bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypercalciuria in children with haemophilia suggests primary skeletal pathology
Authors: Ranta Susanna , Viljakainen Heli , Mäkipernaa Anne , Mäkitie Outi
Published: March 2011

Several factors can compromise optimal bone mass accrual during childhood and predispose to osteoporosis later in life. Patients with haemophilia are already at risk of low bone mass during childhood, partly due to reduced physical activity related to joint bleeds and haemarthrosis. The introduction of primary prophylaxis with regular infusions of the deficient coagulation factor has enabled reduction or prevention of haemophilic arthropathy. Finnish children with severe haemophilia start prophylaxis early and are encouraged to participate in physical activities. We hypothesized that prophylactic therapy would ensure normal childhood bone mass development and carried out a case–control study in 29 children with haemophilia (2 mild, 6 moderate, 21 severe) and 58 age‐matched controls. Their bone health was determined by fracture history, blood and urine biochemistry, bone densitometry and spinal imaging. Bone mineral density was lower in children with haemophilia but there was no evidence for significantly increased fracture rate. The patients had significantly higher urinary calcium excretion and higher serum calcium concentration, and reduced bone resorption as compared with the controls. Our findings suggest primary skeletal pathology, resulting in increased urinary calcium loss and altered bone metabolism, which may over time contribute to the development of osteoporosis in patients with haemophilia.
Immunoglobulin subclass determines ability of immunoglobulin (Ig)G to capture and activate neutrophils presented as normal human IgG or disease-associated anti-neutrophil cytoplasm antibody (ANCA)-IgG
Authors: Pankhurst T , Nash G , Williams J , Colman R , Hussain A , Savage C
Published: March 2011

Immunoglobulin G (IgG) is a potent neutrophil stimulus, particularly when presented as anti-neutrophil cytoplasm antibody (ANCA) in ANCA-associated vasculitis. We assessed whether IgG subclasses had differential effects on neutrophil activation and whether differences were dependent on specific Fc-receptor engagement. Using a physiologically relevant flow model, we compared adhesion of neutrophils to different subclasses of normal IgG coated onto solid surfaces, with adhesion of neutrophils treated with different subclasses of soluble ANCA IgG to P-selectin surfaces or endothelial cells (EC). Normal IgG captured flowing neutrophils efficiently in the order IgG3 > IgG1 > IgG2 > IgG4. Fc-receptor blockade reduced capture, IgG3 being more dependent on CD16 and IgG1/2 on CD32. Blockade of the integrin CD18 reduced neutrophil spreading, while inhibition of calcium-dependent signalling reduced both capture and spreading, suggesting that both were active processes. Neutrophils treated with ANCA IgG subclasses 1, 3 and 4 showed stabilization of adhesion to P-selectin surfaces and EC. ANCA changed neutrophil behaviour from rolling to static adhesion and the potency of the subclasses followed the same pattern as above: IgG3 > IgG1 > IgG4. Blockade of Fc receptors resulted in neutrophils continuing to roll, i.e. they were not ANCA-activated; differential utilization of Fc receptor by particular IgG subclasses was not as apparent as during neutrophil capture by normal IgG. IgG3 is the most effective subclass for inducing neutrophil adhesion and altered behaviour, irrespective of whether the IgG is surface bound or docks onto neutrophil surface antigens prior to engaging Fc receptors. Engagement of Fc receptors underpins these responses; the dominant Fc receptor depends on IgG subclass.
Toll-like receptor 4 signalling attenuates experimental allergic conjunctivitis
Authors: Chung S-H , Choi S H , Cho K J , Joo C-K
Published: March 2011

Allergic conjunctivitis from an allergen-driven T helper type 2 (Th2) response is characterized by conjunctival eosinophilic infiltration. Association between signalling through Toll-like receptor 4 (TLR-4) and adaptive immune responses has been observed in allergic airway disease. We examined whether administration of bacterial lipopolysaccharide (LPS), a prototypic bacterial product that activates immune cells via TLR-4, could affect the development of allergic conjunctivitis and modify the immune response to ovalbumin (OVA) allergen in an experimental allergic conjunctivitis (EAC) model. Mice were challenged with two doses of OVA via conjunctival sac after systemic challenge with OVA in alum. Several indicators for allergy were evaluated in wild-type and TLR-4−/− mice with or without adding of different doses of LPS into OVA in alum. Mice challenged with OVA via conjunctival sac following systemic challenge with OVA in alum had severe allergic conjunctivitis. Of interest, LPS administration markedly suppressed immunoglobulin (Ig)E-mediated and eosinophil-dependent conjunctival inflammation. In addition, mice sensitized with OVA plus LPS had less interleukin (IL)-4, IL-5 and eotaxin secretion than mice sensitized with OVA only. The suppression of allergic response by LPS administration was due to Th1 shift. In contrast, the presence of LPS during sensitization with OVA had no effect on severity of allergic conjunctivitis and Th2 responses in TLR4-4−/− mice. Our findings demonstrate, for the first time, that LPS suppresses Th2 responses via the TLR-4-dependent pathway in the EAC model.
Decreasing trends of bacteraemia among HIV‐infected Ugandan adults: incidence, aetiology, clinical outcomes and effect of antiretroviral therapy in a semi‐urban setting (2000–2008)
Authors: Muyanja Stella Zawedde , Larke Natasha , Rutebarika Diana , Kaddu Ismael , Nakubulwa Susan , Levin Jonathan , Grosskurth Heiner , Miiro George
Published: March 2011

Objective  To investigate the effect of antiretroviral therapy on trends of incidence, aetiology and clinical outcomes of bacteraemia among HIV‐infected Ugandans in a semi‐urban setting.

