bluuebunny/crossref_metadata_2025 huggingface dataset:
Was muss der praktizierende Arzt über dasTransplantationsgesetz und dessen Auswirkungen wissen?
Authors: Immer Franz F.
Published: April 2013

Der vorliegende Artikel soll einen praxisbezogenen Überblick über die aktuellen Hintergründe auf dem Gebiet der Spenderrekrutierung und der Transplantationsmedizin geben. Das Inkrafttreten des Transplantationsgesetzes am 1.7.2007 hat zahlreiche Änderungen in der Erkennung und Meldung von potentiellen Organ- und Gewebespendern in Spitälern mit akkreditierten Intensivstationen nach sich gezogen. Daraus entsteht auch ein großer Einfluss auf die Zuteilungspraxis der raren Organe in der Schweiz. Mit gerade 12.6 Leichenspendern pro Million Einwohner ist die Schweiz im europäischen Vergleich das Schlusslicht. Dies bleibt nicht ohne Auswirkungen auf die Warteliste, die Ende 2010 mit 1029 Patienten einen neuen Höchststand erreicht hat. Man geht davon aus, dass sich in der Schweiz fast die Hälfte der Bevölkerung nicht entschieden hat, ob eine Organspende in Frage kommt. Die wichtigsten Ansprechpersonen in dieser Thematik sind die praktizierenden Kolleginnen und Kollegen, sind Sie. Auf einem für Sie eingerichteten Link [www.swisstransplant.org/medizinerinfo] finden sie weitere Informationen und Unterlagen die Sie in Ihrer Praxis auflegen oder für Weiterbildungen herunterladen können. Organspende ist bis ins hohe Alter möglich, sprechen Sie Ihre Patientinnen und Patienten darauf an, informieren Sie transparent und offen über die Thematik. Bitten Sie Ihre Patientinnen und Patienten den Entscheid ob für oder gegen eine Organspende den nächsten Angehörigen mitzuteilen.
Immunsuppressiva - Wirkungen, Nebenwirkungen und Interaktionen
Authors: Stucker Fabien , Ackermann Daniel
Published: April 2013

Immunsuppressiva sollen die Abstoßung des gespendeten Organs durch den Empfänger verhindern. Die Kenntnis der Wirkmechanismen der Immunsuppressiva sowie deren Nebenwirkungen und Interaktionen mit anderen Medikamenten ist Grundvoraussetzung für die Behandlung von transplantierten Patienten. Immunsuppression kann entweder durch eine Depletion, durch Blockierung der Aktivierung oder durch eine verminderte Proliferation von Lymphozyten erreicht werden. Immunsuppressiva umfassen sogenannte «small-molecule drugs», depletierende und nicht depletierende Antikörper, Fusionsproteine, intravenöse Immunglobuline und Glukokortikoide. «Small-molecule drugs» sind: Calcineurininhibitoren, Inhibitoren des «mammalian Target-of-Rapamycin», der Nukleotidsynthese sowie Azathioprin. Die Wirkmechanismen der am meisten verwendeten Immunsuppressiva werden in dieser Übersichtarbeit erklärt und ihre positiven und negativen Nebenwirkungen aufgezählt. Wirkung und Nebenwirkungen des Fusionsproteins Belatacept werden besonders behandelt. Interaktionen mit häufig verwendeten Medikamenten werden tabellarisch aufgelistet.
Wer kann mit welchem Risiko eine Niere spenden?
Authors: Burkhalter Felix
Published: April 2013

Die Lebendnierentransplantation wird in der Schweiz seit den 70er-Jahren bei terminaler Niereninsuffizienz durchgeführt und wird seit 2000 in allen Transplantationszentren angeboten. Sie gilt als optimale Therapieoption nicht zuletzt durch ihre guten Langzeitresultate hinsichtlich Transplantatfunktion und Patientenüberleben. Aufgrund der seit Jahren bestehenden geringen Anzahl an Leichennierenspendern und der Zunahme der Patienten auf der Warteliste hat der Druck auf die Lebendnierentransplantation zugenommen. Dies widerspiegelt sich auch in der steigenden Zahl an Lebendnierentransplantationen in der letzten Dekade. Um die Spender nicht einem zu hohen Risiko auszusetzen ist eine sorgfältige medizinische und psychologische Abklärung vor einer Spende entscheidend. Im Weiteren müssen die Spender über die möglichen Risiken einer Nierenspende nach bestem Wissen und Gewissen aufgeklärt werden. Dies ist nur durch prospektive Langzeitstudien, wie dies durch das Schweizer Lebendspender-Gesundheitsregister erfolgt, möglich. Die folgende Arbeit soll einen Überblick über die nötigen medizinischen und psychologischen Abklärungen vor einer Nierenspende aufzeigen und nimmt Stellung zu den Risiken und möglichen Folgen.
Der leberkranke Patient - wann und bei wem eine Lebertransplantation?
Authors: Morell Bernhard , Dufour Jean -François
Published: April 2013

