bluuebunny/crossref_metadata_2025 huggingface dataset:
A miniseries of spontaneous intramural esophageal hematoma in hemodialysis patients: A rare cause of dysphagia
Authors: Kumar Vinod , Hm Mallikarjuna , Gokulnath
Published: February 2014

Intramural esophageal hematoma (IEH) is an uncommon clinical condition, with a prognosis that is essentially benign. In most cases, a predisposing factor may be seen, with the most common being the history of esophagic instrumentation, food impactions, and thrombocytopenia. We report a miniseries of 3 patients on hemodialysis, who developed IEH. All 3 of them presented with sudden onset and progressively worsening dysphagia and hematemesis. Diagnosis of IEH was established by upper gastrointestinal endoscopy. All patients were managed conservatively, and symptoms of dysphagia and chest pain improved within 6–8 days. Good resolution of hematoma was noted by repeat endoscopy within 2–3 weeks. The reported case of IEH in hemodialysis patients is rare and needs to be identified early when patients present with dysphagia, as anticoagulation during hemodialysis would possibly worsen the clinical condition, the course of which is otherwise benign.
Influence of Family Psychiatric and Headache History on Migraine‐Related Health Care Utilization
Authors: Minen Mia T. , Seng Elizabeth K. , Holroyd Kenneth A.
Published: February 2014

Objective

We sought to examine the relationship of family history of headache and family history of psychiatric disorders on self‐reported health care utilization tendencies for migraine treatment.

Background

Familial aggregation of both migraine and depression has been well established in the literature. Family history of headache and psychiatric disorders could influence health care utilization tendencies for migraine.

Methods

This is a secondary analysis of patients with severe migraine (n = 225) who answered questions about their family history, previous headache treatment history, disability (Headache Disability Inventory), and psychiatric symptoms (Beck Depression Inventory and Beck Anxiety Inventory). Using regression, we examined the relationship between family history of headache, depression, and anxiety and reported headache‐related health care utilization.

Results

Participants reported family histories of headache (67.6%), anxiety (15.6%), and depression (29.3%). Participants reported seeing a physician for headache an average of 3.1 (standard deviation = 3.8) times in the past 2 years. In a 2‐year period, 27.6% of participants reported seeing a general practitioner and 18.5% of participants reported seeing a neurologist. Twenty‐eight percent of participants went to urgent care for headaches at least once in the last 2 years. Thirty‐nine percent of participants reported using non‐pharmacologic treatment for headache in the prior 2 years, with the highest rates of chiropractic manipulation (27.1%) and massage (18.2%), and fewest rates of biofeedback (0.4%), relaxation training (4.4%), psychotherapy (1.8%), physical therapy (4.9%), or acupuncture (1.8%). Family history of anxiety was associated with trying non‐pharmacologic treatments for headache, but no other self‐reported health care utilization variable. However, neither family history of headache nor family history of depression was associated with self‐reported health care utilization tendencies. Headache Disability Inventory was associated with self‐reported non‐pharmacologic treatments for headache.

Conclusions

Family history of anxiety, but not depression, was associated with utilizing non‐pharmacologic treatments for headache. Also, disability was associated with utilizing non‐pharmacologic treatments for headache. However, participants reported low rates of utilization for non‐pharmacologic treatments with grade‐A evidence.
Diagnostic PCR can be used to illuminate meiofaunal diets and trophic relationships
Authors: Maghsoud Hanna , Weiss Austin , Smith Julian P.S. , Litvaitis Marian K. , Fegley Stephen R.
Published: February 2014

Analysis of the meiofaunal food web is hampered because few prey have features that persist long enough in a predator's digestive tract to allow identification to species. Hence, at least for platyhelminth predators, direct observations of prey preference are almost nonexistent, and where they occur, prey identification is often limited to the phylum level. Studies using an in vitro approach are rare because they are extremely time‐consuming and are subject to the criticism that predators removed from their natural environment may exhibit altered behaviors. Although PCR‐based approaches have achieved wide application in food‐web analysis, their application to meiofaunal flatworms suffers from a number of limitations. Most importantly, the microscopic size of both the predator and prey does not allow for removal of prey material from the digestive tract of the predator, and thus the challenge is to amplify prey sequences in the presence of large quantities of predator sequence. Here, we report on the successful use of prey‐taxon‐specific primers in diagnostic PCR to identify, to species level, specific prey items of 13 species of meiofaunal flatworms. Extension of this method will allow, for the first time, the development of a species‐level understanding of trophic interactions among the meiofauna.
The analgesic effect of electrostimulation (WoundEL®) in the treatment of leg ulcers
Authors: Leloup Pauline , Toussaint Pascal , Lembelembe Jean‐Paul , Célérier Philippe , Maillard Hervé
Published: February 2014