Methods  A cohort of HIV‐1‐infected Ugandans aged 15 or older was followed from 2000 to 2008. Clinical, haematological and immunological measurements were taken at 6‐monthly visits. Additionally, patients reported to outpatient clinics whenever they were ill. Patients with elevated axillary temperature above 37.4 °C consistently triggered clinical assessment (with mandatory blood cultures) and empirical management protocol. Daily cotrimoxazole prophylaxis and highly active antiretroviral therapy (HAART) were introduced stepwise to eligible patients in August 2000 and February 2003, respectively. We compared the rates of bacteraemia across five calendar periods using random‐effects Poisson regression for the effect of HAART at the population level.

Results  A total of 246 bacteraemia episodes (including multiple episodes) were documented among 188 individuals (crude incidence: 42.4 events per 1000 person‐years; 95% CI: 35.0, 51.4). The most common species isolated was Streptococcus pneumoniae. After adjustment for current age, clinical characteristics at enrolment (CD4+ T‐cell counts and WHO stage) and time since enrolment, the incidence of bacteraemia dropped significantly when HAART was widely available compared with the period when treatment was not available (adjusted hazard ratio: 0.17; 95% CI: 0.09, 0.35). No poor health outcomes (death or lack of clinical response to antibiotics) after bacteraemia occurred after complete access to HAART.

Conclusions  HAART availability in a resource‐poor setting substantially reduced the trends of bacteraemia among HIV‐infected adults. This may further impact on future morbidity and healthcare costs of HIV‐infected people.
Papillomaviral DNA and increased p16CDKN2A protein are frequently present within feline cutaneous squamous cell carcinomas in ultraviolet‐protected skin
Authors: Munday John S. , Gibson Isobel , French Adrienne F.
Published: March 2011

Squamous cell carcinomas (SCCs) are common feline skin tumours. While exposure to ultraviolet (UV) light causes some SCCs, a subset develop in UV‐protected skin. In cats, papillomaviruses (PVs) cause viral plaques and Bowenoid in situ carcinomas (BISCs). As both may progress to SCC, it was hypothesized that SCCs in UV‐protected skin may represent neoplastic transformation of a PV‐induced lesion. To investigate this hypothesis, PCR was used to amplify PV DNA from 25 UV‐protected and 45 UV‐exposed SCCs. Oncogenic human PVs cause neoplasia by mechanisms that also increase p16CDKN2A protein (p16). As increased p16 is present in feline viral plaques and BISCs, immunohistochemistry was used to detect p16 within the SCCs. Papillomaviral DNA was amplified from 76% of UV‐protected SCCs, but only 42% of UV‐exposed SCCs. Increased p16 was present in 84% of UV‐protected SCCs, but only 40% of UV‐exposed SCCs. The more frequent detection of PV DNA and increased p16 within UV‐protected SCCs supports the hypothesis that some develop from a PV‐induced plaque or BISC. Felis domesticus PV‐2 is thought to cause viral plaques and BISCs. This PV was detected most frequently within the UV‐protected SCCs, supporting development from a PV‐induced lesion. Increased p16 and PV DNA were less frequent within UV‐exposed SCCs, presumably because these developed from actinic keratosis rather than a PV‐induced lesion. The results support the hypothesis that some feline cutaneous SCCs are caused by PV infection and suggest that PVs may cause neoplasia by mechanisms that also increase p16.
The expression of histamine H4 receptor mRNA in the skin and other tissues of normal dogs
Authors: Eisenschenk Melissa N. C. , Torres Sheila M. F. , Oliveira Simone , Been Clint S.
Published: March 2011

The histamine 4 (H4) receptor was first cloned and characterized in 2000 using the human H3 receptor DNA sequence. The H4 receptor has been shown to participate in various aspects of inflammation, such as chemotaxis, upregulation of adhesion molecule expression and modulation of cytokine secretion. The primary goal of this study was to determine whether H4 receptor mRNA is expressed in normal canine skin by performing an RT‐PCR. An additional goal was to determine the expression of this receptor in the colon, liver, spleen and kidney. Tissues were collected from five healthy, young‐adult pit bull dogs. Samples were immediately placed in RNAlater® solution and stored at −20°C until processed. The amplified products in all skin samples in addition to the colon, liver, spleen and kidney (variable expression) had the expected size of 400–500 bp. The sequenced amplicons matched the National Center for Biotechnology Information published sequence for the canine H4 receptor. The study results showed that canine normal skin expresses the H4 receptor mRNA. Further studies using immunohistochemistry should be conducted to demonstrate the expression of the H4 receptor at the protein level and to localize the expression of this receptor in the skin.
Dose assessment of 2% chlorhexidine acetate for canine superficial pyoderma
Authors: Murayama Nobuo , Terada Yuri , Okuaki Mio , Nagata Masahiko
Published: March 2011

