bluuebunny/crossref_metadata_2025 huggingface dataset:
The natural history of AVM hemorrhage in the posterior fossa: comparison of hematoma volumes and neurological outcomes in patients with ruptured infra- and supratentorial AVMs
Authors: Abla Adib A. , Nelson Jeffrey , Rutledge W. Caleb , Young William L. , Kim Helen , Lawton Michael T.
Published: September 2014

Object

Patients with posterior fossa arteriovenous malformations (AVMs) are more likely to present with hemorrhage than those with supratentorial AVMs. Observed patients subject to the AVM natural history should be informed of the individualized effects of AVM characteristics on the clinical course following a new, first-time hemorrhage. The authors hypothesize that the debilitating effects of first-time bleeding from an AVM in a previously intact patient with an unruptured AVM are more pronounced when AVMs are located in the posterior fossa.

Methods

The University of California, San Francisco prospective registry of brain AVMs was searched for patients with a ruptured AVM who had a pre-hemorrhage modified Rankin Scale (mRS) score of 0 and a post-hemorrhage mRS score obtained within 2 days of the hemorrhagic event. A total of 154 patients met the inclusion criteria for this study. Immediate post-hemorrhage presentation mRS scores were dichotomized into nonsevere outcome (mRS ≤ 3) and severe outcome (mRS > 3). There were 77 patients in each group. Univariate and multivariate logistic regression analyses using severe outcome as the binary response were run. The authors also performed a logistic regression analysis to measure the effects of hematoma volume and AVM location on severe outcome.

Results

Posterior fossa location was a significant predictor of severe outcome (OR 2.60, 95% CI 1.20–5.67, p = 0.016) and the results were strengthened in a multivariate model (OR 4.96, 95% CI 1.73–14.17, p = 0.003). Eloquent location (OR 3.47, 95% CI 1.37–8.80, p = 0.009) and associated arterial aneurysms (OR 2.58, 95% CI 1.09, 6.10; p = 0.031) were also significant predictors of poor outcome. Hematoma volume for patients with a posterior fossa AVM was 10.1 ± 10.1 cm3 compared with 25.6 ±28.0 cm3 in supratentorial locations (p = 0.003). A logistic analysis (based on imputed hemorrhage volume values) found that posterior fossa location was a significant predictor of severe outcome (OR 8.03, 95% CI 1.20–53.77, p = 0.033) and logarithmic hematoma volume showed a positive, but not statistically significant, association in the model (p = 0.079).

Conclusions

Patients with posterior fossa AVMs are more likely to have severe outcomes than those with supratentorial AVMs based on this natural history study. Age, sex, and ethnicity were not associated with an increased risk of severe outcome after AVM rupture, but posterior fossa location, associated aneurysms, and eloquent location were associated with poor post-hemorrhage mRS scores. Posterior fossa hematomas are poorly tolerated, with severe outcomes observed even with smaller hematoma volumes. These findings support an aggressive surgical posture with respect to posterior fossa AVMs, both before and after rupture.
Treatment and outcomes of ARUBA-eligible patients with unruptured brain arteriovenous malformations at a single institution
Authors: Rutledge W. Caleb , Abla Adib A. , Nelson Jeffrey , Halbach Van V. , Kim Helen , Lawton Michael T.
Published: September 2014

Object

Management of unruptured arteriovenous malformations (AVMs) is controversial. In the first randomized trial of unruptured AVMs (A Randomized Trial of Unruptured Brain Arteriovenous Malformations [ARUBA]), medically managed patients had a significantly lower risk of death or stroke and had better outcomes. The University of California, San Francisco (UCSF) was one of the participating ARUBA sites. While 473 patients were screened for eligibility, only 4 patients were enrolled in ARUBA. The purpose of this study is to report the treatment and outcomes of all ARUBA-eligible patients at UCSF.

Methods

The authors compared the treatment and outcomes of ARUBA-eligible patients using prospectively collected data from the UCSF brain AVM registry. Similar to ARUBA, they compared the rate of stroke or death in observed and treated patients and used the modified Rankin Scale to grade outcomes.

Results

Of 74 patients, 61 received an intervention and 13 were observed. Most treated patients had resection with or without preoperative embolization (43 [70.5%] of 61 patients). One of the 13 observed patients died after AVM hemorrhage. Nine of the 61 treated patients had a stroke or died. There was no significant difference in the rate of stroke or death (HR 1.34, 95% CI 0.12–14.53, p = 0.81) or clinical impairment (Fisher’s exact test, p > 0.99) between observed and treated patients.

Conclusions

The risk of stroke or death and degree of clinical impairment among treated patients was lower than reported in ARUBA. The authors found no significant difference in outcomes between observed and treated ARUBA-eligible patients at UCSF. Results in ARUBA-eligible patients managed outside that trial led to an entirely different conclusion about AVM intervention, due to the primary role of surgery, judicious surgical selection with established outcome predictors, and technical expertise developed at high-volume AVM centers.
Management of perisylvian arteriovenous malformations: a retrospective institutional case series and review of the literature
Authors: Pabaney Aqueel H. , Reinard Kevin A. , Massie Lara W. , Naidu Padmaja K. , Mohan Yedathore S. , Marin Horia , Malik Ghaus M.
Published: September 2014

Object

Sylvian arteriovenous malformations (sAVMs) are challenging lesions of the central nervous system. The natural history of these unique lesions as well as clinical outcomes following treatment of sAVMs has been limited to case series owing to the rarity of these lesions. The authors present their experience with sAVMs and review the literature.

