bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeted Therapies in HER2-Positive Breast Cancer - a Systematic Review
Authors: Schramm Amelie , De Gregorio Nikolaus , Widschwendter Peter , Fink Visnja , Huober Jens
Published: June 2015

About 20% of all breast cancer patients have a human epidermal growth factor receptor 2 (HER2)-positive breast tumor. This entity underwent an impressive change in prognosis, with notable improvement of progression-free survival and overall survival. Due to more aggressive tumors and no specific therapy, HER2 overexpression was historically seen as a negative prognostic marker, with worse prognosis and increased risk of recurrent disease. Trastuzumab, the first anti-HER2 antibody, revolutionized the systemic therapy options in HER2-positive breast cancer and initiated several targeted therapies and more personalized treatment strategies. Over the years, multiple HER2-targeting drugs stepped into clinical practice, for the curative as well as the metastatic situation. This review summarizes the targeted treatment options in HER2-positive breast cancer and their current impact in the clinical routine. Results of the most outstanding trials in HER2-targeted therapies and important ongoing trials are subsequently described for an up-to-date overview.
Blastomycosis and Pregnancy: An Unusual Postpartum Disease Course
Authors: Surprenant David , Kaniszewska Monika , Hutchens Kelli , Go Christine , O'Keefe Paul , Swan James , Tung Rebecca
Published: June 2015

Blastomyces dermatitidis is responsible for systemic mycoses. It is predominantly caused by inhalation of spores and often manifests as pneumonia, which can potentially disseminate; however, direct cutaneous inoculation may also occur. Blastomycosis in the perigravid period is exceedingly rare. The partial immunosuppressive state induced by pregnancy can engender more severe infections and is associated with a risk of vertical transmission. Published cases describe postpartum symptomatic improvement accompanying immune reconstitution, even in the absence of treatment. We present a 31-year-old gravid female with multifocal cutaneous blastomycosis. After delivering a healthy full-term infant with no evidence of congenital infection, the patient's cutaneous lesions continued to worsen. At 6 weeks postpartum she was treated with oral itraconazole and demonstrated clinical improvement after 5 months of therapy. This case highlights the importance of prompt disease recognition, understanding of risk factors and initiation of appropriate antifungal therapy of blastomycotic infection occurring in the unique setting of pregnancy.
Burden of Traumatic Brain Injury in New Zealand: Incidence, Prevalence and Disability-Adjusted Life Years
Authors: Te Ao Braden , Tobias Martin , Ameratunga Shanthi , McPherson Kathryn , Theadom Alice , Dowell Anthony , Starkey Nicola , Jones Kelly , Barker-Collo Suzanne , Brown Paul , Feigin Valery ,   on behalf of the BIONIC study group
Published: June 2015

Objective: The study aimed to estimate the incidence, prevalence and disability-adjusted life years (DALY) for traumatic brain injury (TBI) in New Zealand (NZ) in 2010. Methods: A multi-state life table model was constructed using inputs from the Brain Injury Outcomes New Zealand in the Community study for the first-ever incidence of TBI in a lifetime and its severity distribution, from the NZ Ministry of Health's Mortality Collection for the data on TBI mortality and from Statistics of NZ for the population data. The modeled estimate of prevalence was combined with the disability weights for TBI (by stage and severity level) from the Global Burden of Disease 2010 study to obtain estimates of health loss (DALYs) for TBI. Results: Approximately, 11,300 first-ever incident TBIs occurred in NZ during 2010, with 527,000 New Zealanders estimated to have ever experienced a TBI (prevalent cases). The estimated 20,300 DALYs attributable to TBI accounted for 27% of total injury-related health loss and 2.4% of DALYs from all causes. Of the total DALYs attributable to TBI, 71% resulted from fatal injuries. However, non-fatal outcomes accounted for a substantial share of the burden (29%) with mild TBI making the greater contribution of non-fatal outcomes (56%). Conclusions: The burden of TBI in NZ is substantial, and mild TBI contributes to a major part of non-fatal outcomes.
Effects of Synchronization during Noninvasive Intermittent Mandatory Ventilation in Preterm Infants with Respiratory Distress Syndrome Immediately after Extubation
Authors: Huang Li , Mendler Marc Robin , Waitz Markus , Schmid Manuel , Hassan Mohammad Ahmad , Hummler Helmut D.
Published: June 2015

Background: Noninvasive ventilation is increasingly used in very-low-birth-weight infants (VLBWI) to reduce complications that occur with invasive ventilation. However, the physiological effects of synchronization during noninvasive nasal intermittent mandatory ventilation (IMV) have not been tested in VLBWI immediately after extubation. Objective: We aimed to study the short-term effects of synchronized nasal IMV (S-NIMV) compared to nonsynchronized nasal IMV (NIMV) on breathing effort as measured by phasic esophageal pressure (Pe) deflection, spontaneous respiratory rate (RR), gas exchange, cerebral tissue oxygen saturation (StO2) and intermittent episodes of bradycardia or hypoxemia in VLBWI recovering from respiratory distress syndrome (RDS). Methods: Fourteen VLBWI recovering from RDS were studied using a randomized cross-over design during both S-NIMV and NIMV (of 2 h each) immediately after extubation. Results: Phasic Pe deflection, spontaneous RR and transcutaneous PCO2 decreased significantly while transcutaneous PO2 and synchrony rate (defined as peak ventilator pressure delivered within the first half of spontaneous inspiration) increased significantly during S-NIMV compared to during NIMV. There was no difference in blood pressure, average arterial oxygen saturation (SpO2), cerebral StO2, fractional tissue oxygen extraction of the brain and severe bradycardia (defined as time with a heart rate <100 beats/min lasting ≥10 s) and in hypoxemic episodes (SpO2 <80%) between the two modes. Conclusion: Synchronization during nasal ventilation immediately after extubation in VLBWI recovering from RDS improved gas exchange and decreased the respiratory effort, and it could therefore be considered to provide a more efficient respiratory support and synchrony.
Capgras Syndrome in a Patient with Parkinson's Disease after Bilateral Subthalamic Nucleus Deep Brain Stimulation: A Case Report
Authors: Kyrtsos Christina Rose , Stahl Mark C. , Eslinger Paul , Subramanian Thyagarajan , Lucassen Elisabeth B.
Published: June 2015