The dose of 2% chlorhexidine acetate (2CA; Nolvasan® Surgical Scrub; Fort Dodge Animal Health, Fort Dodge, IA, USA) for canine superficial pyoderma was evaluated. The first trial compared three doses (group 1, 57 mL/m2 body surface area; group 2, 29 mL/m2 body surface area; and group 3, 19 mL/m2 body surface area) in a randomized, double‐blind, controlled fashion. Twenty‐seven dogs with superficial pyoderma were treated with 2CA at the allocated doses every 2 days for 1 week. The owners and investigators subjectively evaluated the dogs, and investigators scored skin lesions, including erythema, papules/pustules, alopecia and scales, on a 0–4 scale. There were no significant differences in response between the treatment groups. The second trial established a practical dose‐measuring method for 2CA. Sixty‐eight owners were asked to apply 2CA on their palm in an amount corresponding to a Japanese ¥500 coin, 26.5 mm in diameter. This yielded an average dose of 0.90 ± 0.40 mL. Mathematically, the doses used in groups 1, 2 and 3 can be represented as one coin per approximately one‐, two‐ and three‐hand‐sized lesions, respectively. The results therefore suggest that owners instructed to apply one coin of the product per two‐hand‐sized areas of superficial pyoderma would use the range of doses evaluated in this trial.
Oseltamivir‐resistant 2009 H1N1 influenza pneumonia during therapy in a renal transplant recipient
Authors: Shetty Avinash K. , Ross Gregory A. , Pranikoff Thomas , Gubareva Larissa V. , Sechrist Catherine , Guirand Derek M. , Abramson Jon , Lin Jen‐Jar
Published: March 2011

Shetty AK, Ross GA, Pranikoff T, Gubareva LV, Sechrist C, Guirand DM, Abramson J, Lin J‐J. Oseltamivir‐resistant 2009 H1N1 influenza pneumonia during therapy in a renal transplant recipient.

Abstract:  The emergence of oseltamivir‐resistant 2009 H1N1 influenza virus (conferred by the H275Y substitution in NA) during therapy or prophylaxis in immunocompromised patients is a serious concern. The optimal therapy for immunosuppressed patients with oseltamivir‐resistant 2009 H1N1 influenza virus is unknown and few options exist. We report a 10‐yr‐old recipient of kidney transplant who was hospitalized with oseltamivir‐resistant 2009 H1N1 influenza pneumonia complicated by severe respiratory failure, ARDS, and renal failure requiring institution of ECMO and CRRT. On presentation, treatment with oseltamivir (second course) and broad‐spectrum antibiotics was initiated. Immunosuppressive agents were stopped on hospital day (d) 2. On hospital d 7, given his critical status, immunocompromised state, and difficulty in obtaining intravenous zanamivir, after obtaining ethical approval and parental consent, he was treated with intravenous peramivir (through an Emergency Investigational New Drug Application) for two wk. He tolerated the regimen well and his clinical status improved gradually. Several factors may have contributed to virus clearance and survival including recovery of the immune system, aggressive critical care support, and administration of peramivir. Ongoing surveillance is essential to monitor how oseltamivir‐resistant H275Y mutant viruses may evolve in the future.
Pre‐release feeding on hydrolysed yeast and methoprene treatment enhances male Bactrocera cucurbitae Coquillett (Diptera: Tephritidae) longevity
Authors: Haq I. , Hendrichs J.
Published: March 2011

Enhanced male melon fly, Bactrocera cucurbitae (Coquillett) (Diptera: Tephritidae) mating success due to application of a juvenile hormone analogue, methoprene (M+) and feeding on a sugar–protein diet (P+) (hydrolysed yeast), supports their incorporation into operational area‐wide programmes integrating the sterile insect technique. But enhanced mating success may have a cost in terms of shortened sterile male longevity as has been reported under certain situations for other tephritid pest species. The objective of this study was to analyse the effect of methoprene treatment and addition of protein to the adult diet and then switching from a sugar–protein diet to sugar only (dietary switched after first 3 days; DS), on male longevity in laboratory. The treatments were as follows: (i) M‐P+; (ii) M‐P+ DS; (iii) M+P+ DS; and (iv) M‐P‐ (fed only sugar and water continuously since emergence). All treatments were significantly different from each other in their survival response in the following order, M‐P+ > M+P+ DS > M‐P+ DS > M‐P‐. Access to sugar–protein diet and then switching after 3 days had no negative effect on male longevity compared with males fed only sugar throughout. The results are discussed in the context of methoprene treatment and a sugar–protein diet as a pre‐release feeding protocol for maturing sterile flies in fly emergence/release facilities.
Evaluation of the Resistance of Malus Germplasm to Bot Canker Caused by Botryosphaeria dothidea
Authors: Liu Hai Tao , Zhang Yu Jing , Li Chun Min , Wang Yi , Liu Guo Jian , Chang Rui Feng , Zhao Yong Bo , Xu Xue Feng , Han Zhen Hai , Zhang Xin Zhong
Published: March 2011

The resistance of 240 Malus germplasm accessions to bot canker was evaluated by inoculating branches in the field with cultured mycelia from five pathogenic isolates of Botryosphaeria dothidea. Differences in the disease resistance were significant among the examined germplasm accessions and the different pathogenic isolates. In general, the resistance of the wild species and the Chinese domestic cultivars was much stronger than that of the cultivars or mutants of Malus × domestica. Baccata HR, a genotype from a wild species, is highly resistant. Three M. × domestica cultivars/mutants, Maypole, Spy227 and Fengyan, are resistant, whereas Changhong is highly susceptible. A wide range of resistance levels were observed among the 28 M. sieversii genotypes. Differences in resistance were also found among clonal mutants from cultivars of M. × domestica. The disease indices of the same germplasm in response to different pathogenic isolates of B. dothidea are sometimes significantly different.
Estimating the number of street children and adolescents in two cities of Brazil using capture–recapture
Authors: Bezerra Kátia Floripes , Gurgel Ricardo Queiroz , Ilozue Chinenye , Castaneda Daniel Neyra
Published: March 2011

Aim:  To use the capture–recapture method to estimate the number of street children and adolescents in Maceió and Arapiraca, north‐east Brazil, and describe the characteristics of the two populations.

Methods:  The number of children and adolescents on the street in Maceió and Arapiraca was estimated using the multi‐list capture–recapture method. Two street surveys and an official list from the social services department were compared. The characteristics of the children were recorded during the street surveys using a questionnaire.