This study aims to demonstrate the analgesic efficacy of electrostimulation (ES), a recognised treatment for leg ulcers. Patients treated by ES for leg ulcers between 2011 and 2013 were included in the study. The pain score obtained with the numerical rating scale (NRS) was reported before the start of the ES (D0), after 3 days (D3) and 1 week following treatment initialisation. The analgesic treatments (AT) were reported at each assessment. Seventy‐three patients were included (mean age 75·19 years): 31 venous leg ulcers, 21 mixed venous leg ulcers, 2 arterial ulcers, 17 hypertensive ischaemic ulcers, 1 Hydrea®‐induced ulcer and an amputation stump ulcer. The NRS at D0 was on average 5·3 (median = 6) while it was 2·2 at D7 (median = 2), that is P < 0·001. The results were also significant between D0 and D3 (P < 0·001). A decrease in the number of AT used was observed between D0 (2·0 AT per patient on average) and D7 (1·7 AT on average) (P < 0·001). We also observed a decrease in the consumption of grade 3 analgesics on D0 and D7 (P = 0·03). This study demonstrates the rapid analgesic efficacy of ES in leg ulcers, with a clear impact on the NRS score and especially on the decrease in analgesic consumption.
A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari)
Authors: Apollonio Alessandro , Antignani Pier L , Di Salvo Michelangelo , Failla Giacomo , Guarnera Giorgio , Mosti Giovanni , Ricci Elia ,   SUV Study Group
Published: February 2014

An observational study of 2 years was promoted by the Italian Association for Cutaneous Ulcers (AIUC) in order to monitor the epidemiology of leg ulcers, the trend of healing and the more frequent therapeutic approaches in lower limb ulcers. Fifty‐nine sites in 14 different Italian regions involved in the study, with 1333 enrolled patients (1163 patients fully evaluated and followed up for 9 months). A prevalence of females (62%) was observed with a mean age of 70 years and a high rate of hypertension (62%), diabetes (38%) and obesity (29%). Venous ulcer was most frequent (55%), followed by mixed (25%) and diabetic (8·3%) ulcers. Basically, all patients received a local therapy (LT) (compression and advanced local therapies), while 63% of patients have an associated systemic pharmaceutical treatment. Ulcer healing rates progressively increased throughout the study and despite the type of observational study does not allow conclusions on the treatment, it was observed that the patients receiving additional systemic drugs were associated with a more rapid acceleration of healing rates of ulcers compared to LT alone (3 months: 39·7% versus 29·2%; 6 months: 62·0% versus 47·0%; 9 months: 74·7% versus 63·8%). In particular, the Studio Ulcere Vascolari (SUV) study showed that a combination treatment with sulodexide and compression therapy allows for a greater increase in the healing rates in venous ulcers.
Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study
Authors: Pajardi Giorgio , Rapisarda Vicenzo , Somalvico Francesco , Scotti Andrea , Russo Giulia Lo , Ciancio Francesco , Sgrò Arturo , Nebuloni Manuela , Allevi Raffaele , Torre Maria L , Trabucchi Emilio , Marazzi Mario
Published: February 2014

Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin® to treat superficial wounds or fibroblasts on Hyalograft 3DR to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication.

In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group.

This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes.
Chronic oedema/lymphoedema: under‐recognised and under‐treated
Authors: Keast David H. , Despatis Marc , Allen Jill O. , Brassard Alain
Published: February 2014

Even though it is estimated that at least 300 000 people in Canada may be affected by chronic oedema/lymphoedema, recognition of the seriousness of this chronic disease in health care is scarce. Lymphoedema affects up to 70% of breast and prostate cancer patients, substantially increasing their postoperative medical costs. Adding to this problem are the escalating rates of morbid obesity across North America and the fact that 80% of these individuals are thought to suffer with an element of lymphoedema. The costs related to these patient populations and their consumption of health care resources are alarming. Untreated chronic oedema/lymphoedema is progressive and leads to infection, disfigurement, disability and in some cases even death. Thus, prognosis for the patient is far worse and treatment is more costly when the disease is not identified and treated in the earlier stages. Although the number of individuals coping with chronic oedema/lymphoedema continues to increase, the disparity between diagnosis, treatment and funding across Canada endures. The reasons for this include a lack of public awareness of the condition, insufficient education and knowledge among health care providers regarding aetiology and management and limited financial coverage to support appropriate methods and materials.
The Canine Orthopedic Index. Step 2: Psychometric Testing
Authors: Brown Dorothy Cimino
Published: February 2014

Objective

To perform psychometric testing an owner self‐administered questionnaire, the Canine Orthopedic Index (COI), designed to assess outcome in dogs with orthopedic disease.

Study Design

Original study.

Sample Population

Owners (n = 20) of dogs with osteoarthritis (OA) for item (question) pretesting, and 80 owners of dogs with OA for reliability and validity testing.

Methods

Standard methodology for the stepwise development and testing of instruments designed to assess subjective states was followed. Items generated in previous studies were pretested for readability, ambiguity, and inter‐item correlations; poorly performing items were removed; and the reduced set of items subjected to factor analysis, reliability, and validity testing.

Results

Four factors were identified and named on the basis of the items contained in them: “Stiffness,” “Gait,” “Function,” and “Quality of Life.” Cronbach's α ranged from 0.76 to 0.86, suggesting the items in each factor could be assessed as a group to compute factor scores (i.e., stiffness, gait, function, and quality of life scores). The test–retest analysis revealed κ values from 0.68 to 0.80. Overall, the scores amongst the 4 factors correlated moderately well (r = 0.52–0.58), with a mild correlation (r = 0.35) between gait and function scores.

Conclusions

The COI is a psychometrically sound owner completed instrument that can assess 4 domains in dogs with OA: Stiffness, Gait, Function, and Quality of Life.
Negative Pressure Wound Therapy: Experience in 45 Dogs
Authors: Pitt Kathryn A. , Stanley Bryden J.
Published: February 2014

Objective

To report experience with negative pressure wound therapy (NPWT) in 45 consecutive dogs admitted with extensive cutaneous wounds and to determine if NPWT is feasible in veterinary hospital practice.

