bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Atrial Conduction Time in Patients with Familial Mediterranean Fever
Authors: ACAR GURKAN , AKCAY AHMET , SAYARLIOGLU MEHMET , SOKMEN ABDULLAH , SOKMEN GULIZAR , KOROGLU SEDAT , GUNDUZ MEHMET , İSPIROGLU MURAT , TUNCER CEMAL
Published: February 2009

Background: Increased inflammatory activity is known to be a pathophysiologic characteristic of atrial fibrillation. Familial Mediterranean fever (FMF) is a disease characterized by recurrent and sustained increased inflammatory activity. Atrial conduction abnormalities in these patients have not been investigated in terms of P‐wave duration, P‐wave dispersion (Pd), and atrial electromechanical delay measured by tissue Doppler echocardiography (TDE). We aimed to assess atrial conduction time in patients with FMF.

Methods: A total of 33 patients with FMF (13 males/20 females, 28.4 ± 12.5 years), and 33 controls (13 males/20 females, 28.5 ± 12.1 years) were included. Atrial electromechanical coupling (PA) and intra‐ and interatrial electromechanical delay were measured with TDE. From the 12‐lead electrocardiogram Pd was calculated.

Results: Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) was significantly higher in FMF patients (58.0 ± 9.0 vs 51.0 ± 5.8, P < 0.001). Interatrial (PA lateral–PA tricuspid) and intraatrial electromechanical delay (PA septum–PA tricuspid) were significantly longer in FMF patients (21.3 ± 7.4 vs 12.9 ± 4.6, P < 0.001 and 4.7 ± 5.5 vs 2.1 ± 1.7, P = 0.01, respectively). Also, Pd and maximum P‐wave duration were significantly higher in FMF patients (42.8 ± 7.9 vs 35.3 ± 6.1, P < 0.001 and 98.6 ± 9.0 vs 93.1 ± 8.5, P = 0.01, respectively). A positive correlation was detected between interatrial electromechanical delay and Pd (r = 0.622, P < 0.001). Plasma level of C‐reactive protein (CRP) correlated with interatrial electromechanical delay and Pd (r = 0.733, P < 0.001; and r = 0.427, P < 0.001, respectively).

Conclusion: This study shows that atrial electromechanical delay and Pd are prolonged in FMF patients. Atrial electromechanical delay is closely associated with Pd and plasma level of CRP.
Transfemoral Snaring and Stabilization of Pacemaker and Defibrillator Leads to Maintain Vascular Access During Lead Extraction
Authors: FISCHER AVI , LOVE BARRY , HANSALIA RIPLE , MEHTA DAVENDRA
Published: February 2009

Background: Lead extraction is an effective method for removing pacemaker and defibrillator leads and to obtain venous access when central veins are occluded.

Objective: We report a series of patients who required lead extraction and preservation of vascular access requiring a vascular snare introduced from the femoral vein to provide traction on the lead. This technique allowed advancement of the extraction sheath beyond the level of vascular occlusion, preserving vascular access in all patients.

Methods: All patients had peripheral contrast venography performed immediately prior to the procedure to identify the site(s) of venous occlusion. An extraction sheath was employed and with direct manual traction, the lead tip pulled free from the myocardial surface prior to advancement of the sheath beyond the occlusion. A transfemoral snare was used to grasp the distal portion of the lead and traction was used to immobilize the lead.

Results: In all patients, transfemoral snaring of the leads was necessary to allow safe advancement of a sheath to open the occluded venous system. There were no complications in any of the patients.

Conclusion: Our series demonstrates the simple and safe technique of transfemoral lead snaring to assist lead extraction and maintain vascular access in the setting of venous occlusion, when the distal lead tip pulls free of the myocardium before an extraction sheath is passed beyond the point of venous obstruction.
Device Extraction in Adults with Congenital Heart Disease
Authors: CESARIO DAVID , KEDIA ROHIT , DESAI NIRAV , ABOULHOSN JAMIL , USLAN DANIEL , BOYLE NOEL , FUJIMURA OSAMU , SHEHATA MICHAEL , BUCH ERIC , SHIVKUMAR KALYANAM
Published: February 2009

Background: Device extraction is a critical component in the treatment of patients with device‐related infections. Due to complex anatomic considerations, device extraction in adults with congenital heart disease presents unique challenges to the electrophysiologist.

Methods: Here, we present a series of device‐extraction cases performed in patients with transposition of the great arteries status post either Mustard or Senning surgical procedures that subsequently had permanent pacemakers placed and ultimately developed device‐related infections.

Results: All of these patients eventually underwent successful laser extractions of their infected devices resulting in complete removal of all hardware and resolution of their infections.

Conclusions: These cases illustrate that endovascular device extraction has been safely and effectively performed in adult patients with congenital heart disease, though further studies are needed to determine the procedural risks and success rates of this procedure in this patient population.
Long‐Term Nonoutflow Septal Versus Apical Right Ventricular Pacing: Relation to Left Ventricular Dyssynchrony
Authors: FLEVARI PANAYOTA , LEFTHERIOTIS DIONYSSIOS , FOUNTOULAKI KATERINA , PANOU FOTIS , RIGOPOULOS ANGELOS G. , PARASKEVAIDIS IOANNIS , KREMASTINOS DIMITRIOS Th.
Published: February 2009

Background: Right ventricular (RV) apical pacing deteriorates left ventricular (LV) function. RV nonoutflow (low) septal pacing may better preserve ventricular performance, but this has not been systematically tested. Our aim was to assess (1) whether long‐term RV lower septal pacing is superior to RV apical pacing regarding LV volumes and ejection fraction (EF), and (2) if the changes in LV dyssynchrony imposed by pacing are related to the long‐term changes in LV volumes and EF.