Methods

In accordance with the Henry Ford Institutional Review Board, medical records of patients with sAVMs treated from 2000 to 2012 were reviewed. Clinical data were retrospectively collected to calculate pre- and posttreatment modified Rankin Scale scores for all patients.

Results

The authors identified 15 patients with sAVMs who received treatment. Of these, 12 were female and 3 were male, and the average age at presentation was 39.6 ± 12.94 years (± SD). Two patients (13.3%) had Spetzler-Martin Grade I lesions, 6 patients (40%) had Grade II lesions, 5 patients (33.3%) had Grade III lesions, and another 2 (13.3%) harbored Grade IV arteriovenous malformations (AVMs). According to the Sugita classification, 6 patients (40%) had medial lesions, 6 (40%) had lateral lesions, 2 (13.3%) had deep lesions, and 1 patient (6.67%) had a pure sAVM. Eight patients (53.3%) underwent stereotactic radiosurgery while 7 patients (46.7%) had microsurgical resection; 1 patient underwent surgical extirpation after incomplete response following radiosurgery. After treatment, 9 patients were unchanged from pretreatment (60%), 3 patients worsened, and 2 patients had improved functional outcome (20% and 13.3%, respectively). The authors’ literature search yielded 348 patients with sAVMs, most of them harboring Spetzler-Martin Grade II and III lesions. Approximately 98% of the patients underwent resection with excellent outcomes.

Conclusions

While the ideal choice of therapeutic modality for cerebral AVMs remains controversial in light of the recent publication of the ARUBA (A Randomized trial of Unruptured Brain AVMs) trial, a multidisciplinary treatment approach for the management of sAVMs can lead to acceptable neurological outcome.
Microsurgical resection of intramedullary spinal cord cavernous malformation. Operative video and technical nuances
Authors: Liu James K.
Published: September 2014

Intramedullary spinal cord cavernous malformations account for approximately 5% of all intraspinal lesions. These lesions can present with either acute neurological compromise secondary to hemorrhage inside the spinal cord, or with chronic progressive myelopathy due to repeated microhemorrhages. Surgical resection of spinal cord cavernous malformations remains the definitive treatment strategy for symptomatic lesions. Because of the intimate relationship with surrounding eloquent neural tissue, these lesions can be technically challenging to remove with a significant risk for morbidity. In this operative video, the author demonstrates an illustrative step-by-step technique for microsurgical resection of a large intramedullary spinal cord cavernous malformation at C4–5 causing progressive myelopathy. Complete resection was achieved without neurologic compromise. The operative technique and surgical nuances, including the surgical approach, intradural cavernoma removal, and spinal stabilization are illustrated.

The video can be found here: http://youtu.be/3FUjGSyrKO0.
Surgical resection of subependymoma of the cervical spinal cord
Authors: Tan Lee A. , Kasliwal Manish K. , Mhanna Nakhle , Fontes Ricardo B. V. , Traynelis Vincent C.
Published: September 2014

Subependymomas can rarely occur in the spinal cord, and account for about 2% of symptomatic spinal cord tumors. It most often occurs in the cervical spinal cord, followed by cervicothoracic junction, thoracic cord and conus medullaris. It often has an eccentric location in the spinal cord and lacks gadolinium enhancement on magnetic resonance imaging. We present a rare case of symptomatic subependymoma of the cervical spinal cord, which underwent successful gross total resection. Surgical pearls and nuances are discussed to help surgeons to avoid potential complications.

The video can be found here: http://youtu.be/Rsm9KxZX7Yo.
Microsurgical resection of cauda equina schwannoma with nerve root preservation
Authors: McCormick Paul C.
Published: September 2014

The occurrence of motor deficit following resection of an intradural spinal schwannoma is an uncommon but potentially serious complication. This video illustrates the technique of microsurgical resection of an L-4 sensory nerve root schwannoma with preservation of the corresponding functional L-4 motor nerve root.

The video can be found here: http://youtu.be/HrZkGj1JKd4.
Microsurgical enbloc resection of myxopapillary cauda equina ependymoma
Authors: McCormick Paul C.
Published: September 2014

Benign myxopapillary filum terminale ependymomas are often poorly encapsulated and in apposition the cerebrospinal fluid (CSF). These characteristics present the potential surgical risk of CSF dissemination or injury to the delicate cauda equina nerve roots. This video details the techniques of en bloc surgical resection of a filum terminale ependymoma. Treatment strategies and techniques are illustrated to reduce the risk of CSF dissemination and cauda equina injury.

The video can be found here: http://youtu.be/LK8AYg-5T7o.
Microsurgical resection of intramedullary spinal cord ependymoma
Authors: McCormick Paul C.
Published: September 2014

Ependymomas are the most commonly occurring intramedullary spinal cord tumor in adults. With few exceptions these tumors are histologically benign, although they exhibit some biologic variability with respect to growth rate. While unencapsulated, spinal ependymomas are non-infiltrative and present a clear margin of demarcation from the surrounding spinal cord that serves as an effective dissection plane. This video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy.