Study Design

Prospective descriptive study.

Animals

Dogs (n = 45).

Methods

Collected data were organized into 6 categories: patient data, wound data, NPWT data, adjunctive treatments, complications, and final outcome.

Results

Wounds (53 in 45 dogs) were largely traumatic in origin, and distributed fairly evenly to the trunk, proximal and distal aspects of the limbs. Most wounds (34 dogs, 76%) had no granulation tissue and were treated a mean of 4.2 days after wounding, whereas 11 dogs had granulating wounds that were initially treated a mean of 87 days after wounding. Median NPWT use was 3 days with a mean hospitalization of 7.8 days. Most wounds (33; 62%) were closed surgically after NPWT and were healed by 14 days. The other 18 wounds healed (mean, 21 days) by second intention after hospital discharge. Overall, 96% of the wounds healed; 2 dogs died before definitive closure could be attempted.

Conclusion

NPWT is applicable to a wide variety of canine wounds, is well tolerated, allows for several days between dressing changes, and can used to optimize the wound bed for surgical closure or second intention healing.
In Vitro Biomechanical Comparison of a 5‐Hole 4.5 mm Locking Compression Plate and 5‐Hole 4.5 mm Dynamic Compression Plate for Equine Proximal Interphalangeal Joint Arthrodesis
Authors: Seo Jong‐pil , Yamaga Takashi , Tsuzuki Nao , Yamada Kazutaka , Haneda Shingo , Furuoka Hidehumi , Sasaki Naoki
Published: February 2014

Objective

To compare the biomechanical properties of a 5‐hole 4.5 mm narrow locking compression plate (LCP) and 5‐hole 4.5 mm narrow dynamic compression plate (DCP) for equine proximal interphalangeal (PIP) joint arthrodesis.

Study Design

Experimental mechanical study.

Animals

Cadaveric adult equine forelimbs (n = 6 pair).

Methods

For each forelimb pair, 1 PIP joint was stabilized with LCP and the contralateral PIP joint with DCP. The 6 construct pairs were tested using a single‐cycle, 3‐point dorsopalmar bending system. PIP joints were evaluated with pre‐ and post‐test radiography.

Results

The LCP technique had significantly greater yield load, failure load, and stiffness under single‐cycle, 3‐point dorsopalmar bending to failure than the DCP technique. There was no significant difference between the 2 constructs for displacement at yield and failure point.

Conclusions

Biomechanically, the LCP technique provided significantly greater stability than the DCP technique under the test condition.
Effect of an Intervertebral Disk Spacer on Stiffness After Monocortical Screw/Polymethylmethacrylate Fixation in Simulated and Cadaveric Canine Cervical Vertebral Columns
Authors: Hettlich Bianca F. , Allen Matthew J. , Glucksman Gabriela S. , Fosgate Geoffrey T. , Litsky Alan S.
Published: February 2014

Objective

To determine the biomechanical effect of an intervertebral spacer on construct stiffness in a PVC model and cadaveric canine cervical vertebral columns stabilized with monocortical screws/polymethylmethacrylate (PMMA).

Study Design

Biomechanical study.

Sample Population

PVC pipe; cadaveric canine vertebral columns.

Methods

PVC model—PVC pipe was used to create a gap model mimicking vertebral endplate orientation and disk space width of large‐breed canine cervical vertebrae; 6 models had a 4‐mm gap with no spacer (PVC group 1); 6 had a PVC pipe ring spacer filling the gap (PCV group 2). Animals—large breed cadaveric canine cervical vertebral columns (C2–C7) from skeletally mature dogs without (cadaveric group 1, n = 6, historical data) and with an intervertebral disk spacer (cadaveric group 2, n = 6) were used. All PVC models and cadaver specimens were instrumented with monocortical titanium screws/PMMA. Stiffness of the 2 PVC groups was compared in extension, flexion, and lateral bending using non‐destructive 4‐point bend testing. Stiffness testing in all 3 directions was performed of the unaltered C4–C5 vertebral motion unit in cadaveric spines and repeated after placement of an intervertebral cortical allograft ring and instrumentation. Data were compared using a linear mixed model approach that also incorporated data from previously tested spines with the same screw/PMMA construct but without disk spacer (cadaveric group 1).

Results

Addition of a spacer increased construct stiffness in both the PVC model (P < .001) and cadaveric vertebral columns (P < .001) compared to fixation without a spacer.

Conclusions

Addition of an intervertebral spacer significantly increased construct stiffness of monocortical screw/PMMA fixation.
The enemy release hypothesis as a hierarchy of hypotheses
Authors: Heger Tina , Jeschke Jonathan M.
Published: February 2014