Die orthotope Lebertransplantation (OLT) ist heutzutage Therapie der Wahl für Patienten mit fortgeschrittenen Lebererkrankungen und bietet den Patienten die Chance, mehrere Jahre mit guter Lebensqualität zu leben. Jährlich werden in der Schweiz ungefähr 100 OLT durchgeführt, jedoch liegt der Bedarf deutlich höher. Seit der Einführung des neuen Transplantationsgesetzes in der Schweiz 2007 basiert die Organallokation hauptsächlich auf dem MELD-Score. Der MELD-Score wiederspiegelt als Funktion der Parameter INR, Bilirubin und Kreatinin die Drei-Monate-Mortalität OLT-gelisteter Patienten mit chronischem Leberversagen. Die häufigsten Indikationen für OLT umfassen Zirrhose bei alko-holassoziierter Hepatopathie respektive chronischer viraler Hepatitis durch Hepatitis B und C sowie Patienten mit hepatozellulärem Karzinom. Die rechtzeitige Evaluation an einem Transplantationszentrum ist wichtig, damit genügend Zeit für weitere Abklärungen und Vorbereitung des Patienten bleibt. Zusammengefasst sollten Patienten mit dekompensierter Leberzirrhose, akutem Leberversagen oder Verdacht auf hepatozelluläres Karzinom an einem Transplantationszentrum beurteilt werden.
Fragmented memories in a fragmented country: memory competition and political identity-building in today's Bosnia and Herzegovina
Authors: Moll Nicolas
Published: April 2013

Bosnia and Herzegovina is politically fragmented, and so is the memory landscape within the country. Narratives of the 1992–1995 war, the Second World War, Tito's Yugoslavia, and earlier historical periods form highly disputed patterns in a memory competition involving representatives of the three “constituent peoples” of Bosnia and Herzegovina - Serbs, Croats and Bosniaks – but also non-nationalist actors within BiH, as well as the international community. By looking especially at political declarations and the practices of commemoration and monument building, the article gives an overview of the fragmented memory landscape in Bosnia and Herzegovina, pointing out the different existing memory narratives and policies and the competition between them in the public sphere, and analyzing the conflicting memory narratives as a central part of the highly disputed political identity construction processes in postwar Bosnia and Herzegovina. The paper also discusses the question whether an “Europeanization” of Bosnian memory cultures could be an alternative to the current fragmentation and nationalist domination of the memory landscape in BiH.
The OSCE Mission in Bosnia and Herzegovina: Testing the limits of ownership
Authors: Perry Valery , Keil Soeren
Published: April 2013

This article explores the debate on local ownership in Bosnia and Herzegovina by examining the limits of international community support for reform in a divided political environment in which decision-makers and politicians have little to no interest in reform themselves. After a short review of the key issues and arguments regarding ownership in BiH, the example of education reform is presented to demonstrate the role of the OSCE as an external actor in this reform sector, and the lack of any reform progress in this field in the absence of external pressure. The article closes with reflections on whether or not external organizations can make any systemic-level impact in such a hostile reform environment, and whether the OSCE can still play a constructive role in Bosnia.
The role of the EU in promoting good governance in Macedonia: towards efficiency and effectiveness or deliberative democracy?
Authors: Risteska Marija
Published: April 2013

Good governance has been used as a development tool by international organizations and the European Union (hereinafter: EU) which has included it in cooperation agreements and promotes it within its Enlargement Policy. This paper analyzes the good governance approach in the EU's relations with Macedonia and its effects on the country's democratic policy making. The analysis shows that the Europeanization of Macedonia has an impact on the democratic processes in the country with sub-optimal results as its technocratic approach in assessing the country's readiness for EU membership has proved to be detrimental for the deliberative democratic processes. The intensive pressure for effectiveness and efficiency results in finding short cuts in rule transfer through copying and pasting legislation from member states and limiting the democratic policy making to political deliberation rather than to wide policy consultations between state and non-state actors.
The “Orange revolution” and the “sacred” birth of a civic-republican Ukrainian nation
Authors: Shekhovtsov Anton
Published: April 2013

The article analyzes the “sacred” dimension of the Ukrainian “Orange revolution”, its festive or carnivalesque quality, and properties of a communal ritual. The author argues that Ukrainian citizens who protested against the stolen elections in Kyiv found themselves in the liminoid situation of temporary egalitarian utopianism. This situation resulted in the emergence ofcommunitas, and engendered a powerful feeling of the birth of a civic-republican Ukrainian nation. The festive nature of the “Orange revolution”, sanctioned by the overwhelming confidence in fighting for the rightful democratic cause, reinforced the impression of renewing the society along Western liberal democratic patterns.
Article Commentary: State-Specific Liquor Excise Taxes and Retail Prices in 8 US States, 2012
Authors: Siegel Michael , Grundman Jody , DeJong William , Naimi Timothy S. , King Charles , Albers Alison B. , Williams Rebecca S. , Jernigan David H.
Published: April 2013

The authors investigated the relationship between state excise taxes and liquor prices in 8 states, using 2012 data for 45 brands. The authors made 6042 price observations among 177 liquor stores with online prices. Using a hierarchical model, the authors examined the relationship between excise taxes and product prices. State excise taxes were significantly related to liquor prices, with an estimated pass-through rate of 0.93. The proportion of price accounted for by excise taxes averaged 7.0%. The authors find that excise taxes do increase the price of alcohol, but states are not taking advantage of this opportunity to reduce alcohol-related morbidity and mortality.
Harm Reduction Behaviors among Young Polysubstance Users at Raves
Authors: Fernández-Calderón Fermín , Lozano-Rojas Óscar , Rojas-Tejada Antonio , Bilbao-Acedos Izaskun , Vidal-Giné Claudio , Vergara-Moragues Esperanza , González-Saiz Francisco
Published: April 2013

Background

Raves may be considered recreational settings in which drug use and health risks related to polydrug use are higher than in others. Harm reduction behaviors implemented by ravers are of particular relevance in reducing such risks. This study analyzes harm reduction behaviors and their relationship to raver polysubstance use patterns.