Results:  The estimated number of street children and adolescents was 5225 in Maceió and 1191 in Arapiraca. According to the official records, the population registered was 565 and 157, respectively. Most individuals were male (71.4% and 71.8%, respectively). They still maintain contact with their families (85.5% in Maceió and 89.6% in Arapiraca) and attend school regularly (43.4% and 49.7%). Drug use was admitted by 46.9% of the individuals in Maceió and by 26.9% in Arapiraca. In both cities, glue inhalation, associated or not with other drugs, was most frequently cited.

Conclusions:  Children and adolescents on the streets are a common and underestimated occurrence in Maceió and Arapiraca. They have similar characteristics to street children from other countries and other cities in Brazil. The method of capture–recapture seems to be suited to study populations such as street children.
Staff immunisation: Policy and practice in child care
Authors: Spokes Paula J , Ferson Mark J , Ressler Kelly‐Anne
Published: March 2011

Aim:  The aims of this study were to determine the level of knowledge among child‐care centre directors regarding the National Health and Medical Research Council (NHMRC) recommendations for the immunisation of child‐care workers, the extent to which this knowledge was translated into practice and any organisational barriers to the development and implementation of staff immunisation policy.

Methods:  A cross‐sectional survey, conducted in August 2006, in which a postal questionnaire was sent to a random sample of 784 NSW child‐care centres. Centre directors were asked to complete the questionnaire on immunisation knowledge, policy and practice for the centre. A multivariate logistic‐regression model was used to identify factors independently associated with centres with an immunisation policy for staff and centres that offered to pay all or part of the cost of vaccination of staff.

Results:  Directors from 437 centres participated in the study for a response rate of 56%. Of these, 49% were aware of the NHMRC recommendations, and 57% had a staff immunisation policy in place. In the logistic regression model, centres with a written immunisation policy for staff were more likely to be aware of the NHMRC guidelines and offer long day care services. Centres that offered to pay all or part of the cost of immunisation for staff were more likely to be aware of the NHMRC guidelines, offer other child‐care services and not operate for profit. Barriers to staff immunisation were related to the implementation of policy and included cost, time and access to information.

Conclusions:  The level of awareness of specific staff immunisation recommendations was relatively low. The transition of knowledge to policy was encouraging, although implementation of policies requires further commitment.
Self‐reported level of and factors influencing the compliance to desferrioxamine therapy in multitransfused thalassaemias
Authors: Lee Way Seah , Toh Tsun How , Chai Pei Fan , Soo Thian Lian
Published: March 2011

Aim:  To analyse the self‐reported degree of and factors influencing the compliance to desferrioxamine (DFO) therapy in children with transfusion‐dependent thalassaemia major in Malaysia.

Methods:  A cross‐sectional study was conducted on all children with thalassaemia major on DFO attending Likas Hospital, Sabah, in September 2008. Patients or carer‐providers were interviewed to report on the degree of compliance as either highly (administering >90% of DFO), moderately (51–90%), poorly (1%–50%) or non‐compliant (0%) to DFO in the preceding month. The latest serum ferritin levels were noted.

Results:  The median (range) age at first blood transfusion of these 139 (73 males, median (range) age at interview: 9.0 years (2–16 years)) patients were 1.0 year (2 months to 10 years). The median (range) duration of regular DFO therapy was 2 years (2 months to 10 years). Forty‐three (31%) of the patients reported themselves to be highly compliant, 70 (50%) moderately and 26 (19%) poorly or non‐compliant. Multivariate analysis showed that a lower family income negatively affected the degree of compliance, while family support positively affected the degree of compliance to DFO. No correlation existed between self‐reported degree of compliance and latest serum ferritin level (6444 ± µmol/L; P = 0.186).

Conclusion:  The self‐reported compliance to DFO therapy was moderate in this cohort of patients with thalassaemia major in Malaysia. The serum ferritin level was high, possibly because of the relatively short duration of DFO therapy and compliance. Oral iron chelator should be considered to improve the compliance to iron chelation.
Health status of boys with Duchenne muscular dystrophy: A parent's perspective
Authors: Bray Paula , Bundy Anita C , Ryan Monique M , North Kathryn N , Burns Joshua
Published: March 2011

Aim:  To investigate parent‐reported health status of boys with Duchenne muscular dystrophy (DMD) compared with a large Australian normative population and a cohort of children with Charcot–Marie–Tooth disease type 1A (CMT1A).

Methods:  The Child Health Questionnaire parent form (CHQ‐PF50) was completed by parents of 34 boys with confirmed DMD. Seventeen parents were followed up at 6 months. CHQ‐PF50 data were compared with 2620 age‐matched norms and 90 children with CMT1A.

Results:  All domains of the CHQ‐PF50 for the DMD cohort were significantly lower than the general paediatric population, particularly for physical functioning (t=−17.2, P < 0.001) and the child's ability to fulfil school and social roles because of physical limitations (t=−9.4, P < 0.001). Parents experienced greatest emotional impact of their child's DMD around the time of loss of ambulation. Children with DMD had lower health status compared with children with CMT1A with the exception of the behaviour and pain domains. Physical functioning worsened during 6 months (P= 0.04); no other changes in health status were observed at follow‐up.

