bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of hysterectomy and menopause: a prospective cohort study
Authors: Farquhar Cynthia M. , Sadler Lynn , Harvey Sally A. , Stewart Alistair W.
Published: June 2005

Objective  To determine whether or not hysterectomy leads to an earlier onset of the menopause.

Design  A prospective cohort study.

Setting  Gynaecology service of large urban hospital.

Population  Premenopausal women with and without hysterectomy.

Methods  Multivariate survival analysis techniques were used to adjust for differences in initial follicle stimulating hormone (FSH) levels, body mass index, smoking and unilateral oophorectomy between the groups.

Main outcome measures  FSH levels were measured for five years following hysterectomy and compared with the comparison group. Menopause was defined as a single FSH measurement of at least 40 IU/L.

Results  Two hundred and fifty‐seven women undergoing hysterectomy were compared with 259 women who had not undergone a hysterectomy. Fifty‐three women (20.6%) in the hysterectomy group and 19 women (7.3%) in the comparison group reached menopause over the five years of the study. Women in the hysterectomy group with a pre‐operative FSH <10 IU/L reached menopause 3.7 years (95% CI 1.5–6.0 years) earlier than women in the comparison group independent of BMI, smoking and unilateral oophorectomy. Twenty‐eight women in the hysterectomy group had unilateral oophorectomy and 10 (35.7%) of these women reached menopause over the five years of follow up. Women in the hysterectomy group with unilateral oophorectomy reached menopause 4.4 years (95% CI 0.6, 7.9 years) earlier than women with both ovaries in the hysterectomy group independent of baseline FSH, BMI and smoking.

Conclusions  Hysterectomy is associated with an earlier onset of menopause. Hysterectomy with unilateral oophorectomy is associated with an even earlier onset of the menopause in this study.
DJ‐1 is present in a large molecular complex in human brain tissue and interacts with α‐synuclein
Authors: Meulener Marc C. , Graves Charles L. , Sampathu Deepak M. , Armstrong‐Gold Cecilia E. , Bonini Nancy M. , Giasson Benoit I.
Published: June 2005

DJ‐1 is a ubiquitously expressed protein involved in various cellular processes including cell proliferation, RNA‐binding, and oxidative stress. Mutations that result in loss of DJ‐1 function lead to early onset parkinsonism in humans, and DJ‐1 protein is present in pathological lesions of several tauopathies and synucleinopathies. In order to further investigate the role of DJ‐1 in human neurodegenerative disease, we have generated novel polyclonal and monoclonal antibodies to human DJ‐1 protein. We have characterized these antibodies and confirmed the pathological co‐localization of DJ‐1 with other neurodegenerative disease‐associated proteins, as well as the decrease in DJ‐1 solubility in disease tissue. In addition, we report the presence of DJ‐1 in a large molecular complex (> 2000 kDa), and provide evidence for an interaction between endogenous DJ‐1 and α‐synuclein in normal and diseased tissue. These findings provide new avenues towards the study of DJ‐1 function and how loss of its activity may lead to parkinsonism. Furthermore, our results provide further evidence for the interplay between neurodegenerative disease‐associated proteins.
Oviposition in an eruptive moth species, Yponomeuta evonymellus, is insensitive to the population density experienced during the larval period
Authors: Javoiš Juhan , Tammaru Toomas , Käär Miia
Published: June 2005

We studied if the population density experienced during larval development affects the reproductive schedule of Yponomeuta evonymellus L. (Lepidoptera, Yponomeutidae), a moth species characterized by outbreak population dynamics. More specifically, we predicted that reproduction would be delayed to facilitate emigration from sites with suboptimally high densities of conspecifics. We manipulated larval densities in the laboratory, as well as in those pupae collected from the extremes of natural densities. As the response, we also recorded the timing and sizes of egg clutches laid. The results did not support our initial predictions: the timing of oviposition was not dependent on larval growth conditions. This apparent lack of adaptation might be related to the loss of ‘memory’ during metamorphosis in holometabolous insects. However, oviposition schedules were also only minimally sensitive to elevated adult density. An inability to respond to high larval densities may contribute to the outbreak dynamics in this species.
Behavioural responses in three ichneumonid pollen beetle parasitoids to volatiles emitted from different phenological stages of oilseed rape
Authors: Jönsson Martin , Lindkvist Anna , Anderson Peter
Published: June 2005

Pollen beetles (Meligethes spp.; Coleoptera: Nitiduliae) are a major pest of oilseed rape, Brassica napus L. (Brassicaceae) in northern Europe. Phradis interstitialis Thomson, P. morionellus Holmgr., and Tersilochus heterocerus Thomson (Hymenoptera: Ichneumonidae) are among the most frequent pollen beetle parasitoids. These three species differ in temporal occurrence, as well as in preferred host stage. The behavioural responses of female parasitoids to odours from oilseed rape at bud and flowering stage were evaluated in two‐choice experiments. The role of visual stimuli was examined by combining green and yellow colours with odour stimuli. All three species were attracted to odours from the bud stage of oilseed rape. Tersilochus heterocerus was attracted to odours of flowering rape, but the two Phradis species avoided the flower odours. However, when the odours of flowering rape were combined with yellow, and odours of the bud stage were combined with green, P. interstitialis was equally attracted to both stimuli, and T. heterocerus showed an increased preference for flower odours, while no effect of colours could be found in P. morionellus. The observed differences in responses between the parasitoids may reflect differences in their biology and may be involved in the niche segregation of these often coexisting species. The volatile blends released from the two phenological stages were identified and compared. Clearly, odours can be reliable cues for differentiating between oilseed rape in the bud and flowering stage. Of 20 identified compounds, 18 were released at a significantly higher rate from flowering plants. The terpenes sabinene, myrcene, limonene, and (E,E)‐α‐farnesene were the dominant volatiles in the bud and flower headspace. A group of aromatic compounds including benzaldehyde, methyl benzoate, and phenyl acetaldehyde were mainly released from flowering rape.
Host preference and suitability of some selected crops for two biotypes of Bemisia tabaci in Ghana
Authors: Omondi A.B. , Obeng‐Ofori D. , Kyerematen R.A. , Danquah E.Y.
Published: June 2005