Capgras syndrome is a delusional misidentification syndrome (DMS) which can be seen in neurodegenerative diseases such as Lewy body dementia and, to a lesser extent, in Parkinson's disease (PD). Here, we report the case of a 78-year-old man with a history of idiopathic PD who developed Capgras syndrome following bilateral subthalamic nucleus deep brain stimulation (DBS) implantation. As the risk of DMS has been related to deficits in executive, memory, and visuospatial function preoperatively, this case highlights the importance of continuing to improve patient selection for DBS surgery. Capgras syndrome is a rare potential complication of DBS surgery in PD patients with preexisting cognitive decline.
Ginsenoside Rg1 Ameliorates Motor Function in an Animal Model of Parkinson's Disease
Authors: Jiang Wenda , Wang Zhejian , Jiang Yiyang , Lu Meili , Li Xin
Published: June 2015

Aims: Parkinson's disease (PD) is a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra (SN) and diminished dopamine levels in the striatum. Accumulating evidence supported that ginsenoside Rg1, the major pharmacologically active compound of ginseng, has a wide range of neurotrophic and neuroprotective effects under physiological and pathological conditions. Although Rg1 administration protects dopaminergic neurons in a rat model of PD, it is unclear if Rg1 treatment ameliorates motor function in PD. Methods: Using the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) that causes dopaminergic neurodegeneration, we investigated the effect of Rg1 on 3 tests of motor behaviors in mice: the accelerating rotarod, wire suspension and pole tests. Results: The results showed that Rg1 treatment (10 mg/kg, i.p.) succeeded in restoring motor functions to physiological level in MPTP-treated mice. Importantly, these behavioral ameliorations were accompanied by an attenuation of the MPTP-induced loss of dopaminergic neurons in the SN and striatum. Conclusions: These findings indicate that Rg1 can significantly rescue the deficit of motor function in mice model of PD, and suggest that Rg1 may be a potential therapeutic agent against PD and related disorders.
Normobaric Intermittent Hypoxia over 8 Months Does Not Reduce Body Weight and Metabolic Risk Factors - a Randomized, Single Blind, Placebo-Controlled Study in Normobaric Hypoxia and Normobaric Sham Hypoxia
Authors: Gatterer Hannes , Haacke Sven , Burtscher Martin , Faulhaber Martin , Melmer Andreas , Ebenbichler Christoph , Strohl Kingman P. , Högel Josef , Netzer Nikolaus C.
Published: June 2015

Objective: Both a 1- to 4-week continuous or intermittent stay and moderate exercise in hypoxia versus normoxia can lead to weight loss. We examined the reproducibility and durability of added hypoxic exposure in a feasible health program of several months. Methods: 32 obese persons, randomly assigned to either a hypoxia (age 50.3 ± 10.3 years, BMI 37.9 ± 8.1 kg/m²) or a normoxia (age 52.4 ± 7.9 years, BMI 36.3 ± 4.0 kg/m²) group, completed 52 exercise sessions within 8 months. Participants exercised for 90 min (65-70% HRpeak) either at a simulated altitude of 3,500 m or in normoxia, and rested for further 90 min at 4,500 m or normoxia. Before, after 5 weeks, after 3 months, and after the intervention, body composition and exercise capacity were determined. Risk markers (e.g., blood pressure, cholesterol) were measured before, after 3 months, and after the intervention period. Results: Body weight, BMI, waist and hip circumference, Ppeak and BPsys improved over time (p < 0.05) but without group difference. Fat mass reductions correlated with HDL changes (r = -0.427; p < 0.05) in the entire group. Conclusion: Long-term, moderate intensity exercise and rest in hypoxia does not lead to higher reductions in body weight than normoxia alone. Therefore, for weight loss and metabolic markers hypoxic exposure does not add effects at least when stimuli (i.e., hypoxia dose, exercise intensity/duration) are unaltered throughout the intervention.
Primary Peritoneal Carcinoma Initially Presenting as Atypical Cervical Lymphadenopathy
Authors: Kim Yun Mi , Lee Yeong Min , Lee Si Hyeing , Lee Dong Woo , Kim Ki Hyang
Published: June 2015

Primary peritoneal carcinoma (PPC) is a rare cancer arising from the extraovarian peritoneum and is of müllerian origin. PPC and epithelial ovarian carcinoma share similar clinical, histopathological, and immunohistochemical features. Clinical symptoms and findings include abdominal distension and ascites. We experienced 2 cases of PPC which initially presented with cervical lymphadenopathy. Here, we report the 2 cases and review the literature.
Impact of Endoscopic Ultrasound Procedures in Various Pancreatobiliary Disorders in Indonesia Based on a Case Series in a Private Hospital
Authors: Lesmana C. Rinaldi A. , Ho Khek Yu , Lesmana Laurentius A.
Published: June 2015

