bluuebunny/crossref_metadata_2025 huggingface dataset:
Gallbladder wall thickening in infectious mononucleosis: an ominous sign
Authors: O’Donovan N , Fitzgerald E
Published: December 2008

Gallbladder wall thickening (3 mm or greater) is a nonspecific finding with many causes. We describe two cases caused by infectious mononucleosis. Other causes of gallbladder wall thickening are described and the literature is reviewed. We suggest that the finding of gallbladder wall thickening in a patient with infectious mononucleosis implies that the patient is very ill, and its observation should lead to close patient monitoring.
Carbon monoxide poisoning: easy to treat but difficult to recognise
Authors: Balzan M V , Agius G , Galea Debono A
Published: December 2008

Carbon monoxide (CO) poisoning is a common medical emergency and a frequent cause of deliberate or accidental death. It can cause acute and chronic central nervous system damage which may be minimised by prompt treatment with 100% oxygen or hyperbaric oxygen therapy. However, recognition of this intoxication can be difficult. Failure to diagnose it may have disastrous effects on the patient, and other members of the household who could subsequently become intoxicated. Guidance on the correct diagnosis of this condition is provided in the light of a number of studies screening emergency room populations. Guidelines for treatment with hyperbaric oxygen therapy are also reviewed.
Successful treatment of intracaval and atrial extension of Wilms’ tumour by chemotherapy
Authors: Berberoğlu S , Akyüz C , Büyükpamukçu M
Published: December 2008

A patient presenting with advanced Wilm’s tumour was diagnosed as having inferior vena cava involvement with tumour thrombus extending up to the right atrium, and was treated with preoperative chemotherapy (vincristine, actinocymin D, epirubicin). Atrial and inferior vena cava thrombus disappeared and he underwent a successful nephrectomy.
Cefuroxime-induced thrombocytopenia?
Authors: Aitken Peter , Zaidi S M N
Published: December 2008

We present the case of a 77-year-old man who became thrombocytopenic whilst treated parenterally with cefuroxime in the absence of proven infection and recovered when the cefuroxime was discontinued.
The irritable bowel syndrome
Authors: Francis C Y , Whorwell P J
Published: December 2008

Irritable bowel syndrome is a common disorder varying in severity from trivial to incapacitating. The pathophysiology and epidemiology are gradually being unravelled and it is now becoming apparent just how poor the quality of life of some of these patients can be. It is no longer acceptable practice to diagnose the condition and discharge the patient on a high fibre diet, particularly as the latter can often make the situation worse. Although hard to treat, worthwhile responses can be achieved by careful targeting of therapy to the many different facets of the disorder.
Causes of ischaemic stroke in the young
Authors: Martin P J , Enevoldson T P , Humphrey P R D
Published: December 2008

The causes of ischaemic stroke in young adults are many and diverse. Such patients usually require more extensive investigations in order to find an underlying cause than more elderly patients. It is important that a comprehensive search is made since many of the underlying disorders are treatable. Principal causes are extracranial arterial dissection, cardioembolism, premature atherosclerosis, haematological and immunological disorders and migraine. Drug abuse is becoming increasingly important but the risk of stroke in pregnancy remains unclear. Isolated angiitis of the central nervous system, heritable disorders of connective tissue and other genetically determined disorders (mitochondrial cytopathies, CA-DASIL) account for a small proportion of ischaemic strokes in the young. Management is probably best undertaken by a physician with a specialist interest and, if full investigation fails to elucidate a definite cause, the risk of future stoke is low.
Haemophilia
Authors: Cahill M R , Colvin B T
Published: December 2008

Although the nature of haemophilia has been understood for thousands of years, knowledge of its molecular genetics is recent. These X-linked bleeding disorders have diverse underlying DNA defects and, in 1992, DNA inversion within the X chromosome was found to explain half of the most serious cases of haemophilia A. The life-span and quality-of-life for patients with haemophilia had improved steadily throughout the early 1980s but the principal cause of death remained intracranial haemorrhage until the epidemic of HIV infection due to contaminated factor concentrates. Infection with hepatitis C virus is almost universal for patients treated with clotting factors before 1985. No curative treatment is available for hepatitis C at present. Knowledge of the transmission of viruses in concentrates has led to important developments in processing techniques to eliminate them. Recombinant technology has produced factor VIII and, more recently, factor IX concentrate which is likely to be very safe. Development of inhibitors to factor concentrates (especially factor VIII) remains one of the most serious complications of haemophilia. The variety of treatments available testifies to the lack of a single universally efficacious one. The use of prophylactic treatment has been conclusively demonstrated to result in a preservation of joint function in severely affected patients who might otherwise develop significant joint problems. The many facets of the care of patients with severe haemophilia, ranging from dental care to genetic counselling, can be advantageously co-ordinated in a haemophilia comprehensive care centre.
Barium peritonitis: a rare complication of upper gastrointestinal contrast investigation
Authors: Karanikas I D , Kakoulidis D D , Gouvas Z T , Hartley J E , Koundourakis S S
Published: December 2008