Methods: In thirty‐six patients with atrioventricular (AV) block, a dual‐chamber pacemaker was implanted. The ventricular electrode was placed either at the apex or at the lower septum, in a randomized sequence. Twenty‐four to 48 hours following implantation, we measured LV volumes, EF, and LV dyssynchrony (by tissue Doppler imaging), both with and without pacing. Patients were reassessed echocardiographically after 12 months.

Results: Lower septal pacing induced a more synchronized pattern of LV contraction changes (P < 0.05). Following 12 months, differences were observed between groups regarding LV volumes and EF. EF increased within the septal group (from 52 ± 3.3% to 59 ± 3.0%, P < 0.05). A significant inverse relation was documented between changes in LV dyssynchrony and changes in EF (r =−0.64, P < 0.05).

Conclusions: In patients with AV block, RV nonoutflow septal pacing represents an attractive alternative, since it preserves better and may even improve LV volumes and EF. Late changes in EF are associated with the changes in LV dyssynchrony imposed by pacing.
Monitoring Intrathoracic Impedance with an Implantable Defibrillator Reduces Hospitalizations in Patients with Heart Failure
Authors: CATANZARITI DOMENICO , LUNATI MAURIZIO , LANDOLINA MAURIZIO , ZANOTTO GABRIELE , LONARDI GABRIELE , IACOPINO SAVERIO , OLIVA FABRIZIO , PEREGO GIOVANNI B. , VARBARO ANNAMARIA , DENARO ALESSANDRA , VALSECCHI SERGIO , VERGARA GIUSEPPE ,   on behalf of the Italian Clinical Service Optivol‐CRT Group
Published: February 2009

Purpose: Some implantable cardioverter‐defibrillators (ICDs) are now able to monitor intrathoracic impedance. The aim of the study was to describe the use of such monitoring in clinical practice and to evaluate the clinical impact of the fluid accumulation alert feature of these ICDs.

Methods and Results: Five hundred thirty‐two heart failure (HF) patients implanted with these ICDs were followed up for 11 ± 7 months. A clinical event (CE) was deemed to have occurred if it resulted in hospitalization or milder manifestations of HF deterioration. Three hundred sixty‐two acute decreases in intrathoracic impedance (Z events) occurred in 230 patients. Of these episodes, 171 (47%) were associated with a CE within 2 weeks of the Z event. In another 71 (20%) Z events, drug therapy was adjusted despite the absence of overt signs of clinical deterioration. The rate of unexplained Z events was 0.25 per patient‐year and 25 hospitalizations were not associated with Z events. The audible alert was disabled in a group of 102 patients (OFF group). HF hospitalizations occurred in 29 (7%) patients in the ON group and 20 (20%, P < 0.001) patients in the OFF group. The rate of combined cardiac death and HF hospitalization was lower in patients with Alert ON (log‐rank test, P = 0.007).

Conclusions: The ICD reliably detected CE and yielded low rates of unexplained and undetected events. The alert capability seemed to reduce the number of HF hospitalizations by allowing timely detection and therapeutic intervention.
Obsessive Compulsive Disorder in a Patient with Twiddler's Syndrome
Authors: JAAFARI NEMATOLLAH , BACHOLLET MARIE‐SOPHIE , PAILLOT CELINE , AMIEL ALAIN , ROTGE JEAN‐YVES , LAFAY NICOLAS , QUENTIN SOLENE , WASSOUF ISSA , CAMUS VINCENT , SENON JEAN‐LOUIS , HAGE WISSAM EL
Published: February 2009

Twiddler's or twist syndrome is the twisting of pulse generators around themselves. It may result from mechanical manipulation that can induce the malfunction of the device. In this case, twiddler's syndrome resulted from compulsive checking of the device. The implantable cardioverter‐defibrillator (ICD) triggered the development of an obsessive compulsive disorder (OCD). Two invasive procedures were required to replace the ICD. Psychiatric intervention prevented the recurrence of twiddler's syndrome in this patient for more than 2 years. We believe that preimplant psychiatric assessment should be the rule.
Radiofrequency Catheter Ablation of AV Nodal Reentrant Tachycardia in Situs Inversus Totalis
Authors: BILLAKANTY SREEDHAR , CRAWFORD THOMAS , GOOD ERIC , ORAL HAKAN
Published: February 2009

A 41‐year‐old male with situs inversus totalis had paroxysmal supraventricular tachycardia. On electrophysiology study, the mechanism of the tachycardia was determined as slow/fast atrioventricular nodal reentrant tachycardia and slow pathway was successfully performed under fluoroscopic guidance.
Ventricular Fibrillation Triggered during and after Radiofrequency Energy Delivery to the Site of Origin of Idiopathic Right Ventricular Outflow Tract Arrhythmia
Authors: IIJIMA KENICHI , CHINUSHI MASAOMI , FURUSHIMA HIROSHI , HOSAKA YUKIO , IZUMI DAISUKE , AIZAWA YOSHIFUSA
Published: February 2009