Methods

Cross-sectional study of 248 ravers recruited at underground raves in Andalusia (Spain). A questionnaire was developed to collect information about their sociodemographics, drug use, and harm reduction behaviors.

Results

The results show that ravers employ harm reduction behaviors for minimizing drug-related harm. Nevertheless, only a small minority of the participants frequently employed harm reduction behavior for polysubstance use as well. Ravers identified as high polysubstance users protected themselves significantly less than those identified as low polysubstance users.

Conclusions

This study provides empirical information that may be useful for harm reduction intervention in a hidden and hard-to-reach population like rave attendees. The results point to the need to inform and increase harm reduction behavior specifically aimed at polysubstance use by ravers, especially among more frequent users. Future directions for research are also suggested.
Does Change in Alliance Impact Alcohol Treatment Outcomes?
Authors: Kan Lisa Y. , Henderson Craig E. , von Sternberg Kirk , Wang Wei
Published: April 2013

Background

Although both researchers and practitioners widely recognize therapeutic alliance's importance in general psychotherapy, studies specific to alcohol use treatments have produced mixed results and generally do not investigate if and how alliance changes over course of treatment.

Methods

Using parallel process latent growth curve modeling, the authors examined if increase in alliance was associated with reduced drinking behaviors and a statistical mediator in the relationship between treatment modality and outcome. The authors used data from Project MATCH ( J Stud Alcohol. 1997;58:7–29; Addiction. 1997;92:1671–1698), which investigated client-treatment matching effects for alcohol treatment among outpatient ( n = 952) and aftercare ( n = 774) participants randomized to cognitive behavioral treatment (CBT), 12-step facilitation (TSF), or motivational enhancement therapy (MET).

Results

Results indicate therapist-rated alliance increased significantly for CBT and TSF participants, but not MET. Participants across modalities in both samples evidenced the largest decrease in drinking behaviors from baseline to midtreatment and a slight deterioration in treatment gains from midtreatment to 15 months posttreatment. Alliance did not mediate the relationship between treatment modality and outcome, but increase in alliance was significantly related to decrease in drinking frequency.

Conclusions

These findings provide further justification for researchers to specifically design studies to examine change in alliance as a mechanism of change in alcohol treatments.
Stride frequency in relation to oxygen consumption in experienced and novice runners
Authors: de Ruiter Cornelis J. , Verdijk Peter W. L. , Werker Wout , Zuidema Menno J. , de Haan Arnold
Published: April 2013

We hypothesised that experienced runners would select a stride frequency closer to the optimum (minimal energy costs) than would novice runners. In addition, we expected that optimal stride frequency could simply be determined by monitoring heart rate without measuring oxygen consumption (V̇O2). Ten healthy males (mean±s: 24±2 year) with no running training experience and 10 trained runners of similar age ran at constant treadmill speed corresponding to 80% of individual ventilatory threshold. For two days, they ran at seven different stride frequencies (self‐selected stride frequency±18%) imposed by a metronome. Optimal stride frequency was based on the minimum of a second‐order polynomial equation fitted through steady state V̇O2 at each stride frequency. Running cost (mean±s) at optimal stride frequency was higher (P < 0.05) in novice (236±31 ml O2·kg−1.km−1) than trained (189±13 ml O2·kg−1.km−1) runners. Self‐selected stride frequency (mean±s; strides.min−1) for novice (77.8±2.8) and trained runners (84.4±5.3) were lower (P < 0.05) than optimal stride frequency (respectively, 84.9±5.0 and 87.1±4.8). The difference between self‐selected and optimal stride frequency was smaller (P < 0.05) for trained runners. In both the groups optimal stride frequency established with heart rate was not different (P > 0.3) from optimal stride frequency based on V̇O2. In each group and despite limited variation between participants, optimal stride frequencies derived from V̇O2 and heart rate were related (r > 0.7; P < 0.05). In conclusion, trained runners chose a stride frequency closer to the optimum for energy expenditure than novices. Heart rate could be used to establish optimal stride frequency.
Proton-Dependent Coniferin Transport, a Common Major Transport Event in Differentiating Xylem Tissue of Woody Plants
Authors: Tsuyama Taku , Kawai Ryo , Shitan Nobukazu , Matoh Toru , Sugiyama Junji , Yoshinaga Arata , Takabe Keiji , Fujita Minoru , Yazaki Kazufumi
Published: April 2013

Lignin biosynthesis is an essential physiological activity of vascular plants if they are to survive under various environmental stresses on land. The biosynthesis of lignin proceeds in the cell wall by polymerization of precursors; the initial step of lignin polymerization is the transportation of lignin monomers from the cytosol to the cell wall, which is critical for lignin formation. There has been much debate on the transported form of the lignin precursor, either as free monolignols or their glucosides. In this study, we performed biochemical analyses to characterize the membrane transport mechanism of lignin precursors using angiosperms, hybrid poplar (Populus sieboldii × Populus grandidentata) and poplar (Populus sieboldii), as well gymnosperms, Japanese cypress (Chamaecyparis obtusa) and pine (Pinus densiflora). Membrane vesicles prepared from differentiating xylem tissues showed clear ATP-dependent transport activity of coniferin, whereas less than 4% of the coniferin transport activity was seen for coniferyl alcohol. Bafilomycin A1 and proton gradient erasers markedly inhibited coniferin transport in hybrid poplar membrane vesicles; in contrast, vanadate had no effect. Cis-inhibition experiments suggested that this transport activity was specific for coniferin. Membrane fractionation of hybrid poplar microsomes demonstrated that transport activity was localized to the tonoplast- and endomembrane-rich fraction. Differentiating xylem of Japanese cypress exhibited almost identical transport properties, suggesting the involvement of a common endomembrane-associated proton/coniferin antiport mechanism in the lignifying tissues of woody plants, both angiosperms and gymnosperms.
Defensive microbial symbionts in Hymenoptera
Authors: Kaltenpoth Martin , Engl Tobias
Published: April 2013

In all stages of their life cycle, insects are threatened by a multitude of predators, parasites, parasitoids and pathogens. The lifestyles and feeding ecologies of some hymenopteran taxa render them especially vulnerable to pathogen infestation. Specifically, development in sub‐terranean brood cells, mass provisioning of resources for the offspring and the life of social insects in large communities can enhance the risk of pathogen infestation and/or the spread of disease among conspecifics.