Contrast examination of the gastrointestinal tract is rarely complicated by perforation. The colon and rectum are most commonly affected, with many perforations limited to the retroperitoneum. Generalised peritonitis is therefore rare, but is life-threatening and difficult to treat. We present two analogous cases in which extravasation of barium sulphate complicated contrast meal investigation. These cases illustrate important aspects in the management of this unusual occurrence.
Primary infection by type 1 human immunodeficiency virus: diagnosis and prognosis
Authors: Vanhems P , Beaulieu R
Published: December 2008

Primary infection by type 1 human immunodeficiency virus (HIV) is symptomatic in about 70% of cases. The acute illness is a mononucleosis-like syndrome with characteristics such as mucosal ulcerations. The duration and severity of the symptoms appear to be related to the prognosis. After reviewing the most frequent signs and symptoms of primary HIV infection, we report different prognostic studies which examined the association between the acute illness and the progression of HIV disease.
The use of angiotensin-converting enzyme inhibitors in the treatment of heart failure in hospital practice
Authors: Missouris C G , MacGregor G A
Published: December 2008

Several well-controlled trials in patients with heart failure have shown that the use of angiotensin-converting enzyme (ACE) inhibitors, in combination with a diuretic, causes a reduction in mortality and morbidity, which seems to be mainly due to a reduction in fatal and nonfatal cardiovascular events. Our aim was to determine whether 249 consecutive patients discharged from hospital with a primary diagnosis of heart failure were routinely being treated with an ACE inhibitor at an appropriate dose. At the time of admission to hospital, 91 (36.5%) were receiving a combination of a diuretic and an ACE inhibitor, 129 (51.8%) were receiving a diuretic alone, and 29 (11.6%) had not previously received either a diuretic or an ACE inhibitor. At the time of discharge from hospital all patients were on a diuretic and 144 (57.8%) were also receiving an ACE inhibitor. Although 41 patients (16.5%) had a relative or absolute contraindication for the use of an ACE inhibitor, 64 patients (25.7%) with no contraindication were not receiving an ACE inhibitor. Many of the patients who were prescribed an ACE inhibitor were given it at an inappropriate dose; only 24 patients (16.7%) were on the dose that was used in the clinical trials showing a reduction in mortality. These results show that in one in four patients admitted to hospital with heart failure who should be receiving an ACE inhibitor by the time of discharge, are not. The average age of these patients was 76 years. Whilst it has been shown that the benefit of ACE inhibitors does not appear to be age-related, most published studies have not included many patients over the age of 80. Specific studies looking at the effect of ACE inhibitors in elderly patients would be helpful, as well as studies to determine the optimum treatment regimen for this age group.
Ocular purpura in a swimmer
Authors: Jowett N I , Jowett S G
Published: December 2008

Swimming goggles are increasingly being worn by children during swimming lessons to protect their eyes, although reports of ocular damage associated with their use is becoming more common. We describe a new injury, ‘purpura gogglorum’, caused by overtight application of faulty goggles. Whilst no permanent harm to the eyes resulted in this case, other swimmers have sustained more serious ocular damage, including loss of sight, from goggle-associated injury.
Isolated diastolic heart failure—what is it?
Authors: Shiels P , MacDonald T M
Published: December 2008

Epidemiological evidence suggests that 20 to 40% of all patients with heart failure have normal systolic function. Isolated diastolic dysfunction may be the principle pathophysiological mechanism in these patients. The diagnosis of isolated diastolic heart failure is problematic and not merely based on demonstrating normal systolic function. The prognosis in isolated diastolic heart failure is more favourable than in systolic heart failure. At the present time, there is no licensed treatment for isolated diastolic heart failure and treatment is largely empirical.
Barrett's oesophagus
Authors: Navaratnam R M , Winslet M C
Published: December 2008

Barrett's oesophagus represents the replacement of stratified squamous epithelium by metaplastic columnar epithelium for 3 cm of the distal oesophagus. Gastro-oesophageal reflux, which affects 40% of the adult population, is the principal aetiological factor. This results in predominantly acid but also bile reflux (due to duodenogastrooesophageal reflux) through the lower oesophageal sphincter, transient relaxation of which accounts for the main mechanism of reflux. Conventional Barrett's oesophagus is reported in 11–13% of patients with symptomatic reflux and short segment Barrett's oesophagus (< 3.0 cm) in 18%. Approximately 50% of these patients have recognised complications on presentation, eg, carcinoma (15%). The disparity between clinical symptoms and endoscopic severity is due to reduced oesophageal mucosal sensitivity as a consequence of prolonged mucosal acid exposure. These rather alarming figures combined with the knowledge that Barrett's oesophagus is a pre-malignant condition (the diagnosis is associated with a 25–130-fold increase of malignancy) may account for the substantial increase in junctional gastrooesophageal malignancies. Symptomatic Barrett's oesophagus should be managed with full-dose proton pump inhibitors, eg, lansoprazole. Anti-reflux surgery should be reserved for the medically fit patient with recurrent symptomatic relapse in the histological absence of premalignant change. There is no evidence suggesting that surgery can be used as a prophylactic measure against malignancy. Encouraging short-term results have been obtained with photodynamic therapy in the management of high-grade dysplasia. However, columnar epithelium has been found underlying the regenerated squamous epithelium, suggesting that life-long surveillance is warranted.
Does psychological intervention help chronic skin conditions?
Authors: Capoore H S , Rowland Payne C M E , Goldin D
Published: December 2008

The objective of the study was to assess the impact of psychological/psychiatric assessment in patients with chronic or intractable dermatological conditions. A diagnostic interview was undertaken in order to pin-point any temporal connection between an adverse life-event and the first appearance of the skin disorder. Following this, the dermatologist's assessment of subsequent changes in the skin disorder were noted. The three main dermatological diagnoses were atopic eczema (10), prurigo (10), and psoriasis (nine). Follow-up was for up to 5 years.