Conclusions:  Parents report the impact of DMD on health status to be considerably worse when compared with CMT1A. Interventions should target minimising the impact of physical limitations on role functioning.
Diagnosis of Hashimoto's thyroiditis and IgG4‐related sclerosing disease
Authors: Kakudo Kennichi , Li Yaqiong , Hirokawa Mitsuyoshi , Ozaki Takashi
Published: March 2011

It is about 100 years since the publication of the original description of the disorder now termed as Hashimoto's thyroiditis (HT) or Hashimoto's disease. Hashimoto's thyroiditis has been commonly considered as a well‐defined clinicopathological entity, characterized by the presence of goiter and serum thyroid autoantibodies. Very recently, new studies have reported that there is a unique subtype of HT, termed as immunoglobulin (Ig)G4 thyroiditis, which is characterized by lymphoplasmacytic infiltration, fibrosis, increased IgG4‐positive plasma cell in the thyroid and high IgG4 level in the serum. Furthermore, from a clinical aspect, IgG4 thyroiditis presents significantly different characteristics from non‐IgG4 thyroiditis, with IgG4 thyroiditis being more closely associated with rapid progress, subclinical hypothyroidism, higher levels of circulating antibodies and more diffuse low echogenicity. This review will introduce the most recent concepts about etiologic mechanisms, clinical, imaging and laboratory features of HT and its histological characteristics. Especially, recent advances in recognizing HT with special reference of IgG4‐related sclerosing disease (IgG4‐RSD) will be summarized. Furthermore, the differences and close relationship between HT and Riedel's thyroiditis (RT), which was also demonstrated to be involved in IgG4‐RSD spectrum, will be reviewed.
Fatigue experienced by patients receiving maintenance dialysis in hemodialysis units
Authors: Letchmi Santhna , Das Srijit , Halim Hasliza , Zakariah Farid Azizul , Hassan Hamidah , Mat Samsiah , Packiavathy Ruth
Published: March 2011

The fatigue that is observed in patients who are undergoing dialysis is usually associated with an impaired quality of life. The present cross‐sectional study was conducted from January to April 2009 in three hemodialysis units in Kuala Lumpur, Malaysia. In this study, the Multidimensional Fatigue Inventory and Depression Anxiety and Stress Score 21 were used to determine the level of fatigue, depression, anxiety, and stress of patients who were undergoing dialysis. The data were obtained from a calculated sample of 116 and a total of 103 respondents participated in the study. A total of 56 (54.4%) and 47 (45.6%) respondents experienced a high level and a low level of fatigue, respectively. There was a significant relationship between the duration of treatment and the level of fatigue. The respondents who had been receiving treatment for > 2 years experienced more fatigue, compared to the respondents who had been undergoing hemodialysis for > 2 years. There was a significant difference in relation to the age of the participants regarding the level of fatigue. No significant relationship between the sex of the participants, anemia, depression, anxiety, stress, and the level of fatigue was observed. Special attention needs to be paid to both the younger and older adults who are receiving treatment. In addition, proper planning is needed for the patients regarding their daily activities in order to reduce fatigue. Nurses who work in hemodialysis units are recommended to provide exercise classes or group therapy in order to boost the energy levels among patients who are undergoing dialysis. Health professionals should provide appropriate treatment for patients who are experiencing fatigue in order to prevent any other complications that could arise.
Quality of work life: Experiences of Iranian nurses
Authors: Vagharseyyedin Seyyed Abolfazl , Vanaki Zohreh , Mohammadi Eesa
Published: March 2011

The purpose of this qualitative study was to describe the experiences of Iranian nurses concerning their quality of work life. A purposive sample of nurses (n = 14) was recruited from two university hospitals. The data were collected through unstructured interviews and were analyzed by using qualitative content analysis. The results indicated that the participants discerned their quality of work life by assessing how favorable were their working conditions, the level of fulfilment of their personal needs, and the impact of their working conditions on their private life and their social life. Three main themes were identified: quality of work life, as experienced from a personal perspective; quality of work life, as experienced from a sociocultural perspective; and quality of work life, as experienced from an organizational–professional perspective. The results of the present study will help Iranian nurse administrators to adopt effective strategies in order to improve nurses' quality of work life. Future research can broaden the scope of the current results and offer a more comprehensive understanding of nurses' quality of work life.
Computed tomography for the preoperative diagnosis of pelvic actinomycosis
Authors: Bae Jeong‐Hoon , Song Rok , Lee Ahwon , Park Jong‐Sup , Kim Mee‐Ran
Published: March 2011

Aims:  The aim of this study was to review the clinical manifestations of pelvic actinomycosis in order to aid clinicians in its diagnosis and treatment.

Methods:  We retrospectively reviewed the histopathology and clinical records of all cases confirmed by surgery as pelvic actinomycosis from 1996 to 2006.

Results:  A total of 16 cases of pelvic actinomycosis were selected and evaluated. The median age was 51 years (range, 36–66 years). All patients experienced childbirth, and had risk factors including use of an intrauterine device (93.8%) or pessary (6.2%), and/or a history of dilatation and curettage (68.8%), or previous abdominal surgery (31.3%). Nine patients (56.3%) were correctly diagnosed before surgery with computed tomography. Other common preoperative diagnoses were intra‐abdominal malignancy (18.8%) and tubo‐ovarian abscess (25%). The most common initial laboratory abnormalities were anemia (68.8%) and leukocytosis (62.5%). In six patients (37.5%), the preoperative values of carbohydrate antigen‐125 were elevated. All patients were cured by surgery and no recurrence or mortality was noted.