To counteract these threats, insects have evolved mechanical, chemical and behavioural defences as well as a complex immune system. In addition to the host's own defences, some Hymenoptera are associated with protective symbionts. Leaf‐cutting ants, solitary digger wasps, bees and bumblebees engage in symbiotic interactions with bacteria that protect the adult host, the developing offspring or the food resources against microbial infections. In the well‐studied cases of ants and wasps, the protective activity is mediated by the production of antimicrobial secondary metabolites. In other symbiotic interactions, however, competitive exclusion and immune priming may also play an important role in enhancing protection. Phylogenetic studies indicate that the defensive associations in Hymenoptera are generally more dynamic than the intimate nutritional mutualisms, with horizontal transfer or de novo uptake of the symbionts from the environment occurring frequently.

Mutualistic micro‐organisms can also significantly influence the outcome of host‐parasitoid interactions. Some insects are protected by symbiont‐produced toxins against parasitic wasps. Ichneumonid and braconid parasitoids, on the other hand, are associated with symbiotic viruses that are injected into the caterpillar host during oviposition and suppress its immune system to the advantage of the parasitoid.

The increasing affordability of next‐generation sequencing technologies will greatly facilitate the analysis of insect‐associated microbial communities and undoubtedly uncover a plethora of as yet unknown protective symbioses. However, a detailed understanding of the host's natural history is indispensable for elucidating the fitness benefits of the symbionts and the molecular basis of symbiont‐conferred protection.
No clear effects of acute tryptophan depletion on processing affective prosody in male adults with ADHD
Authors: Grabemann M. , Mette C. , Zimmermann M. , Heinrich V. , Uekermann J. , Wiltfang J. , Abdel‐Hamid M. , Zepf F. D. , Kis B.
Published: April 2013

Objective

Adults with attention deficit hyperactivity disorder (ADHD) have difficulties processing affective prosody, and research evidence demonstrates the importance of brain serotonin (5‐HT) in the neurobiology of ADHD. This study aimed to investigate whether diminished brain 5‐HT synthesis, as achieved by acute tryptophan depletion (ATD), can impair the processing of affective prosody in adults with ADHD.

Method

Twenty male patients with ADHD and twenty male healthy controls received ATD and a tryptophan‐balanced control condition on separate days in a double‐blind within‐subject repeated measures crossover design. In both conditions, the Tübingen Affect Battery was administered in which subjects had to name the affective prosody of sentences with neutral, congruent, or incongruent semantic content.

Results

Participants in the group of patients with ADHD perceived affec‐tive prosody less accurately than controls. Participants with ADHD showed compromised processing of sentences, committing more errors than healthy controls when identifying affect in instances of incongruent semantic content (P = 0.031). ATD did not contribute to this effect (all P > 0.5).

Conclusion

The difficulties male adults with ADHD have in accurately processing affective prosody may result from impairments in their ability to inhibit unwanted stimuli and impulses. No clear evidence implicates 5‐HT as a cause of these impairments.
Short‐term training alters the control of mitochondrial respiration rate before maximal oxidative ATP synthesis
Authors: Layec G. , Haseler L. J. , Hoff J. , Hart C. R. , Liu X. , Le Fur Y. , Jeong E.‐K. , Richardson R. S.
Published: April 2013

Aim

Short‐term exercise training may induce metabolic and performance adaptations before any changes in mitochondrial enzyme potential. However, there has not been a study that has directly assessed changes in mitochondrial oxidative capacity or metabolic control as a consequence of such training in vivo. Therefore, we used 31P‐magnetic resonance spectroscopy (31P‐MRS) to examine the effect of short‐term plantar flexion exercise training on phosphocreatine (PCr) recovery kinetics and the control of respiration rate.

Method

To this aim, we investigated 12 healthy men, experienced with this exercise modality (TRA), and 7 time‐control subjects (TC).

Results

After 5 days of training, maximum work rate during incremental plantar flexion exercise was significantly improved (P < 0.01). During the recovery period, the maximal rate of oxidative adenosine triphosphate synthesis (PRE: 28 ± 13 mm min−1; POST: 26 ± 15 mm min−1) and the PCr recovery time constant (PRE: 31 ± 19 s; POST: 29 ± 16) were not significantly altered. In contrast, the Hill coefficient (nH) describing the co‐operativity between respiration rate and ADP was significantly increased in TRA (PRE: nH = 2.7 ± 1.4; POST: nH = 3.4 ± 1.9, P < 0.05). Meanwhile, there were no systematic variations in any of these variables in TC.