A favourable response was noted in 40 out of the 64 patients who participated in the study; this was usually evident within a few weeks and maintained thereafter. Remission was achieved in 12, while 28 showed some improvement. We conclude that this liaison between dermatology and psychiatry proved a valuable adjunct to normal dermatological treatment and was followed by improvement in the majority of patients.
ON GROUPS AND COUNTER AUTOMATA
Authors: ELDER MURRAY , KAMBITES MARK , OSTHEIMER GRETCHEN
Published: December 2008

We study finitely generated groups whose word problems are accepted by counter automata. We show that a group has word problem accepted by a blind n-counter automaton in the sense of Greibach if and only if it is virtually free abelian of rank n; this result, which answers a question of Gilman, is in a very precise sense an abelian analogue of the Muller–Schupp theorem. More generally, if G is a virtually abelian group then every group with word problem recognized by a G-automaton is virtually abelian with growth class bounded above by the growth class of G. We consider also other types of counter automata.
BOUNDARY INTEGRAL EQUATIONS FOR A THREE-DIMENSIONAL STOKES–BRINKMAN CELL MODEL
Authors: KOHR MIRELA , RAJA SEKHAR G. P. , WENDLAND WOLFGANG L.
Published: December 2008

The purpose of this paper is to prove the existence and uniqueness of the solution in Sobolev or Hölder spaces for a cell model problem which describes the Stokes flow of a viscous incompressible fluid in a bounded region past a porous particle. The flow within the porous particle is described by the Brinkman equation. In order to obtain the desired existence and uniqueness result, we use an indirect boundary integral formulation and potential theory for both Brinkman and Stokes equations. Some special cases, which refer to the cell model for a porous particle with large permeability, or to the exterior Stokes flow past a porous particle, are also presented.
Mast cells are necessary for the hypothermic response to LPS-induced sepsis
Authors: Nautiyal Katherine M. , McKellar Heather , Silverman Ann-Judith , Silver Rae
Published: December 2008

As central nervous system residents, mast cells contain many cytokines and are localized primarily near large blood vessels in the diencephalon and within the leptomeninges, making them candidates for immune to neural “cross talk.” Using mast cell-deficient KitW-sh/W-sh mice, we assessed the role of these cells in the thermoregulatory component of the immune response to lipopolysaccharide (LPS). KitW-sh/W-sh and wild-type (WT) mice differed in several respects in response to injection of a high dose of LPS (1 mg/kg ip). Core temperature (Tc) of WT mice decreased by ∼3°C, whereas KitW-sh/W-sh mice did not become hypothermic but instead exhibited pronounced low-frequency Tc oscillations around their baseline temperature. In addition, KitW-sh/W-sh mice had lower levels of whole brain TNF-α but no differences in IL-1β, IL-6, IFN-γ, or histamine compared with WT mice following injection of the high dose of LPS, consistent with the role of TNF-α in sepsis. KitW-sh/W-sh mice had increased resistance to LPS, and some survived a dose of LPS that was lethal in littermate controls. In contrast, KitW-sh/W-sh and WT mice were similar in other aspects, namely, in the hyperthermia following injection of TNF-α (1.5 μg icv), reduced nighttime Tc and locomotor activity (to 1 mg/kg LPS), response to a low dose of LPS (10 μg/kg ip), and response to subcutaneous turpentine injection. These results indicate that mast cells play a role in the regulation of thermoregulatory responses and survival following sepsis induction and suggest a brain site of action.
Abnormal autoregulation and tubuloglomerular feedback in prediabetic and diabetic OLETF rats
Authors: Hashimoto Seiji , Yamada Kanji , Kawata Tetsuya , Mochizuki Toshio , Schnermann Jurgen , Koike Takao
Published: December 2008