The economic importance of Bemisia tabaci (Gennadius) (Homoptera: Aleyrodidae) is mainly due to its wide host range, variable kinds of damage, and great intraspecific variation. The delineation of two African biotypes of this pest has been carried by molecular, ecological, and host‐affiliation approaches, with largely consistent results. However, an understanding of its intricate host–pest interaction is necessary as a basis of its sustainable integrated control. This study investigated the host preference and suitability of cassava and okra biotypes of B. tabaci, based on multiple‐choice landing and oviposition preference assays and stage‐specific survival on eight common whitefly hosts. The cassava biotype significantly preferred cassava, Manihot esculenta, for landing and oviposition, but did not oviposit on okra, Abelmoschus esculentus. The okra biotype preferred okra, oviposited on eggplant, Solanum melongena, tomato, Lycopersicon esculentum, garden egg, Solanum integrifolium, and cowpea, Vigna unguiculata, but did not oviposit on cassava. The okra biotype developed on all hosts except cassava, but only survived marginally on cabbage, Brassica oleracea, and pepper, Capsicum annum var. grosum, while the cassava biotype did not develop on okra, cabbage, or pepper. Thus the observed host acceptance of the two biotypes is wider than earlier reported by host transfer experiments and molecular genetic surveys. Mortality was highest in the first instar nymphal stage, during which total mortality occurred on non‐hosts. Development time was slightly longer on marginal hosts than on the preferred hosts. Cowpea, garden egg, and tomato are additional common hosts of the two biotypes, whose role as reservoir hosts and biotype interbreeding grounds should be investigated further.
Influence of temperature on alkaloid levels and fall armyworm performance in endophytic tall fescue and perennial ryegrass
Authors: Salminen Seppo O. , Richmond Douglas S. , Grewal Sukhbir K. , Grewal Parwinder S.
Published: June 2005

The symbiotic relationships between Neotyphodium endophytes (Clavicipitacea) and certain cool‐season (C3) grasses result in the synthesis of several alkaloids that defend the plant against herbivory. Over a 3 month period we evaluated the effects of temperature on the expression of these alkaloids in tall fescue, Festuca arundinacea Schreb, and perennial ryegrass, Lolium perenne L. (Poaceae). Response surface regression analysis indicated that month, temperature, and their interaction had an impact on the alkaloid levels in both grasses. We aimed to identify the alkaloids most closely associated with enhanced resistance to the fall armyworm, Spodoptera frugiperda JE Smith (Lepidoptera: Noctuidae), and clarify the role of temperature in governing the expression of these alkaloids. The dry weights and survival of fall armyworms feeding on endophyte‐infected tall fescue or perennial ryegrass were significantly lower than for those feeding on uninfected grass, whereas endophyte infection had no significant influence on survival. For tall fescue, a four‐alkaloid model consisting of a plant alkaloid, perloline, and the fungal alkaloids ergonovine chanoclavine, and ergocryptine, explained 47% of the variation in fall armyworm dry weight, whereas a three‐alkaloid model consisting of the plant alkaloid perloline methyl ether and the fungal alkaloids ergonovine and ergocryptine explained 70% of the variation in fall armyworm dry weight on perennial ryegrass. Although temperature had a significant influence on overall alkaloid expression in both grasses, the influence of temperature on individual alkaloids varied over time. The levels of those alkaloids most closely linked to armyworm performance increased linearly or curvilinearly with increasing temperature during the last 2 months of the study. We conclude that the growth temperature of grasses can influence the performance of fall armyworm, and that this effect may be mediated through a set of plant‐ and endophyte‐related alkaloids.
The Botanophila–Epichloë association in cultivated Festuca in Oregon: evidence of simple fungivory
Authors: Rao S. , Alderman S.C. , Takeyasu J. , Matson B.
Published: June 2005