Conclusion

This study reveals that 5 days of training induces rapid adaptation in the allosteric control of respiration rate by ADP before any substantial improvement in muscle oxidative capacity occurs.
Deworming is not a risk factor for the development of atopic diseases: a longitudinal study in Cuban school children
Authors: van der Werff S. D. , Twisk J. W. R. , Wördemann M. , Ponce M. Campos , Díaz R. Junco , Núñez F. A. , Rivero L. Rojas , Gorbea M. Bonet , Polman K.
Published: April 2013

Background

Soil‐transmitted helminth (STH) infections have been suggested to protect from allergic sensitization and atopic diseases. Consequently, anthelminthic treatment would increase the prevalence of atopic disease in STH endemic populations.

Objective

To investigate the effect of deworming on allergic sensitization and atopic diseases in Cuban schoolchildren.

Methods

We followed up 108 STH positive schoolchildren aged 5–13 in six‐monthly intervals for 24 months. Four consecutive groups of, respectively, 104, 56, 68, and 53 STH positive children were used as ‘untreated’ reference groups to assess general time trends. STH infections were diagnosed by stool examination. Asthma, allergic rhinoconjunctivitis, and atopic dermatitis were diagnosed by International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and allergic sensitization by skin prick testing (SPT). At each time point, STH positive children were treated with one single dose of 500 mg mebendazole.

Results

After deworming, the frequency of asthma significantly decreased (P < 0.001) while the frequency of allergic rhinoconjunctivitis and atopic dermatitis was not affected (P = 0.129 and P = 0.751, respectively). The percentage of SPT positives temporarily increased (P < 0.001) and subsequently returned to nearly baseline values (P = 0.093). In the references groups, no change over time was observed in the proportion of children with allergic sensitization and atopic diseases (P > 0.05).

Conclusion & Clinical Relevance

Our results indicate that atopic diseases do not increase after anthelminthic treatment. Allergic sensitization on the other hand increases after deworming. As this increase appears only temporarily, deworming of schoolchildren does not seem to be a risk factor for the development of allergic sensitization, nor for atopic diseases.
Plasma calcium as a predictor of cardiovascular disease in a community‐based cohort
Authors: Walsh John P. , Divitini Mark L. , Knuiman Matthew W.
Published: April 2013

Objective

Primary hyperparathyroidism and calcium supplementation have been linked to cardiovascular outcomes. The study objective was to examine plasma calcium as a predictor of cardiovascular disease in the general population, as results from previous cohort studies are conflicting.

Design, participants and measurements

Plasma calcium was measured in 4003 participants (aged 25–84 years) in the 1994/1995 Busselton Health Survey. Using a Cox proportional hazards model, we examined albumin‐corrected calcium as a predictor of total mortality, cardiovascular mortality and cardiovascular events up to the end of 2010.

Results

At baseline, there were significant positive relationships between plasma calcium and each of body mass index, systolic and diastolic blood pressure, glucose and total cholesterol. During the follow‐up period, 666 participants died (278 from cardiovascular disease) and 652 had incident cardiovascular events. After adjustment for age and sex, each additional 0·1 mm of albumin‐corrected calcium at baseline was associated with a hazard ratio (HR) of 1·09 [95% confidence interval (CI) 0·99, 1·20; P = 0·062] for total mortality, 1·06 (95% CI 0·92, 1·23; P = 0·41) for cardiovascular mortality and 1·13 (95% CI 1·03, 1·24; P = 0·012) for cardiovascular events. These associations were attenuated by further adjustment for standard cardiovascular risk factors with HR 1·03 (95% CI 0·94, 1·14), 0·99 (95% CI 0·86, 1·16) and 1·05 (95% CI 0·95, 1·15), respectively.

Conclusion

After adjustment for age and sex, plasma calcium is a predictor of cardiovascular events. This appears to be mediated by conventional cardiovascular risk factors, and calcium is not an independent predictor of cardiovascular disease.
Diffusion weighted MRI: overview and implications for rectal cancer management
Authors: Boone D. , Taylor S. A. , Halligan S.
Published: April 2013

Diffusion weighted imaging (DWI) is an MRI technique that quantifies the movement of water molecules at a cellular level. As the diffusion properties of water vary in areas of necrosis, high cellularity, inflammation and fibrosis, this technique is inherently sensitive to different pathologies. Having become a well‐established adjunct to standard sequences during neurological MRI, technological advances have enabled extrapolation to abdominopelvic imaging, including staging of rectal cancer. Scan acquisitions can be performed rapidly using widely available equipment and consequently there has been rapid dissemination into routine practice. However, while DWI shows promise for detecting, staging and monitoring rectal cancer response to therapy, the evidence base remains scant with no current consensus for technical protocols, interpretation or integration into rectal cancer management. Moreover, those studies available to date have a small sample size and few observers, and their results may not be generalizable to daily practice. This article outlines the physical principles of DWI, reviews the literature and suggests avenues for future research into this important technical development.
Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients
Authors: Guner A. , Ozkan O. F. , Kece C. , Kesici S. , Kucuktulu U.
Published: April 2013

Aim

There is no definitive consensus on the best treatment for pilonidal sinus. The Bascom cleft lift technique has been reported to produce successful results. This study presents the results of a modified cleft lift procedure in which the sinus tissue was excised and the lower end of the incision was kept outside the intergluteal sulcus by extending the lower end of the incision laterally.

Method

Between August 2010 and January 2012, 141 consecutive patients who presented with primary or recurrent pilonidal sinus disease were included in the study, which was conducted at a single tertiary academic medical centre. Prospectively collected data were recorded, including complications, pain score, satisfaction level, primary healing rate, length of hospital stay and early recurrence.

