bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers to and acceptability of provider-initiated HIV testing and counselling and adopting HIV-prevention behaviours in rural Uganda: A qualitative study
Authors: Kiene Susan M , Sileo Katelyn , Wanyenze Rhoda K , Lule Haruna , Bateganya Moses H , Jasperse Joseph , Nantaba Harriet , Jayaratne Kia
Published: September 2013

In Uganda, a nationwide scale-up of provider-initiated HIV testing and counselling presents an opportunity to deliver HIV-prevention services to large numbers of people. In a rural Ugandan hospital, focus group discussions and key informant interviews were conducted with outpatients receiving provider-initiated HIV testing and counselling and staff to explore the HIV-prevention information, motivation and behavioural skills strengths and weaknesses, and community-level and structural barriers to provider-initiated HIV testing and counselling acceptability and HIV prevention among this population. Strengths and weakness occurred at all levels, and results suggest brief client-centred interventions during provider-initiated HIV testing and counselling may be an effective approach to increase prevention behaviours in outpatient settings.
Media exposure and smoking intention in adolescents: A moderated mediation analysis from a cultivation perspective
Authors: Yang Fang , Salmon Charles T , Pang Joyce S , Cheng Wendy JY
Published: September 2013

The study tested a moderated mediation model to examine the mechanisms underlying the link between media exposure and adolescent smoking intention by utilizing a modification of cultivation theory. A total of 12,586 non-current smoker adolescents in California were included in the analysis. Results showed that media exposure was positively related to smoking intention via perceived prevalence of peer smoking when friend disapproval of cigarette use was low. This study contributes to a better understanding of the mechanisms regarding the media effects on smoking intention, but the findings should be interpreted with caution due to the small effect size.
Secondary traumatization and self-rated health among wives of former prisoners of war: The moderating role of marital adjustment
Authors: Zerach Gadi , Greene Talya , Solomon Zahava
Published: September 2013

We investigated the relationships between secondary traumatization, marital adjustment, and self-rated health among wives of former prisoners of war. Participants were Israeli wives of former prisoners of war ( N = 116) and a matched control group of wives of combat veterans ( N = 56). Wives of former prisoners of war reported worse self-rated health compared to the control group of wives of combat veterans. Wives of former prisoners of war also reported higher levels of secondary traumatization, and marital adjustment moderated the relationship between wives’ secondary traumatization and their general health. The experience of living with former prisoners of war who might also suffer from posttraumatic stress disorder is associated with wives’ own psychological and self-rated health outcomes.
Psychosocial functioning in adults with beta-thalassaemia major: Evidence for resilience
Authors: Zani Bruna , Prati Gabriele
Published: September 2013

Our aims were to compare the psychosocial functioning of a sample of adults with beta-thalassaemia major to that of a control sample and to examine the protective role of quality of relationship with parents during adolescence and perceived quality of care. A total of 85 Italian beta-thalassaemia major participants and 73 controls completed an ad hoc questionnaire. Compared with controls, beta-thalassaemia major participants did not differ on relationships with significant others and coping strategies. Beta-thalassaemia major participants reported higher scores on job satisfaction, self-esteem and self-description. The relationship with parents during adolescence and the perceived quality of care significantly predicted higher well-being and psychosocial functioning.
Six physical education lessons a week can reduce cardiovascular risk in school children aged 6–13 years: A longitudinal study
Authors: Klakk Heidi , Andersen Lars B. , Heidemann Malene , Møller Niels Christian , Wedderkopp Niels
Published: September 2013

Aims: Cardiovascular disease (CVD) originates during childhood and adolescence. Schools are potentially effective settings for early public health prevention strategies. The aim of this study was to evaluate the effect of six physical education (PE) lessons on children’s CVD risk. Methods: This longitudinal study in 10 public schools (1218 children, aged 6–13 years), 6 intervention and 4 control schools evaluates a natural experiment, where intervention schools tripled PE to six lessons per week compared to the mandatory two PE lessons in the control schools. Baseline (2008) and 2-year follow-up measures were anthropometrics, cardiorespiratory fitness, blood pressure and blood samples providing lipids and measures for insulin resistance. Based on these variables, a composite risk score was calculated and used for further analysis. Multivariate multilevel mixed effect regression models were used to estimate effect of intervention taking the hierarchical structure of data into account. Individual, class and school were considered random effects. Intra class correlation (ICC) was calculated. Results: Intervention significantly lowered mean of composite risk score with 0.17 SD (95% CI: −0.34 to −0.01). Six PE lessons per week had a beneficial effect on triglycerides (TG) levels (−0.18 SD, 95% CI: −0.36 to 0.00), systolic blood pressure (SBP) (−0.22 SD, 95% CI: −0.42 to −0.02) and insulin resistance (HOMA-IR) (−0.17 SD, 95% CI: −0.34 to 0.01). Conclusions: Six PE lessons at school can reduce children’s CVD risk measured as a composite risk score. The changes in risk score are considered substantial in the perspective of public health strategy for preventing CVD in later life.
In situ investigation of gaseous pollution in the ramp of an underground gold mine
Authors: Zhang Ge , Li Lixia , Ji Hongguang , Xiao Kunrong , Yin Guoguang , Li Song
Published: September 2013