Conclusions:  The correct initial diagnosis of pelvic actinomycosis is important for decreasing treatment‐related morbidity. Imaging studies, especially computed tomography, might have assisted the diagnoses of actinomycosis.
Plasma mRNA concentrations of placenta‐specific 1 (PLAC1) and pregnancy associated plasma protein A (PAPP‐A) are higher in early‐onset than late‐onset pre‐eclampsia
Authors: Kodama Miho , Miyoshi Hiroshi , Fujito Naoya , Samura Osamu , Kudo Yoshiki
Published: March 2011

Aim:  Some mRNA concentrations are observed to increase in the maternal circulation in association with pre‐eclampsia, including placenta‐specific 1 (PLAC1) and pregnancy associated plasma protein A (PAPP‐A), which were previously proposed as predictive markers for pre‐eclampsia. Here, we investigated their concentrations in early‐onset and late‐onset pre‐eclampsia maternal plasma to determine whether different mechanisms are involved in these two forms of the disorder.

Material and Methods:  Peripheral blood and placental samples were collected from patients with pre‐eclampsia. RNA was extracted and levels of PLAC1 and PAPP‐A mRNAs were determined using real‐time quantitative PCR.

Results:  PLAC1 and PAPP‐A mRNA levels were significantly increased in plasma from pregnant women with pre‐eclampsia compared with those from healthy pregnant women. The median concentration of PLAC1 was 5.5 times higher (P < 0.01) and that of PAPP‐A was 5.1 times higher (P < 0.01) in early‐onset than in late‐onset pre‐eclampsia. The expression of these mRNAs in the placenta showed no significant difference in early‐onset pre‐eclampsia, late‐onset pre‐eclampsia and healthy pregnant women.

Conclusion:  These findings suggest that the concentration of mRNAs in maternal plasma reflect leakage from damaged villus cells rather than expression levels in the placenta. Injury to chorionic villus cells might be more severe in early‐onset pre‐eclampsia than in late‐onset pre‐eclampsia.
Lausannevirus, a giant amoebal virus encoding histone doublets
Authors: Thomas Vincent , Bertelli Claire , Collyn François , Casson Nicola , Telenti Amalio , Goesmann Alexander , Croxatto Antony , Greub Gilbert
Published: March 2011

Large viruses infecting algae or amoebae belong to the NucleoCytoplasmic Large DNA Viruses (NCLDV) and present genotypic and phenotypic characteristics that have raised major interest among microbiologists. Here, we describe a new large virus discovered in Acanthamoeba castellanii co‐culture of an environmental sample. The virus, referred to as Lausannevirus, has a very limited host range, infecting Acanthamoeba spp. but being unable to infect other amoebae and mammalian cell lines tested. Within A. castellanii, this icosahedral virus of about 200 nm exhibits a development cycle similar to Mimivirus, with an eclipse phase 2 h post infection and a logarithmic growth leading to amoebal lysis in less than 24 h. The 346 kb Lausannevirus genome presents similarities with the recently described Marseillevirus, sharing 89% of genes, and thus belongs to the same family as confirmed by core gene phylogeny. Interestingly, Lausannevirus and Marseillevirus genomes both encode three proteins with predicted histone folds, including two histone doublets, that present similarities to eukaryotic and archaeal histones. The discovery of Lausannevirus and the analysis of its genome provide some insight in the evolution of these large amoebae‐infecting viruses.
Influence of putative exopolysaccharide genes on Pseudomonas putida KT2440 biofilm stability
Authors: Nilsson Martin , Chiang Wen‐Chi , Fazli Mustafa , Gjermansen Morten , Givskov Michael , Tolker‐Nielsen Tim
Published: March 2011

We report a study of the role of putative exopolysaccharide gene clusters in the formation and stability of Pseudomonas putida KT2440 biofilm. Two novel putative exopolysaccharide gene clusters, pea and peb, were identified, and evidence is provided that they encode products that stabilize P. putida KT2440 biofilm. The gene clusters alg and bcs, which code for proteins mediating alginate and cellulose biosynthesis, were found to play minor roles in P. putida KT2440 biofilm formation and stability under the conditions tested. A P. putida KT2440 derivative devoid of any identifiable exopolysaccharide genes was found to form biofilm with a structure similar to wild‐type biofilm, but with a stability lower than that of wild‐type biofilm. Based on our data, we suggest that the formation of structured P. putida KT2440 biofilm can occur in the absence of exopolysaccharides; however, exopolysaccharides play a role as structural stabilizers.
Postnatal ontogenetic scaling of Nesodontine (Notoungulata, Toxodontidae) cranial morphology
Authors: Cassini Guillermo H. , Flores David A. , Vizcaíno Sergio F.
Published: March 2011

Cassini G.H., Flores D.A. and Vizcaíno S.F. 2012. Postnatal ontogenetic scaling of Nesodontine (Notoungulata, Toxodontidae) cranial morphology. —Acta Zoologica (Stockholm) 93: 249–259.

Toxodontidae is a clade of endemic South American ungulates that comprises medium to very large animals, including strict megammamals, i.e., 1000 kg or more. Adinotherium at approximately 120 kg and Nesodon at 550 kg are, respectively, the smallest and the largest Nesodontinae of Santacrucian age (early Miocene). The large number of specimens recorded and the quality of preservation (including very young animals) permit a morphometric study of cranial ontogeny. We measured 17 cranial variables on an ontogenetic series of 23 specimens of Adinotherium ovinum and 11 of Nesodon imbricatus. Bivariate analysis (standardized major axis) was performed to obtain the coefficients of allometry using skull length as the independent variable. Results indicate that eight of 16 variables show an isometric trend, seven exhibit positive allometry, and only the height of the orbit in N. imbricatus exhibits negative allometry. Contrary to expectation, neurocranial variables are positively allometric or isometric. With respect to the splanchnocranium, most variables related to the rostrum, palate, and masticatory muscles show positive allometry, suggesting a strengthening of masticatory system in adults of both taxa. The splanchnocranial allometric trends fail to support previous inferences of specialized herbivory, suggesting generalized herbivory in nesodontines.
Comparison of the rate, location and size of positive surgical margins after laparoscopic and robot‐assisted laparoscopic radical prostatectomy
Authors: Kasraeian Ali , Barret Eric , Chan Jonathan , Sanchez‐Salas Rafael , Validire Pierre , Cathelineau Xavier , Rozet Francois , Galiano Marc , Vallancien Guy
Published: March 2011

Study Type – Therapy (case series)

Level of Evidence 4

OBJECTIVE

To review and compare the rate, location and size of positive surgical margins (PSMs) after pure laparoscopic radical prostatectomy (LRP) and robot‐assisted laparoscopic radical prostatectomy (RALP).

