bluuebunny/crossref_metadata_2025 huggingface dataset:
Applications of a Newly Developed Sonic Surgical Handpiece in Implant Dentistry
Authors: Schmidt Erich C. , Papadimitriou Dimitrios E. , Caton Jack G. , Romanos Georgios E.
Published: May 2012

Introduction: Lack of adequate alveolar bone width or height for proper implant placement is a common clinical situation that clinicians have to overcome in implant dentistry. A new sonic surgical handpiece (SSH) has been developed that uses high‐oscillation amplitude to produce precise bony incisions. In combination with the surgical tips, this device can be used in many clinical situations.

Case Series: In this case series, we present various clinical applications of the SSH in implant dentistry. The handpiece and the tips were evaluated in various procedures. These included: 1) ridge augmentation; 2) maxillary sinus augmentation; 3) atraumatic tooth extraction; and 4) autogenous bone harvesting. The SSH was able to make very precise incisions through bone and atraumatically separate teeth from their periodontal ligaments. All of these cases healed uneventfully and successfully. Advantages and disadvantages of this new innovative device are illustrated with the clinical cases, including postoperative clinical outcomes.

Conclusions: The SSH was able to produce precise atraumatic bony incisions. With the variety of procedures the device can perform, it should be of value to any clinician performing surgical implant dentistry.
GMI Effect of Ultra-Soft Magnetic Soft Amorphous Microwires
Authors: Zhukov A. , Ipatov M. , M. Blanco J. , Zhukova V.
Published: May 2012

In this paper we experimentally studied GMI effect and soft magnetic behavior of Co-rich microwires.
Correlation between magnetoelastic anisotropy and magnetic field dependences of diagonal and off-diagonal impedance
components are observed. Low field GMI hysteresis, explained in terms of magnetoelastic anisotropy of microwires, has
been suppressed by the bias current.
Minimally Invasive Helical Plating for Shaft of Humerus Fractures: Technique and Outcome
Authors: Tan James Chung Hui , Kagda Fareed Husain Yusuf , Murphy Diarmuid , Thambiah Joseph S , Khong Kok Sun
Published: May 2012

Introduction:

The humerus is subjected to substantial amount of torsional stress. Conventional plating may not address this sufficiently and may lead to fixation failure or non-union. A helical plate may offer the solution. We present the surgical technique and functional outcome of 5 cases of humeral shaft fractures treated with this technique in a minimally invasive way.

Materials and Methods:

The operations were performed between 2004 and 2010, by three surgeons. All the patients had closed humeral shaft fractures, either simple transverse or with mild comminution. Two small incisions were made. The proximal incision was placed along the deltopectoral groove over the shaft, and the distal incision was placed as in an antero-lateral approach. The radial nerve was identified and protected. A pre-selected plate was contoured and introduced in the submuscular plane. The plate was placed in a proximal-lateral and distal-anterior position. Screws were inserted through stab incisions. The patients were followed for an average of 6 months. Functional recovery of the shoulder and elbow was assessed using the Constant and Mayo elbow performance score systems.

Results:

All incisions healed by first intention without complications and all the fractures went on to unite. All patients achieved good to excellent shoulder and elbow function.

Conclusion:

The helical plate technique is a safe and effective method of treating humeral shaft fractures and has good functional outcome.
Restorative Integral Support (RIS) for Older Adults Experiencing Co-Occurring Disorders
Authors: Larkin Heather , MacFarland Nicole S.
Published: May 2012

The Restorative Integral Support (RIS) model is a whole person response that assists people to overcome adversity. The Adverse Childhood Experiences (ACE) Study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention shows the association between stressors in childhood and multiple later-life health and social problems. Older adults experiencing co-occurring disorders are an under-served and vulnerable population where gaps in both practice models and research to inform effective service provision exist. The current empirical case study presents Senior Hope as one social service agency employing RIS to intervene on the linkage between ACEs and co-occurring disorders to assist older adults. RIS usefully articulates the way in which Senior Hope is developing ACE-informed programs that mobilize resilience and recovery to help older adults achieve positive mental health outcomes. Implementation and research on the RIS model is recommended to enhance services for groups with ACE characteristics.
A Woman with Recurrent Calcium Phosphate Kidney Stones
Authors: Goldfarb David S.
Published: May 2012