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a common technique for assessing the pancreas and the biliary system; however, the potential complications have raised concern among endoscopists and patients. Recently, the need of endoscopic ultrasound (EUS) as an additional tool of assessment before the ERCP procedure has been increasing. The need of EUS in developing countries is still a matter of debate regarding the cost, investment, and training. Here, we report the significant impact of EUS on several unselected interesting cases of pancreatobiliary disorders. Method: We selected several interesting cases from the patients who underwent EUS at our private hospital in Jakarta, Indonesia. The EUS procedures were performed by one experienced endosonographer and one EUS trainee who are very experienced with transabdominal ultrasound. The equipment was an Olympus JF UCT 180 EUS scope which was connected to an Aloka IPF-1701C ultrasound machine (Tokyo, Japan). Results: Five interesting cases were included from patients who underwent EUS due to pancreatobiliary disorders. The cases included recurrent pancreatitis due to pancreatic stone at the small branch that obstructed the main pancreatic duct, common bile duct (CBD) stone with insignificant duct dilatation, pancreatic head cancer with total obstruction at the distal CBD and portal vein infiltration, pancreas divisum in a young girl, and distal CBD mass that caused obstructive jaundice. Conclusions: The EUS procedure has shown a significant impact in managing patients with pancreatobiliary diseases. In most developing countries, EUS needs to be evaluated further regarding the cost, investment, and training.
Aortic Stiffness and Kidney Disease in an Elderly Population
Authors: Michener Katherine H. , Mitchell Gary F. , Noubary Farzad , Huang Naya , Harris Tamara , Andresdottir Margret B. , Palsson Runolfur , Gudnason Vilmundur , Levey Andrew S.
Published: June 2015

Background/Aims: The causes of chronic kidney disease (CKD) in older people are not well understood. Aortic stiffness increases with age and results in the transmission of increased pulsatility into the kidney microvasculature, potentially contributing to CKD in older populations. Methods: We utilized data from the Age, Gene/Environment, Susceptibility-Reykjavik Study, a community-based prospective cohort study of cardiovascular disease (CVD) in Iceland. The relationship of carotid pulse pressure (CPP) and carotid-femoral pulse wave velocity (CFPWV) with estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and urine albumin-creatinine ratio (ACR) was assessed using linear regression, adjusting for demographics and CVD risk factors. Results: 940 participants (mean (SD) age 75.8 (4.7) years, mean (SD) CFPWV 12.9 (4.2) m/s, mean (SD) CPP 69 (21) mm Hg, mean (SD) eGFR 68 (16) ml/min/1.73 m2, and median (IQR) ACR 3 (2-6) mg/g) were included in this study. At CPP greater than 85 mm Hg, a higher CPP was associated with a lower eGFR in unadjusted analyses but not after adjustment. CPP was significantly associated with a higher ACR in fully adjusted models (β (95% CI) = 0.14 (0.03, 0.24) ln mg/g per SD). Higher CFPWV was associated with lower eGFR and higher ACR in unadjusted analyses but not after adjustment. Conclusion: Greater aortic stiffness may be associated with modestly higher levels of albuminuria in the elderly. The association between aortic stiffness and lower eGFR may be confounded by age and CVD risk factors.
A Pathological Scoring System to Predict Renal Outcome in Diabetic Nephropathy
Authors: Hoshino Junichi , Mise Koki , Ueno Toshiharu , Imafuku Aya , Kawada Masahiro , Sumida Keiichi , Hiramatsu Rikako , Hasegawa Eiko , Yamanouchi Masayuki , Hayami Noriko , Suwabe Tatsuya , Sawa Naoki , Hara Shigeko , Fujii Takeshi , Ohashi Kenichi , Ubara Yoshifumi , Takaichi Kenmei
Published: June 2015

Background: With the association between diabetic nephropathy (DN) and renal outcome being increasingly clear, we aimed at creating a new DN pathological scoring system that could predict the renal outcome. Methods: We studied 205 patients with DN confirmed by renal biopsy, sometime between March 1985 and January 2010, who met the inclusion criteria. Renal biopsy included clinical parameters and Tervaert classifications. Hazard ratios (HRs) for death-censored end-stage renal disease (ESRD) were estimated by adjusted Cox proportional-hazards regression. The overall pathological risk score (D-score) was calculated by summing the products of beta coefficient and bootstrap-inclusion fractions, its predictive utility evaluated by Kaplan-Meier methods and c-statistics for a 10-year risk of ESRD. Results: The D-scores of glomerular classes 1, 2A, 2B, 3, and 4 were, respectively, 0, 3, 4, 6, and 6. Those of interstitial fibrosis and tubular atrophy classes 0, 1, 2, and 3 were 0, 7, 9, and 11, and those of interstitial inflammation classes 0, 1, and 2 were 0, 3, and 4, respectively. The D-score of hyalinosis class 2 was 3 and that of arteriosclerosis class 2 was 1. So, a patient's D-score could be 0-25. HRs for ESRD in patients with D-score ≤14, 15-18, 19-21, and 22-25 were, respectively, 1.00 (reference) 16.21 (95% confidence interval (CI), 1.86-140.90), 19.78 (95% CI, 2.15-182.40), and 45.46 (95% CI, 4.63-446.68) after adjusting for clinical factors. The c-statistics suggested a better predictive ability for a 10-year renal death with models that included the D-score. Conclusion: Prediction of DN patients' renal outcome was better with the D-score than without it. Patients with a D-score ≤14 had excellent renal prognosis.
Estimated Pulmonary Artery Systolic Pressure and Self-Reported Physical Function in Patients on Hemodialysis
Authors: Abreo Adrian P. , Herzog Charles A. , Kutner Nancy G. , Lea Janice , Johansen Kirsten L.
Published: June 2015