PATIENTS AND METHODS

The study comprised 200 patients who underwent RALP and 200 patients who underwent LRP up to January 2008.

We compared patient age, body mass index, preoperative prostate‐specific antigen (PSA), preoperative stage and grade, prostate size, pathological stage and grade and neurovascular bundle preservation, as well as PSM rate, size and location.

Continuous and categorical data were compared using Student’s t‐test and Pearson’s chi‐squared test.

Multivariate regression analyses were used to identify preoperative and intraoperative predictors of PSMs.

RESULTS

Although the PSM rate was similar between the two groups (LRP: 12% vs RALP: 13.5%; P= 0.76), location and size were not. PSMs after LRP were mostly at the apex (58.3%; P= 0.038), while most PSMs after RALP were posterolateral ([PL] 48%; P= 0.046).

In addition, the median margin size after RALP was significantly smaller than after LRP (RALP: 2 mm vs LRP: 3.5 mm; P= 0.041).

In univariate and multivariate analyses, tumour‐node‐metastasis (TNM) stage and preoperative PSA were the only independent preoperative predictors of PSMs (P= 0.044 and P= 0.01, respectively).

CONCLUSION

The PSM risk is dependent on TNM stage and preoperative PSA and not the surgical technique, when comparing LRP with RALP.
Is there a prostate‐specific antigen upper limit for radical prostatectomy?
Authors: Gontero Paulo , Spahn Martin , Tombal Bertrand , Bader Pia , Hsu Chao‐Yu , Marchioro Giansilvio , Frea Bruno , Van Der Eeckt Kathy , Kneitz Burkhard , Frohneberg Detlef , Tizzani Alessandro , Van Poppel Hendrik , Joniau Steven
Published: March 2011

Study Type – Prognosis (retrospective cohort)

Level of Evidence 2b

OBJECTIVE

• To assess the feasibility of radical prostatectomy (RP) in a series of patients with prostate cancer with very high prostate‐specific antigen (PSA) levels by comparing the clinical outcomes of different PSA thresholds (20.1–50 ng/mL, 50.1–100 ng/mL and >100 ng/mL, respectively).

PATIENTS AND METHODS

• Within a multicentre European retrospective database of 712 RP in patients with a baseline PSA level >20 ng/mL, we identified 48 patients with prostate cancer with a preoperative PSA level >100 ng/mL, 137 with a PSA level between 50.1 and 100 ng/mL and 527 with PSA values between 20.1 and 50 ng/mL.

• Comparisons between groups were performed using chi‐square test, analysis of variance and Kaplan–Meier analysis with log‐rank test.

RESULTS

• Ten‐year projected cancer‐specific survival (79.8% in the PSA >100 ng/mL group vs 85.4% in the PSA 50.1–99 ng/mL group vs 90.9% in the PSA 20.1–50 ng/mL interval; P= 0.037) but not overall survival (59.6% in the PSA >100 ng/mL group vs 71.8% in the PSA 50.1–99 ng/mL group vs 75.3% in the PSA 20.1–50 ng/mL interval; P= 0.087) appeared significantly affected by the different PSA thresholds.

• At a median follow‐up of 78.7 months, 25.8%, 6.6% and 8.3% of patients in the PSA level groups for 20.1–50 ng/mL, 50.1–100 ng/mL and >100 ng/mL respectively, were cured by surgery alone.

CONCLUSIONS

• Ten‐year cancer‐specific survival, while showing significant reduction with increasing PSA values intervals, remain relatively high even for PSA levels >100 ng/mL.

• As part of a multimodal treatment strategy, RP may therefore be an option, even in selected patients with prostate cancer whose PSA level is >100 ng/mL.
EQUALITY OF OPPORTUNITY: POLICY AND MEASUREMENT PARADIGMS
Authors: Pignataro Giuseppe
Published: March 2011

Abstract Equality of opportunity is a widely accepted principle of distributive justice and it is the leading idea of most political platforms in several countries. According to this principle, a society might institute policies that secure an equal distribution of the means to reach a valuable outcome among its members. Once the set of opportunities have been equalized, which particular opportunity, the individual chooses from those open to her, is outside the scope of justice. Ex ante inequalities, and only those inequalities, should be eliminated or compensated for by public intervention. The recent literature on the opportunity egalitarianism often merges these questions introducing two different economic issues. On one side the design of a public policy intended to implement the equality of opportunity view and on the other side the problem of measuring the degree of opportunity inequality in a society. We describe the basic setting and assumptions of some different approaches derived by Roemer’s algorithm for public policy and then we discuss some theoretical and empirical studies to separate and test alternative paradigms on the measurement of inequality of opportunity. Accordingly, an extended critique on the causality issue on policies and measurements is taken into account.
Induction of fat cell necrosis in human fat tissue after treatment with phosphatidylcholine and deoxycholate
Authors: Bechara F.G. , Mannherz H.G. , Jacob M. , Mazur A.J. , Sand M. , Altmeyer P. , Hoffmann K.
Published: March 2011

Background  Injections with phosphatidylcholine‐ and deoxycholate‐containing substances are used to treat localized fat accumulation and lipomas. It is believed that the injected substances induce fat cell destruction with subsequent acute panniculitis followed by a repair process of the treated fat tissue.