Kidney stones composed predominantly (50% or more) of calcium phosphate constitute up to 10% of all stones and 15%–20% of calcium stones, 80% of which are composed of calcium oxalate. Calcium phosphate is a minor component of up to 30% of calcium oxalate stones as well. The cause of calcium phosphate stones is often obscure but most often related to a high urine pH. Some patients with calcium phosphate stones may have incomplete renal tubular acidosis. Others have distal renal tubular acidosis characterized by hyperchloremic acidosis, hypocitraturia, and high urine pH. The use of carbonic anhydrase inhibitors such as acetazolamide, topiramate, and zonisamide leads to a similar picture. Treatment options to specifically prevent calcium phosphate stone recurrence have not been tested in clinical trials. Increases in urine volume and restriction of sodium intake to limit calcium excretion are important. Citrate supplementation is probably effective, although the concomitant increase in urine pH may increase calcium phosphate supersaturation and partially offset the inhibition of crystallization resulting from the increased urine citrate excretion and the alkali-associated reduction in urine calcium excretion. Thiazides lower urine calcium excretion and may help ensure the safety of citrate supplementation.
Prioritizing comparative effectiveness research for cancer diagnostics using a regional stakeholder approach
Authors: Klein Gregory , Gold Laura S , Sullivan Sean D , Buist Diana SM , Ramsey Scott , Kreizenbeck Karma , Snell Kyle , Loggers Elizabeth Trice , Gifford Joseph , Watkins John B , Kessler Larry
Published: May 2012

Aims:
This paper describes our process to engage regional stakeholders for prioritizing comparative effectiveness research (CER) in cancer diagnostics. We also describe a novel methodology for incorporating stakeholder data and input to inform the objectives of selected CER studies.
Materials & methods:
As an integrated component to establishing the infrastructure for community-based CER on diagnostic technologies, we have assembled a regional stakeholder group composed of local payers, clinicians and state healthcare representatives to not only identify and prioritize CER topics most important to the western Washington State region, but also to inform the study design of selected research areas. A landscape analysis process combining literature searches, expert consultations and stakeholder discussions was used to identify possible CER topics in cancer diagnostics. Stakeholders prioritized the top topics using a modified Delphi/group-nominal method and a standardized evaluation criteria framework to determine a final selected CER study area. Implementation of the selected study was immediate due to a unique American Recovery and Reinvestment Act funding structure involving the same researchers and stakeholders in both the prioritization and execution phases of the project. Stakeholder engagement was enhanced after study selection via a rapid analysis of a subset of payers’ internal claims, coordinated by the research team, to obtain summary data of imaging patterns of use. Results of this preliminary analysis, which we termed an ‘internal analysis,’ were used to determine with the stakeholders the most important and feasible study objectives.
Results:
Stakeholders identified PET and MRI in cancers including breast, lung, lymphoma and colorectal as top priorities. In an internal analysis of breast cancer imaging, summary data from three payers demonstrated utilization rates of advanced imaging increased between 2002 and 2009 in the study population, with a great deal of variability in use between different health plans. Assessing whether breast MRI affects treatment decisions was the top breast cancer study objective selected by the stakeholders. There were other high-priority research areas including whether MRI use improved survival that were not deemed feasible with the length of follow-up time following MRI adoption.
Conclusion:
Continuous stakeholder engagement greatly enhanced their enthusiasm for the project. We believe CER implementation will be more successful when undertaken by regional stakeholders.
Interview: Health technology assessment in Asia: an emerging trend
Authors: Yang Bong-min
Published: May 2012

Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for
Journal of Comparative Effectiveness Research
, is co-editor-in-chief for
Value in Health Regional Issues
, and is currently chair of the Management Advisory Board of
Value in Health
and a member of the editorial board of the
Journal of Medical Economics
. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research–Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research.
Pharmacologic and nonpharmacologic thromboprophylactic strategies in atrial fibrillation
Authors: Alam Tawkiful , Clyne Christopher A , White C Michael
Published: May 2012