Background/Aims: Patients on chronic hemodialysis have a high prevalence of heart disease and poor self-reported physical function. The association between structural heart disease and self-reported physical function in patients on hemodialysis is unknown. Methods: We studied the association between elevated pulmonary artery systolic pressure (PASP) and self-reported physical function in ESRD in 253 patients in the USRDS ACTIVE/ADIPOSE study between 2009 and 2011. We used multivariate linear regression with PASP obtained from clinical echocardiogram reports as the primary predictor and the Physical Function (PF) subscale of the SF-36 as the primary outcome. To determine whether associations between PASP and PF were driven by fluid overload or left ventricular hypertrophy, we assessed whether PASP was associated with bioimpedance spectroscopy (BIS)-derived extracellular water (ECW) and with left ventricular posterior wall thickness. Results: In a multivariable model, each 10 mm Hg higher PASP was associated with a 3.32-point lower PF score (95% CI -5.95, -0.68). In a multivariable model that included BIS estimates, both left ventricular posterior wall thickness (LVPW, per 5 mm) and ECW were associated with a higher PASP (LVPW 4.21 mm Hg, 95% 0.38-8.04; ECW 1.12 mm Hg per liter, 95% CI 0.07-2.18). Higher LVPW and ECW were independently associated with a lower PF score. Conclusion: Left ventricular hypertrophy and elevated pulmonary pressure are associated with worse self-reported physical function in patients on hemodialysis. The role of chronic volume overload on PASP and PF score should be evaluated in a prospective manner.
Trends in Anemia Management Practices in Patients Receiving Hemodialysis and Peritoneal Dialysis: A Retrospective Cohort Analysis
Authors: Wetmore James B. , Peng Yi , Monda Keri L. , Kats Allyson M. , Kim Deborah H. , Bradbury Brian D. , Collins Allan J. , Gilbertson David T.
Published: June 2015

Background/Aims: Recent changes in clinical practice guidelines and reimbursement policies may have affected the use of anemia-related medications and red blood cell (RBC) transfusions in peritoneal dialysis (PD) and hemodialysis (HD) patients. We sought to compare patterns of erythropoiesis-stimulating agents (ESA) and intravenous (IV) iron use, achieved hemoglobin levels, and RBC transfusion use in PD and HD patients. Methods: In quarterly cohorts of prevalent dialysis patients receiving persistent therapy (>3 months), 2007-2011, with Medicare Parts A and B coverage, we assessed ESA and IV iron use and dose, RBC transfusions, and hemoglobin levels. Quarterly transfusion rates were calculated. Results: Observable PD and HD patients numbered 14,958 and 221,866 in Q1/2007 and 17,842 and 256,942 in Q4/2011. Adjusted ESA use was lower in PD (71.4-80.1%) than in HD (86.9-92.0%) patients, decreasing from 80.1% (Q1/2010) to 71.4% (Q4/2011) in PD patients, and from 92.0 to 86.9% in HD patients. The mean adjusted ESA dose decreased by 67.5% in PD and 58.4% in HD patients. IV iron use tended to increase, peaking at 39.3% for PD (Q3/2011) and 80.5% for HD (Q2/2011) patients. Adjusted mean hemoglobin levels fell from 11.7 to 10.6 mg/dl in PD and from 12.0 to 10.7 mg/dl in HD ESA users; adjusted transfusion rates increased from 2.4 to 3.0 per 100 patient-months in PD and from 2.6 to 3.3 in HD patients. Conclusions: In patients receiving persistent dialysis, dose and frequency of ESA administrations decreased during the period 2007-2011. Mean hemoglobin levels decreased by more than 1 g/dl, while transfusion rates increased by approximately 25%.
Extracellular Uridine Triphosphate and Adenosine Triphosphate Attenuate Endothelial Inflammation through miR-22-Mediated ICAM-1 Inhibition
Authors: Gidlöf Olof , Sathanoori Ramasri , Magistri Marco , Faghihi Mohammad Ali , Wahlestedt Claes , Olde Björn , Erlinge David
Published: June 2015

Adenosine and uridine triphosphate (ATP and UTP) can act as extracellular signalling molecules, playing important roles in vascular biology and disease. ATP and UTP acting via the P2Y2-receptor have, for example, been shown to regulate endothelial dilatation, inflammation and angiogenesis. MicroRNAs (miRNAs), a class of regulatory, short, non-coding RNAs, have been shown to be important regulators of these biological processes. In this study, we used RNA deep-sequencing to explore changes in miRNA expression in the human microvascular endothelial cell line HMEC-1 upon UTP treatment. The expression of miR-22, which we have previously shown to target ICAM-1 mRNA in HMEC-1, increased significantly after stimulation. Up-regulation of miR-22 and down-regulation of cell surface ICAM-1 were confirmed with qRT-PCR and flow cytometry, respectively. siRNA-mediated knockdown of the P2Y2-receptor abolished the effect of UTP on miR-22 transcription. Leukocyte adhesion was significantly inhibited in HMEC-1 following miR-22 overexpression and treatment with UTP/ATP. In conclusion, extracellular UTP and ATP can attenuate ICAM-1 expression and leukocyte adhesion in endothelial cells through miR-22.
Wells' Syndrome Mimicking Facial Cellulitis: A Report of Two Cases
Authors: Cormerais Maxence , Poizeau Florence , Darrieux Laure , Tisseau Laurent , Safa Gilles
Published: June 2015

Wells' syndrome (WS), or eosinophilic cellulitis, is an uncommon inflammatory dermatosis of unknown etiology that typically presents with pruritic cellulitis-like plaques on the extremities. Therefore, WS is often misdiagnosed as bacterial cellulitis due to its similarity in presentation. Here, we report two cases of WS that masqueraded as bacterial facial cellulitis. Under treatment with oral prednisone and/or a combination therapy with levocetirizine and hydroxyzine, both patients showed a dramatic improvement of the skin lesions. These cases highlight the need for clinicians to consider WS in the differential diagnosis when evaluating a patient with facial cellulitis that does not respond to an initial antimicrobial regimen. In addition, our cases suggest that combination therapy with levocetirizine and hydroxyzine may be successfully used as corticosteroid-sparing treatment or to prevent relapse after the discontinuation of corticosteroid treatment.
Free-Floating Iris Cyst in a Patient with Recurrent Iritis
Authors: Teong Joanne M.Y. , Adler Paul A. , Fuzzard Dujon R.W.
Published: June 2015