We observed a case of idiopathic ventricular arrhythmias originating from the right ventricular outflow tract (RVOT). The origin of target premature ventricular contraction (PVC) and nonsustained ventricular tachycardia (VT) was within a wide low‐voltage area around the RVOT. During radiofrequency (RF) application to the site of arrhythmia origin, polymorphic VT and ventricular fibrillation were repeatedly triggered by new PVC that had developed near the site of ablation. This electrical storm persisted >30 minutes after cessation of RF current delivery, and was suppressed by additional RF applications to the site of origin of the new PVC.
A Cardio‐Neurological Form of Laminopathy: Dilated Cardiomyopathy with Permanent Partial Atrial Standstill and Axonal Neuropathy
Authors: DUPARC ALEXANDRE , CINTAS PASCAL , SOMODY ELISABETH , BIETH ERIC , RICHARD PASCALE , MAURY PHILIPPE , DELAY MARC
Published: February 2009

We present the first form of laminopathy connected with a new mutation of the lamin A/C gene expressed by dilated cardiomyopathy and partial atrial standstill associated with Charcot‐Marie‐Tooth type 2 axonal neuropathy. The rapid development of the cardiac disease was controlled by medical treatment and resynchronization therapy associated with a defibrillator.
Unusual Cause of Recurrent Syncope in a Child
Authors: SINGH HARINDER R.
Published: February 2009

A 5‐year‐old boy with an unremarkable past medical and family history presented with recurrent syncope precipitated by physical activity. Electrocardiogram performed in the emergency room after one of his episodes revealed atrial flutter. He had a structurally normal heart. Exercise stress test revealed atrial fibrillation with rapid ventricular response immediately on commencement of running. Atrial fibrillation subsequently organized into atrial flutter with variable ventricular response followed by spontaneous conversion to sinus rhythm. This case highlights the use of exercise stress test in a preschool child to elicit an unusual cause of syncope.
Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory
Authors: Thorell L.‐H.
Published: February 2009

Objective:  Studies from three independent laboratories report varying relationships between electrodermal hyporeactivity and suicidal behavior in depressed patients. The aims of this study were to explain that variation, to assess the discriminative validity of electrodermal hyporeactivity for suicide and suicide attempts and to suggest a tentative explanation model.

Method:  A meta‐analysis was performed of 279 depressed patients and 59 healthy subjects.

Results:  The sensitivity was 96.6% and specificity 92.9% of electrodermal hyporeactivity for suicide and 83.3% and 92.7%, respectively, for suicide and/or violent attempts. The shares of hyporeactives were strongly significantly and greatly larger in high than in low suicidal propensity groups, P‐value ranging from 4.7 × 10−8 to 1.1 × 10−14.

Conclusion:  The high discriminative validity and the emerging links over a proposed interest‐limiting precognitive set to cognitive theory of suicide encourage clinical application of tests of electrodermal reactivity. The study offers a series of testable hypotheses constituting a new platform for suicidological research in depression.
Augmentation of clozapine with a second antipsychotic – a meta‐analysis of randomized, placebo‐controlled studies
Authors: Taylor D. M. , Smith L.
Published: February 2009

Objective:  Inadequate response to clozapine treatment is frequently encountered in practice and augmentation strategies have been developed in an attempt to improve response. Aims of the study were to evaluate the therapeutic effect of adding an antipsychotic drug to clozapine treatment.

Method:  Meta‐analysis of randomized, placebo‐controlled studies of antipsychotic augmentation of clozapine treatment.

Results:  Ten studies (including 522 subjects) met inclusion criteria. Antipsychotic augmentation showed significant benefit over the addition of placebo on only one outcome measure examined [mean effect size for rating scale score (BPRS/PANSS) −0.180, 95% CI −0.356 to −0.004]. Antipsychotic augmentation showed no advantage on withdrawals from trials (risk ratio 1.261, 95% CI 0.679–2.345) or on CGI scores (effect size −0.661, 95% CI −1.475 to 0.151). Duration of study was not associated with outcome (P = 0.95). There was no evidence of publication bias.

Conclusion:  In studies lasting up to 16 weeks, the addition of an antipsychotic to clozapine treatment has marginal therapeutic benefit. Longer and larger trials are necessary to demonstrate the precise therapeutic utility of antipsychotic co‐therapy with clozapine.
Simulation of a mycological KOH preparation – e‐learning as a practical dermatologic exercise in an undergraduate medical curriculum
Authors: Bernhardt Johannes , Hye Florian , Thallinger Sigrid , Bauer Pamela , Ginter Gabriele , Smolle Josef
Published: February 2009

Background: Mycological KOH preparation is one of the most popular practical laboratory skills in dermatology. The study addresses the question whether an interactive simulation program enhances knowledge of students about this procedure.

Methods: 166 students, 107 female and 59 male, participated. We separated our study in three phases: pretest, completing the simulation three times and post‐test. In the pre‐ and post‐test we recorded the number of correct steps of the mycological KOH preparation listed by the students. The full text feedback was explored by content analysis.

Results: In the pre‐test the students listed an average of 3.1 ± 2.2 correct steps, compared to 8.8 ± 1.2 correct steps after completing the simulation (p < 0.001). Furthermore, the improvement was significant for each individual step. There were no significant differences between male and female students. In content analysis of the feedback, positive statements prevailed with 78.3%, compared to only 1.8% critical items.

Conclusion: Our study shows that an interactive computer simulation program of mycological KOH preparation results in a significant learning effectiveness as far as recall of the correct procedural steps is concerned. Furthermore, subjective acceptance by students is high.
On a level field: the utility of studying native and non‐native species in successional systems
Authors: Meiners Scott J. , Rye Timothy A. , Klass Jeremy R.
Published: February 2009

Questions: How do successional systems contribute to our understanding of plant invasions? Why is a community‐level approach important in understanding invasion? Do native and non‐native plant species differ in their successional trajectories within communities?