We investigated the Botanophila (Diptera: Anthomyiidae)–Epichloë (Ascomycetes: Clavicipitaceae) interaction in cultivated Festuca spp. (fine fescue) in Oregon in western USA. Epichloë spp. are endophytic fungi of grasses in the subfamily Pooideae. They develop a felt‐like stroma on the surface of grass culms and a dense mycelium within the culms that typically prevents seed head emergence. As a result, seed yields are suppressed, and hence the disease is known as choke. Studies of Epichloë spp. on wild grasses indicate that the fly–fungus interaction is an obligatory mutualism. During oviposition, Botanophila transfers Epichloë spermatia between stromata of opposite mating types, and the perithecia that develop after fungal fertilization serve as food for Botanophila larvae. In the current study, we surveyed 19 cultivated fields of Festuca spp. in Oregon, and observed choke caused by Epichloë festucae Leuchtmann, Schardl and Siegl in 10 of these. However, perithecia were observed in only four fields, and on only 1.0–2.6% of stromata. Perithecial development was also low, and rarely covered 50% of the stroma surface. Despite the absence or low frequency of fertilized stromata, Botanophila lobata Collin larvae were present in all choke‐infested fields. Infestation levels ranged from 2.5 to 70.7%, based on an examination of 175–200 stromata from each field. Only eight (= 2%) of the 450 stromata with B. lobata had perithecia, and the greater majority of B. lobata larvae completed development and exited from unfertilized stromata. This is the first report of the B. lobata–E. festucae association in the USA, and of B. lobata larvae developing successfully on unfertilized Epichloë stromata. The average pupal weight (0.0032 g) did not differ significantly from pupae (0.0030 g) originating from larvae that had developed on fertilized stromata of E. typhina on Dactylis glomerata in a neighboring field. This result indicates that in cultivated fine fescue fields in Oregon, B. lobata forages on E. festucae, but fly development is not dependent on the fertilized stromata of Epichloë.
Disease, deficit or denial? Models of poor insight in psychosis
Authors: Cooke M. A. , Peters E. R. , Kuipers E. , Kumari V.
Published: June 2005

Objective: To examine the evidence for the three kinds of aetiological model that dominate the current literature on poor insight in psychosis: clinical models, the neuropsychological model, and the psychological denial model.

Method: Studies pertaining to one or more of these aetiological models were identified, reviewed and critically evaluated.

Results: There is little support for clinical models, partly because they lack testable hypotheses. Several studies reveal a positive relationship between insight and executive function, which may be related to frontal lobe dysfunction. However, the extent to which this relationship is specific and independent of general cognitive impairment remains unclear. There is tentative evidence to support the psychological denial model. Recent data combining the latter two approaches suggest that multiple factors contribute to poor insight.

Conclusion: Integration of different aetiological models is necessary for a fuller understanding of insight in psychosis. Future research should assess multiple aetiological mechanisms in single investigations.
Breastfeeding and risk of schizophrenia in the Copenhagen Perinatal Cohort
Authors: Sørensen H. J. , Mortensen E. L. , Reinisch J. M. , Mednick S. A.
Published: June 2005

Objective:  The aim was to study whether early weaning from breastfeeding may be associated with increased risk of schizophrenia.

Method:  The current sample comprises 6841 individuals from the Copenhagen Perinatal Cohort of whom 1671 (24%) had been breastfed for 2 weeks or less (early weaning) and 5170 (76%) had been breastfed longer. Maternal schizophrenia, parental social status, single mother status and gender were included as covariates in a multiple regression analysis of the effect of early weaning on the risk of hospitalization with schizophrenia.

Results:  The sample comprised 93 cases of schizophrenia (1.4%). Maternal schizophrenia was the strongest risk factor and a significant association between single mother status and elevated offspring risk of schizophrenia was also observed. Early weaning was significantly related to later schizophrenia in both unadjusted and adjusted analyses (adjusted odds ratio 1.73 with 95% CI: 1.13–2.67).

Conclusion:  No or <2 weeks of breastfeeding was associated with elevated risk of schizophrenia. The hypothesis of some protective effect of breastfeeding against the risk of later schizophrenia is supported by our data.
UV‐induced Skin Cancer: Similarities – Variations
Authors: Boukamp Petra
Published: June 2005

Skin cancer, the most common cancer world wide, encompasses different tumor entities, the keratinocyte‐derived basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) as well as the neuroectodermal malignant melanoma (MM) and the neuroendocrine Merkel cell carcinomas (MCC). While knowledge is significantly increasing about genetic changes contributing to BCCs and MMs, our understanding for the development and progression of SCCs and MCCs is still fragmentary. This review, thus, aims, on the one hand to summarize the present knowledge without claiming completeness and, on the other hand, to provide information on the HaCaT in vitro skin carcinogenesis model that is used to evaluate the functional consequence of genetic aberrations believed to play a role in skin cancer development and progression.
Die Excimer‐Laser‐Therapie der Alopecia areata – Halbseitige Evaluation eines repräsentativen Areals
Authors: Raulin Christian , Gündogan Cüneyt , Greve Bärbel , Gebert Susanne
Published: June 2005

Wir berichten erstmals über den Behandlungserfolg einer Alopecia areata am Capillitium durch den Einsatz des 308‐nm‐Xenon‐Chlorid‐Excimer‐Lasers in einem prospektiven Halbseitenversuch. Eine seit drei Jahren progrediente Alopecia areata konnte im Vorfeld durch unterschiedlichste Therapiemaßnahmen nicht beeinflußt werden. Es wurde von mehreren bestehenden Alopeziearealen gezielt ein repräsentativer Herd hälftig behandelt. Nach 27 Sitzungen (200 – 4 000 mJ/cm2, kumulative Dosis 52,9 J/cm2) erreichten wir innerhalb von 3 Monaten nur im behandelten Areal ein Wiedereinsetzen des Haarwachstums. Dies impliziert, daß es sich mit an Sicherheit grenzender Wahrscheinlichkeit nicht um eine Spontanremission handeln kann.
Cost‐of‐illness in patients with moderate and severe chronic psoriasis vulgaris in Germany
Authors: Berger Karin , Ehlken Birgit , Kugland Barbara , Augustin Matthias
Published: June 2005

Background: Data regarding costs of outpatient and office‐based care, as well as out‐of‐pocket expenses, for psoriasis patients in Germany are not available. Aim of this study was to assess average annual cost and cost per flare of outpatient and office‐based care for patients with moderate to severe chronic psoriasis vulgaris from several perspectives.