The video can be found here: http://youtu.be/lcHhymSvSqU.
Microsurgical resection of cervical spinal arteriovenous malformation: the pial resection technique
Authors: Rangel-Castilla Leonardo , Spetzler Robert F.
Published: September 2014

We present the case of a 26-year-old female patient who had two episodes of sudden, left, upper and lower extremity paresthesias and weakness, which resolved completely after 5 months. After recovery, she presented for evaluation. Imaging demonstrated a C3-C6 intra- and extra-axial arteriovenous malformation (AVM) with spinal cord compression and edema. A spinal angiogram showed arterial feeders arising from both vertebral arteries and from the right ascending pharyngeal artery. The AVM had been partially embolized after her first bleeding episode. She underwent C3-C6 laminoplasty and microsurgical resection of the AVM. After locating the main arterial feeders and draining veins, the malformation was resected using the pial resection technique. A postoperative spinal angiogram demonstrated gross total resection. Video used with permission from Barrow Neurological Institute.

The video can be found here: http://youtu.be/JbbIwCTUsuI.
Minimally invasive surgery for synchronous, same-level lumbar intradural-extramedullary neoplasm and acute disc herniation
Authors: Tan Lee A. , Kasliwal Manish K. , Wewel Joshua , Fontes Ricardo B. V. , O'Toole John E.
Published: September 2014

Schwannomas are the most common intradural-extramedullary spinal tumors, with an estimated incidence of 3 to 10 cases per 100,000 people. With continued advances in minimally invasive surgery (MIS) over recent years, MIS techniques have been utilized by spine surgeons in the resection of intradural spinal neoplasms with favorable surgical results and clinical outcomes. This video demonstrates a rare case of symptomatic, synchronous, same-level lumbar intradural-extramedullary neoplasm and acute disc herniation, both of which were successfully treated using a single MIS approach. Surgical pearls and nuances are discussed to better delineate technique and minimize potential complications.

The video can be found here: http://youtu.be/78ibbicBRUk.
Microsurgical technique in excision of intramedullary craniocervical ependymomas. Video report
Authors: Refaee Ehab El , Matthes Marc , Schroeder Henry W. S.
Published: September 2014

We present the microsurgical technique in excision of intramedullary craniocervical ependymomas. A 27-year-old female came presenting with neck pain and parasthesia in her both arms and hands, where MRI was performed showing intramedullary lesion that extend in the medulla just beyond the foramen magnum to the level of C5–6 disc. Tumor was totally excised using irrigation-dissection microscopic technique with favorable outcome.

The video can be found here: http://youtu.be/Yj1yvZOaz58.
Resection of a ventral intramedullary cervical spinal cord cavernous malformation through an anterior approach
Authors: Weil Alexander G. , Bhatia Sanjiv
Published: September 2014

Ventrally-located intramedullary cervical spinal cord cavernomas are rare entities in the pediatric population. Surgical access to these lesions is challenging. The authors present the complete resection of a symptomatic ventral cervical intramedullary cavernoma through an anterior approach in a 15-year-old boy. The lesion was accessed following left anterolateral dissection, C3–4 discectomy and C3/C4 partial corpectomy. The authors will discuss the rationale for intervening in this patient and for selecting this anterior approach over other approaches, such as the anterolateral, posterolateral or posterior approach. The steps, pitfalls and pearls of this surgical approach will be demonstrated in a detailed video.

The video can be found here: http://youtu.be/-ARTp6g13hgs.
Influence of Rice Husk Ash and Fly Ash on Properties of Red Clay
Authors: Sultana M.S. , Hossain M.I. , Rahman M.A. , Khan M.H.
Published: September 2014

Effects of rice husk ash and fly ash on properties of red clay collected from Naogaon district of Bangladesh were investigated. Different percentages of rice husk ash (RHA) and fly ash (5%, 10% and 15%) were thoroughly mixed with clay to analyse various physical and chemical properties of clay followed by heat treatment of 8000C to 11000C. The samples were tested for compressive strength, linear shrinkage, water absorption, porosity and bulk density. XRD analysis indicates the clay sample was mainly illite type. Water absorption and porosity increased with increasing percentage of ashes. The percentage of water absorption was within 6 to 10% for different mixture which may be suitable for ceramic and tiles purposes. Both fly ash and RHA of 15% could be used to improve some properties of clay. The optimum firing temperature for all the samples was 10500C. XRD pattern of clay with fly ash and rice husk ash heated at 10500C confirms the presence of feldspar and quartz as major phase and hematite (Fe2O3) and cristobalite phase as minor phase. This red clay deposits reinforced with different appropriate quantities of rice husk ash and fly ash could be used for various low temperature applications in industry and construction purposes. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.15343 J. Sci. Res. 6 (3), 421-430 (2014)
Analysis of Kidney and Gall Stones of Patients from North-East Bangladesh by FTIR
Authors: Subhan M. A. , Sarker P. , Ahmed T.
Published: September 2014

Kidney and gallstones represent a prevalent and costly health problem. This study aimed to define patterns of stones and identify chemical compositions in the sample of symptomatic kidney and gallstones from North-East part of Bangladesh (Sylhet City, Sylhet) using infrared spectroscopy. Kidney and gallstones were recovered from patients of Osmani Medical College and Hospital, Sylhet, Bangladesh. A total of 5 kidney and 3 gall stone samples were collected randomly and analyzed for composition by Fourier Transform Infrared Spectroscopy (FTIR). Among the five kidney stone samples, KDS 01 was mixture of calcium oxalate monohydrate and calcium phosphate, KDS 02 and 03 were calcium oxalate and uric acid stones, KDS 04 was uric acid stone and KDS 05 was calcium oxalate dehydrate and calcium phosphate. Among the three gall stone samples, GBS 01 was cholesterol stone, GBS 02 was mixed stone and GBS 03 was pigment stone. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.16721 J. Sci. Res. 6 (3), 553-561 (2014)
Hall Effects on Steady MHD Heat and Mass Transfer Free Convection Flow along an Inclined Stretching Sheet with Suction and Heat Generation
Authors: Ali M. , Alam M. S.
Published: September 2014