This paper presents an in situ investigation of gaseous pollution in the ramp of an underground gold mine in Shandong, China. Air velocities, number of vehicles and the concentrations of gaseous pollutants such as carbon monoxide (CO), carbon dioxide (CO2) and nitrogen dioxide (NO2) were measured at different depths of the ramp. The relationship between these data sets was analysed statistically. The results showed that the gaseous pollution in most sections of the ramp was severe except the section close to the ground entrance. In the sections close to the main production area, the concentrations of CO, CO2 and NO2 exceeded the Chinese air quality standards more than two times, posing a health and safety risk to underground miners. Given that the air velocity in the ramp was generally lower than 0.5 m/s, increasing the air flow rate in the entire ventilation network may help to control the gaseous pollution. However, the added energy cost of the exhaust fans should be evaluated. It may be more cost-effective to reduce vehicle emissions by improving the performance of automobile engines or by adopting high-efficiency exhaust control systems. These alternatives are important considerations for further study.
Effects of ambient air pollution on the prevalence of pneumonia in children: Implication for National Ambient Air Quality Standards in China
Authors: Lu Chan , Deng Qihong , Yu Chuck W. F. , Sundell Jan , Ou Cuiyun
Published: September 2013

Pneumonia is the most important cause of child death in the world today. Recent findings suggest that exposure to outdoor air pollutants may increase the pneumonia occurrence, but so far the associations have not been clearly illustrated. Therefore, the effects of outdoor air pollutants and the episode day on childhood pneumonia were investigated by this study. A standardized questionnaire on health, home and environmental factors of 4988 children was conducted in the city of Changsha, China. Average exposure to ambient air pollutants during 2008–2011 was monitored by the air pollution monitoring stations of Changsha Environmental Protection Agency. A two-stage hierarchical regression approach was adopted to estimate the effects of PM10, SO2 and NO2 on pneumonia risk. The prevalence of pneumonia in children aged 3–6 years was 38.2%, which is greatly higher than the developed countries but lower than some developing countries. Furthermore, the increased risk of childhood pneumonia was significantly associated with elevated NO2 concentration (odds ratio (OR) = 1.157, 95% confidence interval (CI): 1.121–1.195) and the episode day (OR = 1.038, 95% CI: 1.024–1.051), but not significantly associated with PM10 and SO2. Exposure to traffic-related air pollution could play an important role in the development of pneumonia in preschool children. The revised National Ambient Air Quality Standards (2012) for NO2 has provided a better control strategy for ambient air quality to reduce the risk of adverse health effects such as pneumonia for children.
When are defunctioning stomas in rectal cancer surgery really reversed? Results from a population-based single center experience
Authors: Floodeen H. , Lindgren R. , Matthiessen P.
Published: September 2013

Background and Aims:

This study assessed the timing of reversal of defunctioning stoma following low anterior resection of the rectum for cancer and risk factors for a defunctioning stoma becoming permanent in patients who were not reversed.

Material and Methods:

Patients who underwent low anterior resection with defunctioning stoma during a 12-year period were assessed with regard to timing of stoma reversal. Delayed reversal was defined as >4 months after low anterior resection. Patients with a defunctioning stoma that was never reversed were assessed regarding risk factors for permanent stoma.

Results:

A total of 134 patients were analyzed. Of 106 stoma reversals, 19% were reversed within 4 months of low anterior resection, while 81% were reversed later than 4 months. In 58% of these patients, the delay was to due to low medical priority given to this procedure. The other main reasons for delayed stoma reversal were nonsurgical complications (20%), symptomatic anastomotic leakage following low anterior resection (12%), and postoperative adjuvant chemotherapy (10%). Of all patients, 21% (28/134) ended up with a permanent stoma. Risk factors for a defunctioning stoma becoming permanent were stage IV cancer (P < 0.001) and symptomatic anastomotic leakage following low anterior resection (P < 0.001).

Conclusion:

Four in five patients experienced a delayed stoma reversal, in a majority because of the low priority given to this surgical procedure.
Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty
Authors: Mokka J. , Keemu H. , Koivisto M. , Stormi T. , Vahlberg T. , Virolainen P. , Junnila M. , Seppänen M. , Mäkelä K. T.
Published: September 2013

Background and Aims:

Loss of femoral bone stock in elective revision total hip arthroplasty poses unique and substantial challenges. Structural onlay allografts may provide mechanical stability for the cementless revision prosthesis and increase bone stock.

Material and methods:

At least one cortical onlay allograft was used in 40 elective total hip arthroplasty revisions (40 patients) to reconstruct femoral bone defects. The operations were performed between January 1999 and August 2010 in the Turku University Hospital, Finland. The mean follow-up time was 52 months (range: 12–125 months).