Methods: In this multi‐center, cross‐sectional, retrospective and prospective cost‐of‐illness study, direct (medical and non‐medical) and indirect costs were considered from patient, third‐party payer (TPP) and societal perspectives.

Results: Out of 227 patients enrolled consecutively in 17 centers, 192 cases could be analyzed. On average, TPP reimbursed 864 € per patient annually, 60 % for prescribed medication and 22 % for hospitalization. Patients spent 596 € yearly mainly for alternative therapies and OTC‐medication/skin care products as well as for additional expenses (e. g. ultraviolet lamp, clothes or cleaning agents). Indirect costs per patient amounted to 1,440 € yearly. Total annual costs per patient were 2,866 € and 4,985 € if treated with systemic drugs additionally. 1,173 € if treated topically and/or with phototherapy.

Conclusions: The relatively high average annual costs per patient indicate need for efficient control of psoriasis. This cost‐of‐illness study provides basic data for further decision making, including economic assessment of innovative therapies for psoriasis.
Strategy of the review
Authors: Hogan Warren P
Published: June 2005

This offering is about the ways in which the work of the recent review into aged care was conducted. The account is not exhaustive but is illustrative of some of the major issues experienced. Some of the policy themes and outcomes were explored in the recent Shann Memorial Lecture [1]. The circumstances with which the review was confronted are treated in the second part of the paper. This comes in two segments with the first explaining the measures in place and the second exploring some of the important questions arising from initial considerations of those measures. The onerous nature of the queries should be acknowledged.

The following part is about the activities of the review in an effort to cast light on questions raised by the measures in place in relation to the Terms of Reference. The dual task of the review reflected the very substantial lack of empirical work on the aged care industry as well as evidence on the efforts of boards and managements of entities providing aged care services. This coverage is taken further in the final segment which deals with some of the major issues which the review was seeking to address. Some are of the greatest strategic moment.
Host family respite: description and assessment of a program
Authors: Boldy Duncan , Davey Margaret , Crouchley Kathy , Lilly Ellen
Published: June 2005

Objective:  To describe the characteristics of the Host Family Respite Program and its value within the community, and to discuss some of the issues associated with the use of respite care services.

Method:  The study includes a retrospective analysis of the characteristics of 97 families and 33 host family carers taking part in the program between 1998 and 2002. Benefits associated with the program were assessed through information provided by 31 primary carers.

Results:  Most care recipients suffered from some form of dementia (93%). Host family carers were primarily women aged 50–59 years. Primary carers described feeling worried, stressed and exhausted prior to using the service, but reported a high degree of satisfaction after their break.

Conclusion:  The Host Family Respite Program represents an alternative service that can make a significant impact on and improvement in the quality of life of older people with dementia living in the community, and their carers.
As time goes by: issues for older people with their medication use
Authors: Kippen Sandra , Fraser Mary , Ellis Julie
Published: June 2005

Objective:  To explore the impact of medication use on the lives of older people.

Method:  A convenience sample of self‐selecting participants from five community‐based groups was used. Four focus groups were held in a large regional city and one in a small rural town. Participants (11 men and 15 women) were a cross‐section of people aged 60 years and older.

Results:  Many participants reported a sense of their life being controlled by when and how they needed to use medication. They experienced lifestyle impacts and struggled to deal with sometimes debilitating side‐effects. Formerly routine activities such as ease of mobility and travel had become challenges to their autonomy and independence. Information given by general practitioners, pharmacists and pamphlets accompanying medication was helpful but, nevertheless, often incomplete. Packaging was reported to be often not ‘user friendly’ and prescribing was sometimes done in a way that could create waste and confusion.

Conclusions:  Embarking on medication regimens can impact significantly on lifestyle, and erect barriers to a positive experience of ageing through exacerbating loss of control in life situations.
Sensitivity of the Psychological and Interpersonal Relationship Scales to Oral Therapies for Erectile Dysfunction
Authors: Rosen Raymond , Broderick Gregory , Shabsigh Ridwan , Swindle Ralph , Lockhart Daniel , Cameron Ann
Published: June 2005

Introduction

Studies of erectile dysfunction (ED) therapies typically assess erectile function end- points, although other treatment outcomes may also be of value to men and their partners.

Aim

To examine the treatment sensitivity of the Psychological and Interpersonal Relationship Scales (PAIRS) associated with the use of two phosphodiesterase type 5 (PDE5) inhibitors with different duration of action.

Methods

Men with ED were recruited from three clinical trials of tadalafil and sildenafil citrate to complete post-treatment questionnaires that included the PAIRS. In Study 1, the PAIRS was assessed after 6 months of open-label tadalafil (20 mg) treatment and after 2 months of real-world sildenafil use (25–100 mg). In studies 2 and 3, the PAIRS was assessed at the end of the trial assessment phase. In Study 2, men with a 6–24 week history of sildenafil use (25–100 mg) received 3 weeks of open-label sildenafil treatment (dosage at study entry), and then switched to 9 weeks of tadalafil treatment. In Study 3, a double-blind, crossover study, men were randomized to 12 weeks of either tadalafil (20 mg) or sildenafil (50 mg) treatment, followed by 12 weeks of the alternate treatment; PAIRS scores for the second treatment period were evaluated.