The heat and mass transfer of a steady flow of an incompressible electrically conducting fluid over an inclined stretching plate under the influence of an applied uniform magnetic field with heat generation and suction and the effects of Hall current are investigated. Using suitable similarity transformations the governing boundary layer equations for momentum, thermal energy and concentration are reduced to a set of coupled ordinary differential equations which are then solved numerically by the shooting method along with Runge- Kutta fourth-fifth order integration scheme. The numerical results concerned with the velocity, secondary velocity, temperature and concentration profiles effects of various parameters on the flow fields are investigated and presented graphically. The results have possible technological applications in liquid-based systems involving stretchable materials. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.16903 J. Sci. Res. 6 (3), 457-466 (2014)
Synthesis, Characterization and Antimicrobial Activity of Mixed-Ligand Complexes of Cu(II) with 1,2,4, Triazole and Amino Acids
Authors: Anupama B. , Kumari C. G.
Published: September 2014

Mixed-ligand ternary complexes of Cu (II) metal ion with 1,2,4 triazole (TRZ) and amino acids (histidine (L1), threonine (L2), proline (L3) and hydroxyl proline (L4)) have been synthesized. The prepared ternary chelates were characterized by elemental analysis, IR and electronic spectra, as well as conductivity measurements. The general formula [Cu(TRZ)L]H2O were found for the ternary chelates containing TRZ. From the analytical and spectral data, the stoichiometry has been found to be 1:1:1 for all the complexes. A tetrahedral geometry has been proposed. Molecular modeling studies were also carried out to confirm the geometries of the complexes. All the new complexes were found to be active against bacteria. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.16993 J. Sci. Res. 6 (3), 487-496 (2014)
Experimental Investigation of the Effect of Vibrator Machine for Desilting Sediment in the Pressure Flushing
Authors: Dodaran A. A. , Park S. K. , Mardashti A.
Published: September 2014

As natural streams enter reservoirs, the streams flow depth increases and the flow velocity decreases. Itdecreases the sediment transport capacity of the stream and causes settling. Numerous methods have been planned to control the sedimentation process. These may include catchment's management, flushing, sluicing etc. Flushing is used to erode previously deposited sediments. When outlet is opened the sediment in the vicinity of the outlet openings is scoured and a funnel shaped crater is created.In this research experimental studywas performed to investigatethe effect of localized vibrations in the sediment layers on the dimensions of the flushing cone. For this purpose laboratory test was carried out under different hydraulic conditions such as five discharges of 0.23, 0.53, 1.21, 1.53 and 2.1 lit/s with bottom outlets with diameters of 1 and 2 inch. Using the vibrator machine mounted in the reservoir and close to the bottom outlet, different frequencies(e.g. 20, 35 and 50 Hz) have been applied for the deposited sediment in the vicinity of the outlet. The results showthat, the dimension offlushing cone significantly increaseddue tovibrations. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.17236 J. Sci. Res. 6 (3), 475-485 (2014)
Effect of Biologically Significant Metal Complex Additives on the Micellar Properties of SDS
Authors: Subhan M. A. , Rahman M. A. , Rahaman M. S.
Published: September 2014

The effect of some biologically significant transition metal complexes such as [Fe(bpy)Cl4] [bpy-H], [Co(bpy)(phen)2](NO3)2·2H2O, [Fe(PDCl4][PD-H], [Cu(L)(NO3)2], [Cu(phen)2] Cl2·2H2O and [Cu(PD)(phen)2](NO3)2·2H2O (L=3,14-diethyl-2,6,13,17-tetraazatricyclo (16,4,07,12)docosane, bpy=2,2?-bipyridine, PD =1,10-phenanthroline-5,6-dione, phen=1,10-phenanthroline) on the critical micelle concentration (CMC) of an anionic surfactant, sodium dodecyl sulfate (SDS) were studied by conductance measurement method. The investigation was performed in the additives concentration ranging from 2.0 × 10-4 M to 8.0 × 10-4 M and at temperature ranging from 20°C to 35°C with an interval of 5°C. Different micellar parameters such as CMC, degree of counter ion dissociation (?), degrees of counter ion binding (f), binding constant (Kb) as well as thermodynamic parameters were determined using the conductivity data. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.17761 J. Sci. Res. 6 (3), 497-508 (2014)
Performance Characteristics of UV and Visible Spectrophotometry Methods for Quantitative Determination of Norfloxacin in Tablets
Authors: Chierentin L. , Salgado H. R. N.
Published: September 2014

This work has proposed the development and validation of ultraviolet (UV) and visible (Vis) spectrophotometric methods for the determination of norfloxacin in the tablets. The proposed methods were applied to pharmaceutical formulation and percent amount of drug estimated (96.08% for UV method and 102.65% for Vis method) and was found in good agreement with the label claim. Using the UV method norfloxacin showed an absorption maximum at 277 nm, in 0.1 M hydrochloridric acid medium, whereas for the Vis spectrophotometric method it reacts with chloranilic acid reagent, forming a purple solution with an absorption maximum at 520 nm. The calibrations curves were linear over the working range of 2.0-7.0 ?g.mL-1 for the UV method and 90.0-120.0 ?g/mL for the Vis method. The linear regression equation for UV method was y = 0.1303x+0.0026 (r2=0.9999) and for Vis method y = 0.0037x-0.0069 (r2 = 0.9948), they proved to be linear. The methods were completely validated according to the International Conference Harmonization (ICH) guidelines, showing good accuracy, precision, selectivity, linearity and robustness. Therefore the both methods were found to be simple, rapid, sensitive, and easily contributing to the quality control of norfloxacin tablets while being interchangeable. © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.18381 J. Sci. Res. 6 (3), 531-541 (2014)
Bioequivalence Assessment of Metformin Tablet Formulations of Bangladesh
Authors: Islam M. A. , Islam A. , Khan M. R. I. , Sharmin R. , Wahed M. I. I. , Anisuzzaman A. S. M
Published: September 2014