Results:

The allografts were incorporated into the bone tissue in 37 of 40 (92.5%) patients. Cementless revision stems healed in 36 of 40 (90.0%) patients, but these patients were not exactly the same patients whose allografts were successfully incorporated. One or more surgical complications were experienced by 14 of 40 (35.0%) patients during follow-up. In all, 4 of 40 (10.0%) patients (all women) had hip infections during follow-up. Of the 7 patients with rheumatoid arthritis, 4 (57.1%) had at least one complication.

Conclusions:

The use of the cortical onlay allografts provides a feasible option for restoring the integrity of the proximal femur in revision total hip arthroplasty, but the complication rate is high, particularly in female patients with rheumatoid arthritis.
Does D2 plus Para-Aortic Nodal Dissection surgery offer a better survival outcome compared to D2 surgery only for gastric cancer consistently? A definite result based on a hospital population of nearly two decades
Authors: Zhang Y. , Tian S.
Published: September 2013

Background and Aims:

Curative resection is the treatment of choice for gastric cancer. Although it has been concluded that D2 lymphadenectomy plus para-aortic nodal dissection does not improve survival rate in curable gastric cancer, it is unclear whether D2 plus para-aortic nodal dissection has a benefit in some groups of patients. We conducted a retrospective study in our hospital, in which we compared D2 with D2 plus para-aortic nodal dissection lymphadenectomy for gastric cancer in subgroups of each clinical characteristic in terms of long-term survival after surgery.

Material and Methods:

We selected 1792 patients who had undergone the treatment with curative intent between 1990 and 2007, 1344 in the D2 group and 448 in the D2 plus para-aortic nodal dissection group. Each procedure was verified by pathological analyses. The primary end points were 5-year overall survival.

Results and Conclusions:

Median follow-up periods were 50 months for patients assigned to D2 group and 54 months for patients assigned to D2 plus para-aortic nodal dissection group. Overall 5-year survival was not significantly higher in patients assigned to D2 plus para-aortic nodal dissection surgery compared to those assigned to D2 surgery (31.2% (95% confidence interval: 19.8%–42.6%) vs 26.6% (95% confidence interval: 20.3%–32.9%); log-rank p = 0.433). D2 plus para-aortic nodal dissection surgery should only be used for curable gastric cancer of T3-4 and N2 stage and should not be used for T1 disease and total gastrectomy.
Boerhaave’s Syndrome: Lessons Learned from 83 Cases over Three Decades
Authors: Salo J. , Sihvo E. , Kauppi J. , Räsänen J.
Published: September 2013

The authors describe their experience in the treatment of 83 Boerhaave patients. During the last few years the mortality of the disease has decreased. A successful treatment requires good treatment resources and experienced team work. The tailored open primary repair technique with fundic reinforcement, developed by the authors, is described in detail. This technique has decreased the amount of postoperative fistulation and esophageal resection. The mortality after stenting was 20%.
Technique and short-term outcomes of single-port surgery for rectal cancer: A feasibility study of 25 patients
Authors: Bulut O. , Aslak K. K. , Rosenstock S.
Published: September 2013

Background and Aims:

Although conventional laparoscopic surgery is less traumatic than open surgery, it does cause tissue trauma and multiple scar formation. The size and number of ports determine the extent of the trauma. Single-port laparoscopic surgery is assumed to minimize and perhaps eliminate the potential adverse effects of conventional laparoscopy. The aim of this study was to examine short-term outcomes of single-port laparoscopic surgery for rectal cancer.

Material and Methods:

Prospectively collected data from 25 consecutive patients who underwent single-port laparoscopic surgery for rectal cancer between January 2010 and March 2012. Perioperative data, oncological resections, and short-term outcomes were assessed.

Results:

Male:female ratio was 10:15. Of the 25 patients, 44% had previously undergone abdominal surgery. Median body mass index was 24 kg/m2 (range: 19–32 kg/m2). In all, four patients (16%) had neoadjuvant therapy. Median operating time was 260 min (range: 136–397 min). An additional port was needed in two patients, and one case was converted to hand-assisted approach. Median postoperative stay was 7 days (range: 4–39 days), and three patients (12%) were readmitted. Median lymph node harvest was 13 (range: 3–33). The surgical margins were clear in all patients. Complications were seen in six patients.

Conclusion:

Single-port laparoscopic surgery for rectal cancer can be performed in selected patients with rectal cancer without compromising oncological safety and with acceptable morbidity and mortality rates.
Comparison of above-the-knee prosthetic femoro-popliteal bypass versus percutaneous transluminal angioplasty and stenting for treatment of occlusive superficial femoral artery disease
Authors: Linnakoski H. , Uurto I. , Suominen V. , Vakhitov D. , Salenius J.
Published: September 2013

Background and Aims:

Treatment of occlusive femoro-popliteal artery disease has changed during the last decade because of intensive development of endovascular technology. The aim of this study was to evaluate patient treated endovascularly or surgically for femoro-popliteal atherosclerotic lesions and to assess perioperative and mid-term outcome.

Material and Methods:

This is a retrospective analysis of consecutive patients who had undergone prosthetic above-the-knee femoro-popliteal bypass or percutaneous transluminal angioplasty and stenting of superficial femoral artery stenosis or occlusion at Tampere University Hospital, Finland, between January 2007 and December 2009. Patients who were alive were re-evaluated in 2010. Primary and secondary patency and outcomes were assessed.