Main Outcome Measure

Treatment outcomes were assessed with the PAIRS, a new reliable and valid self-report measure of sexual self-confidence, spontaneity, and time concerns before sex.

Results

Significant mean differences were observed on all PAIRS domain scores associated with tadalafil and sildenafil treatment. Across studies, men had significantly higher sexual self-confidence and spontaneity scores, and lower time concerns scores in reference to tadalafil compared with their scores in reference to sildenafil.

Conclusions

Mean differences observed on PAIRS domains across studies support the sensitivity of the measure to differentiate between these two ED treatments.
Proposal for a Definition of Lifelong Premature Ejaculation Based on Epidemiological Stopwatch Data
Authors: Waldinger Marcel D. , Zwinderman Aeilko H. , Olivier Berend , Schweitzer Dave H.
Published: June 2005

Introduction

Consensus on a definition of premature ejaculation has not yet been reached because of debates based on subjective authority opinions and nonstandardized assessment methods to measure ejaculation time and ejaculation control.

Aim

To provide a definition for lifelong premature ejaculation that is based on epidemiological evidence including the neurobiological and psychological approach.

Methods

We used the 0.5 and 2.5 percentiles as accepted standards of disease definition in a skewed distribution. We applied these percentiles in a stopwatch-determined intravaginal ejaculation latency time (IELT) distribution of 491 nonselected men from five different countries. The practical consequences of 0.5% and 2.5% cutoff points for disease definition were taken into consideration by reviewing current knowledge of feelings of control and satisfaction in relation to ejaculatory performance of the general male population.

Main Outcome Measures

Literature arguments to be used in a proposed consensus on a definition of premature ejaculation.

Results

The stopwatch-determined IELT distribution is positively skewed. The 0.5 percentile equates to an IELT of 0.9 minute and the 2.5 percentile an IELT of 1.3 minutes. However, there are no available data in the literature on feelings of control or satisfaction in relation to ejaculatory latency time in the general male population. Random male cohort studies are needed to end all speculation on this subject. Exact stopwatch time assessment of IELT in a multinational study led us to propose that all men with an IELT of less than 1 minute (belonging to the 0.5 percentile) have “definite” premature ejaculation, while men with IELTs between 1 and 1.5 minutes (between 0.5 and 2.5 percentile) have “probable” premature ejaculation. Severity of premature ejaculation (nonsymptomatic, mild, moderate, severe) should be defined in terms of associated psychological problems.

Conclusion

We define lifelong premature ejaculation as a neurobiological dysfunction with an unacceptable increase of risk to develop sexual and psychological problems anywhere in a lifetime. By defining premature ejaculation from an authority-defined disorder into a dysfunction based on epidemiological evidence it is possible to establish consensus based on epidemiological evidence. Additional epidemiological stopwatch studies are needed for a final decision of IELT values at both percentile cutoff points.
Successful Withdrawal of Oral Long-Acting Nitrates to Facilitate Phosphodiesterase Type 5 Inhibitor Use in Stable Coronary Disease Patients with Erectile Dysfunction
Authors: Jackson Graham , Martin Emma , McGing Elaine , Cooper Alethea
Published: June 2005

Introduction

Vascular disease is the most common cause of male erectile dysfunction (ED). Phosphodiesterase type 5 (PDE5) inhibitors are effective in up to 80% of men but are contraindicated in the presence of oral nitrates, because of a potentially severe hypotensive interaction.

Aims

To see if stable coronary disease patients with ED could have their oral nitrates discontinued to allow safe use of a PDE5 inhibitor.

Methods

Prospective study of 425 men with ED and cardiac disease conducted in an outpatient cardiac sexual advice clinic.

Main Outcome Measures

Discontinuation of oral nitrates to facilitate subsequent use of PDE5 therapy.

Results

Oral nitrates were being used by 88 (21%) coronary artery disease patients all of whom were clinically stable. Fifty-five (63%) of these men with a good exercise ability had their nitrates discontinued in the presence of continuing beta-blockade or calcium antagonist therapy. They were reviewed 1 week later. Only three restarted their nitrate therapy because of an increase in symptoms. Forty-nine of the 52 men no longer taking nitrates were treated with a PDE5 inhibitor which was effective in 22 out of 26 (85%) patients who have completed follow-up. Fifteen patients are currently undergoing clinic follow-up in order to optimize treatment, and nine patients have continued therapy with their family doctors. Importantly, there have been no adverse cardiac events.

Conclusion

Oral nitrates can be discontinued in the presence of continuing beta-blockade and/or calcium antagonist therapy in stable coronary disease patients with ED to allow for the safe use of PDE5 inhibitors.
The Use of an Erectogenic Pharmacotherapy Regimen Following Radical Prostatectomy Improves Recovery of Spontaneous Erectile Function
Authors: Mulhall John , Land Spencer , Parker Marilyn , Waters W. Bedford , Flanigan Robert C.
Published: June 2005

Purpose

It has been suggested that postradical prostatectomy (RP) erectile function outcomes are improved by early use of erectogenic medications. This analysis was designed to assess the ability of a post-RP vasoactive drug program to improve long-term spontaneous erectile function.

Methods

Men with functional preoperative erections who underwent RP were challenged early postoperatively with oral sildenafil. Nonresponders were switched to intracavernosal injection therapy (ICI). Patients were instructed to inject three times a week. Only patients who presented within 6 months post RP, who completed the International Index of Erectile Function (IIEF) questionnaire on at least three separate occasions after surgery, and who had been followed for at least 18 months were included. Data from men who were committed to rehabilitation were compared with those of men who did not follow the protocol but continued to be followed serially following RP.

