Aetiology and risk factors related to traumatic dental injuries – a review of the literature
Authors: Glendor Ulf
Published: January 2009

Abstract –  Background/Aim:  During the past 30 years, the number of aetiologies of traumatic dental injuries (TDIs) has increased dramatically in the literature and now includes a broad spectrum of variables, including oral and environmental factors and human behaviour. The aim of this study is to present an international review of well‐known as well as less well‐known unintentional and intentional causes of TDIs. Moreover, some models that are useful in investigating contact sport injuries are presented.

Materials and methods:  The databases of Medline, Cochrane, Social Citation Index, Science Citation Index and CINAHL from 1995 to the present were used.

Result:  Oral factors (increased overjet with protrusion), environmental determinants (material deprivation) and human behaviour (risk‐taking children, children being bullied, emotionally stressful conditions, obesity and attention‐deficit hyperactivity disorder) were found to increase the risk for TDIs. Other factors increasing the risk for TDIs are presence of illness, learning difficulties, physical limitations and inappropriate use of teeth. A new cause of TDIs that is of particular interest is oral piercing. In traffic facial injury was similar in unrestrained occupants (no seat belts) and occupants restrained only with an air bag. Amateur athletes have been found to suffer from TDIs more often than professional athletes. Falls and collisions mask intentional TDIs, such as physical abuse, assaults and torture. Violence has increased in severity during the past few decades and its role has been underestimated when looking at intentional vs unintentional TDIs. There are useful models to prevent TDIs from occurring in sports. WHO Healthy Cities and WHO Health Promoting Schools Programmes offer a broad solution for dental trauma as a public health problem.

Conclusion:  The number of known causes of TDIs has grown to alarming levels, probably because of increased interest of the causes and the underlying complexity of a TDI. Accepted oral, environmental and human aetiological factors must therefore be included in the registration of TDIs.
Do American football players in Turkey protect themselves from dental or orofacial trauma?
Authors: Çaglar Esber , Onder Kuscu Ozgur , Kıranatlıoglu Gokhan , Sandalli Nuket
Published: January 2009

Abstract –  Background/Aims:  Dental and orofacial trauma in contact sports differs from other sources, as it is possible to prevent it and reduce the dental and orofacial trauma by using protection devices. The aim of this study was to evaluate the occurrence of dental or orofacial trauma in American football players of Turkey National League as well as to investigate if the players were aware of mouthguards (MGs) and had used any.

Material and methods:  An epidemiological survey was carried out through interviews with 78 American football players in four clubs competing in Turkey National League. Thirteen players had already been affected by orofacial trauma.

Results and Conclusions:  Results revealed that 67 of 78 Turkish–American football players were aware of MG, while 46 of 78 players also demonstrated its use. It should be concluded that from the moment a youngster starts practising football, he should be encouraged to wear an MG to get used to the sensation and, would automatically consider it as a part of the game. A great responsibility lies on dentists, to inform their patients about the importance of wearing MG and the consequences, if it is not worn.
Oral and facial trauma among paratroopers in the Israel Defense Forces
Authors: Zadik Yehuda , Levin Liran
Published: January 2009

Abstract –  Background:  Military fighters are one of the highest risk populations for dental and oro‐facial trauma. The aim of this study was to evaluate the incidence and etiology of oro‐facial injuries among active duty paratroopers in the Israeli Defense Forces.

Methods:  Paratroopers from selected companies were interviewed using a structured questionnaire regarding oro‐facial trauma during active service years. The study consisted of 311 male paratroopers, with a mean age of 21.1 years (± 1.7). Mean duration of military service until the study was conducted was 25.9 months (± 6.9).

Results:  Oro‐facial injuries during military service was found in 87 (28.0%) of the participants, with an incidence rate of 129.6 cases per 1000‐fighter‐years. Extra‐oral lacerations (lip, chin, cheek/facial muscles) were the most common injury. Tooth injuries were reported by 48 of the participants, of whom 44 (50.6%) suffered from dental fractures and four (4.6%) from subluxation/luxation. Most oro‐facial injuries occurred in an isolated training or operational field. Thirty‐seven participants (42.5%) reported postevent disturbance and 10 (11.5%) reported loss of operative activities because of the event (mean 8.6 ± 4.0 day loss).

Conclusions:  Military paratroopers are highly predisposed to oro‐facial trauma. Besides the physical and mental associated damage, these injuries result in the interference of their continuous daily activity. Prevention, mouth‐guard usage and treatment intervention are two important actions that should be adopted to reduce trauma and its interference.
Prevalence and determining factors of traumatic injuries to primary teeth in preschool children
Authors: Robson Flavia , Ramos‐Jorge Maria Letícia , Bendo Cristiane Baccin , Vale Miriam Pimenta , Paiva Saul Martins , Pordeus Isabela Almeida
Published: January 2009

Abstract –  The objective of the study was to assess the prevalence of dental injuries and the influence of determining factors in preschool children from Belo Horizonte, Brazil. A cross‐sectional survey was carried out through clinical examinations and the application of a questionnaire to the parents of 419 children aged 0 to 5 years attending preschool. The sample was stratified by region, type of institution and age. The eighteen preschools visited were chosen randomly. The prevalence of traumatic injury to primary teeth was 39.1%. Enamel fractures were the most common traumatic injury (49.7%). Boys were 1.62 times more likely to have dental injuries than girls. Children with inadequate lip coverage were 3.75 times more likely to have a traumatic dental injury than those with adequate lip coverage. Children attending state preschools had nearly two times greater chances of having dental trauma than children attending private preschools. It was concluded that the prevalence of dental injuries in preschool children is high in Belo Horizonte, Brazil and constitutes a public health problem.
Comparative assessment of time‐related bioactive glass and calcium hydroxide effects on mechanical properties of human root dentin
Authors: Marending Monika , Stark Wendelin J. , Brunner Tobias J. , Fischer Jens , Zehnder Matthias
Published: January 2009