In ecology, a hypothesis is usually not discarded if a few studies reject it, as long as there are other studies supporting it. How to assess the usefulness of ecological hypotheses is therefore not straightforward. Using the enemy release hypothesis as an example, we show how creating a hierarchy of hypotheses (HoH) can help reviewing and evaluating evidence for and against an ecological hypothesis. In a HoH, a broad, overarching hypothesis branches into more specific and better testable sub‐hypotheses. The enemy release hypothesis is a major hypothesis in invasion ecology and posits that the absence of enemies in the exotic range of an alien species is a cause of its invasion success. Based on a systematic review of empirical tests of this hypothesis, we divided it into sub‐hypotheses, differentiating among 1) indicators for enemy release, 2) types of comparisons, and 3) types of enemies. We identified 176 empirical tests and weighted each test according to the number of alien species studied and the research method (experimental vs observational, field vs enclosure vs laboratory). For the broadly formulated enemy release hypothesis, we found nearly as much supporting (36%) as questioning evidence (43%). At the sub‐hypotheses level, however, we found that some sub‐hypotheses are strongly supported by empirical evidence, whereas others receive hardly any support. These differences are further emphasized for some types of habitat and focal taxonomic groups. Our findings suggest that several specific formulations (i.e. sub‐hypotheses) of the broad enemy release hypothesis are useful, whereas other formulations should be viewed more critically. In general, the approach outlined here can help evaluate major ecological hypotheses and their specific sub‐hypotheses. Our study also highlights the need for a scientific debate on how much supporting evidence is sufficient to consider an ecological hypothesis to be useful.
Effect of endurance training on retinol‐binding protein 4 gene expression and its protein level in adipose tissue and the liver in diabetic rats induced by a high‐fat diet and streptozotocin
Authors: Mansouri Masoume , Nikooie Rohollah , Keshtkar Abasali , Larijani Bagher , Omidfar Kobra
Published: February 2014

Aims/Introduction

The present study was designed to investigate from which tissues the decrease in retinol‐binding protein 4 (RBP4) expression could contribute to the improvement of serum RBP4 and insulin resistance (IR) after endurance training.

Materials and Methods

Male 7‐week‐old Wistar rats were randomly assigned into four groups including control (C), trained (T), diabetic control (DC) and trained diabetic (TD). At 8 weeks‐of‐age, diabetes was induced by a high‐fat diet and intraperitoneal injection of low‐dose streptozotocin (STZ; 35 mg/kg). Rats in the T and TD groups carried out a 7‐week exercise program on a motorized treadmill (15–20 m/min for 20 min/day for 5 weeks), whereas the C and DC remained sedentary in their cages. Tissues gene expression and protein levels of RBP4 were assessed by using real‐time polymerase chain reaction and western blot, respectively, while serum RBP4 was measured using an enzyme‐linked immunosorbent assay kit.

Results

Exercise significantly improved IR and reduced serum concentration of RBP4 in the TD group. This reduction of serum RBP4 was accompanied by decreased RBP4 protein expression in visceral fat tissue. In contrast, exercise had no significant effect on RBP4 expression in liver and subcutaneous fat tissue in the TD group. Exercise also significantly decreased RBP4 gene expression in visceral fat tissue and muscle, whereas the effect of exercise on liver RBP4 messenger ribonucleic acid expression was not significant.

Conclusions

The present study showed that the mechanism for RBP4 reducing the effect of endurance training could involve decreased RBP4 messenger ribonucleic acid expression and its protein level in adipose tissue in STZ‐induced diabetic rats.
Polyandrous females produce sons that are successful at post‐copulatory competition
Authors: Klemme I. , Bäumer J. , Eccard J. A. , Ylönen H.
Published: February 2014

Some of the genetic benefit hypotheses put forward to explain multiple male mating (polyandry) predict that sons of polyandrous females will have an increased competitive ability under precopulatory or post‐copulatory competition via paternally inherited traits, such as attractiveness or fertilization efficiency. Here, we tested these predictions by comparing the competitive ability of sons of experimentally monandrous and polyandrous female bank voles (Myodes glareolus), while controlling for potential material and maternal effects. In female choice experiments, we found no clear preference for sons of either monandrous or polyandrous mothers. Moreover, neither male type was dominant over the other, indicating no advantage in precopulatory male contest competition. However, in competitive matings, sons of polyandrous mothers significantly increased their mating efforts (mating duration, intromission number). In line with this, paternity success was biased towards sons of polyandrous mothers. Because there was no evidence for maternal effects, our results suggest that female bank voles gain genetic benefits from polyandry.
Otolith microchemistry of tropical diadromous fishes: spatial and migratory dynamics
Authors: Smith W. E. , Kwak T. J.
Published: February 2014

Otolith microchemistry was applied to quantify migratory variation and the proportion of native Caribbean stream fishes that undergo full or partial marine migration. Strontium and barium water chemistry in four Puerto Rico, U.S.A., rivers was clearly related to a salinity gradient; however, variation in water barium, and thus fish otoliths, was also dependent on river basin. Strontium was the most accurate index of longitudinal migration in tropical diadromous fish otoliths. Among the four species examined, bigmouth sleeper Gobiomorus dormitor, mountain mullet Agonostomus monticola, sirajo goby Sicydium spp. and river goby Awaous banana, most individuals were fully amphidromous, but 9–12% were semi‐amphidromous as recruits, having never experienced marine or estuarine conditions in early life stages and showing no evidence of marine elemental signatures in their otolith core. Populations of one species, G. dormitor, may have contained a small contingent of semi‐amphidromous adults, migratory individuals that periodically occupied marine or estuarine habitats (4%); however, adult migratory elemental signatures may have been confounded with those related to diet and physiology. These findings indicate the plasticity of migratory strategies of tropical diadromous fishes, which may be more variable than simple categorization might suggest.
The experience of the endoscopist increases detection rates of smaller size and higher histological grade polyps
Authors: Solís‐Muñoz Pablo , Solís‐Herruzo José A , Rodríguez‐Muñoz Sarbelio
Published: February 2014

Background

Adenoma and polyp detection rates (ADR and PDR, respectively) are important indicators of endoscopy quality, particularly in colorectal carcinoma screening.