Purpose: We describe an unusual clinical finding of a free-floating iris cyst in a patient with recurrent iritis. Method: The clinical finding of a free-floating iris cyst was recorded using slit-lamp photography. Results: A 39-year-old male with a 5-year history of recurrent right iritis was found to have a small mobile iris cyst within his right anterior chamber, first identified 3 years ago. The patient did not experience any discomfort or visual symptoms resulting from the cyst. Conclusion: Surgical removal is not indicated for asymptomatic non-progressive free-floating iris cysts. The significance of a free-floating iris cyst in the setting of recurrent iritis remains unknown.
Nicotine-Induced Modulation of the Cholinergic Twitch Response in the Ileum of Guinea Pig
Authors: Donnerer Josef , Liebmann Ingrid
Published: June 2015

In the present study, the direct drug effects of nicotine and its effects on the cholinergic twitch responses of the electrically stimulated longitudinal muscle-myenteric plexus strip from the ileum of guinea pig were investigated. Nicotine dose-dependently (0.3-10 µmol/l) evoked the well-known contractile responses on its own. Whereas the interposed twitch responses remained present without a change in height at 1 µmol/l nicotine, a nicotine concentration of 3 µmol/l slightly and a concentration of 10 µmol/l markedly diminished the twitch during their presence. After the washout of 1-10 µmol/l nicotine, the height of the twitch response was also temporarily and significantly reduced by 30-77%. The P2X purinoceptor agonist αβ-methylene ATP (1-10 µmol/l) dose-dependently induced contractions on its own and reduced the twitch response during its presence in the organ bath; however, it did not diminish the twitch responses after washout of the drug as nicotine did. The P2X antagonist pyridoxalphosphate-6-azophenyl-2′-4′-disulphonic acid, the NMDA channel blocker MK-801 and the inhibitor of small conductance Ca2+-activated K+ (SK) channels apamin reduced the contractile effect of 1 µmol/l nicotine. Apamin also significantly prevented the ‘post-nicotine inhibition of the twitch' following the washout of 1-3 µmol/l nicotine. As a conclusion, we provide evidence for a functional interaction between nicotinic receptors and the P2X receptors in the ileum of the guinea pig. The ‘post-nicotine inhibition of the twitch' is not due to nicotinic acetylcholine receptor desensitization or transmitter depletion, but most probably the secondary effects of nicotine on SK channels determine the reduced cholinergic motor neuron excitability.
The Blood Group A Genotype Determines the Level of Expression of the Blood Group A on Platelets But Not the Anti-B Isotiter
Authors: Lehner Barbara , Eichelberger Beate , Jungbauer Christof , Panzer Simon
Published: June 2015

Background: The extent of expression of the blood group A on platelets is controversial. Further, the relation between platelets' blood group A expression and the titers of isoagglutinins has not been thoroughly investigated, so far. Methods: We evaluated the relation between the genotype with platelets' blood group A and H expression estimated by flow cytometry and the titers of isoagglutinins. Results: The A expression varied between genotypes and within genotypes. However, the expression in A1 was stronger than in all other genotypes (p < 0.0001). An overlap of expression levels was apparent between homozygous A1A1 and heterozygous A1 individuals. Still, The A1A1 genotype is associated with a particularly high antigen expression (p = 0.009). Platelets' A expression in A2 versus blood group O donors was also significant (p = 0.007), but there was again an overlap of expression. The secretor status had only little influence on the expression (p = 0.18). Also, isoagglutinin titers were not associated with genotypes. Conclusion: To distinguish between A1 and A2 donors may reduce incompatible platelet transfusions and therefore be favorable on platelet transfusion increment. Clinical data are needed to support this notion.
Prevalence and Related Risk Factors of Overweight and Obesity among the Adult Population in the Balearic Islands, a Mediterranean Region
Authors: Coll Josep L. , Bibiloni Maria del Mar , Salas Rogelio , Pons Antoni , Tur Josep A.
Published: June 2015

Objective: To assess the prevalence and risk factors of overweight (OW) and obesity (OB) by BMI and abdominal obesity (AO) by waist-to-height ratio, (WHtR) among the Balearic Islands' adult population. Methods: Cross-sectional nutritional survey carried out in the Balearic Islands (2009-2010). A random sample (n = 1,081) of young (18-35 years) and middle-aged adults (36-55 years) were interviewed and anthropometrically measured. OW (BMI 25.0-29.9 kg/m2) and OB (BMI ≥ 30 kg/m2) were defined according to WHO criteria. AO was defined as WHtR ≥ 0.5. Socio-economic and lifestyle determinants were considered. Results: The overall prevalence of OW/OB and AO was 29.4% (95% confidence interval (95% CI) 26.9-32.3%), 11.2% (95% CI 9.5-13.2%) and 33.1% (95% CI 30.4-36.0%), respectively. Men showed higher prevalence of OW (35.9%, 95% CI 31.6-40.5%) and AO (37.9%, 95% CI 33.6-42.5%) than women (OW 24.9%, 95% CI 21.7-28.4%; AO 29.7%, 95%CI 26.2-33.4%). Overall prevalence of OB was 11.8% (95% CI 9.1-15.1%) in men and 10.8% (95% CI 8.6-13.5%) in women. Age and no leisure-time physical activity (LTPA) were main risk factors associated with OW/OB and AO. Living with at least one child at home and to be married in men as well as to be unemployed, to be born in South America, and a low level of education in women were associated with AO. Conclusions: Men showed higher prevalence of OW and AO than women. In both sexes, age is the main risk factor associated with OW/OB and AO; in men also the absence of LTPA plays a significant role.
Central Administration of the Ciliary Neurotrophic Factor Analogue, Axokine, Does Not Play a Role in Long-Term Energy Homeostasis in Adult Mice
Authors: Borg Melissa L. , Reichenbach Alex , Lemus Moyra , Oldfield Brian J. , Andrews Zane B. , Watt Matthew J.
Published: June 2015