Six marketed oral antidiabetic metformin tablets in Bangladesh have been studied for their drug content, release profile and glucose lowering capacities. This sort of study is a good indicator for in vivo evaluation of the quality of an oral antidiabetic preparation. Marketed preparations of metformin-HCl from different manufacturers were randomly chosen for this study. The drug content was within the United State Pharmacopoeia (USP) specified limit (95-105%) in all cases. The blood glucose levels were investigated in streptozotocin-induced diabetic rats (SIDRs) after 5 hours of single dose (110 mg/kg body weight) treatment of the products; significantly (p<0.05) reduced blood glucose level by 58.1, 53.2, 50.8, 77.0, 72.9 and 49.1%, respectively; which were consistent with antihyperglycemic effects of standard metformin-HCl (71.3%). All the products were found to be qualified in lowering blood glucose level. It may be inferred that the metformin-HCl tablets of Bangladeshi manufacturers complies with the standard specifications for drug contents, dissolution and antihyperglycemic properties.© 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved. doi: http://dx.doi.org/10.3329/jsr.v6i3.19290 J. Sci. Res. 6 (3), 581-588 (2014)
A Health Care Associated Infection
Authors: Nasir Tareak Al
Published: September 2014

Abstract not available DOI: http://dx.doi.org/10.3329/pulse.v5i2.20258 Pulse Vol.5 July 2011 p.4
Utility Of Procalcitonin As A Diagnostic And Prognostic Biomarker Of Sepsis In Comparison To Culture & Other Inflammatory Markers
Authors: Nargis W , Ibrahim M , Ahamed BU , Ahmed M , Ara N
Published: September 2014

Background Rapid diagnosis and timely initiation of effective therapy are the major challenges in intensive care units (ICUs) despite the advances in critical care medicine. Procalcitonin (PCT) is an innovative valuable laboratory marker in this regard. Objectives This study was undertaken to introduce PCT as a routine tool in regional hospitals by evaluating the utility of PCT in early diagnosis as well as in assessment of severity in septic patients in comparison to the traditional methods and inflammatory markers like cultures and C-reactive Protein (CRP). Method & Materials PCT and CRP were simultaneously measured in 73 medico-surgical ICU patients. The results of PCT, CRP and microbiological cultures were compared according to the five categories of PCT concentrations and the American College of Chest Physicians (ACCP) criteria based study groups. Results The clinical presentation of 75.3 % cases revealed a range of systemic inflammatory responses (SIRS). The diagnostic accuracy of PCT was higher (75.34%) with greater specificity (72.2 %), sensitivity (76.36%), positive and negative predictive values (89.36 % and 50%), positive likelihood ratio (2.75) as well as the smaller negative likelihood ratio (0.33). Both serum PCT and CRP values in cases with sepsis, severe sepsis and septic shock were significantly higher from that of the cases with SIRS and no SIRS (p< 0.01). Conclusion The diagnostic utility of both PCT and CRP are close yet PCT is found to be superior to that of CRP or microbiological culture in terms of accuracy in identification of patients with sepsis and to assess the severity of sepsis as well DOI: http://dx.doi.org/10.3329/pulse.v5i2.20259 Pulse Vol.5 July 2011 p.5-15
Diagnosis and Management of Acute Pulmonary Embolism
Authors: Dokwal Chandra Prakash
Published: September 2014

Abstract not available DOI: http://dx.doi.org/10.3329/pulse.v5i2.20263 Pulse Vol.5 July 2011 p.31-40
Medication Management System: An Approach to Reduce Medication Error In Apollo Hospitals Dhaka
Authors: Mahmud A , Noor F , Nasrullah M
Published: September 2014

Apollo Hospitals Dhaka surely stepped ahead than any other hospital of Bangladesh for reducing medication errors significantly. From the very beginning of its establishment, reducing medication errors was taken as a major challenge and effective and approved strategies were developed when no other hospital took efforts in this regard. Strategies included tracking incidents of medication errors, analyzing, reporting & arranging proper training sessions for hospital staffs etc. All four types of errors like Prescription errors, Transcription errors, Dispensing errors and Administration errors are rectified and officially reported by hospital pharmacists. Along with these, Prescription Reviewing, Medication Reconciliation, incidents of Adverse Drug Reactions (ADR) are also monitored to ensure rational drug use for patients. With all its efforts, Apollo Hospitals Dhaka was able to reduce the rate of medication errors within the internationally acceptable range. DOI: http://dx.doi.org/10.3329/pulse.v5i2.20265 Pulse Vol.5 July 2011 p.41-47
Rare Vascular Surgery in Apollo Hospitals, Dhaka - Right Popletial to Dorsalis pedis Artery Anastomosis and Axillary Bi Femoral Bi Poplileal Bypass Grafting - limb salvage procedure
Authors: Zahangir NM , Nazmul Md , Khan TMNS , Chowdury RA , Haider Z
Published: September 2014