Objectives  We investigated whether necrosis or apoptosis of fat cells was induced by the injected substances.

Methods  Samples of fat tissue of lipoma were collected at various times after injection and evaluated by light and electron microscopy, by immunostaining for active caspase‐3 and antideoxyribonuclease I, in situ end‐labelling (TUNEL staining), and biochemical caspase‐3 assays.

Results  Light and electron microscopy showed fat cell necrosis in all areas of the treated lipomas. Low levels of active caspase‐3 indicated the absence of apoptosis.

Conclusions  Injection of the lipolytic substances phosphatidylcholine and deoxycholate leads to fat cell necrosis rather than apoptosis. However, additional studies evaluating different dosing and further time points after treatment are necessary.
Roscovitine blocks leukocyte extravasation by inhibition of cyclin‐dependent kinases 5 and 9
Authors: Berberich Nina , Uhl Bernd , Joore Jos , Schmerwitz Ulrike K , Mayer Bettina A , Reichel Christoph A , Krombach Fritz , Zahler Stefan , Vollmar Angelika M , Fürst Robert
Published: March 2011

BACKGROUND AND PURPOSE

Roscovitine, a cyclin‐dependent kinase (CDK) inhibitor that induces tumour cell death, is under evaluation as an anti‐cancer drug. By triggering leukocyte apoptosis, roscovitine can also enhance the resolution of inflammation. Beyond death‐inducing properties, we tested whether roscovitine affects leukocyte‐endothelial cell interaction, a vital step in the onset of inflammation.

EXPERIMENTAL APPROACH

Leukocyte‐endothelial cell interactions were evaluated in venules of mouse cremaster muscle, using intravital microscopy. In primary human endothelial cells, we studied the influence of roscovitine on adhesion molecules and on the nuclear factor‐κB (NF‐κB) pathway. A cellular kinome array, in vitro CDK profiling and RNAi methods were used to identify targets of roscovitine.

KEY RESULTS

In vivo, roscovitine attenuated the tumour necrosis factor‐α (TNF‐α)‐induced leukocyte adherence to and transmigration through, the endothelium. In vitro, roscovitine strongly inhibited TNF‐α‐evoked expression of endothelial adhesion molecules (E‐selectin, intercellular cell adhesion molecule, vascular cell adhesion molecule). Roscovitine blocked NF‐κB‐dependent gene transcription, but not the NF‐κB activation cascade [inhibitor of κB (IκB) kinase activity, IκB‐α degradation, p65 translocation]. Using a cellular kinome array and an in vitro CDK panel, we found that roscovitine inhibited protein kinase A, ribosomal S6 kinase and CDKs 2, 5, 7 and 9. Experiments using kinase inhibitors and siRNA showed that the decreased endothelial activation was due solely to blockade of CDK5 and CDK9 by roscovitine.

CONCLUSIONS AND IMPLICATIONS

Our study highlights a novel mode of action for roscovitine, preventing endothelial activation and leukocyte‐endothelial cell interaction by inhibition of CDK5 and 9. This might expand its usage as a promising anti‐inflammatory compound.
Functional, morphological and molecular characterization of bladder dysfunction in streptozotocin‐induced diabetic mice: evidence of a role for L‐type voltage‐operated Ca2+ channels
Authors: Leiria LOS , Mónica FZT , Carvalho FDGF , Claudino MA , Franco‐Penteado CF , Schenka A , Grant AD , De Nucci G , Antunes E
Published: March 2011

BACKGROUND AND PURPOSE Diabetic cystopathy is one of the most common and incapacitating complications of diabetes mellitus. This study aimed to evaluate the functional, structural and molecular alterations of detrusor smooth muscle (DSM) in streptozotocin‐induced diabetic mice, focusing on the contribution of Ca2+ influx through L‐type voltage‐operated Ca2+ channels (L‐VOCC).

EXPERIMENTAL APPROACH Male C57BL/6 mice were injected with streptozotocin (125 mg·kg−1). Four weeks later, contractile responses to carbachol, α,β‐methylene ATP, KCl, extracellular Ca2+ and electrical‐field stimulation were measured in urothelium‐intact DSM strips. Cystometry and histomorphometry were performed, and mRNA expression for muscarinic M2/M3 receptors, purine P2X1 receptors and L‐VOCC in the bladder was determined.

KEY RESULTS Diabetic mice exhibited higher bladder capacity, frequency, non‐void contractions and post‐void pressure. Increased bladder weight, wall thickness, bladder volume and neural tissue were observed in diabetic bladders. Carbachol, α,β‐methylene ATP, KCl, extracellular Ca2+ and electrical‐field stimulation all produced greater DSM contractions in diabetic mice. The L‐VOCC blocker nifedipine almost completely reversed the enhanced DSM contractions in bladders from diabetic animals. The Rho‐kinase inhibitor Y27632 had no effect on the enhanced carbachol contractions in the diabetic group. Expression of mRNA for muscarinic M3 receptors and L‐VOCC were greater in the bladders of diabetic mice, whereas levels of M2 and P2X1 receptors remained unchanged.

CONCLUSIONS AND IMPLICATIONS Diabetic mice exhibit features of urinary bladder dysfunction, as characterized by overactive DSM and decreased voiding efficiency. Functional and molecular data suggest that overactive DSM in diabetes is the result of enhanced extracellular Ca2+ influx through L‐VOCC.