The mechanisms underlying the development and prevention of diabetic nephropathy are still not fully understood. In the present study in the Otsuka Long-Evans Tokushima Fatty (OLETF) model of type 2 diabetic rats, we investigated whether renal hemodynamic abnormalities exist and whether they precede the onset of diabetes. Using OLETF rats in both prediabetic and diabetic stages, we assessed autoregulatory responses of total renal blood flow (RBF) and of superficial (SBF) and deep renal cortical (DBF) blood flow to stepwise reductions of renal perfusion pressure (RPP) induced by a manual clamp on the abdominal aorta. During clamp-induced reductions of RPP by 10 or 20 mmHg, RBF fell significantly more in OLETF rats than in lean control [Long-Evans Tokushima Otsuka (LETO)] rats. Whereas SBF showed no significant changes in either OLETF rats or LETO rats during mild clamping, DBF decreased significantly more in OLETF rats than LETO rats. Reduced autoregulatory efficiency in OLETF rats was observed in both prediabetic and diabetic stages. Micropuncture studies showed that tubuloglomerular feedback (TGF) responses of stop flow pressure are reduced in prediabetic (−7.3 vs. −25.7%) as well as in diabetic OLETF rats compared with LETO control rats (−4.4 vs. −18.8%). Renal corticotomy was performed to measure glomerular capillary pressure (Pgc) directly. Pgcof deep cortical glomeruli was higher than superficial glomerular Pgcin both strains of rats, but the difference was especially pronounced in OLETF rats (deep 78 ± 2 vs. superficial 57 ± 4 mmHg). This study demonstrates reduced autoregulatory adjustments and impaired TGF efficiency in prediabetic OLETF rats. Thus abnormal RBF regulation precedes the onset of diabetes and is especially pronounced in the deep cortical region.
Surround Suppression of V1 Neurons Mediates Orientation-Based Representation of High-Order Visual Features
Authors: Tanaka Hiroki , Ohzawa Izumi
Published: December 2008

Neurons with surround suppression have been implicated in processing high-order visual features such as contrast- or texture-defined boundaries and subjective contours. However, little is known regarding how these neurons encode high-order visual information in a systematic manner as a population. To address this issue, we have measured detailed spatial structures of classical center and suppressive surround regions of receptive fields of primary visual cortex (V1) neurons and examined how a population of such neurons allow encoding of various high-order features and shapes in visual scenes. Using a novel method to reconstruct structures, we found that the center and surround regions are often both elongated parallel to each other, reminiscent of on and off subregions of simple cells without surround suppression. These structures allow V1 neurons to extract high-order contours of various orientations and spatial frequencies, with a variety of optimal values across neurons. The results show that a wide range of orientations and widths of the high-order features are systematically represented by the population of V1 neurons with surround suppression.
Déterminants des réponses aux vaccins oraux dans les pays en développement
Authors: Sack David A. , Qadri Firdausi , Svennerholm Ann-Mari
Published: December 2008

Les vaccins oraux conçus pour une utilisation globale n’induisent pas nécessairement les mêmes réponses immunitaires chez tous les enfants du monde entier. En effet, plusieurs vaccins induisent souvent des réponses anticorps moyennes moins fréquentes et moins intenses chez les enfants des pays en développement, suggérant qu’ils pourraient moins les protéger. Les causes de cette différence ne sont pas totalement élucidées, mais il apparaît que des facteurs liés à la nutrition, dont une malnutrition tant en protéines et en calories qu’en micronutriments, sont importants pour expliquer ce problème. Des domaines voisins dont l’allaitement maternel, l’interférence d’anticorps placentaires maternels, des infections parasitaires intestinales, des lésions de la muqueuse intestinale et, peut-être, une malnutrition maternelle au cours de la grossesse paraissent également importants. Les vaccins conçus pour la voie orale doivent être adaptés à ces problèmes potentiels afin d’optimiser leurs bénéfices pour tous les enfants. Les vaccins oraux administrés aux enfants des pays en développement peuvent nécessiter une dose plus élevée, des doses de rappel, une supplémentation en calories, micronutriments et vitamines, un arrêt de l’allaitement maternel avant la vaccination, des médicaments contre les parasites intestinaux ou d’autres mesures afin d’obtenir leur bénéfice complet.
Taking and Coordinating Perspectives: From Prereflective Interactivity, through Reflective Intersubjectivity, to Metareflective Sociality
Authors: Martin Jack , Sokol Bryan W. , Elfers Theo
Published: December 2008

Despite being eclipsed in recent years by simulation theory, theory of mind and accounts of executive functioning, social-relational approaches to perspective taking and coordination based on the ideas of Jean Piaget and George Herbert Mead have never completely disappeared from the literature of developmental psychology. According to the social-relational view presented here, perspectives are holistic orientations to situations, within which individuals coordinate their actions and interactions with objects and others. The developmental processes by which perspectives are occupied, differentiated, and coordinated move from (1) prereflective interactivity (i.e., positioning within routine, repetitive interactive sequences during infancy and early childhood), to (2) reflective intersubjectivity (i.e., the simultaneous consideration and use of multiple perspectives within the intersubjective transactions of later childhood and early adolescence – processes that are accelerated and extended through increasingly sophisticated uses of language), and finally to (3) metareflective sociality (i.e., the abstracted and generalized social engagement across a diversity of personal, interpersonal, and sociocultural perspectives witnessed in mature adult negotiations and problem solving). These social-relational processes are used to reinterpret, revise, and extend Robert Selman’s theory of the development of perspective taking and coordination. The result is a developmental process of occupying, experiencing, coordinating, and engaging across a diversity of perspectives within interactive, intersubjective, and psychological-sociocultural transactions that spans the course of individuals’ lives and captures some facets of the complex, transformative, and ongoing interplay between societies and persons.
‘I Am a Human Being like You’: An Identification Strategy to Maintain Continuity in a Cultural Contact Zone
Authors: O’Sullivan-Lago Ria , de Abreu Guida , Burgess Mark
Published: December 2008