Results:

A total of 131 patients were treated; surgically 63 patients (69 procedures) and endovascularly 68 patients (74 procedures). The mean follow-up time was 17 months (SD ± 13 months). In the late follow-up visit, 8 (18%) patients in the bypass group suffered from claudication and 9 (20%) from critical limb ischemia. The corresponding figures for the endovascular group were 20 (36%) and 8 (20%), respectively. The primary patency was 60% at 2 years in the bypass group and 73% in the endovascular group (p = 0.092); the primary assisted patency was 62% versus 76%, respectively (p = 0.068). The secondary patency was 74% in the bypass group versus 79% in the endovascular group (p = 0.487).

Conclusions:

According to current results following TASC II guideline, satisfied overall mid-term results can be achieved in the treatment of superficial femoral artery atherosclerotic disease.
“Willing but Unwilling”: Attitudinal barriers to adoption of home-based health information technology among older adults
Authors: Young Rachel , Willis Erin , Cameron Glen , Geana Mugur
Published: September 2013

While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30–90 min duration) with 35 American adults, aged 46–72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults’ active and engaged self-image.
‘Mic Power’: ‘Public’ connections through the hip hop nation in Kampala
Authors: Schneidermann Nanna
Published: September 2013

Hip hop culture has been celebrated in the media and scholarship as a universal youth language, part of a global hip hop nation, and a type of counter-public. This article examines the everyday meanings and practices of hip hop among hip hop activists in Kampala, Uganda, specifically within the Batuuze rap group. Rather than portraying hip hop as a counter-public of the disempowered, I argue that the Batuuze engagement is based on what I call moral economy that enables the negotiation of connections in social and cultural networks towards what is considered a good life. Here, the hip hop nation is less of an alternative public sphere and more a way of articulating and contextualizing the world in a specific locality, which produces connections and opportunities in the young rappers’ lives.
Shame on me … emotions in the fieldwork on old age in Japan
Authors: Wilińska Monika
Published: September 2013

The starting point of this article is my research experience in Japan. As a non-Japanese, white woman, I spent four months in Japan researching about old age. Those four months were a period of an extensive research activity filled with various events and situations. The main aim of this article is to attend to emotions in fieldwork by illuminating the role of emotions in research and knowledge construction. More specifically, this article is a record of my own experiences of various accumulated emotions and knowledge that have shaped my understanding of what I saw, heard and felt during my fieldwork on old age in Japan. The particular focus is on shame and how shame became the mediator and activator of my knowledge about old age in Japan. The examples presented here demonstrate that openness and ability to feel contribute greatly to the type of research in which we engage, and the type of research we are capable of performing.
‘Having housing made everything else possible’: Affordable, safe and stable housing for women survivors of violence
Authors: Clough Amber , Draughon Jessica E. , Njie-Carr Veronica , Rollins Chiquita , Glass Nancy
Published: September 2013

Research indicates that the need for safe housing and the economic resources to maintain safe housing are two of the most pressing concerns among abused women who are planning to or have recently left abusers. Intimate partner violence (IPV) is frequently an immediate cause or precursor to homelessness and housing instability. The aim of the study is to explore abused women’s experiences accessing affordable, safe, and stable housing. To achieve the aim, adult female IPV survivors answered questions about: 1) steps that were taken to secure housing; 2) safety issues after leaving the abuser; 3) barriers to obtaining housing; and 4) responses from housing and domestic violence advocacy systems related to survivors’ housing needs. Four major themes emerged from the in-depth interviews: 1) stable, affordable housing is critical in increasing safety; 2) survivors face multiple systemic or individual barriers; 3) survivors develop and utilize an array of creative and resourceful strategies; and 4) survivors identified a variety of supportive services tailored to address their needs. The findings inform practice, policy and research for both the housing and domestic violence service systems with an emphasis on collaboration to meet the complex safety and stable housing needs of survivors and their families, particularly following the impact on housing of the 2008 US economic crisis and subsequent recession.
Lamp spectrum and spatial brightness at photopic levels: A basis for developing a metric
Authors: Fotios S , Atli D , Cheal C , Houser K , Logadóttir Á
Published: September 2013

Light sources are available in a variety of spectral power distributions (SPDs) and this affects spatial brightness in a manner not predicted by quantities such as illuminance. Tuning light source SPD to better match the sensitivity of visual perception may allow the same spatial brightness but at lower illuminance with potential reductions in energy consumption. Consideration of experimental design was used to review 70 studies of spatial brightness. Of these, the 19 studies considered to provide credible evidence of SPD effects were used to explore metrics for predicting the effect of SPD but did not provide conclusive evidence of a suitable metric, in part because of incomplete reporting of SPD characteristics. For future work, these data provide an independent database for validating proposed metrics.
Usual suspects, ideal victims and vice versa: The relationship between youth offending and victimization and the mediating influence of risky lifestyles
Authors: Cops Diederik , Pleysier Stefaan
Published: September 2013