Location: Northeastern United States, in the Piedmont region of New Jersey. Previously farmed since the 1700s, ten fields were experimentally retired from agriculture beginning in 1958.

Methods: Fifty years of permanent plot data were used to quantify the population demographics of the 84 most abundant species during succession. These measures were then used to compare native, non‐native and non‐native invasive species' population dynamics in succession.

Results: Once basic life‐history characteristics were accounted for, there were no differences in the population dynamics of native, non‐native, and non‐native invasive plant species. However, the species pool in this study was biased towards ruderal species, which largely constrained non‐native species to early succession.

Conclusion: Successional systems are crucial to our understanding of invasions as they constrain all species to the role of colonizer. By focusing on the whole community, rather than on individual problematic species, we found no systematic differences between native and non‐native species. Thus, knowing simple life‐history information about a species would be much more useful in setting management priorities than where the species originated.
Tree age is a key factor for the conservation of epiphytic lichens and bryophytes in beech forests
Authors: Fritz Örjan , Niklasson Mats , Churski Marcin
Published: February 2009

Questions: What factors limit the distribution of epiphytic lichens and bryophytes at plot and tree level in beech forests? At what ages do epiphytic species, and species of conservation concern in particular, occur along a chronosequence of beech?

Location: South‐west Sweden.

Method: Five hundred and seventy‐one age‐determined trees from 37 plots distributed among 29 beech‐dominated stands were surveyed along with a number of environmental (16) and substrate (seven) variables in a landscape of ca. 550 ha. Non‐metric multidimensional scaling (NMS) and indicator species analysis (ISA) were used for data analysis.

Results: Plots containing old trees, confined to the base of slopes and with low impacts of recent forestry (thinning), generally had a high richness of species of conservation concern. Richness of common species and red‐listed bryophytes were mostly related to the surveyed bark area. At tree level, primary factors explaining both species richness and composition were age, diameter at breast height and moss cover. There was a gradual replacement of tree age ranges for 58 lichens and 37 bryophytes along the chronosequence of beech. Red‐listed lichens favoured damaged beech trees (≥180 years), whereas red‐listed bryophytes were found on old and young stems in dense stands.

Conclusions: Tree age exerts a profound influence on epiphytic lichens and bryophytes growing on beech. Many of the habitat specialists were found mainly on old beech because they inhabit specific substrates that occur on older trees. The association to high tree age commonly excludes red‐listed lichens from conventionally managed beech forests with a 100‐ to 140‐year rotation period.
The success of succession: a symposium commemorating the 50th anniversary of the Buell‐Small Succession Study
Authors: Cadenasso M.L. , Meiners S.J. , Pickett S.T.A.
Published: February 2009

Motivation: The Buell‐Small Succession Study (BSS) is the longest running study of post agricultural succession in North America. To honor this program, a symposium at the Ecological Society of America meetings was organized to explore the state of succession theory and its contribution to the field of ecology and its application to restoration. The BSS was originally motivated by two controversies in the literature during the 1950's. The first was between a community versus and individual basis of secondary succession. The second was the validity of the Initial Floristic Composition hypothesis.

Location: Hutcheson Memorial Forest, Somerset, New Jersey, USA

Methods: Vegetation composition and cover has been continuously quantified in permanent plots established in 10 old fields.

Continued Research Motivation: The rich data set has documented population and community dynamics and the spatio‐temporal controls and historical contingencies that influence those dynamics. The regulation of community dynamics continues to be a line of inquiry as does the application of results to restoration and understanding the dynamics of non‐native species.

Conclusions: Long term vegetation studies are uncommon in ecology yet they are uniquely valuable for understanding system dynamics – particularly if the studies capture periodic events or system shifts such as droughts and invasions by non‐native species. Resilient long term studies, of which the BSS is an example, maintain methods and data structure while allowing motivating questions to evolve along side advancements in the theoretical and conceptual realms of the field. Succession continues to serve as a basic tenet of ecology which is demonstrated by the papers making up this special issue.
Ever since Clements: from succession to vegetation dynamics and understanding to intervention*
Authors: Pickett S.T.A. , Cadenasso M.L. , Meiners S.J.
Published: February 2009

Introduction: This paper surveys a framework for vegetation dynamics to provide conceptual background for a series of papers addressing the role of vegetation dynamics in restoration.

Richness of the foundation: Classical succession theory provides key ingredients for contemporary process studies of vegetation dynamics. The contemporary framework incorporates processes identified by Gleason and other critics of Clements' theory.

Multiple causality: The Clementsian causes, when expanded to include interaction and to clarify net effects, accommodate those now recognized in vegetation dynamics.

A mature successional framework: A hierarchical framework has emerged to evaluate the causes of vegetation dynamics. The framework identifies the general causes as site availability, species availability, and species performance.

Differentials as drivers: Differentials in any of the three general causes can drive change in plant communities. Each general cause consists of specific mechanisms.

A model template: To predict vegetation dynamics trajectories, models are required. A model template is presented to operationalize the hierarchical framework. Outcomes are contingent on species pools and environmental contexts and may be progressive or retrogressive.

Relationships of frameworks: Other contemporary frameworks in biology relate to vegetation dynamics.

Application to restoration: The vegetation dynamics framework is relevant to restoration through linkages with landscape ecology, disturbance ecology, competition, invasion ecology, and community assembly. The differentials of site availability, species availability, and species performance suggest the processes and strategies available for restoration.