Stroke prevention in atrial fibrillation (SPAF) has traditionally been confined to aspirin and warfarin therapy. Based on CHADS
2
scoring it was clearly delineated when aspirin and warfarin would be used in individual patients, but many patients had to forgo recommended therapy due to contraindications or adverse events. There has recently been a paradigm shift in SPAF, with new and promising options on the horizon. These emerging strategies include dual antiplatelet therapy, direct thrombin inhibition, factor Xa inhibition and mechanical prophylaxis therapy. With each of these aforementioned approaches there are moderate to large clinical trials that assess the comparative effectiveness of these approaches in direct comparative trials. From an Ovid MEDLINE search from 1950 to present, we systematically identified 15 randomized trials comparing two thromboprophylactic drugs, devices or procedures for SPAF. Specific mechanical, pharmacologic and pharmacokinetic advantages and disadvantages are also reviewed.
A translation table for patient-centered comparative effectiveness research: guidance to improve the value of research for clinical and health policy decision-making
Authors: Tunis Sean R , Messner Donna A , Mohr Penny , Gliklich Richard E , Dubois Robert W
Published: May 2012

This article provides background and context for a series of papers stemming from a collaborative effort by Outcome Sciences, Inc., the National Pharmaceutical Council and the Center for Medical Technology Policy to use a stakeholder-driven process to develop a decision tool to select appropriate methods for comparative effectiveness research. The perceived need and origins of the ‘translation table’ concept for method selection are described and the legislative history and role of the Patient-Centered Outcomes Research Institute are reviewed. The article concludes by stressing the significance of this effort for future health services and clinical research, and the importance of consulting end-users – patients, providers, payers and policy-makers – in the process of defining research questions and approaches to them.
Building useful evidence: changing the clinical research paradigm to account for comparative effectiveness research
Authors: Greenfield Sheldon , Kaplan Sherrie H
Published: May 2012

Comparative effectiveness research (CER) calls for substantial changes in the way clinical research is conducted, interpreted and practically applied in the USA, in order to produce useful clinical evidence. Departing from classic efficacy and effectiveness research, the evolving CER paradigm requires structural and substantive innovations that address three basic questions: what works? for whom? and in whose hands? Addressing these questions will require fundamental changes in the approach to clinical research that include: the use of active treatments (or comparators) versus placebos in the comparisons of treatments, innovative or ‘alternative’ research methods, the specification and a priori design of studies to account for important subgroups, accounting for the nested nature of healthcare delivery in design and analysis of CER, the simultaneous study of multiple treatments or treatment modalities, the study of multiple outcomes (benefits and harms) for each treatment compared, and the reassessment of the value of different study designs in the hierarchy of collective ‘evidence’. In order to aid individual providers and patients in making informed, personalized treatment decisions, guided by the best evidence possible, CER studies must generalize to a broad range of subgroups reflecting the spectrum of patients, providers and health systems that populate real-world practice settings. Without expansion in the scope, conduct and subsequent interpretation of clinical research reflected in the issues outlined above, CER will fall short of its potential for informing evidence-based practice and personalized medicine. The current paradigm for conducting, interpreting and applying clinical research does not meet the needs of optimal generalizability and application to individual physician–patient efforts to identify the most effective treatment, and therefore does not support the basic requirements of CER. The proposed changes should neither require decades nor exorbitant budgets to achieve. Using two examples, prostate cancer, and comparisons of single medications, we illustrated how the proposed changes in clinical research, matching strategy to each application, might be addressed.
Which design for which question? An exploration toward a translation table for comparative effectiveness research
Authors: Montori Victor M , Kim Simon P , Guyatt Gordon H , Shah Nilay D
Published: May 2012