The fact that young people report disproportionately high levels of offending has resulted in substantial criminological attention to the topic of young people as offenders. However, we tend to forget that victims of those young delinquents are largely young people as well. Moreover, not only are young people overrepresented in both offender and victim populations, there are equally remarkable similarities between the two populations. Despite the generally accepted homogeneity in victim and offender characteristics and their respective risk factors, little theory-driven empirical research has been conducted in an attempt to further explain this overlap. This study tries to fill this gap by focusing on the relationship between offending and victimization in a large sample of young people in the Brussels Capital Region ( N = 2070). More specifically, the influence of risky lifestyles on the relationship between offending and victimization is studied in order to test the assumption that the offending–victimization overlap is in reality the result of the convergence in time and space of (groups of potential) offenders and victims.
Incisional Negative Pressure Therapy to Prevent Wound Complications Following Cesarean Section in Morbidly Obese Women
Authors: Mark Katrina S. , Alger Lindsay , Terplan Mishka
Published: September 2013

Objective. We sought to evaluate the efficacy of incisional negative pressure therapy in decreasing postoperative wound complications when placed prophylactically over clean, closed incisions following cesarean section in obese patients. Study design. This was a retrospective cohort study comparing rates of wound complications following cesarean sections in morbidly obese women prior to and following the institution of standard use of prophylactic incisional negative pressure therapy. All women with a body mass index greater than 45 kg/m2 undergoing cesarean section in a 2-year period in a single institution were included. The exposure was incisional negative pressure therapy, which began in September 2009, versus standard wound dressing used in the previous year. The main outcome was wound complication identified by ICD-9 codes. Demographic and wound outcomes were compared with χ2 and t tests. Stata version 11.0 was used for all analysis. Results. A total of 63 women met the inclusion criteria, 21 of whom received negative pressure wound therapy. The historical comparison and exposure groups were similar in all characteristics studied with the exceptions of length of surgery (64 vs 76 minutes, P = .03), length of labor (78 vs 261 minutes, P = .02), scheduled versus nonscheduled (77% vs 52%, P = .04), and mean age (29.5 vs 26.1 years, P = .04), respectively. There were 5 wound complications in the control group (10.4%) and none (0%) in the study group ( P = .15). Conclusions. This pilot study suggests a decrease in wound complications in morbidly obese women receiving incisional negative pressure therapy following cesarean section.
One-Year Postoperative Morbidity Associated With Near-Infrared–Guided Indocyanine Green (ICG) or ICG in Conjugation With Human Serum Albumin (ICG:HSA) Sentinel Lymph Node Biopsy
Authors: Murawa Dawid , Polom Karol , Murawa Pawel
Published: September 2013

Background. Sentinel lymph node biopsy (SLNB) is a standard staging procedure in breast cancer and skin melanoma patients. Radioactive colloid (RC) and blue dye are the routinely used markers for staining. The new dye used in this procedure, indocyanine green (ICG), seems to have true potential in near-infrared–guided SLNB. The aim of this study was to analyze 1-year morbidity after SLNB using RC and ICG or RC and ICG conjugated to human serum albumin (ICG:HSA) in breast cancer and skin melanoma patients. Methods. Forty-nine patients diagnosed with breast cancer and 10 patients with skin melanoma underwent SLNB using ICG with RC and ICG:HSA with RC. A total of 47 SLNB patients without the need for additional lymphadenectomy were evaluated approximately 1 year (11-13 months) for the presence of tattoo, extremity swelling, nerve dysfunction/pain, range of motion, and stiffness. Results. From the 47 patients examined, long-term morbidity was present in 3 (6.4%). In 1 patient, tattoo persisted for 11 months. Mild lymphedema was seen in 1 patient, and 1 patient exhibited minor functional deficit. Conclusions. Using ICG or ICG:HSA seems to be safe, and long-term morbidity in SLNB patients is low. However, skin discoloration may appear as it does after the use of blue dye, and an increased number of harvested nodes might be associated with an increased number of iatrogenic lymphedema.
Immunological role of prostaglandin E2 production in mouse auditory cells in response to LPS
Authors: Tanigawa Tohru , Odkhuu Erdenezaya , Morikawa Akiko , Hayashi Ken , Sato Takashi , Shibata Rei , Goto Fumiyuki , Ueda Hiromi , Yokochi Takashi
Published: September 2013

The effect of LPS on the production of prostaglandin E2 (PGE2) in mouse HEI-OC1 auditory cells was examined. HEI-OC1 auditory cells constitutively produce a small amount of PGE2. LPS augmented the PGE2 production via enhanced cyclooxygenase 2 (COX2) expression. LPS-induced augmentation of COX2 expression was dependent on up-regulation of COX2 mRNA expression. LPS induced the production of TNF-α, but not IL-1β· An anti-TNF-α neutralizing Ab significantly inhibited PGE2 production and COX2 mRNA expression in response to LPS. LPS-induced PGE2 production was prevented by a series of pharmacological signaling inhibitors to NF-κB and MAPKs. Pam3CSK4 as a TLR2 ligand, as well as LPS as a TLR4 ligand, augmented the PGE2 production. However, poly I:C as a TLR3 ligand, imiquimod as a TLR7 ligand and CpG DNA as a TLR9 ligand did not augment it. HEI-OC1 cells expressed TLR2, TLR4 and TLR9, but not TLR3 or TLR7. The putative role of LPS-induced PGE2 production in auditory cells is discussed.
Treatment of latent tuberculosis infection
Authors: Parekh Madhavi J. , Schluger Neil W.
Published: September 2013