Background/Aims: Ciliary neurotrophic factor (CNTF) exerts powerful anorectic effects and has been suggested to regulate long-term energy balance by inducing adult neurogenesis in the arcuate nucleus of the hypothalamus. Methods: The CNTF analogue, Axokine, was infused into the lateral ventricle of high-fat-fed mice for 1 week. Food intake, energy expenditure, body mass, glucose metabolism, and neurogenesis in the arcuate nucleus (ARC) of the hypothalamus were assessed 3 weeks after cessation of Axokine treatment. Results: Short-term administration of Axokine induced an anorexic response but did not promote sustained weight loss. Instead, a rapid rebound in food intake and body mass occurred immediately after cessation of Axokine treatment, and this tended to reduce insulin sensitivity. Immunolabeling of 5-bromo-2′-deoxyuridine revealed limited neurogenesis in the ARC 3 weeks after Axokine treatment. Conclusion: These findings suggest that Axokine/CNTF does not induce substantial or sustained ARC neurogenesis or contribute to the long-term regulation of energy balance in mice.
FEATURES OF THE EXCIPIENTS SELECTION FOR SEMI-SOLID DOSAGE FORMS
Authors: Shostak T. A. , Bilous S. B. , Gudz’ N. I. , Kalynyuk T. G.
Published: June 2015

The requirements for the selection of excipients during the pharmaceutical development of semi-solid medicinal preparations for cutaneous application were generalized from a point of view of their impact on the quality, efficacy and safety of medicinal preparations. It was justified which excipients from the examined groups should be used for the pharmaceutical development of ointments, gels, and creams. The information about physico-chemical and technological properties of excipients and their compatibility was summarized.
ВИВЧЕННЯ ДОПОМІЖНИХ РЕЧОВИН ДЛЯ СТВОРЕННЯ ОРОМУКОЗАЛЬНИХ ТАБЛЕТОК НА ОСНОВІ СУБСТАНЦІЇ АЛЬТАБОР
Authors: Крутських Т. В. , Кобилінська В. І. , Шаламай А. С.
Published: June 2015

обрано допоміжні речовини для маскування гірко-в’яжучого смаку субстанції альтабор для виготовлення оромукозальних таблеток.
МАРКЕТИНГОВИЙ АНАЛІЗ АСОРТИМЕНТУ ЛІКАРСЬКИХ ПРЕПАРАТІВ ДЛЯ ЛІКУВАННЯ ВАРИКОЗНОГО РОЗШИРЕННЯ ВЕН І ЗАПАЛЬНИХ ЗАХВОРЮВАННЬ СУГЛОБІВ
Authors: Сімонян Л. С. , Грубник І. М.
Published: June 2015

досліджено асортимент лікарських засобів для застосування при варикозному розширенні вен і запальних захворювань суглобів на фармацевтичному ринку України. Встановлено, що в досліджуваному асортименті препаратів референтної групи 70 % від загальної кількості складають гелі, 25 % мазі і 5 % креми.
ЗМІНИ ГІСТОЛОГІЧНОЇ БУДОВИ ПЕЧІНКИ ЩУРІВ ЗА УМОВ ТЕТРАХЛОРМЕТАНОВОГО ГЕПАТИТУ ТА КОРЕКЦІЇ ГУСТИМ ЕКСТРАКТОМ ІЗ ЛИСТЯ ШОВКОВИЦІ ЧОРНОЇ
Authors: Герасимець І. І.
Published: June 2015

проведено гістологічне вивчення впливу густого екстракту з листя шовковиці чорної на перебіг вільнорадикальних процесів у печінці щурів, уражених тетрахлорметаном. Встановлено, що під впливом досліджуваного фармакологічного препарату зменшуються порушення гістологічної структури печінки, які виникають при гострому тетрахлорметановому гепатиті.
Is There Still a Role for Complex Fractionated Atrial Electrogram Ablation in Addition to Pulmonary Vein Isolation in Patients With Paroxysmal and Persistent Atrial Fibrillation?
Authors: Providência Rui , Lambiase Pier D. , Srinivasan Neil , Ganesh Babu Girish , Bronis Konstantinos , Ahsan Syed , Khan Fakhar Z. , Chow Anthony W. , Rowland Edward , Lowe Martin , Segal Oliver R.
Published: June 2015

Background—

Ablation of complex fractionated atrial electrograms (CFAEs) has been proposed as a strategy to improve outcomes in atrial fibrillation (AF) catheter ablation, but the use of this technique remains contentious. We aimed to assess the impact of CFAE ablation in addition to pulmonary vein isolation (PVI) in patients undergoing ablation for AF.

Methods and Results—

We performed a random effects meta-analysis of studies comparing PVI versus PVI+CFAE ablation. The outcomes of freedom from AF/atrial tachycardia after 1 or several ablation procedures and acute procedural–related complications were assessed. Studies were searched on MEDLINE, EMBASE, COCHRANE, and
clinicaltrials.gov
, and sensitivity analyses were performed. Thirteen studies including a total of 1415 patients were considered eligible. Additional ablation of CFAEs resulted in no improvement in mid-term procedural outcome or freedom from AF or atrial tachycardia (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.58–1.10;
P
=0.17). Sensitivity analysis of 398 paroxysmal AF ablation procedures showed no incremental benefit of CFAE ablation (OR, 0.80; 95% CI, 0.46–1.38;
P
=0.42). PVI+CFAE ablation versus PVI alone did not improve the overall rate of freedom from AF or atrial tachycardia in patients with persistent AF (OR, 1.01; 95% CI, 0.63–1.64;
P
=0.96) or longstanding persistent AF (OR, 0.84; 95% CI, 0.24–2.96;
P
=0.79). There was no increase in procedural-related adverse events (OR, 1.06; 95% CI, 0.41–2.75;
P
=0.91).