Conclusions: A synthetic framework of vegetation brings together the mechanisms required for successful restoration.
The Persistence of Induced Abortion in Cuba: Exploring the Notion of an “Abortion Culture”
Authors: Bélanger Danièle , Flynn Andrea
Published: February 2009

Cuba's annual induced abortion rate persistently ranks among the highest in the world, and abortion plays a prominent role in Cuban fertility regulation despite widespread contraceptive prevalence and state promotion of modern contraceptives. We explore this phenomenon using the concept of an “abortion culture,” typically used in reference to Soviet and post‐Soviet countries. We synthesize existing literature to provide a historical account of abortion and contraception in Cuba. We also provide a qualitative analysis of abortion and contraceptive use based on in‐depth interviews conducted in 2005 in Havana with 24 women who have had an abortion and 10 men whose partners have had an abortion. Information gained from a focus‐group discussion with medical professionals also informed the study. Our four principal findings are: (a) longstanding awareness of abortion, (b) the view of abortion as a personal decision, (c) the influence of economic constraints on the decision to induce an abortion, and (d) general skepticism toward contraceptives. We discuss our results on abortion in Cuba in relation to the notion of social diffusion, an approach commonly used to explain the spread of fertility control throughout a population.
Women's Use of Private and Government Health Facilities for Childbirth in Nairobi's. Informal Settlements
Authors: Bazant Eva S. , Koenig Michael A. , Fotso Jean‐Christophe , Mills Samuel
Published: February 2009

The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household‐survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one‐third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better‐off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home.
A Framework of Sexual Partnerships: Risks and Implications for HIV Prevention in Africa
Authors: Green Edward C. , Mah Timothy L. , Ruark Allison , Hearst Norman
Published: February 2009

The global diversity of HIV epidemics can be explained in part by types and patterns of sexual partnerships. We offer a typology of sexual partnerships that corresponds to varying levels of HIV‐transmission risk to help guide thinking about appropriate behavioral interventions, particularly in the epidemics of sub‐Saharan Africa. Declines in HIV prevalence have been associated with reductions in numbers of sex partners, whereas many other prevention strategies have not been demonstrated to reduce HIV transmission at a population level. We suggest a reorientation of current prevention efforts, based on the epidemiology of sexually transmitted HIV epidemics and trends in sexual behavior change. Concurrent sexual partnerships are likely to play a large role in transmission dynamics in the generalized epidemics of East and Southern Africa, and should be addressed through improved behavior‐change interventions.
COMPARISON OF CLINICAL, RADIOGRAPHIC, COMPUTED TOMOGRAPHIC, AND MAGNETIC RESONANCE IMAGING METHODS FOR EARLY PREDICTION OF CANINE HIP LAXITY AND DYSPLASIA
Authors: GINJA MÁRIO M. D. , FERREIRA ANTÓNIO J. , JESUS SANDRA S. , MELO‐PINTO PEDRO , BULAS‐CRUZ JOSÉ , ORDEN MARIA A. , SAN‐ROMAN FIDEL , LLORENS‐PENA MARIA P. , GONZALO‐ORDEN JOSÉ M.
Published: February 2009

The purpose of the study was to use two palpation methods (Bardens and Ortolani), a radiographic distraction view, three computed tomography (CT) measurements (dorsolateral subluxation score, the lateral center‐edge angle, and acetabular ventroversion angle) and two magnetic resonance (MR) imaging hip studies (synovial fluid and acetabular depth indices) in the early monitoring of hip morphology and laxity in 7–9 week old puppies; and in a follow‐up study to compare their accuracy in predicting later hip laxity and dysplasia. The MR imaging study was performed with the dog in dorsal recumbency and the CT study with the animal in a weight‐bearing position. There was no association between clinical laxity with later hip laxity or dysplasia. The dorsolateral subluxation score and the lateral center‐edge angle were characterized by a weak negative correlation with later radiographic passive hip laxity (−0.26<r<−0.38,P<0.05) but its association with hip dysplasia was not significant. There was an association between early radiographic passive hip laxity and synovial fluid index with later passive hip laxity (0.41<r<0.55,P<0.05) and this was significantly different in dysplastic vs. nondysplastic hips (P<0.05). There was no association between the remaining variables and later hip laxity or dysplasia. The overlapping ranges of early passive hip laxity and synovial fluid index for hip dysplasia grades and the moderate correlations with the later passive hip laxity make the results of these variables unreliable for use in predicting hip laxity and dysplasia susceptibility.
COMPUTED TOMOGRAPHIC ARTHROGRAPHY OF THE STIFLE FOR DETECTION OF CRANIAL AND CAUDAL CRUCIATE LIGAMENT AND MENISCAL TEARS IN DOGS
Authors: SAMII VALERIE F. , DYCE JONATHAN , POZZI ANTONIO , DROST WM. TOD , MATTOON JOHN S. , GREEN ERIC M. , KOWALESKI MICHAEL P. , LEHMAN AMY M.
Published: February 2009