Results

The mean operating time was 30 min and the mean length of hospital stay was 1.2 days. The most common surgical‐site complication was a collection followed by partial wound dehiscence and superficial infection. The primary healing rate was 88%, the mean time for functional recovery was 13 days and the mean follow‐up time was 14 months. No recurrence was observed within this follow‐up period.

Conclusion

The modified Bascom cleft lift technique is effective and reliable. It is applicable to all pilonidal sinus cases and has low complication rates, high satisfaction scores, rapid early recovery and low recurrence rates.
Risk factors associated with poor lymph node harvest after colon cancer surgery in a national cohort
Authors: Nedrebø B. S. , Søreide K. , Nesbakken A. , T. Eriksen M. , Søreide J. A. , Kørner H. ,   the Norwegian Colorectal Cancer Group
Published: April 2013

Aim

Evaluation of ≥ 12 lymph nodes (LNs) is recommended after surgery for colon cancer. A harvest of ≤ 8 is considered poor, but few reports have evaluated risk factors associated with a poor harvest. This aims of this study were to analyse the clinical, surgical and pathological factors associated with poor LN harvest (LNH), the total number of examined nodes and the effect of LN number on stage.

Method

All patients reported to the Norwegian Colorectal Cancer Registry during 2007 and 2008 who underwent curative resection for Stage I–III colon cancer were studied. Risk factors for poor LNH and the proportion of Stage III disease were analysed by univariate and multivariate analyses.

Results

A total of 2879 patients were included in the study. The median LNH was 14. Overall, 69.9% had ≥ 12 lymph nodes and 14.4% had ≤ 8 LN (poor harvest). Multivariate analysis showed that male sex, age > 75 years, sigmoid tumours, pT category 1–2, failure to use the pathology report template and distance of ≤ 5 cm from the bowel resection margin were all independent factors for poor LNH. Age < 65 years, pT category 3–4, and poor tumour differentiation were independent predictors of Stage III disease. An increased LNH did not increase the proportion of patients identified as being LN positive at the ≤ 8, 9–11 and ≥ 12 LN levels.

Conclusion

Adequate LNH was achieved in the majority of curative colon cancer resections in this national cohort. Elderly, male patients with sigmoid cancers, and a short distal margin were at increased risk of a poor LNH.
Pseudolymphomatous cutaneous angiosarcoma: a report of 2 new cases arising in an unusual setting
Authors: Rongioletti Franco , Albertini Ann‐Flore , Fausti Valentina , Cinotti Elisa , Parodi Aurora , Fraitag Silvie
Published: April 2013

Pseudolymphomatous cutaneous angiosarcoma represents a rare, relatively new variant of cutaneous angiosarcoma exhibiting a prominent inflammatory lymphoid infiltrate that can mask the underlying vascular malignant proliferation and mimic a lymphomatous or pseudolymphomatous process. We describe the clinicopathologic characteristics of two new cases of pseudolymphomatous cutaneous angiosarcoma whose originality lies in the unusual setting from which they have arisen. In fact, the first case was an exceedingly lymphocyte‐rich recurrence of a typical epithelioid cutaneous angiosarcoma whose primary lesion that was almost devoid of inflammatory infiltrate underwent surgical excision and radiotherapy while the second one was an unexpected histopathological finding associated with a basal cell carcinoma. Immunohistochemically, most of the lymphocytes expressed immunoreactivity for T‐cell markers, while the neoplastic endothelial lymphatic cells expressed CD31 and CD34. D2‐40 immunoreactivity was observed lining some channels and some neoplastic cells. In the first case a possible relationship between radiotherapy and the pseudolymphomatous reactive pattern is discussed while the second case has been considered as a rare example of collision tumor.
Prediction of hemorrhagic transformation in acute ischaemic stroke by micro‐ and macroalbuminuria after intravenous thrombolysis
Authors: Cho B.‐H. , Kim J.‐T. , Chang J. , Choi K.‐H. , Park M.‐S. , Cho K.‐H.
Published: April 2013

Background and purpose

Hemorrhagic transformation (HT) is one of the most problematic complications to arise from intravenous thrombolysis (IVT). This study was conducted to assess whether micro‐ and macroalbuminuria could be associated with HT after IVT in patients with acute ischaemic stroke, and to investigate whether the value of urinary albumin‐to‐creatinine ratios would correlate with the degree of HT.

Methods

This was a retrospective study of stroke patients who had undergone IVT within 3 h of symptom onset. Albuminuria assessment was based on random morning spot urine collection with patients in a fasting state, the first morning after IVT. Multiple logistic regression analysis was used to evaluate whether the presence of micro‐ and macroalbuminuria might be independent predictors of HT.

Results

One‐hundred and fifty‐four patients were included in the study. Fifty‐one patients had HT. The presence of micro‐ or macroalbuminuria was associated with HT after adjustment for variables with clinical significance (adjusting for age, atrial fibrillation, platelet counts, baseline National Institutes of Health Stroke Scale score, hypertension and diabetes mellitus; odds ratio, 2.542; 95% confidence interval, 1.106–5.841; P = 0.028). There were significant relationships between the presence of micro‐ and macroalbuminuria and types of HT.