Treatment of latent tuberculosis (TB) infection is an important component of TB control programs in both high- and low-prevalence countries. Clinical trials of treatment of latent TB conducted over several decades have demonstrated that preventive treatment can reduce the risk of developing active TB up to 90%. Although 9 months of daily, self-administered isoniazid has been the most widely used and recommended regimen for the treatment of latent infection, other regimens such as 3 months of daily isoniazid and rifampin, or 4 months of daily rifampin alone have also been recommended and used. Most recently, a 12-dose regimen of once-weekly isoniazid and rifapentine has been shown to be noninferior to 9 months of daily isoniazid in a large and well conducted clinical trial. Adoption of such a regimen on a large scale could have significant implications for TB elimination efforts.
Beneficial role of vitamin D3 in the prevention of certain respiratory diseases
Authors: Lương Khanh vinh quốc , Nguyễn Lan Thi Hoàng
Published: September 2013

There is evidence of aberrations in the vitamin D–endocrine system in subjects with respiratory diseases. Vitamin D deficiency is highly prevalent in patients with respiratory diseases, and patients who receive vitamin D have significantly larger improvements in inspiratory muscle strength and maximal oxygen uptake. Studies have provided an opportunity to determine which proteins link vitamin D to respiratory pathology, including the major histocompatibility complex class II molecules, vitamin D receptor, vitamin D-binding protein, chromosome P450, Toll-like receptors, poly(ADP-ribose) polymerase-1, and the reduced form of nicotinamide adenine dinucleotide phosphate. Vitamin D also exerts its effect on respiratory diseases through cell signaling mechanisms, including matrix metalloproteinases, mitogen-activated protein kinase pathways, the Wnt/β-catenin signaling pathway, prostaglandins, reactive oxygen species, and nitric oxide synthase. In conclusion, vitamin D plays a significant role in respiratory diseases. The best form of vitamin D for use in the treatment of respiratory diseases is calcitriol because it is the active metabolite of vitamin D3 and modulates inflammatory cytokine expression. Further investigation of calcitriol in respiratory diseases is needed.
Coinfection with Hepatitis C Virus among HIV-Positive People in the Kathmandu Valley, Nepal
Authors: Poudel Krishna C. , Palmer Paula H. , Jimba Masamine , Mizoue Tetsuya , Kobayashi Jun , Poudel-Tandukar Kalpana
Published: September 2013

Background:

Previous research has studied the rate of hepatitis C virus (HCV) coinfection among HIV-positive people regardless of their antiretroviral therapy (ART) status. Our objectives were to measure the seroprevalence of HCV both in HIV-positive people receiving ART and in those not receiving ART and to describe the characteristics of coinfected people in the Kathmandu Valley, Nepal.

Methods:

We conducted a cross-sectional survey of 319 HIV-positive people residing in the Kathmandu Valley, Nepal. We screened the participants’ serum samples for HCV antibodies using the Latex Photometric Immunoassay based on third-generation assay.

Results:

A total of 138 (43.3%) participants were HCV positive. The prevalence of HCV coinfection was 96.2% (125 of 130) among participants with lifetime injection drug use (IDU). Among participants not receiving ART, the coinfection rate was 58.1% (50 of 86) compared with 37.8% (88 of 233) among those receiving ART. In multivariable analysis, participants who reported lifetime IDU and were current smokers were more likely to have HCV coinfection. The adjusted odds ratio (AOR) of HCV coinfection for ART was decreased, although it was not statistically significant (AOR = 0.45; 95% confidence interval = 0.13-1.48).

Conclusion:

The high prevalence of HCV coinfection among both individuals receiving ART and those not receiving ART suggests that screening for HCV among HIV-positive people would be useful, in particular, for those with lifetime IDU and soon after their HIV diagnosis.
Mucocutaneous Disorders of Pediatric HIV in South West Nigeria
Authors: Katibi Oludolapo Sherifat , Ogunbiyi Adebola O. , Oladokun Regina E. , Ernest Samuel K. , Osinusi Kikelomo , Brown Biobele J. , Adedoyin Olanrewaju T. , Ojuawo Ayodele I.
Published: September 2013

Objectives:

Nigeria has the world’s highest burden of pediatric HIV. In the face of paucity of monitoring tests in Nigeria, we studied the spectrum of pediatric mucocutaneous manifestations and evaluated their clinical utility as surrogate markers for immunodeficiency and plasma viral load levels.

Methods:

Cross-sectional study comparing mucocutaneous manifestations in 155 HIV-positive children aged 12 weeks to 14 years with 155 HIV-negative children. Relationships between mucocutaneous manifestations in HIV-infected patients and their immunologic and virologic indices were analyzed.