In this article, we discuss a qualitative study carried out in a cultural contact zone. Irish nationals, immigrants, and asylum seekers in Cork, Ireland, were interviewed about their cultural identities and future trajectories. Cultural Continuity theory was used as a model to offer an insight into the processes and strategies of the Dialogical Self. The results suggest that the development of a cultural contact zone caused a break in cultural continuity which aroused uncertainty. Our analytical focus is on one of the strategies that enabled the individuals to alleviate that uncertainty. The suggestive preliminary results are that each participant, within each group, utilized their dialogical ‘I as a human being’ identity position to maintain continuity. The function of this strategy and the theoretical integration are discussed.
Inhibitory Function of Interferon on Hepatocarcinogenesis
Authors: Yano Hirohisa
Published: December 2008

Objective: We examined the growth-inhibitory effect and the mechanism of action of type I interferon (IFN) in human liver cancer cell lines in vitro and in vivo. Methods: We examined the growth-inhibitory effect of 5 types of type I IFN preparations (e.g., pegylated, nonpegylated IFN-α, and IFN-β) used for the treatment of chronic hepatitis C in 13 liver cancer cell lines in vitro. After liver cancer cells were transplanted into nude mice, various doses of IFN preparations were subcutaneously administered, and the antitumor effect was examined. Results: The growth-inhibitory effect of each preparation was different, but IFN-β expressed the strongest effects in vitro. Induction of an inhibition of cell cycle progression at the G1, S or G2/M phase with or without apoptosis was the mechanism of action of IFN. IFN preparations induced a dose-dependent decrease in tumor volume and weight by inducing tumor cell apoptosis in vivo, and tumor growth was effectively suppressed even at the clinical dose for chronic hepatitis C treatment. The antitumor effect of pegylated IFN was significantly stronger than that of nonpegylated IFN. Conclusion: The data suggest potential clinical application of pegylated IFN for the prevention and treatment of hepatocellular carcinoma.
Urinary D-Lactate Excretion in Infants Receiving Lactobacillus johnsonii with Formula
Authors: Haschke-Becher Elisabeth , Brunser Oscar , Cruchet Sylvia , Gotteland Martin , Haschke Ferdinand , Bachmann Claude
Published: December 2008

Background/Aims: Supplementation with certain probiotics can improve gut microbial flora and immune function but should not have adverse effects. This study aimed to assess the risk of D-lactate accumulation and subsequent metabolic acidosis in infants fed on formula containing Lactobacillus johnsonii (La1®). Methods: In the framework of a double-blind, randomized controlled trial enrolling 71 infants aged 4–5 months, morning urine samples were collected before and 4 weeks after being fed formulas with or without La1 (1 × 108/g powder) or being breastfed. Urinary D- and L-lactate concentrations were assayed by enzymatic, fluorimetric methods and excretion was normalized per mol creatinine. Results: At baseline, no significant differences in urinary D-/L-lactate excretion among the formula-fed and breastfed groups were found. After 4 weeks, D-lactate excretion did not differ between the two formula groups, but was higher in both formula groups than in breastfed infants. In all infants receiving La1, urinary D-lactate concentrations remained within the concentration ranges of age-matched healthy infants which had been determined in an earlier study using the same analytical method. Urinary L-lactate also did not vary over time or among groups. Conclusions: Supplementation of La1 to formula did not affect urinary lactate excretion and there is no evidence of an increased risk of lactic acidosis.
To Treat or Not to Treat Euthyroid Autoimmune Disorder during Pregnancy?
Authors: Debiève F. , Dulière S. , Bernard P. , Hubinont C. , De Nayer P. , Daumerie C.
Published: December 2008

Background: Subclinical autoimmune hypothyroidism during pregnancy is associated with an increased risk of miscarriage and has a deleterious effect on fetal development. The aim of this study was to evaluate a screening and treatment strategy of subclinical hypothyroidism, and to establish normal ranges of thyroid-stimulating hormone (TSH) and thyroxine (T4) during pregnancy. Methods: A retrospective study was carried out on 784 consecutive files of pregnant women; the files were systematically searched for thyroid function and antithyroid antibodies in order to determine the effect and the prevalence of anti-thyroid peroxidase antibodies (TPO-Ab) during pregnancy, and to evaluate treatment with levothyroxin (LT4) in TPO-Ab carriers. Results: Among the 75 TPO-Ab-positive patients, 42 received LT4 treatment during pregnancy. Although the range of TSH serum levels was wide, the mean TSH level was significantly higher in TPO-Ab-positive women (3 vs. 1 mIU/l, p < 0.01). No significant difference in the obstetrical complications rate was observed between TPO-Ab-positive and TPO-Ab-negative populations. Conclusions: Our study provides information on normal ranges of serum TSH and free T4 for Belgian pregnant women receiving iodide supplementation. Based on our results, we suggest supplementation of TPO-Ab-positive pregnant women with 50 μg/day of LT4, unless their TSH levels are lower than 1 mIU/l, to avoid the risk of hypothyroidism during pregnancy.
Effect of Cabergoline on Parkinsonian Tremor Assessed by Long-Term Actigraphy
Authors: Binder Sabine , Deuschl Günther , Volkmann Jens
Published: December 2008