In this paper, we explore the relative value that different methods offer in answering some stereotypical comparative effectiveness research questions with the goal of informing development of a ‘translation table’ – a selection tool for choosing appropriate methods for specific comparative effectiveness research questions. This paper was written as a parallel effort to Greenfield and Kaplan (also in this volume) to support the endeavor described in the manuscript by Tunis
et al.
(also in this volume). Originally based on four cases, the current article has been shortened to two cases for the current discussion. These cases represent research priorities proposed to orient the work of the Patient-Centered Outcomes Research Institute, comparative clinical effectiveness and comparative health services.
Incorporating stakeholder perspectives in developing a translation table framework for comparative effectiveness research
Authors: Gliklich Richard E , Leavy Michelle B , Velentgas Priscilla , Dreyer Nancy A , Tunis Sean R , Mohr Penny , Messner Donna A , Moloney Rachael M , Karkare Swapna U , Dubois Robert W , Graff Jennifer S
Published: May 2012

This project used a stakeholder-driven process to understand the factors that drive the selection of study designs for comparative effectiveness research (CER). The project assembled a diverse stakeholder committee to explore the basis of a translation framework and gathered input through surveys, interviews and an in-person meeting. Stakeholders recommended different study designs for the CER topic areas and identified different outcomes as the most important outcomes to study in each area. During the discussions, stakeholders described a variety of factors that influenced their study design recommendations. The stakeholder activities resulted in the identification of several key themes, including the need to have a highly specific detailed research question before discussing appropriate designs and the need to use multiple studies, potentially of different designs, to address the CER topic areas. The insights and themes from this project may inform efforts to develop a translation table.
Myostatin Inhibition Prevents Diabetes and Hyperphagia in a Mouse Model of Lipodystrophy
Authors: Guo Tingqing , Bond Nichole D. , Jou William , Gavrilova Oksana , Portas Jennifer , McPherron Alexandra C.
Published: May 2012

Lipodystrophies are characterized by a loss of white adipose tissue, which causes ectopic lipid deposition, peripheral insulin resistance, reduced adipokine levels, and increased food intake (hyperphagia). The growth factor myostatin (MSTN) negatively regulates skeletal muscle growth, and mice with MSTN inhibition have reduced adiposity and improved insulin sensitivity. MSTN inhibition may therefore be efficacious in ameliorating diabetes. To test this hypothesis, we inhibited MSTN signaling in a diabetic model of generalized lipodystrophy to analyze its effects on glucose metabolism separate from effects on adipose mass. A-ZIP/F1 lipodystrophic mice were crossed to mice expressing a dominant-negative MSTN receptor (activin receptor type IIB) in muscle. MSTN inhibition in A-ZIP/F1 mice reduced blood glucose, serum insulin, triglyceride levels, and the rate of triglyceride synthesis, and improved insulin sensitivity. Unexpectedly, hyperphagia was normalized by MSTN inhibition in muscle. Blood glucose and hyperphagia were reduced in double mutants independent of the adipokine leptin. These results show that the effect of MSTN inhibition on insulin sensitivity is not secondary to an effect on adipose mass and that MSTN inhibition may be an effective treatment for diabetes. These results further suggest that muscle may play a heretofore unappreciated role in regulating food intake.
Identification of Adipose Tissue Dendritic Cells Correlated With Obesity-Associated Insulin-Resistance and Inducing Th17 Responses in Mice and Patients
Authors: Bertola Adeline , Ciucci Thomas , Rousseau Déborah , Bourlier Virginie , Duffaut Carine , Bonnafous Stéphanie , Blin-Wakkach Claudine , Anty Rodolphe , Iannelli Antonio , Gugenheim Jean , Tran Albert , Bouloumié Anne , Gual Philippe , Wakkach Abdelilah
Published: May 2012