Bypass grafts to the dorsalis pedis artery provide excellent revascularization to ischemic foot. It is a durable and effective procedure for limb salvage. Axillo femoral-popliteal procedure offers a reasonable alternative in high-risk patients. We are reporting 2 cases of such procedures from Apollo hospitals, Dhaka. Right Popletial to Dorsalis pedis artery anastomosis was done in a 32 years old man. Interposition venous graft was done from the right popliteal artery to dorsalis pedis artery. Axillo-Bi Femoral-Bi Poplileal Bypass Grafting: was done in a 59 years old man. Knitted fabric strength graft was used. Both the patients were doing well in postoperative period. DOI: http://dx.doi.org/10.3329/pulse.v5i2.20270 Pulse Vol.5 July 2011 p.65-71
Performance of a Small-Scale, Variable Temperature Fixed Dome Digester in a Temperate Climate
Authors: Castano Juan , Martin Jay , Ciotola Richard
Published: September 2014

Small-scale digesters, similar to popular Chinese designs, have the potential to address the energy needs of smaller dairy farmers in temperate U.S. climates. To assess this potential, a 1.14 m3 (300 gallon) modified fixed-dome digester was installed and operated, at variable temperatures (5.3 to 27.9 °C) typical of the Midwestern United States, from March 2010 to March 2011 (363 days). Temperature, gas production, and other variables were recorded. The system was fed with dilute dairy manure with 6% volatile solids (VS) and an organic loading rate (OLR) ranging from 0.83 to 2.43 kg volatile solids (VS)/m3/day. The system was loaded with no interruption and exhibited no signs of inhibition from July 2010 to mid-November 2010 (129 days). During this period the digester temperature was over 20 °C with an average daily biogas production of 842 ± 69 L/day, a methane yield of 0.168 m3/kg VS added, and a Volatile Solids reduction of 36%. After the temperature dropped below 20 °C, the digester showed signs of inhibition and soured. These findings suggest that an ambient temperature, modified fixed dome digester could operate without temperature inhibition for approximately six months (169 days) a year in a temperate climate when digester temperatures exceed 20 °C. However, during colder months the digester temperature must maintained above 20 °C for viable gas production year round.
The Gouy-Stodola Theorem in Bioenergetic Analysis of Living Systems (Irreversibility in Bioenergetics of Living Systems)
Authors: Lucia Umberto
Published: September 2014

Thermodynamics studies the transformations of energy occurring in open systems. Living systems, with particular reference to cells, are complex systems in which energy transformations occur. Thermo-electro-chemical processes and transports occur across their border, the cells membranes. These processes take place with important differences between healthy and diseased states. In particular, different thermal and biochemical behaviours can be highlighted between these two states and they can be related to the energy transformations inside the living systems, in particular the metabolic behaviour. Moreover, living systems waste heat. This heat is the consequence of the internal irreversibility. Irreversibility is effectively studied by using the Gouy-Stodola theorem. Consequently, this approach can be introduced in the analysis of the states of living systems, in order to obtain a unifying approach to study them. Indeed, this approach allows us to consider living systems as black boxes and analyze only the inflows and outflows and their changes in relation to the modification of the environment, so information on the systems can be obtained by analyzing their behaviour in relation to the modification of external perturbations. This paper presents a review of the recent results obtained in the thermodynamics analysis of cell systems.
A Balanced Look at the Implications of Genomic (and Other “Omics”) Testing for Disease Diagnosis and Clinical Care
Authors: Boyd Scott , Galli Stephen , Schrijver Iris , Zehnder James , Ashley Euan , Merker Jason
Published: September 2014

The tremendous increase in DNA sequencing capacity arising from the commercialization of “next generation” instruments has opened the door to innumerable routes of investigation in basic and translational medical science. It enables very large data sets to be gathered, whose interpretation and conversion into useful knowledge is only beginning. A challenge for modern healthcare systems and academic medical centers is to apply these new methods for the diagnosis of disease and the management of patient care without unnecessary delay, but also with appropriate evaluation of the quality of data and interpretation, as well as the clinical value of the insights gained. Most critically, the standards applied for evaluating these new laboratory data and ensuring that the results and their significance are clearly communicated to patients and their caregivers should be at least as rigorous as those applied to other kinds of medical tests. Here, we present an overview of conceptual and practical issues to be considered in planning for the integration of genomic methods or, in principle, any other type of “omics” testing into clinical care.
Urinary 1-Hydroxypyrene is Associated with Oxidative Stress and Inflammatory Biomarkers in Acute Myocardial Infarction
Authors: Freitas Fernando , Brucker Natália , Durgante Juliano , Bubols Guilherme , Bulcão Rachel , Moro Angela , Charão Mariele , Baierle Marília , Nascimento Sabrina , Gauer Bruna , Sauer Elisa , Zimmer Marcelo , Thiesen Flávia , Castro Iran , Saldiva Paulo , Garcia Solange
Published: September 2014