Abstract –  Suspensions of micro‐ or nanoparticulate SiO2‐Na2O‐CaO‐P2O5 bioactive glasses could potentially be used as dressings in traumatized front teeth with open apices as an alternative to Ca(OH)2. These materials have a disinfecting capacity similar to Ca(OH)2, but bear the advantage of bioactivity. However, because bioactive glasses initially act as alkaline biocides just as Ca(OH)2 does, they may also negatively affect mechanical dentin properties over time. This was assessed in the current study using standardized human root dentin bars. Specimens were immersed in 1:20 (wt vol−1) suspensions of nanometric bioactive glass 45S5 or calcium hydroxide for 1, 10, or 30 days. Control specimens were immersed in pure saline for 30 days (n = 20 per group). Subsequently, modulus of elasticity (E) and flexural strength (FS) of the specimens were determined. Results were compared between groups using one‐way anova and Scheffé’s post‐hoc test. Ca(OH)2 caused a significant (P < 0.001) 35% drop in mean flexural strength values compared to the control treatment after 10 days. No further change was observed between 10 days and 30 days. Bioactive glass caused a 20% drop in mean flexural strength as compared to the control after 10 days. However, this difference did not reach statistical significance (P > 0.05). No effects of either material on dentin modulus of elasticity values were observed. It was concluded that the calcium hydroxide suspension affected the dentin more than the bioactive glass counterpart; however, the effect was self‐limiting and probably restricted to superficial dentin layers, as suggested by the mere decrease in flexural strength but not in modulus of elasticity values.
The effect of Emdogain® and 24% EDTA root conditioning on periodontal healing of replanted dog’s teeth
Authors: Guzmán‐Martínez Nayelli , Silva‐Herzog Flores Daniel , Méndez González Verónica , Martín‐Pérez Silvia , Cerda‐Cristerna Bernardino Isaac , Cohenca Nestor
Published: January 2009

Abstract –  Controversies still exist as for the regenerative role of enamel matrix derivatives and the need for removal of the periodontal ligament in replanted teeth. The purpose of this study was to evaluate the effect of Emdogain® and 24% ethylenediamine tetraacetic acid (EDTA) root conditioning on periodontal healing of replanted dog’s teeth. Teeth were extracted, endodontically treated and preconditioned as follows: group 1, Emdogain®; group 2, Emdogain® + EDTA and group 3, EDTA. Teeth were replanted after 30 min extraoral time, splinted for 15 days and animals sacrificed after 8 weeks of observation. Histological evaluation was performed using hematoxylin/eosin and Masson trichrome and results scored based on previously reported criteria for histological evaluation. Replacement root resorption was histologically diagnosed in all groups except in the negative control. A parametric analysis showed no statistically significant differences between experimental groups. Root preconditioning with Emdogain® alone or in combination with 24% EDTA showed no evidence of regeneration of collagen fibers and consequently did not prevent the development of replacement root resorption on replanted dog’s teeth.
Impact energy absorption of three mouthguard materials in an aqueous environment
Authors: Mendel Deborah A. , Ucar Yurdanur , Brantley William A. , Rashid Robert G. , Harrell Sarah L. , Grentzer Thomas H.
Published: January 2009

Abstract –  High impact energy absorption is an essential property for mouthguard materials. The impact test performance of three popular mouthguard materials was evaluated, using the procedure in American Society for Testing and Materials (ASTM) Standard D3763. Conventional ethylene vinyl acetate (EVA; T&S Dental and Plastics, Myerstown, PA, USA) served as the control. Pro‐form™ (Dental Resources Inc., Delano, MN, USA), another EVA material, and PolyShok™ (Sportsguard Laboratories, Kent, OH, USA), an EVA product containing polyurethane were also evaluated. Specimens having dimensions of 3 inch × 3 inch × 4 mm were prepared from each material. After processing that followed manufacturer recommendations, specimens were conditioned for 1 h in 37°C deionized water and loaded at 20 mph by a 0.5 inch diameter indenter containing a force transducer (Dynatup Model 9250 HV; Instron Corp., Canton, MA, USA). Both large‐diameter (3 inches) and small‐diameter (1.5 inch) support rings were used. For comparison, two specimens of each material were tested in the dry condition. Energy absorption was determined from the area under the force–time curve at 30 ms, and results for the water‐conditioned specimens were compared using anova and the Kruskal–Wallis test. For the large‐diameter support ring, energy absorption (mean ± SD in ft·lbf inch−1), normalized to specimen thickness, was: EVA (n = 5), 110.2 ± 48.4; Pro‐form™ (n = 4), 110.0 ± 11.3; PolyShok™ (n = 5), 105.7 ± 16.5. For the small‐diameter support ring, energy absorption was: EVA (n = 6), 140.5 ± 13.9; Pro‐formTM (n = 5), 109.0 ± 26.0; PolyShok™ (n = 6), 124.4 ± 28.4 (1 ft·lbf inch−1 = 0.534 J cm−1). Because of substantial variation within some specimen groups, there was no significant difference in energy absorption for the three water‐conditioned mouthguard materials and the two support ring sizes. The energy absorption for each material was much greater for other specimens tested in the dry condition.