Results:

Mucocutaneous lesions were seen in 53.5% of HIV-infected children compared with 18.1% of the controls. Prevalence of lesions increased with worsening levels of immunodeficiency and increasing viral loads ( P < .01). Oral candidiasis, angular stomatitis, and fluffy hair were associated with more severe degrees of immunodeficiency.

Conclusion:

Mucocutaneous disorders are common in HIV-infected children. Oral candidiasis and nutritional dermatoses can be used as surrogates for advanced or severe immunodeficiency.
Three-Dimensional Gait Analysis Following Achilles Tendon Rupture With Nonsurgical Treatment Reveals Long-Term Deficiencies in Muscle Strength and Function
Authors: Tengman Tine , Riad Jacques
Published: September 2013

Background:

Precise long-term assessment of movement and physical function following Achilles tendon rupture is required for the development and evaluation of treatment, including different regimens of physical therapy.

Purpose:

To assess intermediate-term (<10 years by conventional thinking) objective measures of physical function following Achilles tendon rupture treated nonsurgically and to compare these with self-reported measures of physical function.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Two to 5 years after Achilles tendon rupture, 9 women and 43 men (mean age, 49.2 years; range, 26-68 years) were assessed by physical examination, performance of 1-legged jumps, and 3-dimensional gait analysis (including calculation of muscle work). Self-reported scores for foot function (Achilles tendon rupture score) and level of physical activity were collected. Twenty age- and sex-matched controls were assessed in the same manner.

Results:

Physical examination of patients with the knee extended revealed 11.1° of dorsiflexion on the injured side and 9.2° on the uninjured side ( P = .020), indicating gastrocnemius muscle lengthening. The 1-legged jump distance was shorter on the injured side (89.5 vs 96.2 cm; P < .001). Gait analysis showed higher peak dorsiflexion (14.3° vs 13.3°; P = .016) and lower concentric (positive) plantar flexor work (16.6 vs 19.9 J/kg; P = .001) in the ankle on the uninjured side. At the same time, eccentric (negative) dorsiflexor work was higher on the injured side (13.2 vs 11.9 J/kg; P = .010). Self-perceived foot function and physical activity were lower in patients than in healthy controls (mean Achilles tendon rupture score, 78.6 and 99.8, respectively).

Conclusion:

Nonsurgically treated patients with Achilles tendon rupture showed signs of both anatomic and functional lengthening of the tendon. Attenuated muscle strength and function were present during walking as long as 2 to 5 years after rupture, as determined by 3-dimensional gait analysis. More extensive future studies involving patients having both surgical and nonsurgical treatment could provide additional valuable information.
Return to Sports and Subsequent ACL Injury Rates after Revision ACL reconstruction with Patellar Tendon Autograft
Authors: Shelbourne K. Donald , Benner Rodney W. , Gray Tinker
Published: September 2013

Objectives:

We sought to determine the rate at which competitive and recreational athletes of different age groups returned to the same sport at the same level after revision ACL reconstruction with a patella tendon autograft, as well as define the subsequent ACL injury rate to either knee.

Methods:

We prospectively studied patients after revision ACL reconstruction with patellar tendon autograft. Patients who were involved in jumping/pivoting sports when they injured the ACL reconstructed knee and had the desire to return to the same sport at the same competitive level were included in the study. All patients underwent a perioperative rehabilitation program that emphasized limiting postoperative hemarthrosis, obtaining full range of motion, and achieving quadriceps muscle control before participating in an aggressive strengthening and functional progression program. Patients were grouped by age and competitive sport levels of high school (age <17.5 years, mean 16.6 ± 0.9 years; N=84), college (ages 18 to 21.9 years, mean 19.6 ± 1.2 years; N=58) or recreational (22 to 35 years, mean age 27.6 ± 4.1 years; N=117). A subjective activity survey was used to determine what specific sport and sport level patients participated in before and after surgery. The International Knee Documentation Committee (IKDC) and modified Noyes knee surveys were also obtained.

Results:

Of 84 high school athletes, 62 (74%) returned to play the same sport in high school. Of 58 college athletes, 43 (74%) returned to play the same sport at the college level. Of 117 recreational athletes, 73 (62%) returned to the same sport at a recreational level. The number of patients who had a subsequent ACL graft tear rate after revision surgery was 2 of 84 (2.3%) in the high school group, 3 of 58 (5.1%) in the college group, and 4 of 117 (3.4%) in the recreational group. The number of patients who had a subsequent ACL tear in the contralateral knee was 1 of 84 (1.1%) in the high school group, 1 of 58 (1.7%) in the college group, and 2 of 117 (1.7%) in the recreational group. Long-term subjective follow-up was obtained for 210 patients at 7.2 ± 5.3 years after surgery. The mean IKDC subjective total score was 86.1 ± 11.7 points at 2 years after surgery and 76.7 ± 18.3 at long-term follow-up. The mean modified Noyes total score was 89.7 ± 11.1 points at 2 years after surgery and 83.7 ± 16.2 points at long-term follow-up.