Several studies have associated exposure to environmental pollutants, especially polycyclic aromatic hydrocarbons (PAHs), with the development of cardiovascular diseases. Considering that 1-hydroxypyrene (1-OHP) is the major biomarker of exposure to pyrenes, the purpose of this study was to evaluate the potential association between 1-OHP and oxidative stress/inflammatory biomarkers in patients who had suffered an acute myocardial infarction (AMI). After adopting the exclusion criteria, 58 post-infarction patients and 41 controls were sub-divided into smokers and non-smokers. Urinary 1-OHP, hematological and biochemical parameters, oxidative stress biomarkers (MDA, SOD, CAT, GPx and exogenous antioxidants) and the inflammatory biomarker (hs-CRP) were analyzed. 1-OHP levels were increased in post-infarct patients compared to controls (p < 0.05) and were correlated to MDA (r = 0.426, p < 0.01), CAT (r = 0.474, p < 0.001) and β-carotene (r = −0.309; p < 0.05) in non-smokers. Furthermore, post-infarction patients had elevated hs-CRP, MDA, CAT and GPx levels compared to controls for both smokers and non-smokers. Besides, β-carotene levels and SOD activity were decreased in post-infarction patients. In summary, our findings indicate that the exposure to pyrenes was associated to lipid damage and alterations of endogenous and exogenous antioxidants, demonstrating that PAHs contribute to oxidative stress and are associated to acute myocardial infarction.
Multiple Zoonotic Parasites Identified in Dog Feces Collected in Ponte de Lima, Portugal—A Potential Threat to Human Health
Authors: Mateus Teresa , Castro António , Ribeiro João , Vieira-Pinto Madalena
Published: September 2014

Dogs play many roles and their presence within people’s houses has increased. In rural settings dog faeces are not removed from the streets, representing an environmental pollution factor. Our aim was to evaluate the occurrence of environmental contamination with zoonotic intestinal parasites of three groups of dogs in Ponte de Lima, Portugal, with a particular emphasis on Echinococcus granulosus. We collected 592 dog faecal samples from the environment, farm and hunting dogs. Qualitative flotation coprological analysis was performed and the frequency in the positive samples ranged between 57.44% and 81.19% in different groups. We isolated up to four different parasites in one sample and detected seven intestinal parasitic species, genera or families overall. Ancylostomatidae was the most prevalent parasite, followed by Trichuris spp., Toxocara spp., Isospora spp., Dipylidium caninum, Taeniidae and Toxascaris leonina. Taeniidae eggs were analyzed with the PCR technique and revealed not to be from Echinococcus. The parasite prevalence and the diversity of zoonotic parasites found were high, which calls for a greater awareness of the problem among the population, especially hunters. Promoting research at the local level is important to plan control strategies. Health education should be developed with regard to farmers and hunters, and a closer collaboration between researchers, practitioners and public health authorities is needed.
Biosurfactant-and-Bioemulsifier Produced by a Promising Cunninghamella echinulata Isolated from Caatinga Soil in the Northeast of Brazil
Authors: Andrade Silva Nadielly , Luna Marcos , Santiago André , Franco Luciana , Silva Grayce , De Souza Patrícia , Okada Kaoru , Albuquerque Clarissa , Silva Carlos , Campos-Takaki Galba
Published: September 2014

A Mucoralean fungus was isolated from Caatinga soil of Pernambuco, Northeast of Brazil, and was identified as Cunninghamella echinulata by morphological, physiological, and biochemical tests. This strain was evaluated for biosurfactant/bioemulsifier production using soybean oil waste (SOW) and corn steep liquor (CSL) as substrates, added to basic saline solution, by measuring surface tension and emulsifier index and activity. The best results showed the surface water tension was reduced from 72 to 36 mN/m, and an emulsification index (E24) of 80% was obtained using engine oil and burnt engine oil, respectively. A new molecule of biosurfactant showed an anionic charge and a polymeric chemical composition consisting of lipids (40.0% w/w), carbohydrates (35.2% w/w) and protein (20.3% w/w). In addition, the biosurfactant solution (1%) demonstrated its ability for an oil displacement area (ODA) of 37.36 cm2, which is quite similar to that for Triton X-100 (38.46 cm2). The stability of the reduction in the surface water tension as well as of the emulsifier index proved to be stable over a wide range of temperatures, in pH, and in salt concentration (4%–6% w/v). The biosurfactant showed an ability to reduce and increase the viscosity of hydrophobic substrates and their molecules, suggesting that it is a suitable candidate for mediated enhanced oil recovery. At the same time, these studies indicate that renewable, relatively inexpensive and easily available resources can be used for important biotechnological processes.
G Protein-Coupled Receptors: Extranuclear Mediators for the Non-Genomic Actions of Steroids
Authors: Wang Chen , Liu Yi , Cao Ji-Min
Published: September 2014

Steroids hormones possess two distinct actions, a delayed genomic effect and a rapid non-genomic effect. Rapid steroid-triggered signaling is mediated by specific receptors localized most often to the plasma membrane. The nature of these receptors is of great interest and accumulated data suggest that G protein-coupled receptors (GPCRs) are appealing candidates. Increasing evidence regarding the interaction between steroids and specific membrane proteins, as well as the involvement of G protein and corresponding downstream signaling, have led to identification of physiologically relevant GPCRs as steroid extranuclear receptors. Examples include G protein-coupled receptor 30 (GPR30) for estrogen, membrane progestin receptor for progesterone, G protein-coupled receptor family C group 6 member A (GPRC6A) and zinc transporter member 9 (ZIP9) for androgen, and trace amine associated receptor 1 (TAAR1) for thyroid hormone. These receptor-mediated biological effects have been extended to reproductive development, cardiovascular function, neuroendocrinology and cancer pathophysiology. However, although great progress have been achieved, there are still important questions that need to be answered, including the identities of GPCRs responsible for the remaining steroids (e.g., glucocorticoid), the structural basis of steroids and GPCRs’ interaction and the integration of extranuclear and nuclear signaling to the final physiological function. Here, we reviewed the several significant developments in this field and highlighted a hypothesis that attempts to explain the general interaction between steroids and GPCRs.
Inhibition of Autophagy via Activation of PI3K/Akt Pathway Contributes to the Protection of Ginsenoside Rb1 against Neuronal Death Caused by Ischemic Insults
Authors: Luo Tianfei , Liu Guiying , Ma Hongxi , Lu Bin , Xu Haiyang , Wang Yujing , Wu Jiang , Ge Pengfei , Liang Jianmin
Published: September 2014