Results

There were 58 patients in the rehabilitation (R) group and 74 in the nonrehabilitation (NR) group. No differences existed in mean patient age, comorbidity profile, intraoperative nerve sparing status, or postoperative erectile hemodynamics between the two groups. At 18 months post RP, there were statistically significant differences between the two groups in the percentage of patients who were capable of having medication-unassisted intercourse (R = 52% vs. NR = 19%, P < 0.001); mean erectile rigidity (R = 53 ± 21% vs. NR = 26 ± 43%, P < 0.01); mean IIEF erectile function (EF) domain scores (R = 22 ± 6 vs. NR = 12 ± 14, P < 0.01); the percentage of patients with normal EF domain scores (R = 22% vs. NR = 6%, P < 0.01); the percentage of patients responding to sildenafil (R = 64% vs. NR = 24%, P < 0.001); the time to become a sildenafil responder (R = 9 ± 4 vs. NR = 13 ± 3 months, P = 0.02); and the percentage of patients responding to ICI (R = 95% vs. NR = 76%, P < 0.01).

Conclusions

The data generated from this nonrandomized study indicate that a pharmacologic penile rehabilitation protocol results in higher rates of spontaneous functional erections and erectogenic drug response after RP.
Comparison of the COBAS AMPLICOR MTB and BDProbeTec ET Assays for Detection of
Mycobacterium tuberculosis
in Respiratory Specimens
Authors: Goessens W. H. F. , de Man P. , Koeleman J. G. M. , Luijendijk A. , te Witt R. , Endtz H. P. , van Belkum A.
Published: June 2005

The performances of the BDProbeTec ET (Becton Dickinson) and COBAS AMPLICOR MTB (Roche) were retrospectively evaluated for detecting
Mycobacterium tuberculosis
complex in various respiratory specimens. The BACTEC and MGIT liquid culture system (Becton Dickinson) was used as a reference method. A total of 824 respiratory specimens, comprised of sputa, bronchoalveolar lavage fluid, and bronchial and tracheal aspirates from 580 patients, were evaluated. Out of 824 clinical specimens, 109 specimens from 43 patients were culture positive for
M. tuberculosis
. Of these 109 specimens, 67 were smear positive, 85 were positive by the COBAS AMPLICOR MTB test, and 94 were positive by the BDProbeTec ET. Of the 715 culture-negative specimens, 17 were positive by the auramine staining, 11 were positive by the COBAS AMPLICOR MTB test, and 12 were positive by the BDProbeTec ET. After discrepancy analysis and review of the patients' clinical data, 130 specimens from 50 patients were considered “true-positive” specimens. This resulted in the following sensitivities: microscopy, 61.5%; COBAS AMPLICOR MTB test, 78.0%; and BDProbeTec ET, 86.2%. The specificities of each system, based on the clinical diagnosis, were 99.7% for microscopy, 99.9% for the COBAS AMPLICOR MTB test, and 99.9% for the BDProbeTec ET. The data presented represent a considerable number of specimens evaluated with a considerable number of culture- and auramine-positive and culture-positive and auramine-negative results and therefore give a realistic view of how the data should be interpreted in a daily routine situation. Specifically, the data with regard to the culture-positive and auramine-negative specimens are useful, because in a routine situation, auramine-negative specimens are sometimes accepted, on clinical indications, to be analyzed by an amplification method.
Use of the INNO-LiPA-MYCOBACTERIA Assay (Version 2) for Identification ofMycobacterium avium-Mycobacterium intracellulare-Mycobacterium scrofulaceumComplex Isolates
Authors: Lebrun Léa , Weill François-Xavier , Lafendi Leila , Houriez Florence , Casanova François , Gutierrez M. Cristina , Ingrand Didier , Lagrange Philippe , Vincent Véronique , Herrmann Jean Louis
Published: June 2005

Using INNO-LiPA-MYCOBACTERIA (Lipav1; Innogenetics) and the AccuProbe (Gen-Probe Inc./bioMérieux) techniques, 35Mycobacterium avium-Mycobacterium intracellulare-Mycobacterium scrofulaceum(MAC/MAIS) complex strains were identified between January 2000 and December 2002. Thirty-four of 35 isolates were positive only for the MAIS complex probe by Lipav1 and were further analyzed by INNO-LiPA-MYCOBACTERIA version 2 (Lipav2),hsp65PCR restriction pattern analysis (PRA), and ribosomal internal transcribed spacer (ITS),hsp65, and 16S rRNA sequences. Lipav2 identified 14 of 34 strains at the species level, including 11 isolates positive for the newly specific MAC sequevar Mac-A probe (MIN-2 probe). Ten of these 11 isolates corresponded to sequevar Mac-A, which was recently defined asMycobacterium chimeraesp. nov. Among the last 20 of the 34 MAIS isolates, 17 (byhsp65PRA) and 18 (byhsp65sequence) were characterized asM. avium. Ten of the 20 were identified as Mac-U sequevar. All these 20 isolates were identified asM. intracellulareby 16S rRNA sequence except one isolate identified asMycobacterium paraffinicumby 16S rRNA and ITS sequencing. One isolate out of 35 isolates that was positive forM. aviumby AccuProbe and that wasMycobacteriumgenus probe positive and MAIS probe negative by Lipav1 and Lipav2 might be considered a new species. In conclusion, the new INNO-LiPA-MYCOBACTERIA allowed the identification of 40% of the previously unidentified MAIS isolates at the species level. The results of the Lipav2 assay on the MAIS isolates confirm the great heterogeneity of this group and suggest the use ofhsp65or ITS sequencing for precise identification of such isolates.
First Reported Outbreak of Diarrhea Due to Adenovirus Infection in a Hematology Unit for Adults
Authors: Jalal Hamid , Bibby David F. , Tang Julian W. , Bennett Julie , Kyriakou Chara , Peggs Karl , Cubitt David , Brink Nicola S. , Ward Kate N. , Tedder Richard S.
Published: June 2005