Background: Tremor is one of the cardinal symptoms in Parkinson’s disease, but only few clinical studies have focussed on its therapy as the primary endpoint. One reason is the substantial fluctuation of tremor severity over time, which is difficult to capture and may render momentary clinical assessments unreliable. Methods: We evaluated the usefulness of a novel wrist-worn actigraph allowing long-term recordings of tremor in a pilot study, in which we assessed the therapeutic effect of cabergoline on tremor in 10 patients with tremor-dominant Parkinson’s disease. Clinical data were obtained by using the Unified Parkinson’s Disease Rating Scale (UPDRS Part III, item 20) and simultaneously a patient’s tremor diary. Results: We found a significant reduction in UPDRS motor and tremor scores, in tremor duration and tremor amplitude by actigraphy and diaries. Furthermore, we found significant correlations between actigraphy measurements and patient ratings of tremor intensity and occurrence in diaries. Conclusion: Long-term actigraphy is a reliable method to assess tremor occurrence and severity and may be used to document antitremor effects in clinical studies.
Flexible Bronchoscope Damage and Repair Costs in a Bronchoscopy Teaching Unit
Authors: Rozman Ales , Duh Stefan , Petrinec-Primozic Marija , Triller Nadja
Published: December 2008

Background: A significant part of the budget of our bronchoscopy unit represents repair costs for damaged bronchoscopes. Objectives: The purpose of this study was to determine the frequency, type and cause of damage to the bronchoscope as well as the repair costs. Methods: Frequency, type and cause of bronchoscope damage and repair costs of 13 new bronchoscopes that were used between August 1, 2001, and December 31, 2006, were retrospectively studied. Results: We recorded 47 instances of bronchoscope damage during the study, which is 1 instance of damage/141.6 procedures. Six instances of damage (12.7%) were potentially preventable. The most frequent wear and tear damage was to the rubber sheath on the distal bending portion of flexible bronchoscopes, and the most frequently preventable damage was that of the suction channel of the bronchoscope. The repair costs totaled 34,950.00 EUR or 5.25 EUR/procedure. 17,781.00 EUR (50.9%) can be attributed to preventable damage. The use of bronchoscopes for educational purposes was not associated with a higher rate of bronchoscope damage at our institution. Conclusions: Only a small number of occurrences of bronchoscope damage in our unit are potentially preventable, but they still represent an important expense. The relatively low occurrence of preventable damage is a result of the successful bronchoscopy training program.
G2A Deficiency in Mice Promotes Macrophage Activation and Atherosclerosis
Authors: Bolick David T. , Skaflen Marcus D. , Johnson Laura E. , Kwon Seong-Chun , Howatt Deborah , Daugherty Alan , Ravichandran Kodi S. , Hedrick Catherine C.
Published: December 2008

G2A is a stress-inducible G protein–coupled receptor that is expressed on several cell types within atherosclerotic lesions. We demonstrated previously that G2A deficiency in mice increased aortic monocyte recruitment and increased monocyte:endothelial interactions. To investigate the impact of G2A deficiency in macrophages, we isolated peritoneal macrophages from G2A
+/+
ApoE
−/−
and G2A
−/−
ApoE
−/−
mice. G2A
−/−
ApoE
−/−
macrophages had significantly lower apoptosis than control macrophages. The prosurvival genes BCL-2, BCL-xL, and cFLIP were increased in G2A
−/−
ApoE
−/−
macrophages. Macrophages from G2A
−/−
ApoE
−/−
mice also had increased proinflammatory status that was indicative of a M1 macrophage phenotype. This was indicated by significantly increased nuclear translocation of nuclear factor κB, as well as production of interleukin-12p40, tumor necrosis factor α, and interleukin-6, and reduced expression of arginase-I. Moreover, G2A
−/−
ApoE
−/−
macrophages had reduced ability to engulf apoptotic cells in vitro. We examined atherosclerosis in mice fed a Western diet for 10 weeks and found that G2A deficiency increased lesion size in the aortic root by 50%. Plasma lipid levels were not changed in G2A
−/−
ApoE
−/−
mice. However, we found that absence of G2A increased the number of aortic macrophages and attenuated apoptosis in this cell type. Moreover, bone marrow transplantation studies indicated that deficiency of G2A in marrow-derived cells significantly contributed to atherosclerosis development. In the absence of G2A, increased macrophage activation and decreased apoptosis is associated with accumulation of macrophages in the aorta and increased atherosclerosis.
Modifying Artending-to-Work Behavior of a Learning Disabled Child
Authors: Novy Pamela , Burnett Joseph , Powers Maryann , Sulzer-Azaroff Beth
Published: December 2008