T-cell regulation in adipose tissue provides a link between inflammation and insulin resistance. Because of alterations in adipose tissue T-cell composition in obesity, we aimed to identify the antigen-presenting cells in adipose tissue of obese mice and patients with insulin resistance. Dendritic cells (DCs) and T cells were studied in mice and in two cohorts of obese patients. In lean mice, only CD11c+ DCs were detected in adipose tissue. Adoptive transfer of naive CD4+ T cells in Rag1−/− mice led to a predominant Th1 response in adipose tissue. In contrast, during obesity DCs (human CD11c+CD1c+ and mouse CD11chighF4/80low) accumulated in adipose tissue. CD11chighF4/80low DCs from obese mice induced Th17 differentiation. In patients, the presence of CD11c+CD1c+ DCs correlated with the BMI and with an elevation in Th17 cells. In addition, these DCs led to ex vivo Th17 differentiation. CD1c gene expression further correlated with homeostatic model assessment-insulin resistance in the subcutaneous adipose tissue of obese patients. We show for the first time the presence and accumulation of specific DCs in adipose tissue in mouse and human obesity. These DCs were functional and could be important regulators of adipose tissue inflammation by regulating the switch toward Th17 cell responses in obesity-associated insulin resistance.
Early-Outgrowth Bone Marrow Cells Attenuate Renal Injury and Dysfunction via an Antioxidant Effect in a Mouse Model of Type 2 Diabetes
Authors: Zhang Yanling , Yuen Darren A. , Advani Andrew , Thai Kerri , Advani Suzanne L. , Kepecs David , Kabir M. Golam , Connelly Kim A. , Gilbert Richard E.
Published: May 2012

Cell therapy has been extensively investigated in heart disease but less so in the kidney. We considered whether cell therapy also might be useful in diabetic kidney disease. Cognizant of the likely need for autologous cell therapy in humans, we sought to assess the efficacy of donor cells derived from both healthy and diabetic animals. Eight-week-old db/db mice were randomized to receive a single intravenous injection of PBS or 0.5 × 106 early-outgrowth cells (EOCs) from db/m or db/db mice. Effects were assessed 4 weeks after cell infusion. Untreated db/db mice developed mesangial matrix expansion and tubular epithelial cell apoptosis in association with increased reactive oxygen species (ROS) and overexpression of thioredoxin interacting protein (TxnIP). Without affecting blood glucose or blood pressure, EOCs not only attenuated mesangial and peritubular matrix expansion, as well as tubular apoptosis, but also diminished ROS and TxnIP overexpression in the kidney of db/db mice. EOCs derived from both diabetic db/db and nondiabetic db/m mice were equally effective in ameliorating kidney injury and oxidative stress. The similarly beneficial effects of cells from healthy and diabetic donors highlight the potential of autologous cell therapy in the related clinical setting.
Cytokine and Chemokine Production by Human Pancreatic Islets Upon Enterovirus Infection
Authors: Schulte Barbara M. , Lanke Kjerstin H.W. , Piganelli Jon D. , Kers-Rebel Esther D. , Bottino Rita , Trucco Massimo , Huijbens Richard J.F. , Radstake Timothy R.D.J. , Engelse Marten A. , de Koning Eelco J.P. , Galama Jochem M. , Adema Gosse J. , van Kuppeveld Frank J.M.
Published: May 2012

Enteroviruses of the human enterovirus B species (HEV-Bs) (e.g., coxsackie B viruses [CVBs] and echoviruses) have been implicated as environmental factors that trigger/accelerate type 1 diabetes, but the underlying mechanism remains elusive. The aim of this study was to gain insight into the cytokines and chemokines that are produced by human pancreatic islets upon infection with CVBs. To this end, we studied the response of human islets of Langerhans upon mock or CVB3 infection. Using quantitative PCR, we showed that upon CVB3 infection, transcription of interferon (IFN), IFN-stimulated genes, and inflammatory genes was induced. Analysis of secreted cytokines and chemokines by Luminex technology confirmed production and secretion of proinflammatory cytokines (e.g., interleukin [IL]-6 and tumor necrosis factor-α) as well as various chemotactic proteins, such as IFN-γ–induced protein 10, macrophage inflammatory protein (MIP)-1α, MIP-1β, and IL-8. Infection with other HEV-Bs induced similar responses, yet their extent depended on replication efficiency. Ultra violet–inactivated CVB3 did not induce any response, suggesting that virus replication is a prerequisite for antiviral responses. Our data represent the first comprehensive overview of inflammatory mediators that are secreted by human islets of Langerhans upon CVB infection and may shed light on the role of enteroviruses in type 1 diabetes pathogenesis.
Insulin Sensitivity and β-Cell Function in Adults Born Preterm and Their Children
Authors: Mathai Sarah , Cutfield Wayne S. , Derraik José G.B. , Dalziel Stuart R. , Harding Jane E. , Robinson Elizabeth , Biggs Janene , Jefferies Craig , Hofman Paul L.
Published: May 2012