Numerous outbreaks of adenovirus infection from different types of health care settings, except a hematology unit, have been reported. This is the first report describing an outbreak of adenovirus infection causing diarrhea among adult hematopoietic stem cell transplant recipients. Six of 21 patients from the outbreak cohort were affected with diarrhea. Electron microscopy, cell culture, and direct DNA sequencing of amplicons generated from stool and blood samples were used to investigate this outbreak. Electron microscopy and cell culture detected adenovirus in stools from symptomatic patients. DNA sequencing of amplicons generated from stool samples confirmed nosocomial transmission of infection from a single index case. The outbreak strain was also detected in plasma of four of these patients, suggesting systemic infection. The outbreak strain was identified as type 12. Standard infection control measures were effective to control this outbreak.
Evaluation of a Novel Rapid One-Step Immunochromatographic Assay for Detection of Monoclonal
Helicobacter pylori
Antigen in Stool Samples from Children
Authors: Antoš David , Crone Julia , Konstantopoulos Nikolaos , Koletzko Sibylle
Published: June 2005

A new rapid one-step immunochromatographic test using monoclonal antibodies for detection of
Helicobacter pylori
antigen in stool in children was evaluated on coded stool samples from 159 children (mean age, 9.7 ± 5.0 years; 118 from Munich, 41 from Vienna): 86 children were
H. pylori
infected defined by positive culture and/or ≥2 other positive tests ([
13
C]urea breath test, histology, rapid urease test), and 73 children showed concordant negative results. Seventy-nine patients (12.1 ± 3.8 years; 42 from Munich; 37 from Vienna) were tested 6 to 8 weeks after anti-
Helicobacter pylori
therapy with urea breath test and stool test. In Munich, all 160 tests (118 pre- and 42 posttreatment) were independently read by two observers. Equivocal results were excluded for calculation of sensitivity and specificity but were considered as false to assess accuracy. The two observers in Munich agreed in 63 out of 65 positive and 89 out of 95 negative results, while eight times (5.0%) they judged the test as equivocal. Pretreatment and posttreatment results for sensitivity were 88.1% (79.2 to 94.1) and 88.9% (51.8 to 99.7), specificity 88.1% (77.8 to 94.1) and 93.9% (85.2 to 98.3), and accuracy 83.5% and 81.5%, respectively. We conclude that the new monoclonal immunochromatographic quick test shows a good interobserver agreement, but equivocal results occur in 5%. Performance is comparable before and after therapy. The test may become a good alternative in children in settings where a [
13
C]urea breath test or a reliable enzyme immunoassay stool test are not available.
Selection of Strains for Quality Assessment of the Disk Induction Method for Detection of Inducible Clindamycin Resistance in Staphylococci: a CLSI Collaborative Study
Authors: Zelazny Adrian M. , Ferraro Mary Jane , Glennen Anita , Hindler Janet F. , Mann Linda M. , Munro Susan , Murray Patrick R. , Reller L. Barth , Tenover Fred C. , Jorgensen James H.
Published: June 2005

A nine-laboratory collaborative study was conducted to select positive and negative quality assessment control strains for the detection of inducible clindamycin resistance in staphylococci. Four strains of
Staphylococcus aureus
were tested as unknowns on 10 different days in each laboratory using the recently recommended CLSI (formerly NCCLS) disk diffusion method and the inoculum purity control method. Strains contained either macrolide-lincosamide-streptogramin B (MLS
B
) resistance genes encoded by
erm
(A) or
erm
(C) or a macrolide resistance efflux pump encoded by
msr
(A). Based upon the results of this study, strain UT 32 (now designated ATCC strain BAA-977) containing
erm
(A) is recommended as the positive control organism for inducible clindamycin resistance. Strain UT 25 (now designated ATCC BAA-976), which harbors the efflux pump encoded by
msr
(A), is recommended as the negative control organism.
Development, Technical Performance, and Clinical Evaluation of a NucliSens Basic Kit Application for Detection of Enterovirus RNA in Cerebrospinal Fluid
Authors: Ginocchio Christine C. , Zhang Frank , Malhotra Amisha , Manji Ryhana , Sillekens Peter , Foolen Helma , Overdyk Marlieke , Peeters Margot
Published: June 2005