Objective

To assess the influence of the endoscopist's experience on the ADR and PDR.

Patients and Methods

In this study, 9635 colonoscopies were screened during a 5‐year period. Only 5738 were finally analyzed due to exclusion criteria. The endoscopists were separated in three groups of experience according to the number of colonoscopies performed in the past (yearly and total). The number of polyps and adenomas, as well as the size and histology of these polyps were recorded.

Results

The ADR and PDR were similar regardless of the experience of the endoscopist, but those with more experience clearly found more polyps of less than 10 mm (P = 0.01) and of less than 3 mm (P < 0.0001). Most of the differences were due to a higher number of flat polyps detected by the experienced group. This study also shows that more experienced endoscopists detect adenomas with more advanced histology (P < 0.0001).

Conclusion

Even though the ADR and PDR are similar in all groups of endoscopists, the less experienced endoscopists could be missing some of the smaller polyps, sometimes with more advanced histology.
Randomized controlled trial of monthly versus biweekly endoscopic variceal ligation for the prevention of esophageal variceal rebleeding
Authors: Wang Huay‐Min , Lo Gin‐Ho , Chen Wen‐Chi , Chan Hoi‐Hung , Tsai Wei‐Lun , Yu Hsien‐Chung , Tsay Feng‐Woei , Hsu Ping‐I
Published: February 2014

Background

Endoscopic variceal ligation (EVL) is effective in preventing esophageal variceal rebleeding. However, the optimal EVL interval remains unclear.

Aim

To investigate the effectiveness and safety of EVL using two intersession intervals.

Methods

From January 2009 to October 2012, 214 patients with acute esophageal variceal bleeding were screened. Emergency ligation was performed for patients with acute variceal bleeding. After achieving hemodynamic stability, eligible patients (n = 70) were randomized to either the monthly group or the biweekly group.

Results

Median time from randomization to variceal obliteration was 2.7 months in the monthly group and 1.7 months in the biweekly group, at a mean of 2.3 ± 2.0 and 3.0 ± 1.8 sessions, respectively. After a median follow up of 23 months, six patients (17%) in the monthly group and nine patients (26%) in the biweekly group developed upper gastrointestinal rebleeding (P = 0.382). Esophageal variceal rebleeding occurred in six patients (17%) in the monthly group and in seven patients (20%) in the biweekly group (P = 0.759). No rebleeding from EVL ulcers occurred in the monthly group and was 5.7% (n = 2) for the biweekly group. Both treatment groups had similar rates of esophageal variceal recurrence and mortality. Notably, the incidence of post‐EVL ulcers in the monthly group was lower than that in the biweekly group (11% vs 57%, P < 0.001).

Conclusions

Patients receiving EVL monthly had similar rebleeding rate, variceal recurrence, and mortality to those receiving EVL biweekly for secondary prophylaxis of variceal bleeding; however, the monthly interval was associated with fewer post‐EVL ulcers found at follow‐up endoscopies.
Interleukin‐28B rs12979860 C allele: Protective against advanced fibrosis in chronic hepatitis C genotype 1 infection
Authors: Kitson Matthew T , George Jacob , Dore Gregory J , Leung Reynold , Button Peter , McCaughan Geoffrey W , Crawford Darrell H G , Sievert William , Weltman Martin D , Cheng Wendy S C , Roberts Stuart K ,   CHARIOT Study Group
Published: February 2014

Background and Aim

While genetic polymorphisms upstream of the interleukin‐28B (IL28B) gene are associated with necroinflammatory activity grade in chronic hepatitis C virus genotype 1 (HCV‐1) infection, any association with fibrosis is less definitive. Pretreatment liver biopsies in a cohort of treatment‐naïve patients with HCV‐1 were analyzed to evaluate associations between liver histology, and the rs12979860 and rs8099917 IL28B single nucleotide polymorphisms.

Methods

Two hundred sixty‐six patients with HCV‐1 infection and pretreatment liver biopsy were tested for the rs12979860 and rs8099917 single nucleotide polymorphisms. Predictors of advanced fibrosis (METAVIR F3/4) and high activity grade (A2/3) were identified using multivariable logistic regression analysis.

Results

Forty‐four patients (16.5%) had advanced fibrosis and 141 patients (53.0%) high activity grade. Prevalence of rs12979860 IL28B genotype was: CC 45.7%, CT 42.7%, and TT 11.6%. Prevalence of advanced fibrosis was lower in those with IL28B CC genotype compared with those without (11.0% vs 21.3%; P = 0.03), with an increasing number of T alleles associated with a higher frequency of advanced fibrosis: CC 11.0%, CT 18.0%, TT 33.3% (P = 0.01). Predictors of advanced fibrosis on multivariate analysis were platelet count (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.97–0.99; P < 0.0001), high activity grade (OR 5.68, 95% CI% 1.86–17.32; P = 0.002), IL28B rs12979860 CC genotype (OR 0.36, 95% CI 0.14–0.93; P = 0.03), and aspartate aminotransferase (OR 1.02, 95% CI 1.00–1.03; P = 0.046). No association was found between rs8099917 IL28B genotype and liver histology.