The purpose of this study was to evaluate the utility of single‐detector computed tomographic arthrography (CT arthrography) for the diagnosis of cranial and caudal cruciate ligament and meniscal lesions in the dog stifle. Four normal and 25 abnormal stifle joints, determined to have lesions related to intra‐articular ligamentous insufficiency based on clinical history, orthopedic examination, and survey orthogonal radiographs, were imaged using a previously developed CT arthrography protocol. Surgery was performed immediately following the CT procedure. Three board‐certified radiologists inexperienced at interpreting CT stifle arthrograms reviewed all CT studies independently, and then as a group, without knowledge of surgical or necropsy findings. Sensitivity, specificity, positive predictive value, and negative predictive value for determination of cranial and caudal cruciate and meniscal tears were calculated for each individual reviewer and based on group consensus. All reviewers identified the normal canine stifle joints imaged correctly. Reviewers did well in discriminating normal from torn cranial cruciate ligaments, with sensitivities of 96–100% and specificities of 75–100%. No reviewer correctly identified the solitary caudal cruciate ligament tear and specificity ranged from 89.3% to 100%. Reviewers were less adept at discriminating normal from torn meniscal fibrocartilage, with sensitivities of 13.3–73.3% and specificities of 57.1–100%. Interpretive accuracy improved slightly when consensus scores were compared with surgical findings. Single‐detector CT arthrography may be useful for identifying pathology of the canine cruciate ligaments but is of limited value for assessing the menisci.
PUPPY LINE, METAPHYSEAL SCLEROSIS, AND CAUDOLATERAL CURVILINEAR AND CIRCUMFERENTIAL FEMORAL HEAD OSTEOPHYTES IN EARLY DETECTION OF CANINE HIP DYSPLASIA
Authors: RISLER AMANDA , KLAUER JULIA M. , KEULER NICHOLAS S. , ADAMS WILLIAM M.
Published: February 2009

Ventrodorsal extended hip radiographs were analyzed from Foxhounds, Irish setters, Greyhounds, and Labrador retrievers radiographed four to seven times between 8 and 110 weeks of age. Occurrence in these 91 dogs of a puppy line, an ill‐defined zone of proximal femoral metaphyseal sclerosis, a femoral neck linear sclerosis, or circumferential linear femoral head osteophytosis at 15–17 weeks of age were compared with hip joint laxity, as measured by distraction index, and to later findings of caudal curvilinear femoral neck osteophytes, circumferential femoral head osteophytes, hip incongruity consistent with hip dysplasia and degenerative joint disease by 52 weeks of age. A puppy line and/or femoral metaphyseal sclerosis was common at 15–17 weeks of age for dogs at mimimal risk (Greyhounds) and high risk (Foxhounds) of developing early degenerative joint disease associated with canine hip dysplasia. Though 44% of Greyhound hips had puppy lines and 28% had femoral metaphyseal sclerosis at 15–17 weeks of age, no Greyhound had a caudolateral curvilinear osteophyte or circumferential femoral head osteophyte at 24–27 or 52 weeks of age. No significant relationship was found between occurrence of a puppy line, a circumferential femoral head osteophyte or femoral metaphyseal sclerosis at 15–17 weeks and canine hip dysplasia or degenerative joint disease incidence at 42–52 weeks. Presence of a caudolateral curvilinear osteophyte in at least one hip at 24–27 weeks was significantly related to the diagnosis of canine hip dysplasia by 42–52 weeks. When both a caudolateral curvilinear osteophyte and a circumferential femoral head osteophyte were present in a hip at 24–27 weeks, degenerative joint disease was evident in all such hips by 42–52 weeks of age.
THE EFFECT OF MANUAL LUNG INFLATION VS. SPONTANEOUS INSPIRATION ON THE CARDIAC SILHOUETTE IN ANESTHETIZED DOGS
Authors: WEBSTER NATALIE , ADAMS VICKI , DENNIS RUTH
Published: February 2009

The purpose of this study was to assess radiographic heart size in anesthetized dogs, comparing radiographs made with the patient breathing spontaneously to radiographs obtained using positive pressure manual lung inflation. The hypothesis was that manual inflation would cause reduction in the cardiac size. With dogs in right recumbency a radiograph was made at peak spontaneous inspiration followed immediately a radiograph made with application of positive pressure manual inflation of the thorax. Cardiac size was assessed, both subjectively and objectively using the vertebral heart scale (VHS). Two hundred and six dogs were studied. Manual inflation resulted in a significantly greater degree of lung inflation assessed radiographically (P<0.0001). The subjectively assessed heart size was significantly smaller in radiographs made with manual inflation, leading to different subjective categorization of heart size in 67 (32%) of dogs. The objectively measured VHS was also significantly smaller in the radiographs made using manual inflation by a mean of 0.24 of a vertebral length (95% CL of mean difference: −0.29, −0.19,P<0.0001). A statistically significant reduction in subjective heart size and in VHS occurred with manual inflation of the lungs, and these differences may be clinically significant. Thus, if serial radiographs are obtained to assess cardiac size, the radiographic technique used should be the same.
CHARACTERIZATION OF CANINE FOCAL LIVER LESIONS WITH CONTRAST‐ENHANCED ULTRASOUND USING A NOVEL CONTRAST AGENT—SONAZOID
Authors: KANEMOTO HIDEYUKI , OHNO KOICHI , NAKASHIMA KO , TAKAHASHI MASASHI , FUJINO YASUHITO , NISHIMURA RYOHEI , TSUJIMOTO HAJIME
Published: February 2009