Conclusion:

Revision ACL reconstruction with a patellar tendon autograft combined with perioperative rehabilitation allows patients to return to the same sport at the same level at a high rate, which is higher than what is reported for revision surgery with hamstring grafts or allografts. Subsequent ACL injury rates to either knee is low and appears lower than after primary surgery, which may indicate that although patients report they return to the same level of sport, they may be doing so at a lower intensity.
Posterolateral Knee Repair Versus Reconstruction
Authors: McCarthy Mark A. , Bollier Matthew , Wolf Brian R. , Amendola Annunziato
Published: September 2013

Objectives:

Our goal was to compare clinical, functional and radiographic outcomes of posterolateral knee injuries treated with repair versus reconstruction. In addition, we compared varus stress radiographs of these patients with controls.

Methods:

A retrospective chart review was performed to identify patients that underwent posterolateral knee reconstruction or repair from January 1, 2000 to March 1, 2012. Patients were asked to return for a clinical exam and varus stress radiographs, as well as fill out IKDC and Lysholm knee scales. Patients that could not return to clinic were assessed via phone interviews. Chart reviews were performed on patients that could not be contacted.Further, we compared varus stress radiographs of 20 control knees, with no history of knee trauma, to both posterolateral knee repair and reconstruction groups.

Results:

We identified 61 knees in 60 patients who underwent posterolateral knee reconstruction or repair. 26 knees in 25 patients (17 reconstructions and 9 repairs) were evaluated at mean of 41.86 months postoperatively (range: 6-108). Average IKDC scores for reconstruction and repair were 68.23 and 71.30, respectively. Average Lysholm scores for these groups were 83.11 for reconstructions and 83.30 for repairs. There were no statistically significant differences in IKDC or Lysholm scores between the repair and reconstruction groups. Average varus gapping with the knee at zero degrees was 8.21 and 8.84 millimeters (mm) for reconstructions and repairs, respectively. Average varus gapping at 20 degrees knee flexion was 11.25 mm for reconstructions and 10.34 mm for repairs. No statistically significant differences were observed in varus gapping between the two groups. Control knee measurements, 20 knees in 20 different controls, showed average varus gapping of 5.27 mm at zero degrees and 6.55 mm at 20 degrees knee flexion. There was a statistically significant difference in varus gapping when comparing the operatively treated knees to the control group. On review of all 61 knees, there were five failures: three failed reconstructions, two failed repairs. The other complication included one small wound dehiscence in the reconstruction group that resolved without intervention.

Conclusion:

Unlike previous studies, we did not find statistical differences in our posterolateral knee patients treated with reconstruction versus repair. We did find statistically significant differences in varus gapping, at both 0 and 20 degrees of knee flexion, between control knees and the operatively treated groups. However, this did not correlate to poor clinical outcomes in either group..
The Effect of Capsulectomy On Hip Joint Biomechanics
Authors: Bayer Jennifer L. , Bigelow Erin , Jameel Omar , Sekiya Jon K.
Published: September 2013

Objectives:

Hip arthroscopy is performed in young adult patients with hip pain. During arthroscopy, capsulectomy is performed to improve intraoperative visualization. The stability of the hip joint after capsulectomy is relatively unknown. Our study evaluated anterior hip stability in capsular sectioned states with labral injury. We theorized the load required for anterior translation would decrease with greater capsular injury.

Methods:

Ten human cadaveric pelvises (20 hips, mean 54.25 years) without radiographic evidence of degeneration or dysplasia were harvested. The hips were prepared and mounted onto a custom built testing fixture. Two pelvises were excluded due to fixation issues for one or both hips. The 16 hips were tested in five states (table 1). Each hip was tested in neutral position with a 20N compressive force. The capsular incision was made in-line with the femoral neck. The labrectomy was made at 2:30 position. The sutured capsule was created using #2 Ethibond suture 1cm apart along the incision. The partial capsulectomy was made by resecting the iliofemoral ligament, leaving the pubofemoral and ischiofemoral ligaments intact. Total capsulectomy state was created by removing the remaining capsule. The load at 12mm of anterior translation was recorded for each state after two preconditioning trials.

Results:

A repeated measures ANOVA with a Bonferroni adjustment showed no difference between all-intact vs. sutured-intact. It also demonstrated no significant difference between the sutured-intact and the sutured labrectomy states. A repeated measures ANOVA with a Bonferroni adjustment was run to compare the capsular states with a 1cm partial labrectomy (table 2). There was a significant difference between the sutured-labrectomy and the partial capsulectomy (p=0.0146) and between the sutured-labrectomy and the total capsulectomy (p=0.0005). There was also a significant difference when comparing the partial capsulectomy and the total capsulectomy (p=0.0377).

Conclusion:

The findings demonstrate that both the capsule and labrum play a role in providing anterior hip stability. These results indicate that the iliofemoral ligament is crucial for preventing anterior translation in labral injured states. Intraoperative capsulectomy should be avoided in patients with large irreparable labral tears to prevent postoperative anterior hip instability