Conclusions

IL28B rs12979860 CC genotype appears to be independently associated with a lower prevalence of advanced fibrosis stage in HCV‐1 infection. This association warrants further evaluation.
Cystic fibrosis: An update for clinicians. Part 1: Nutrition and gastrointestinal complications
Authors: Haller Wolfram , Ledder Oren , Lewindon Peter J , Couper Richard , Gaskin Kevin J , Oliver Mark
Published: February 2014

During three decades, the demographics of cystic fibrosis (CF) has undergone a significant change. Advances in nutritional and pulmonary management allow the vast majority of patients reaching adulthood today. With increasing survival, new and previously less common aspects of CF are encountered by the clinician expanding the concept of CF as a multisystem disease. The first part of this two‐part review will focus on the nutritional and gastrointestinal aspects of the CF phenotype and outline core principles of diagnosis and care.
Different roles for p16INK4a‐Rb pathway and INK4a/ARF methylation between adenocarcinomas of gastric cardia and distal stomach
Authors: Xue Liying , Ouyang Qin , Li Jie , Meng Xinxing , Li Yuehong , Xing Lingxiao , Wang Junling , Yan Xia , Zhang Xianghong
Published: February 2014

Background and Aim

The incidence of distal gastric adenocarcinoma has significantly decreased, but gastric cardia adenocarcinoma has been on the rise. Cardia adenocarcinoma might be a specific entity distinct from the carcinoma of the rest stomach. The aim was to explore putative differences in p16INK4a‐retinoblastoma (Rb) pathway and INK4a/ARF methylation between gastric cardia and distal adenocarcinomas.

Methods

Ninety‐six cardia adenocarcinomas and 79 distal samples were analyzed for comparing p16INK4a‐Rb expressions, INK4a/ARF deletion, and methylation using immunohistochemistry, polymerase chain reaction, and methylation‐specific polymerase chain reaction.

Results

The expression of p16INK4a in cardia adenocarcinoma (43.2%) was significantly lower than in distal cases (75.0%, P < 0.05). As well, cardia adenocarcinoma showed lower expression of p14ARF compared with distal cases (34.1% vs 57.5%, P < 0.05). The incidence of p16INK4a deletion was 20.5% and 15.0%, while p14ARF deletion was 18.2% and 10.0% in cardia and distal adenocarcinomas, respectively, showing no significant differences between two entities. However, the incidences of p14ARF and p16INK4a methylation in cardia adenocarcinoma were significantly higher than in distal samples (p14ARF: 61.5% vs 43.6%; p16INK4a: 73.1% vs 51.3%, P < 0.05). INK4a/ARF methylations were more prevalent in poorly differentiated cardia carcinoma compared with poorly differentiated distal cases.

Conclusions

There were differences in p16INK4a‐Rb immunotypes and INK4a/ARF methylation between two entities, indicating that cardia adenocarcinoma may be different in cell proliferation, differentiation, and gene biomarkers compared with distal gastric adenocarcinoma.
Comorbidity Burden and Guideline‐Concordant Care for Breast Cancer
Authors: Kimmick Gretchen , Fleming Steven T. , Sabatino Susan A. , Wu Xiao‐Cheng , Hwang Wenke , Wilson J. Frank , Lund Mary Jo , Cress Rosemary , Anderson Roger T. ,   The Centers for Disease Control and Prevention National Program of Cancer Registry Patterns of Care Study Group
Published: February 2014

Objectives

To explore the relationship between level and type of comorbidity and guideline‐concordant care for early‐stage breast cancer.

Design

Cross‐sectional.

Setting

National Program of Cancer Registry (NPCR) Breast and Prostate Cancer Patterns of Care study, which re‐abstracted medical records from 2004 in seven cancer registries.

Participants

Individuals with stage 0–III breast cancer.

Measurements

Multicomponent guideline‐concordant management was modeled based on tumor size, node status, and hormone receptor status, according to consensus guidelines. Comorbid conditions and severity were measured using the Adult Comorbidity Evaluation Index (ACE‐27). Multivariate logistic regression models determined factors associated with guideline‐concordant care and included overall ACE‐27 scores and 26 separate ACE comorbidity categories, age, race, stage, and source of payment.

Results

The study sample included 6,439 women (mean age 58.7, range 20–99; 76% white; 44% with no comorbidity; 70% estrogen‐ or progesterone‐receptor positive, or both; 31% human epidermal growth factor receptor 2 positive). Care was guideline concordant in 60%. Guideline concordance varied according to overall comorbidity burden (70% for none; 61% for minor; 58% for moderate, 43% for severe; P < .05). In multivariate analysis, the presence of hypertension (odds ratio (OR) = 1.15, 95% confidence interval (CI) = 1.01–1.30) predicted guideline concordance, whereas dementia (OR = 0.45, 95% CI = 0.24–0.82) predicted lack of guideline concordance. Older age (≥50) and black race were associated with less guideline concordance, regardless of comorbidity level.

Conclusion

When reporting survival outcomes in individuals with breast cancer with comorbidity, adherence to care guidelines should be among the covariates.
Alterations in Platelet Function During Aging: Clinical Correlations with Thromboinflammatory Disease in Older Adults
Authors: Mohebali Donya , Kaplan David , Carlisle McKenzie , Supiano Mark A. , Rondina Matthew T.
Published: February 2014

Platelets have a dynamic functional repertoire that mediates hemostatic and inflammatory responses. Many of these functions are altered in older adults, promoting a prothrombotic, proinflammatory milieu and contributing to risk of adverse clinical events. Drawing primarily from human studies, this review summarizes important aspects of aging‐related changes in platelets. The relationship between altered platelet functions and thrombotic and inflammatory disorders in older adults is highlighted. Established and developing antiplatelet therapies for the treatment of thrombotic and inflammatory disorders are also discussed in light of these data.
‘Health and happiness is more important than weight’: a qualitative investigation of the views of parents receiving written feedback on their child's weight as part of the National Child Measurement Programme
Authors: Syrad H. , Falconer C. , Cooke L. , Saxena S. , Kessel A. S. , Viner R. , Kinra S. , Wardle J. , Croker H.
Published: February 2014

Background

The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback.