Conclusion

In conclusion, the results of this study suggest that the presence of micro‐ and macroalbuminuria after IVT could be a predictor of severe HT in patients with acute ischaemic stroke.
Optical coherence tomography does not support optic nerve involvement in amyotrophic lateral sclerosis
Authors: Roth N. M. , Saidha S. , Zimmermann H. , Brandt A. U. , Oberwahrenbrock T. , Maragakis N. J. , Tumani H. , Ludolph A. C. , Meyer T. , Calabresi P. A. , Paul F.
Published: April 2013

Background and purpose

In recent years a possible non‐motor involvement of the nervous system in amyotrophic lateral sclerosis (ALS) has come into the focus of research and has been investigated by numerous techniques. Optical coherence tomography (OCT) – with its potential to reveal neuroaxonal retinal damage – may be an appropriate tool to investigate whether the anterior visual pathway is involved. Our aim was to determine whether OCT‐based measures of retinal nerve fiber layer, ganglion cell layer, inner nuclear layer and outer nuclear layer thickness are abnormal in ALS, or correlated with disease severity.

Methods

Seventy‐six ALS patients (144 eyes) and 54 healthy controls (108 eyes; HCs) were examined with OCT, including automated intraretinal macular segmentation. ALS disease severity was determined with the Amyotrophic Lateral Sclerosis Functional Rating Scale – Revised.

Results

There was no significant difference between ALS patients and HCs in any of the examined OCT measures. Moreover, OCT parameters showed no correlation with clinical measures of disease severity.

Conclusions

These findings indicate that involvement of the anterior visual pathway is not one of the non‐motor manifestations of ALS.
Sonographic detection of basal ganglia abnormalities in spasmodic dysphonia
Authors: Walter U. , Blitzer A. , Benecke R. , Grossmann A. , Dressler D.
Published: April 2013

Background and purpose

Abnormalities of the lenticular nucleus (LN) on transcranial sonography (TCS) are a characteristic finding in idiopathic segmental and generalized dystonia. Our intention was to study whether TCS detects basal ganglia abnormalities also in spasmodic dysphonia, an extremely focal form of dystonia.

Methods

Transcranial sonography of basal ganglia, substantia nigra and ventricles was performed in 14 patients with spasmodic dysphonia (10 women, four men; disease duration 16.5 ± 6.1 years) and 14 age‐ and sex‐matched healthy controls in an investigator‐blinded setting.

Results

Lenticular nucleus hyperechogenicity was found in 12 spasmodic dysphonia patients but only in one healthy individual (Fisher's exact test, P < 0.001) whilst other TCS findings did not differ. The area of LN hyperechogenic lesions quantified on digitized image analysis correlated with spasmodic dysphonia severity (Spearman test, r = 0.82, P < 0.001).

Conclusion

Our findings link the underlying pathology of spasmodic dysphonia to that of more widespread forms of dystonia.
Young adult ischaemic stroke related acute symptomatic and late seizures: risk factors
Authors: Roivainen R. , Haapaniemi E. , Putaala J. , Kaste M. , Tatlisumak T.
Published: April 2013

Background and purpose

After first‐ever ischaemic stroke, to assess the risk and baseline factors associated with acute symptomatic seizure (ASS) (occurring within 7 days) and late post‐stroke seizure (LPS) (>7 days).

Methods

All consecutive patients aged 15–49 with first‐ever ischaemic stroke between 1994 and 2007 treated at the Helsinki University Central Hospital were included, using Cox proportional hazard models to identify factors associated with seizures. Adjustment was for age, gender, vascular risk factors, admission hyperglycemia (>6.1 mm) and hyponatremia (<137 mm), use of psychiatric medication, stroke severity (NIH Stroke Scale) and anatomical (Bamford criteria) and etiological (Trial of Org in Acute Stroke Treatment) stroke subtype.

Results

ASSs emerged in 35 (3.5%) patients. LPSs (n = 102) occurred at a cumulative rate of 6.1% at 1 year, 9.5% at 5 years and 11.5% at 10 years. In multivariate analysis, anxiolytic use at time of index stroke (hazard ratio 13.43, 95% confidence interval 3.91–46.14), moderate stroke severity (3.95, 1.86–8.41), cortical involvement (3.69, 1.66–8.18) and hyponatremia (3.26, 1.41–7.57) were independently associated with ASSs. Risk factors for LPSs were total anterior circulation infarct (15.94, 7.62–33.33), partial anterior circulation infarct (3.48, 1.52–7.93), history of ASS (3.94, 2.07–7.48), antidepressant use at the time of LPS (3.88, 2.46–6.11), hemorrhagic infarct (1.94, 1.19–3.15), male gender (1.79, 1.10–2.92) and hyperglycemia (1.62, 1.05–2.51).

Conclusions

In young ischaemic stroke patients, the magnitude of seizure risk and the major risk factors were similar to older ischaemic stroke patients but risk factors for ASSs and LPSs differed.
Impact of homocysteine on cortical perfusion and cognitive decline in mild Alzheimer's dementia
Authors: Huang C.‐W. , Chang W.‐N. , Huang S.‐H. , Lui C.‐C. , Chen N.‐C. , Chang Y.‐T. , Lee C.‐C. , Chang C.‐C. , Chang A. Y. W.
Published: April 2013

Background and purpose

Elevated plasma total homocysteine level (tHcy) is associated with increased risk of dementia via increased white matter changes or reduction in cortical volume. Whether tHcy has an independent impact on regional perfusion and if it can predict a more rapid cognitive decline in mild Alzheimer dementia (AD) warrants investigation.

Methods

Eighty AD patients with a clinical dementia rating of 1 were enrolled. Their Cognitive Ability Screening Instrument (CASI) scores on enrolment and after 1 year of follow‐up as well as their perfusion index (PI) from single photon emission computed tomography upon enrolment were analyzed.