Conclusions—

Despite the apparent safety of this technique, CFAE ablation did not improve freedom from AF/atrial tachycardia in patients with paroxysmal or persistent AF. The role of CFAE ablation in addition to PVI should be questioned and other alternatives assessed to improve the outcome of AF ablation.
Expansion and Characterization of Neonatal Cardiac Pericytes Provides a Novel Cellular Option for Tissue Engineering in Congenital Heart Disease
Authors: Avolio Elisa , Rodriguez‐Arabaolaza Iker , Spencer Helen L. , Riu Federica , Mangialardi Giuseppe , Slater Sadie C. , Rowlinson Jonathan , Alvino Valeria V. , Idowu Oluwasomidotun O. , Soyombo Stephanie , Oikawa Atsuhiko , Swim Megan M. , Kong Cherrie H. T. , Cheng Hongwei , Jia Huidong , Ghorbel Mohamed T. , Hancox Jules C. , Orchard Clive H. , Angelini Gianni , Emanueli Costanza , Caputo Massimo , Madeddu Paolo
Published: June 2015

Background

Living grafts produced by combining autologous heart‐resident stem/progenitor cells and tissue engineering could provide a new therapeutic option for definitive correction of congenital heart disease. The aim of the study was to investigate the antigenic profile, expansion/differentiation capacity, paracrine activity, and pro‐angiogenic potential of cardiac pericytes and to assess their engrafting capacity in clinically certified prosthetic grafts.

Methods and Results

CD
34
pos
cells, negative for the endothelial markers
CD
31 and
CD
146, were identified by immunohistochemistry in cardiac leftovers from infants and children undergoing palliative repair of congenital cardiac defects. Following isolation by immunomagnetic bead‐sorting and culture on plastic in
EGM
‐2 medium supplemented with growth factors and serum,
CD
34
pos
/
CD
31
neg
cells gave rise to a clonogenic, highly proliferative (>20 million at P5), spindle‐shape cell population. The following populations were shown to expresses pericyte/mesenchymal and stemness markers. After exposure to differentiation media, the expanded cardiac pericytes acquired markers of vascular smooth muscle cells, but failed to differentiate into endothelial cells or cardiomyocytes. However, in Matrigel, cardiac pericytes form networks and enhance the network capacity of endothelial cells. Moreover, they produce collagen‐1 and release chemo‐attractants that stimulate the migration of c‐Kit
pos
cardiac stem cells. Cardiac pericytes were then seeded onto clinically approved xenograft scaffolds and cultured in a bioreactor. After 3 weeks, fluorescent microscopy showed that cardiac pericytes had penetrated into and colonized the graft.

Conclusions

These findings open new avenues for cellular functionalization of prosthetic grafts to be applied in reconstructive surgery of congenital heart disease.
Carotid Plaque Morphological Classification Compared With Biomechanical Cap Stress
Authors: Gijsen Frank J.H. , Nieuwstadt Harm A. , Wentzel Jolanda J. , Verhagen Hence J.M. , van der Lugt Aad , van der Steen Antonius F.W.
Published: June 2015

Background and Purpose—

Two approaches to target plaque vulnerability—a histopathologic classification scheme and a biomechanical analysis—were compared and the implications for noninvasive risk stratification of carotid plaques using magnetic resonance imaging were assessed.

Methods—

Seventy-five histological plaque cross sections were obtained from carotid endarterectomy specimens from 34 patients (>70% stenosis) and subjected to both a Virmani histopathologic classification (thin fibrous cap atheroma with <0.2-mm cap thickness, presumed vulnerable) and a peak cap stress computation (<140 kPa: presumed stable; >300 kPa: presumed vulnerable). To demonstrate the implications for noninvasive plaque assessment, numeric simulations of a typical carotid magnetic resonance imaging protocol were performed (0.62×0.62 mm
2
in-plane acquired voxel size) and used to obtain the magnetic resonance imaging–based peak cap stress.

Results—

Peak cap stress was generally associated with histological classification. However, only 16 of 25 plaque cross sections could be labeled as high-risk (peak cap stress>300 kPa and classified as a thin fibrous cap atheroma). Twenty-eight of 50 plaque cross sections could be labeled as low-risk (a peak cap stress<140 kPa and not a thin fibrous cap atheroma), leading to a κ=0.39. 31 plaques (41%) had a disagreement between both classifications. Because of the limited magnetic resonance imaging voxel size with regard to cap thickness, a noninvasive identification of only a group of low-risk, thick-cap plaques was reliable.

Conclusions—

Instead of trying to target only vulnerable plaques, a more reliable noninvasive identification of a select group of stable plaques with a thick cap and low stress might be a more fruitful approach to start reducing surgical interventions on carotid plaques.
Transverse tensile damage behaviors of three-dimensional five-directional braided composites by meso-scale finite element approach
Authors: Zhang Diantang , Chen Li , Sun Ying , Wang Xinmiao
Published: June 2015

In this paper, the meso-scale finite element method is used to evaluate the transverse tensile damage behaviors of three-dimensional five-directional braided composites based on the representative volume cell. Finite element models with two kinds of interior braiding angles, 30° and 45°, are established on the basis of the realistic geometry shape of each yarn. A continuum damage mechanics model, which is implemented as a user-defined material subroutines in the ABAQUS commercial finite element code, is used to capture the complete damage initiation/evolution in yarns and matrix. The local responses and the failure mechanisms are analyzed. Numerical results show that the transverse tensile strength and the failure mechanisms are significantly influenced by the braiding angle. The predicted stress–strain responses and final damage morphology agree well with the experimental data, verifying the applicability of the meso-scale finite element method.
Influence of alkali treatment on the mechanical properties of new cane fibre/polyester composites
Authors: Chikouche M Dj Ladghem , Merrouche A , Azizi A , Rokbi M , Walter S
Published: June 2015