A token reinforcement system was used to modify the attending-to-work behavior of a 9-year-old boy selected as the subject from a special classroom for the learning disabled. During Phase A, the baseline phase, he was attending to his work for an average of 60 percent of the time during a 30-minute period. (Data were taken at 10-second intervals.) During Phase B, when reinforcement for attending to work was instituted, the boy attended to his work an average of 88 percent of the 30-minute time period. The reversal phase showed the boy's rate for attention to work to drop to an average of 67 percent. To earn a token, the boy had to attend to his work consistently for five minutes, and was notified of earning a token by a light signal. Five tokens were needed to purchase one of the back-up reinforcers. In this study, attending-to-work behavior of a learning disabled child was amenable to the modification procedure of token reinforcement.
Comparison of Revised and Experimental Editions of the Illinois Test of Psycholinguistic Abilities
Authors: Waugh Ruth
Published: December 2008

Selected subtests of the experimental and revised editions of the Illinois Test of Psycholinguistic Abilities were administered to 30 six-year-old subjects. Correlations between subtests of the two editions were found to be of the same general magnitude as test-retest coefficients reported for the subtests of each edition. It appears that performance on one edition of the ITPA may be compared with performance on the other, and that the two editions may be used interchangeably for some purposes.
WISC Tesr Patterns and Underachievers
Authors: Bush Wilma Jo , Mattson Bruce D.
Published: December 2008

The WlSC test patterns of 28 bright and gifted underachievers were compared with those of 23 bright and gifted achievers. A comparison also was made of 36 normal-level underachievers with 22 normal-level achievers. Significant differences were found between underachievers and achievers at both levels. A second step involved a rank comparison between the underachievers at both intellectual levels and achievers at both intellectual levels. The WISC Information subtest was the only subtest to show a significant rank deviation between the bright and gifted and normal-level underachievers. No rank deviation differences were found between the achievers at the two different levels.
Project "ME": A New Approach to Media in the Education of Learning Disabled Children
Authors: Schaefer Florence , Heilig Morton , Rubin Sherwin
Published: December 2008

An innovative way of using audio-visual programs to help in the education of preschool children and older children with learning disabilities is described. Traditional audio-visual methods usually demand that the child sit still, remain quiet, and look and listen. These demands are too stringent for these young children to meet successfully; so, in the past, media has not been effectively used in early childhood education. Project "ME" has designed a system which enables children to interact, with a life-sized projected image, motorically, tactically, and verbally. Opportunities for visual-perceptual-motor training are expanded and programs have been designed to promote emotional awareness and enhance self-concept. An evaluation of two of the interactive programs is presented.
The Diagnostic Evaluation of Children with Learning Problems: A "Process" Approoch
Authors: Ozer Mark N. , Burtt Richardson H.
Published: December 2008

A protocol for evaluation of children with learning problems was initially designed to identify those children for whom a special education program might be helpful. However, self-contained special education programs are frequently not available and/or not appropriate for the large number of children with learning problems. There is thus a need for diagnostic data which can serve to enhance children's learning within the regular classroom. An evaluation protocol has been developed to produce a diagnosis that is a sampling of some conditions under which a given child's problems with learning may be solved. The protocol defines an interactive process between examiner and child: the examiner responds to the child's attempt to perform a set of prototype tasks with supportive feedback and provides new ways to try the task until the child is successful. The strategies include varying the time provided (programming), kind of input (modality) and at one point in time, the amount of competing stimuli (focusing). During this process the teacher observes the child's actual experience and what can be done to help the child perform certain tasks. The particular strategies used to bring the child to successful performance of the tasks are translated for use in the classroom in relation to tasks defined by the teacher as high priority. Thus what works to help the child in the evaluation process can work to help the child in the classroom. Furthermore, the strategies helpful to the particular child evaluated may be adapted to help other children having difficulties as well.
Attention and Applicatlon: The Oft Forgotten Steps in Teaching Reading
Authors: Allington Richard
Published: December 2008

Often the characteristics of effective teaching seem obvious. But when working with children who are experiencing difficulty in learning, one can become aware of limitations in literature describing the teaching act. Teaching is more than a simple presentation of information and assessment of its acquisition. Two aspects of teaching that are crucial in the training of basic skills involve specificity in directing attending behavior and application of the learned element. The effective application of these elements should facilitate any teaching/learning interaction.
programs, materials and techniques
Authors: Bannatyne Alex
Published: December 2008

The first review this month is of the series, Developing Oral Language in Young Children. There is more to these workbooks and teachers' manuals than meets the eye because "oral language" is a springboard for discussions of several other subject areas. Those who like practical activities will find some good material in Eldon Elkwall's Locating and Correcting Reading Difficulties and even more in Marciene Mattleman's 101 Activities for Teaching Reading. National Geographic has provided us with yet another set of Books for Young Explorers, while Carol Chomsky opened our eyes with her investigations into The Acquisition of Syntax in Children from 5 to 10. By contrast, Developing Language Programs for Young Disadvantaged Children and Guide to an Effective Kindergarten Program offer sound information for the teachers of the younger set. We swing back to teenagers' and older students' needs in A Time To Learn, an important book on study skills and personal effectiveness. Also related to the needs of older students is a followup on The Validity of Occupational Aptitude Tests. The Life-Space Survey by R. Heckelman is a unique test that assesses a child's relationships and attitudes within his local environment. The Smoking Scene is a part of that environment you may wish to counter. Understanding Young Children is a fine series of booklets on child development, handicaps, and how to work with them— for teachers, parents and other care givers. Finally / was spurred by an article / recently read to discuss my own similar views on the effective Counseling of Parents.
Using the Peabody Picture Vocabulary Test with Children Having Difficulty Learning
Authors: Gensemer Ira B. , Walker J. Calvin , Cadman Thomas E.
Published: December 2008