Results

In cross‐sectional analysis, elevated tHcy was associated with lower frontal PI independent of cerebrovascular risk factors (β = −0.35, P = 0.009). The CASI scores correlated with temporo‐parietal PI (Pearson r range 0.3–0.39, P < 0.01) but not with tHcy or frontal PI. By longitudinal analysis, only tHcy level was related to a more rapid cognitive decline (odds ratio for executive function score 1.82; odds ratio for total CASI score 1.74).

Conclusions

Cognitive performance in mild AD can be reflected by hypo‐perfusion of the temporo‐parietal region while frontal hypo‐perfusion may be mediated by tHcy. tHcy level is an independent risk factor for rapid cognitive decline, especially in the executive function.
Designing a new scale to measure anxiety symptoms in Parkinson's disease: item selection based on canonical correlation analysis
Authors: Martinez‐Martin P. , Rojo‐Abuin J. M. , Dujardin K. , Pontone G. M. , Weintraub D. , Forjaz M. J. , Starkstein S. , Leentjens A. F. G.
Published: April 2013

Background and purpose

The lack of appropriate measures has hindered the research on anxiety syndromes in Parkinson's disease (PD). The objective of the present cross‐sectional, international study was to identify shared elements and grouping of components from anxiety scales as a basis for designing a new scale for use in PD.

Methods

For this purpose, 342 consecutive PD patients were assessed by means of the Mini International Neuropsychiatric Inventory (depression and anxiety sections), the Clinical Global Impression of severity of the anxiety symptoms, the Hamilton Anxiety Rating Scale (HARS), the Neuropsychiatric Inventory (section E), the Beck Anxiety Inventory (BAI) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS‐A).

Results

As the HADS‐A showed a weak correlation with the HARS and BAI, it was not considered for more analyses. HARS and BAI exploratory factor analysis identified nine factors (62% of the variance), with only two of them combining items from both scales. Therefore, a canonical correlation model (a method to identify relations between components of two groups of variables) was built and it showed four factors grouping items from both scales: the first factor corresponded to ‘generalized anxiety’; the second factor included muscular, sensory and autonomic ‘non‐specific somatic symptoms’; the third factor was dominated by ‘respiratory symptoms’; and the fourth factor included ‘cardiovascular symptoms’.

Conclusions

BAI is heavily focused on panic symptoms, whilst HARS is more focused towards generalized anxiety symptoms. The new scale should include additional components in order to assess both episodic and persistent anxiety as well as items for evaluation of avoidance behaviour.
Reflux dolomitization of the Upper Permian Changxing Formation and the Lower Triassic Feixianguan Formation, NE Sichuan Basin, China
Authors: Jiang L. , Cai C. F. , Worden R. H. , Li K.‐K. , Xiang L.
Published: April 2013

Natural gas is found in Upper Permian and Lower Triassic dolomite reservoirs of the NE Sichuan Basin, China. Studying the mechanisms for porosity‐modifying dolomitization and predicting its spatial distribution is of great importance for exploration and field appraisal. Subsurface core samples from the oolitic Lower Triassic Feixianguan Formation and outcrop samples reef carbonate Upper Permian Changxing Formation were studied using cathodoluminescence (CL), electron microprobe, fluid inclusion and isotope studies (δ18O, δ13C and 87Sr/86Sr), in an attempt to determine the origin of the dolomitizing fluids. Trace element and isotope data show that Lower Triassic seawater was most likely responsible for dolomitization of both the Permian and Triassic rocks. Sr/Ca molar ratios, calculated for the diagenetic fluid, suggest seawater was involved in dolomitization. Strontium isotope data suggest that seawater 87Sr/86Sr during the Jialingjiang (Lower Triassic) reached 0.7078; this ratio is recorded ubiquitously in both Lower Triassic oolitic dolomite and the underlying Lower Permian reef dolomite. In the Permian Changxing Formation, elevated Triassic 87Sr/86Sr values have overprinted the significantly lower 87Sr/86Sr ratio characteristic of Upper Permian seawater. Fluid inclusion analysis led to the conclusion that dolomitization must have commenced at a temperature lower than about 50°C. Integrating the sedimentology, petrology and geochemistry data, we conclude that coeval Lower Triassic (Feixianguan or slightly younger) seawater caused dolomitization by a reflux‐seepage process for both the Lower Triassic and Upper Permian units. There is no evidence for deep burial or meteoric‐marine mixing‐zone dolomitization. It is likely that evaporating seawater initially flowed into the highly porous oolitic Feixianguan Formation in a sabkha/lagoonal setting and precipitated anhydrite nodules and beds. Concomitant dolomitization, in the underlying Permian reef carbonates, continued during seepage even after the supply of sulphate was exhausted, leading to an absence of anhydrite in Permian Changxing Formation.
Description of two new HLA‐C alleles: C*08:63 and C*14:44
Authors: Mantovani M. , Longhi E. , Frison S. , Lazzari R. , Espadas De Arias A. , Piccolo G. , Poli F.
Published: April 2013

Here, we present two new HLA allelic variants at C locus: HLA‐C*08:63 and HLA‐C*14:44 detected by sequence‐based typing. In both cases, a single‐nucleotide mutation in exon 3 is responsible for a change in aminoacid translation. The extremely high polymorphism of human leucocyte antigen (HLA) system in human genome is responsible for the capability to recognize different antigens, including non‐self‐MHC (Major Histocompatibility Complex) molecules. This very high polymorphism and the improving accuracy of genomic HLA typing methods lead to an exponential increasing of known HLA alleles. Here, we describe the characterization of two new HLA‐C alleles identified by sequence‐based typing (SBT): HLA‐C*08:63 and HLA‐C*14:44.