Methods

Fifty‐two parents of overweight and obese children aged 4–5 years and 10–11 years enrolled in the NCMP programme in England in 2010–2011 participated in qualitative, semi‐structured interviews about their perceptions of their child's weight and health risk after receiving weight feedback. Interviews were audio tape recorded and were conducted either by telephone (n = 9) or in the respondents’ homes (n = 41). Interviews were transcribed verbatim and analysed using interpretative thematic analysis.

Results

Parents who received NCMP written feedback informing them that their child was overweight disregarded the results because they viewed ‘health and happiness as being more important than weight’. The feedback was viewed as less credible because it did not consider the individual child's lifestyle. ‘Broad definitions of healthy’ were described that did not include weight, such as reference to the child having good emotional and physical health and a healthy diet. Parents attributed weight to ‘inherited/acquired factors’ such as genetics or puppy fat, or did not regard their child's ‘appearance’ as reflecting being overweight. ‘Cultural influence’ also meant that being overweight was not viewed negatively by some non‐white parents.

Conclusions

After receiving written weight feedback, parents use methods other than actual weight when evaluating their child's weight status and health risks. Parents’ conceptions of health and weight should be considered when communicating with parents, with the aim of bridging the gap between parental recognition of being overweight and subsequent behaviour change.
Persistent babesiosis in a Rhesus macaque (Macaca mulatta) infected with a simian–human immunodeficiency virus
Authors: Liu David X. , Gill Amy , Holman Patricia J. , Didier Peter J. , Blanchard James L. , Veazey Ronald S. , Lackner Andrew A.
Published: February 2014

Background

A rhesus macaque developed chronic anemia, lymphocytic leukocytopenia, fever, and anorexia while immunodeficient following inoculation with a simian‐human immunodeficiency virus.

Methods

A complete blood count, peripheral blood smear, polymerase chain reaction and gene sequence were performed.

Results

Blood smears demonstrated persistent intraerythrocytic piroplasms with rare Maltese cross forms. Babesia microti‐like protozoa were confirmed by polymerase chain reaction and sequencing of the 18S ribosomal RNA gene.

Conclusion

With continued use of non‐human primates as models for human diseases, infection and complications from babesiosis should be monitored.
Insights into the physiological function of the β‐amyloid precursor protein: beyond Alzheimer's disease
Authors: Dawkins Edgar , Small David H.
Published: February 2014

The β‐amyloid precursor protein (APP) has been extensively studied for its role as the precursor of the β‐amyloid protein (Aβ) of Alzheimer's disease. However, the normal function of APP remains largely unknown. This article reviews studies on the structure, expression and post‐translational processing of APP, as well as studies on the effects of APP in vitro and in vivo. We conclude that the published data provide strong evidence that APP has a trophic function. APP is likely to be involved in neural stem cell development, neuronal survival, neurite outgrowth and neurorepair. However, the mechanisms by which APP exerts its actions remain to be elucidated. The available evidence suggests that APP interacts both intracellularly and extracellularly to regulate various signal transduction mechanisms.

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This article reviews studies on the structure, expression and post‐translational processing of β‐amyloid precursor protein (APP), as well as studies on the effects of APP in vitro and in vivo. We conclude that the published data provide strong evidence that APP has a trophic function. APP is likely to be involved in neural stem cell development, neuronal survival, neurite outgrowth and neurorepair. However, the mechanisms by which APP exerts its actions remain to be elucidated. The available evidence suggests that APP interacts both intracellularly and extracellularly to regulate various signal transduction mechanisms.
Impaired one carbon metabolism and DNA methylation in alcohol toxicity
Authors: Kruman Inna I. , Fowler Anna‐Kate
Published: February 2014

Excessive alcohol consumption is a prominent problem and one of the major causes of mortality and morbidity around the world. Long‐term, heavy alcohol consumption is associated with a number of deleterious health consequences, such as cancer, heart and liver disease, a variety of neurological, cognitive, and behavioral deficits. Alcohol consumption is also associated with developmental defects. The causes of alcohol‐induced toxicity are presently unclear. One of the mechanisms underlying alcohol toxicity has to do with its interaction with folic acid/homocysteine or one‐carbon metabolism (OCM). OCM is a major donor of methyl groups for methylation, particularly DNA methylation critical for epigenetic regulation of gene expression, and its disturbance may compromise DNA methylation, thereby affecting gene expression. OCM disturbance mediated by nutrient deficits is a well‐known risk factor for various disorders and developmental defects (e.g., neural tube defects). In this review, we summarize the role of OCM disturbance and associated epigenetic aberrations in chronic alcohol‐induced toxicity.