The combination of nucleic acid sequence-based amplification and electrochemiluminescence detection was used to develop an internally controlled, highly sensitive and specific assay for the detection of enterovirus (EV) RNA in cerebrospinal fluid (CSF). The analytical performance of the assay was determined using both in vitro-transcribed EV RNAs and viral culture isolates. The sensitivity of the assay was 10 EV RNA copies per amplification reaction. The assay detected all enteroviral isolates tested with no cross-reactivity to 21 nonenteroviral species, including rhinovirus and parechovirus. The clinical performance of the assay was evaluated by testing 992 CSF specimens collected from adult and pediatric patients. NucliSens EV results from a subset of 327 CSF samples were compared to viral culture of nasopharyngeal specimens and rectal swabs (
n
= 195) and/or CSF (
n
= 212). Of the 212 CSF samples, 96 samples were positive by either the NucliSens EV assay (94/96; 97.9%) or culture (63/96; 65.6%), and 61/96 (63.5%) were positive by both methods. The inclusion of an EV-specific internal control monitored the entire process, including the efficiency of nucleic acid extraction, amplification, and detection. In total, only five blood-clotted CSF samples (0.5%) were inhibited. The NucliSens EV assay demonstrated superior sensitivity over viral culture (
P
< 0.001), excellent specificity, clear delineation of positive samples, and minimal amplification inhibition.
Comparison of Two Commercial Assays for Detection of Human Papillomavirus (HPV) in Cervical Scrape Specimens: Validation of the Roche AMPLICOR HPV Test as a Means To Screen for HPV Genotypes Associated with a Higher Risk of Cervical Disorders
Authors: van Ham Maaike A. P. C. , Bakkers Judith M. J. E. , Harbers Gonneke K. , Quint Wim G. V. , Massuger Leon F. A. G. , Melchers Willem J. G.
Published: June 2005

Certain high-risk (HR) human papillomavirus (HPV) types are a necessary cause for the development of cervical disorders. Women with persistent HR HPV infections have an increased risk of developing high-grade cervical lesions, compared with those who have no or low-risk HPV infections. Therefore, implementation of HPV detection into cervical screening programs might identify women at risk of cervical cancer. Several HPV detection methods with different sensitivities and specificities are available. Recently, a new PCR-based technique, the Roche AMPLICOR HPV Test, was developed. This test recognizes a group of 13 HR HPV types simultaneously. This study was undertaken to validate and compare HPV detection in 573 cervical scrape specimens by the AMPLICOR HPV Test and the INNO-LiPA HPV detection/genotyping assay (SPF10-LiPA system version 1). Human β-globin was not detected in nine specimens, which were therefore excluded from the comparison. Eleven scrape specimens containing HPV type 53 or 66 were also excluded from the comparison because these (probably) HR HPV types cannot be detected by the AMPLICOR HPV Test. The results of HPV detection by the Roche AMPLICOR HPV Test were confirmed by INNO-LiPA HPV detection/genotyping assay in 539/553 cases, showing an absolute agreement of 97.5% with a Cohen's kappa of 0.9327, indicating almost complete similarity of the two tests. Like the INNO-LiPA HPV detection/genotyping assay, the AMPLICOR HPV Test was sensitive, specific, feasible, and easy to handle. The value of the Roche AMPLICOR HPV Test with a broad-spectrum HR HPV detection has to be determined in prospective clinical studies.
Prospective Study of the Prevalence, Genotyping, and Clinical Relevance of
Dientamoeba fragilis
Infections in an Australian Population
Authors: Stark D. , Beebe N. , Marriott D. , Ellis J. , Harkness J.
Published: June 2005

A prospective study was conducted over a 30-month period, in which fecal specimens from 6,750 patients were submitted to the Department of Microbiology at St. Vincent's Hospital, Sydney, Australia. Trophozoites of
Dientamoeba fragilis
were detected in 60 (0.9%) patients by permanent staining, and confirmation was performed by PCR. Gastrointestinal symptoms were present in all patients, with diarrhea and abdominal pain the most common symptoms. Thirty-two percent of patients presented with chronic symptoms. The average age of infected patients was 39.8 years. No correlation was found between
D. fragilis
and
Enterobius vermicularis
, a proposed vector of transmission for
D. fragilis
. The genetic diversity of 50
D. fragilis
isolates was examined by PCR, and the PCR products were analyzed for the presence of restriction fragment length polymorphisms. These results showed no variation in the small-subunit rRNA gene and demonstrated a single genotype for all Australian isolates. This study shows the potential pathogenic properties of
D. fragilis
and the need for all laboratories to routinely test for this organism.
Emergence of Fluconazole Resistance in a
Candida parapsilosis
Strain That Caused Infections in a Neonatal Intensive Care Unit
Authors: Sarvikivi Emmi , Lyytikäinen Outi , Soll David R. , Pujol Claude , Pfaller Michael A. , Richardson Malcolm , Koukila-Kähkölä Pirkko , Luukkainen Päivi , Saxén Harri
Published: June 2005

Candida parapsilosis
is an increasing cause of bloodstream infections (BSIs) in neonatal intensive care units (NICUs). It has been a persistent problem in the NICU of Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland, since 1987. Fluconazole prophylaxis has been used to control the problem. The number of new infections has, however, increased markedly since September 2000. We assessed fluconazole consumption and occurrence of all
Candida
species in the NICU from 1991 to 2002.
C. parapsilosis
bloodstream isolates obtained in the NICU from 1990 to 2002 (
n
= 26) were genotyped and their fluconazole susceptibility was defined. A low rate of
C. parapsilosis
BSIs was correlated with high rates of consumption of fluconazole. No emergence of
Candida
species with primary resistance to fluconazole was detected. However, genotyping with a complex DNA fingerprinting probe revealed that a single strain of
C. parapsilosis
with decreasing susceptibility to fluconazole was responsible for cross-infections that caused BSIs in the NICU over a 12-year period. The emergence of fluconazole resistance in that strain was observed after more than 10 years of fluconazole prophylaxis.