Contrast‐enhanced ultrasound using Sonazoid, a novel contrast medium with a liver‐specific Kupffer phase, was evaluated in canine focal liver lesions Twenty‐five dogs with a liver mass were given intravenous Sonazoid, and the enhancement pattern in the arterial, portal, and parenchymal phase was characterized. An enhancement defect in the lesion in the parenchymal phase was observed in all malignant lesions, whereas only one of nine benign lesions had a filling defect. The diagnostic value of the presence of a filling defect for malignancy was statistically significant (100% sensitivity, 88.9% specificity, 94.1% positive predictive value, 100% negative predictive value), and was equal to that of hypoenhancement in the portal or delayed phase. The defect pattern (clear or irregular defect) was dependent (P<0.05) on the types of malignancy (i.e., hepatocellular carcinoma and other types of malignancies). In the arterial phase, five of the six hepatocellular carcinomas had hypervascularity, whereas no other lesion was characterized by hypervascularity. In some dogs, additional lesions that could not be observed with conventional B‐mode ultrasonography were detected in the parenchymal phase. The enhancement pattern of Sonazoid, especially in the parenchymal phase, has potential as a diagnostic tool for canine focal liver lesions.
ULTRASONOGRAPHIC FEATURES OF INTESTINAL ENTRAPMENT IN DOGS
Authors: SWIFT INAR
Published: February 2009

The clinical and ultrasonographic features of postoperative intestinal entrapment were assessed in five dogs. Four had vomiting and lethargy, and one had peracute collapse and hematochezia. Ultrasonographic findings in four of five dogs were similar, being characterized by focally hyperechoic mesentery and abdominal effusion, surrounding a single loop of amotile and dilated intestine. In some dogs, the affected intestinal loop had a thickened or corrugated wall, or alteration of wall layering. In one dog, the site of entrapment could be directly visualized. In the most severely affected dog, a large volume of echogenic peritoneal effusion was present, as well as fluid dilation of multiple intestinal loops. The ultrasonographic appearance of intestinal entrapment is similar to that of intestinal perforation or infarction by other causes.
QUANTITATIVE THYROID SCINTIGRAPHY IN GREYHOUNDS SUSPECTED OF PRIMARY HYPOTHYROIDISM
Authors: PINILLA MANUEL , SHIEL ROBERT E. , BRENNAN SHEILA F. , McALLISTER HESTER , MOONEY CARMEL T.
Published: February 2009

The existence of hypothyroidism in greyhounds remains controversial and its investigation is complicated by the low circulating thyroid hormone concentrations typically found in healthy dogs of this breed. Quantitative measurement of thyroidal technetium‐99m pertechnetate (99mTcO4−) uptake is known to be useful in assessing thyroid function in other breeds. The aim of this study was to evaluate thyroid scintigraphy as a method of assessing thyroid function in greyhounds suspected of primary hypothyroidism. Twenty greyhounds (eight females, 12 males) were studied. Thirteen had bald thigh syndrome and seven poor performance and low total T4. Total T4 concentrations were decreased in 18 (90%), and free T4 in two (10%) dogs. All canine thyroid stimulating hormone concentrations were within the reference interval. Thyroidal99mTcO4−uptake values (mean ± SD, 0.76 ± 0.26%) were within the reference limits published for euthyroid dogs (0.39–1.86%) making hypothyroidism highly unlikely. There were no significant differences (P<0.05) when comparing data between dogs with bald thigh syndrome (13 dogs) and the remaining dogs (seven dogs). Seventeen (85%) dogs had higher uptake in the left thyroid gland than in the right that might reflect an anatomic feature of the greyhound breed. Calculation of percent thyroidal uptake of99mTcO4−is more accurate than thyroid:salivary gland ratios because of high variability in salivary gland uptake. Percent thyroidal uptake of99mTcO4−should be used when assessing thyroid function scintigraphically in the greyhound breed.
ASSESSMENT OF A RADIOTHERAPY PATIENT CRANIAL IMMOBILIZATION DEVICE USING DAILY ON‐BOARD KILOVOLTAGE IMAGING
Authors: HARMON JOSEPH , VAN UFFLEN DEREK , LARUE SUSAN
Published: February 2009

The purpose of this study was to utilize state‐of‐the‐art on‐board digital kilovoltage (kV) imaging to determine the systematic and random set‐up errors of an immobilization device designed for canine and feline cranial radiotherapy treatments. The immobilization device is comprised of a custom made support bridge, bite block, vacuum‐based foam mold and a modified thermoplastic mask attached to a commercially available head rest designed for human radiotherapy treatments. The immobilization device was indexed to a Varian exact couch‐top designed for image guided radiation therapy (IGRT). Daily orthogonal kV images were compared to Eclipse treatment planning digitally reconstructed radiographs (DRRs). The orthogonal kV images and DRRs were directly compared online utilizing the Varian on‐board imaging (OBI) system with set‐up corrections immediately and remotely transferred to the treatment couch prior to treatment delivery. Off‐line review of 124 patient treatments indicates systematic errors consisting of +0.18 mm vertical, +0.39 mm longitudinal and −0.08 mm lateral. The random errors corresponding to 2 standard deviations (95% CI) consist of 4.02 mm vertical, 2.97 mm longitudinal and 2.53 mm lateral and represent conservative CTV to PTV margins if kV OBI is not available. Use of daily kV OBI along with the cranial immobilization device permits reduction of the CTV to PTV margins to approximately 2.0 mm.
The potential benefits of dental implants on the oral health quality of life of people with Parkinson’s disease
Authors: Packer Mark , Nikitin Vladimir , Coward Trevor , Davis Devid Michael , Fiske Janice
Published: February 2009

Objective:  To investigate how dental implants impact on the oral health quality of life of people with Parkinson’s disease (PD).