In recent years, natural fibres have been experimented to replace glass fibres in reinforcing thermosetting polymer. Since the interfacial adhesion between the raw natural fibres and the polymer matrix are often not adapted to the intended applications, the fibre surface most often requires a preliminary chemical modification. The fibres which were extracted from the Arundo donax L. Plant (called cane fibres), are little studied in the literature of fibre/polymer composites. In the present work, the cane fibres have been treated at constant soaking time with 2–8% NaOH aqueous solutions for 24 h. The composite reinforced by 6% NaOH-treated cane fibres, exhibited maximum improvements in tensile and flexural strength by 57% and 45% respectively. A combination of Fourier transform infrared, scanning electron microscopy, X-ray diffraction and moisture absorption techniques has been used for material characterisation. The crystallinity index yields information about fibre modification by NaOH. Such cane fibre composites could become an alternative to existing materials, with interesting tensile and flexural strengths, low cost and less ecological impact.
Experimental study on strain-rate-dependent behavior and failure modes of long glass fiber-reinforced polypropylene composite
Authors: Duan Shuyong , Yang Xujing , Tao Yourui
Published: June 2015

Due to its good mechanical performances and design flexibility, long glass fiber-reinforced polypropylene (hereinafter referred to as LGFRP) composite has been increasingly used in the automotive industry, in which the LGFRP components are likely to sustain different strain rates loading during a crash event. The objectives of this study are to investigate the correlations between the LGFRP and strain rates 10−3 s−1 to 50 s−1, and the corresponding failure modes of LGFRP. Therefore, tensile and compression tests are conducted at different strain rates and the corresponding microstructures of the specimens are investigated with scanning electron microscope. The experimental results show that the failure strain and ultimate strength increase as increasing strain rate. The elastic modulus is sensitive to strain rate in tensile tests, but less sensitive to strain rate in compression tests. The main failure modes of the specimens are the matrix crack and fiber pull-out. The defects such as bubbles, shrinkage cavities, or dry fibers of the specimens play important roles in the initiation and propagation of cracks during the tensile and compression tests.
Tribology of fiber reinforced polymer matrix composites—A review
Authors: Parikh Hiral H , Gohil Piyush P
Published: June 2015

The use of fiber reinforced polymer matrix composites (FRPCs) is in boom in many structural, industrial, automotive, and engineering applications. Polymer matrix composites have been turned out the most hopeful material which can replace the conventional materials, metals, and woods. Owing to this the demand for analyzing the tribological behavior of FRPCs is amplified. In the current article an inclusive literature survey on the tribological behavior of FRPCs in terms of friction and wear properties of composite materials is explored. The paper reviews the effects of different operating parameters and material parameters on wear rate and frictional behavior of FRPCs. The analysis reveals that operating parameters like sliding velocity, sliding distance, load, temperature and material parameters like a fiber volume fraction, orientation of fibers, fiber length, filler content, and effect of surface treatment have a significant effect on the tribological behavior of composite material. The wear rate of FRPCs is controlled by adding the proper amount of filler content and fiber orientation.
Cadres social, linguistique et climatique d’une enquête alimentaire à Dakar - Adaptation d’une chercheuse à son terrain
Authors: Leport Julie
Published: June 2015

The Social, Linguistic and Climatic Frameworks of a Dietary Survey in Dakar - Adaptation of a Researcher in her Field. In Africa concerning food, large quantitative surveys dominate and take precedence over the use of qualitative methodologies, only slightly developed until now. Yet the complexity of food and diet encourages the production of ethnographic studies to understand all dimensions involved. The approach taken in the framework of my thesis is both qualitative and quantitative. How can a Western female researcher, and French in particular, manage the contextual constraints of working in Dakar, an African city open to the world and symbolically charged by colonial history? Field work access is negotiated specifically by adopting the rules of greetings and self-presentation. Complicity in the kitchen creates the “in-common” and the presence of the translator makes for triangular discussions. Time management – that passes and goes on – taking into account local constraints, is necessary for the proper conduct of the survey.
Testing an Attribution Model of Caregiving in a Latino Sample
Authors: Villalobos Bianca T. , Bridges Ana J.
Published: June 2015

Purpose: This study tests the parameters of Weiner’s attribution model of caregiving, which describes how attributions of controllability relate to emotional reactions, which in turn influence willingness to provide support to stigmatized individuals. To date, the model has not been explored in the context of cultural variables, the caregiver–recipient relationship, or types of support. Design: The present study examined the attribution model using a Latino community sample ( N = 96) that was presented with vignettes describing an individual with depression. Results: Support was found for the basic attribution model. Familismo was predictive of attributions of controllability and the basic model was predictive of emotional support, but not instrumental support. Participants were more willing to provide instrumental support to a partner, but had more positive affective reactions toward a sibling. Conclusions: The findings provide important information about contextual factors that may motivate Latino caregivers to provide support.
Gangliocytic Paraganglioma With Atypical Immunohistochemical Features Presenting as Extrahepatic Biliary Obstruction
Authors: Sharma Saniya , Gaspar Balan Louis , Kumar Pradeep , Yadav Thakur Deen , Vasishta Rakesh Kumar
Published: June 2015

Gangliocytic paraganglioma is a rare benign tumor of upper gastrointestinal tract that most commonly involves the second part of duodenum. The tumor is detected incidentally on imaging in most of the cases. However, presentation with extrahepatic biliary obstruction is extremely rare. We recently encountered a 50-year-old male patient who was evaluated for extrahepatic biliary obstruction and was found to have a periampullary mass on imaging. The patient underwent pylorus-preserving pancreaticoduodenectomy along with liver biopsy and hepatoduodenal lymph node dissection. On histopathological examination, a tumor was detected in the periampullary region of duodenum, which was confirmed to be gangliocytic paraganglioma on immunohistochemistry along with atypical histological and immunohistochemical features.