This research examined differences between WISC and PPVT scores for children with learning problems who were patients in a multispecialty group medical practice. The sample was composed of 99 children seen by a psychologist and a pediatric neurologist: 77 showed significant evidence of diffuse neurological dysfunction, 25 had speech problems, and 20 were diagnosed as having learning problems only. Results support previous research which indicates that PPVT IQs are frequently higher than WISC IQs when both instruments are used with the same children. PPVT IQs were significantly higher than WISC IQs both for the total sample and by diagnostic classification.
The Effects of Paradigmatic Organization on Verbal Recall
Authors: Suiter Margaret L. , Potter Robert E.
Published: December 2008

Initial tests of the possible processing problems of LD children compare their functioning with that of normal learners. The suggestion that LD children do not group items by categories to facilitate memory has been made. While past studies with auditory stimuli found such a deficit, visual materials that could be related conceptually were more easily remembered by LD children. Whether such potential conceptual deficits characterize at least some LD children remains to be seen. - G.M.S.
Interactions of First-Grade Teachers with Learning Disordered Children
Authors: Chapman Robert B. , Larsen Stephen C. , Parker Randall M.
Published: December 2008

Research suggests that the extent and nature of teacher-child classroom interactions are related to certain pupil characteristics, e.g., achievement level. The purpose of this study was to determine whether learning disordered students (broadly defined) were afforded different interactions from their regular classroom teachers than were children achieving at low, medium, or high levels. The dyadic teacher-child interactions of 110 first-grade students in four classrooms in two middle-class, suburban schools were recorded for seven hours per week for the first 13 weeks of the school year. Data analysis revealed that learning disordered children received more teacher criticism in interactions concerning classroom procedures and more teacher criticism and warning regarding behavior than their nondisabled peers. The authors concluded with the speculation that regular classroom teachers may be ill-equipped to manage the learning behavior of learning disordered children.
A First-Grade Intervention Program for Children at Risk for Reading Failure
Authors: White Margaret
Published: December 2008

All children entering first grade in two suburban elementary schools in Western Australia (N=124 ) were tested with the Satz test battery for early identification of failing readers. Twenty-one children were identified as being at risk after excluding those who were likely to be generally retarded intellectually. All 21 children continued to attend normal first-grade classes throughout the year, with the experimental group being withdrawn for two periods per week for six months for individual sensory-integrative therapy. At the end of the year the experimental group had reached a level of reading that was significantly higher than the control group. One and two years later, with no further intervention, the reading scores of the experimental group were still significantly higher than those of the control group.
Using Sign Language to Remediate Severe Reading Problems
Authors: Vernon McCay , Develin Coley Joan , Hafer DuBois Jan
Published: December 2008

This issue of PMT focuses on identification and remediation strategies for children with academic achievement difficulties. Vernon, Coley, and Dubois describe the results from a study using sign language and the manual alphabet to improve spelling skills of learning disabled children. Stein and Goldman compare the effects of DISTAR's operant model of reading instruction with an assumed cognitive approach of impacting reading by using the Palo Alto Reading Program. Van Camp describes the development and administration of a test designed to assess the auditory attending skills of beginning readers. — D.A.S.
Verbal Mediation for Perceptual Deficits in Learning Disabilities: A Review and Suggestions
Authors: Miller Maurice , Rohr Michael E.
Published: December 2008

An intervening variable between perceptual deficits and academic learning — verbal mediation processes — is explored. Research reviewed, primarily that of Luria, leads to the conclusion that verbal mediational processes can compensate for perceptual learning-process deficits. Relevant teaching applications are discussed.
On the Attempt to Find WISC-R Profiles for Learning and Reading Disabilities (A Response to Vance, Wallbrown, and Blaha)
Authors: Miller Maurice
Published: December 2008

In this issue we will depart from the typical Programs, Materials, and Techniques column format to include a response by Miller to two recent articles submitted by Vance, Wallbrown, and Blaha that describe the use of WISC-R scoring patterns in planning remediation strategies for learning disabled students. Miller's rebuttal claims that many of the conclusions and interpretations are unjustified. Vance, Wallbrown, and Blaha's rejoinder and a final reply by Miller are offered. Augmenting this theme with new information, Stevenson describes the value of a functional analysis of WISC-R performance in the assessment and remediation of the learning disabled child. Finally, Scull and Brand compare the performance of severely learning disabled children on the Wide Range Achievement Test and the Peabody Individual Achievement Test.