Background:  PD is a progressive neurological disorder that can result in a number of oral health care challenges, including denture difficulties. Lack of evidence related to use of implants in PD prompted this study to investigate their use in this group of people.

Materials and methods:  Nine people with PD were provided with either fixed or removable prostheses using Astra‐Tech implants. Participants completed the socio‐dental questionnaire, ‘The Dental Impact on Daily Living Assessment’ (DIDL) prior to implant surgery, and at 3 and 12 months after provision of the final prosthesis. DIDL comprises two components – the Oral Health Quality of Life Inventory (OH‐QoL) and the Self‐Reported Assessment of Oral Health and Functional Status (SROH).

Results:  Nine people (with an age range of 54–77 years) had implants placed. The implant success rate was 85 and 81% in the maxilla and mandible, respectively. The OH‐QoL and SROH results (analysed using the one‐way analysis of variance and pairwise multiple comparisons) demonstrated a significant improvement in the domains of eating and satisfaction with the prosthesis after 3 months, which was maintained at the twelve month review. The OH‐QoL indicated a gradual improvement in oral well‐being over the 12‐month period.

Conclusion:  The oral health quality of life of people with PD was improved by the use of dental implants, indicating this as a viable treatment option.
Robert Browning's Compounds
Authors: Wilson Ross
Published: February 2009

This article is part of a cluster that draws material from the recent conference Metre Matters: New Approaches to Prosody, 1780–1914. It comprises an introduction by Jason David Hall and six articles presented at the conference, whose aim was to address renewed scholarly interest in versification and form across the long nineteenth century, as well as some of the methodologies underpinning it. The papers included in the cluster look both to the minutiae of Romantic and Victorian metres and to their cultural intertexts. The conference, hosted by the University of Exeter's Centre for Victorian Studies, was held 3–5 July 2008.

The cluster is made up of the following articles: Jason David Hall, ‘Metre, History, Context: Introduction to the Metre Matters Cluster’.

Emma Mason and Rhian Williams, ‘Reciprocal Scansion in Wordsworth's “There Was a Boy” ’.

Ross Wilson, ‘Robert Browning's Compounds’.

Margaret A. Loose, ‘The Internationalism of Ernest Jones's Dialectical Prosody’.

Nancy Jiwon Cho, ‘Gender and Authority in British Women Hymn‐Writers’ Use of Metre, 1760–1900’.

Ashley Miller, ‘Involuntary Metrics and the Physiology of Memory’.

Summer Star, ‘ “For the Ins?ape's Sake”: Sounding the Self in the Metres of Gerard Manley Hopkiṅs’.

***

This article is a study of the use of compound words in Robert Browning's poetry. It explores the use of compounds in Sordello, The Ring and the Book and The Agamemnon of Aeschylus in particular. Although it addresses the semantic aspects of compound words, it especially focuses on their metrical aspects and thus makes a contribution to our current understanding of Browning's versification. I claim that the metrical features of compound words are central to the formation of meaning in Browning's verse. In order to conduct this investigation, I draw on work by a number of literary critics, metrists and linguists, including Derek Attridge, Noam Chomsky and Morris Halle.
The Internationalism of Ernest Jones's Dialectical Prosody
Authors: Loose Margaret A.
Published: February 2009

This article is part of a cluster that draws material from the recent conference Metre Matters: New Approaches to Prosody, 1780–1914. It comprises an introduction by Jason David Hall and six articles presented at the conference, whose aim was to address renewed scholarly interest in versification and form across the long nineteenth century, as well as some of the methodologies underpinning it. The papers included in the cluster look both to the minutiae of Romantic and Victorian metres and to their cultural intertexts. The conference, hosted by the University of Exeter's Centre for Victorian Studies, was held 3–5 July 2008.

The cluster is made up of the following articles: Jason David Hall, ‘Metre, History, Context: Introduction to the Metre Matters Cluster’.

Emma Mason and Rhian Williams, ‘Reciprocal Scansion in Wordsworth's “There Was a Boy” ’.

Ross Wilson, ‘Robert Browning's Compounds’.

Margaret A. Loose, ‘The Internationalism of Ernest Jones's Dialectical Prosody’.

Nancy Jiwon Cho, ‘Gender and Authority in British Women Hymn‐Writers’ Use of Metre, 1760–1900’.

Ashley Miller, ‘Involuntary Metrics and the Physiology of Memory’.

Summer Star, ‘ “For the Inscape's Sake”: Sounding the Self in the Metres of Gerard Manley Hopkins’.

***

The poems, essays and fiction of the Chartist Ernest Jones (1819–69) consistently demonstrate his notion that British labourers cannot attain social justice without a principled solidarity with the labourers of other countries. This essay examines some prosodic tensions in ‘A Song for May’ (1847), an unlikely example of his internationalism because its topic has nothing to do with it. However, the formal features of the poem – from its stanzaic organization to its metrical choices, its focus on the plight of individuals to its communal nature as a Chartist song – call for a dialectical negotiation of its public and private qualities that maps onto Jones's nuanced treatment of personal and collective identities in his internationalist writing. His emphasis on the individual's ability to define itself would seem to contradict his broader intention to foster a mass, class‐based identity that seeks social justice through collective action. But it is precisely that power which permits one to choose one's loyalties and national identity, choices that might not coincide with the accidents of birth and ancestry, and which thus open the way for a border‐crossing solidarity. A dialectical prosody illuminates Jones's poetics and could also cast light on the junction of poetry and politics in the writing of authors both within and beyond Chartism.