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In this review, we summarize the role of one‐carbon metabolism (OCM) aberrations in chronic alcohol‐induced toxicity. OCM is a major donor of methyl groups for methylation reactions, particularly DNA methylation critical for epigenetic regulation of gene expression. Alcohol interference with OCM and consequent reduced availability of methyl groups, improper DNA methylation, and aberrant gene expression can play a causative role in alcohol toxicity.
Financial Knowledge among Educated Women: Room for Improvement
Authors: MAHDAVI MAHNAZ , HORTON NICHOLAS J.
Published: February 2014

We examined financial knowledge among educated women with at least a bachelor's degree by analyzing the results from a 2009 survey representing a well‐defined sample (N = 4,344) of alumnae from a highly selective liberal arts college for women. This study found modest levels of financial knowledge with wide variation. Specifically, in the sample of alumnae, respondents in an older cohort, with higher household income, and those who obtained an MBA degree exhibit higher levels of financial knowledge. These results highlighted the need for effective financial education for many college‐educated women.
Percutaneous Closure of a Perimembranous Ventricular Septal Defect Through Arm Approach (Radial Artery and Basilic Vein)
Authors: SANGHVI KINTUR , SELVARAJ NEMALAN , LUFT ULRICH
Published: February 2014

We report a case of percutaneous closure of a congenital perimembranous ventricular septal defect (VSD) performed via a radial artery and basilic vein accesses. We further discuss the technique, advantages, and limitation of this innovative approach for perimembranous VSD closure. (J Interven Cardiol 2014;27:199–203)
Secular Trends in Alcohol Drinking Among Danish 15‐Year‐Olds: Comparable Representative Samples From 1988 to 2010
Authors: Andersen Anette , Rasmussen Mette , Bendtsen Pernille , Due Pernille , Holstein Bjørn E.
Published: February 2014

This study describes the secular trends in weekly intake of beer, wine, liquor, and drunkenness among 15‐year‐olds 1988–2010 (total N = 8,701), a period with several policy initiatives regarding alcohol in Denmark. Data from seven comparative and representative school surveys conducted in 1988, 1991, 1994, 1998, 2002, 2006, and 2010 were used. The proportion of 15‐year‐olds in Denmark who drank alcohol and were drunk increased from 1988 to 2002, but decreased substantially to 2010; for example, the proportion of 15‐year‐old girls who drank beer at least weekly increased from 15% in 1988 to 31% in 2002 and decreased to 7% in 2010. We hypothesize that age limits for purchasing alcohol may have resulted in a decrease in young people's alcohol use.
Effect of the menstrual cycle on inflammatory cytokines in the periodontium
Authors: Khosravisamani M. , Maliji G. , Seyfi S. , Azadmehr A. , Abd Nikfarjam B. , Madadi S. , Jafari S.
Published: February 2014

Background and Objective

The effects of different levels of steroid hormones, as experienced during puberty, pregnancy and menopause, on the periodontium have been demonstrated, but changes in sex hormone levels during the menstrual cycle, and the influence of these changes on the periodontium, remain unresolved. The aim of this study was to investigate the effect of the menstrual cycle on the levels of interleukin‐1beta (IL‐1β) and tumor necrosis factor‐alpha (TNF‐α) in gingival crevicular fluid and on periodontal clinical parameters, including the gingival bleeding index (GBI) and the modified gingival index (MGI), in periodontally healthy women.

Material and Methods

Twenty‐seven periodontally healthy women with a regular menstrual cycle were included in the study. Clinical parameters, including the GBI, the MGI and the simplified oral health index, were recorded during menstruation, ovulation and premenstruation phases (e.g. on days 1–2, 12–14 and 22–24, respectively) of the menstrual cycle. Gingival crevicular fluid and unstimulated saliva were collected, at each study phase, for assessment of IL‐1β, TNF‐α, estrogen and progesterone.

Results

Both the GBI and the MGI increased significantly during the menstrual cycle, and were significantly higher during ovulation than during menstruation or premenstruation (p < 0.001). No significant change in the simplified oral health index was observed during the menstrual cycle ( p = 0.18). The levels of IL‐1β and TNF‐α increased during the different phases of the menstrual cycle, but only the change in the TNF‐α concentration was significant ( p < 0.05).

Conclusion

This study indicated that changes occurring during the menstrual cycle influence the periodontium and induce inflammatory conditions.
HIV co‐infection accelerates decay of humoral responses in spontaneous resolvers of HCV infection
Authors: Liu Y. , Shen T. , Zhang C. , Long L. , Duan Z. , Lu F.
Published: February 2014

Acute hepatitis C virus (HCV) infection is primarily followed by chronic infection, while spontaneous recovery of HCV infection (SR‐HCV) occurs in a minority of those infected. Identification of SR‐HCV clinically depends on two combined indicators, persistently undetectable peripheral HCV RNA and positivity for anti‐HCV. However, the characteristics of dynamic variation in anti‐HCV antibodies in SR‐HCV, especially in those patients co‐infected with HIV, are still undefined. In this study, a cohort of patients infected with HCV through commercial blood collection practices was studied. We found that the annual decreasing rate of anti‐HCV presented a gradually accelerated process in HCV resolvers. However, the variation in the decline of anti‐HCV presented a slowly accelerated process within the early decrease stage and a gradually decelerated process within the latter decrease stage. In addition, we deduced that it expended approximately 16 years from natural HCV recovery to undetectable peripheral anti‐HCV in HCV resolvers co‐infected with HIV, while this time was estimated to be 20 years in SR‐HCV without HIV co‐infection. Our data indicated that the decay of anti‐HCV was accelerated by HIV‐related impairment of immune function. The prevalence of HCV infection may be severely underestimated in this large‐scale retrospective epidemiologic investigation in an HIV‐infected population.