Lethal autophagy is a pathway leading to neuronal death caused by transient global ischemia. In this study, we examined the effect of Ginsenoside Rb1 (GRb1) on ischemia/reperfusion-induced autophagic neuronal death and investigated the role of PI3K/Akt. Ischemic neuronal death in vitro was induced by using oxygen glucose deprivation (OGD) in SH-SY5Y cells, and transient global ischemia was produced by using two vessels occlusion in rats. Cellular viability of SH-SY5Y cells was assessed by MTT assay, and CA1 neuronal death was evaluated by Hematoxylin-eosin staining. Autophagic vacuoles were detected by using both fluorescent microscopy in combination with acridine orange (AO) and Monodansylcadaverine (MDC) staining and transmission electronic microscopy. Protein levels of LC3II, Beclin1, total Akt and phosphor-Akt at Ser473 were examined by western blotting analysis. GRb1 inhibited both OGD and transient ischemia-induced neuronal death and mitigated OGD-induced autophagic vacuoles in SH-SY5Y cells. By contrast, PI3K inhibitor LY294002 counteracted the protection of GRb1 against neuronal death caused by either OGD or transient ischemia. LY294002 not only mitigated the up-regulated protein level of phosphor Akt at Ser473 caused by GRb1, but also reversed the inhibitory effect of GRb1 on OGD and transient ischemia-induced elevation in protein levels of LC3II and Beclin1.
Mechanical Forces Induce Changes in VEGF and VEGFR-1/sFlt-1 Expression in Human Chondrocytes
Authors: Beckmann Rainer , Houben Astrid , Tohidnezhad Mersedeh , Kweider Nisreen , Fragoulis Athanassios , Wruck Christoph , Brandenburg Lars , Hermanns-Sachweh Benita , Goldring Mary , Pufe Thomas , Jahr Holger
Published: September 2014

Expression of the pro-angiogenic vascular endothelial growth factor (VEGF) stimulates angiogenesis and correlates with the progression of osteoarthritis. Mechanical joint loading seems to contribute to this cartilage pathology. Cyclic equibiaxial strains of 1% to 16% for 12 h, respectively, induced expression of VEGF in human chondrocytes dose- and frequency-dependently. Stretch-mediated VEGF induction was more prominent in the human chondrocyte cell line C-28/I2 than in primary articular chondrocytes. Twelve hours of 8% stretch induced VEGF expression to 175% of unstrained controls for at least 24 h post stretching, in promoter reporter and enzyme-linked immunosorbent assay (ELISA) studies. High affinity soluble VEGF-receptor, sVEGFR-1/sFlt-1 was less stretch-inducible than its ligand, VEGF-A, in these cells. ELISA assays demonstrated, for the first time, a stretch-mediated suppression of sVEGFR-1 secretion 24 h after stretching. Overall, strained chondrocytes activate their VEGF expression, but in contrast, strain appears to suppress the secretion of the major VEGF decoy receptor (sVEGFR-1/sFlt-1). The latter may deplete a biologically relevant feedback regulation to inhibit destructive angiogenesis in articular cartilage. Our data suggest that mechanical stretch can induce morphological changes in human chondrocytes in vitro. More importantly, it induces disturbed VEGF signaling, providing a molecular mechanism for a stress-induced increase in angiogenesis in cartilage pathologies.
Economic Valuation of Land Uses in Oudomxay Province, Lao PDR: Can REDD+ be Effective in Maintaining Forests?
Authors: Wong Grace , Darachanthara Souphith , Soukkhamthat Thanongsai
Published: September 2014

The rapid economic growth in Lao PDR over the last two decades has been driven by the natural resource sectors and commercialization in the agriculture sector. Rural landscapes are being transformed over the past decade from land use mosaics of subsistence and smallholder farms to large-scale plantations dominated by a few commercial crops. The capacity of these commercial agriculture plantations to alleviate rural poverty, part of the Government of Lao PDR’s national development policy, is increasingly weighed against its long-term impacts on ecosystem services and sustainability of land and forest resources. We used an extended cost-benefit approach (CBA) to integrate certain environmental elements to traditional financial analysis for a comparative look at four land use systems in the northern part of the country. The CBA results demonstrate that commercial agriculture (maize and rubber plantations) does have the potential to support poverty alleviation in the short-run. It, however, exposes the land to serious environmental risks. By comparison, the traditional land uses studied (upland rice farming and non-timber forest products collecting) are largely subsistence activities that are still considered as sustainable, though this is increasingly affected by changing market and population dynamics. The results suggest that longer-term environmental costs can potentially cancel out short-term gains from the commercialization to mono-crop agriculture. Incentives for conserving ecosystem services (such as the Reducing Emissions from Deforestation and forest Degradation (REDD+) mechanism) may have a potential role in supporting diversification of traditional livelihoods and increasing the competitiveness of maintaining forests.