We aimed to evaluate insulin secretion and insulin sensitivity in adults born preterm and their children. Subjects were adults born both preterm and at term, with their children aged 5–10 years born at term. Insulin sensitivity and secretion were assessed using hyperglycemic clamps in adults and frequently sampled intravenous glucose tolerance tests using Bergman minimal model in children. In total, 52 adults aged 34–38 years participated (31 born preterm, mean gestational age 33.3 weeks). Adults born preterm were less insulin sensitive than those born at term (19.0 ± 2.5 vs. 36.3 ± 5.2 mg ⋅ kg−1 ⋅ min−1mU ⋅ L; P < 0.05) with compensatory increased first-phase insulin secretion (56.1 ± 8.5 vs. 25.3 ± 3.7 mU/L; P < 0.001) but similar disposition index indicating appropriate insulin secretion. These differences were independent of sex and remained when subjects born <32 weeks' gestation were excluded from analyses. In total, 61 children were studied (37 of preterm parents, mean age 7.9 ± 0.3 years). Children of parents born preterm had similar insulin sensitivity to children of parents born at term, but a correlation between parental and offspring insulin sensitivity was noted only among children of parents born preterm. In conclusion, adults born preterm have insulin resistance in midadulthood, but this was not associated with insulin resistance in their children.
Intrinsic Differences in Adipocyte Precursor Cells From Different White Fat Depots
Authors: Macotela Yazmín , Emanuelli Brice , Mori Marcelo A. , Gesta Stephane , Schulz Tim J. , Tseng Yu-Hua , Kahn C. Ronald
Published: May 2012

Obesity and body fat distribution are important risk factors for the development of type 2 diabetes and metabolic syndrome. Evidence has accumulated that this risk is related to intrinsic differences in behavior of adipocytes in different fat depots. In the current study, we demonstrate that adipocyte precursor cells (APCs) isolated from visceral and subcutaneous white adipose depots of mice have distinct patterns of gene expression, differentiation potential, and response to environmental and genetic influences. APCs derived from subcutaneous fat differentiate well in the presence of classical induction cocktail, whereas those from visceral fat differentiate poorly but can be induced to differentiate by addition of bone morphogenetic protein (BMP)-2 or BMP-4. This difference correlates with major differences in gene expression signature between subcutaneous and visceral APCs. The number of APCs is higher in obesity-prone C57BL/6 mice than obesity-resistant 129 mice, and the number in both depots is increased by up to 270% by exposure of mice to high-fat diet. Thus, APCs from visceral and subcutaneous depots are dynamic populations, which have intrinsic differences in gene expression, differentiation properties, and responses to environmental/genetic factors. Regulation of these populations may provide a new target for the treatment and prevention of obesity and its metabolic complications.
Ephrin-B2–Activated Peripheral Blood Mononuclear Cells From Diabetic Patients Restore Diabetes-Induced Impairment of Postischemic Neovascularization
Authors: Broquères-You Dong , Leré-Déan Carole , Merkulova-Rainon Tatiana , Mantsounga Chris S. , Allanic David , Hainaud Patricia , Contrères Jean-Olivier , Wang Yu , Vilar José , Virally Marie , Mourad Jean-Jacques , Guillausseau Pierre-Jean , Silvestre Jean-Sébastien , Lévy Bernard I.
Published: May 2012

We hypothesized that in vitro treatment of peripheral blood mononuclear cells (PB-MNCs) from diabetic patients with ephrin-B2/Fc (EFNB2) improves their proangiogenic therapeutic potential in diabetic ischemic experimental models. Diabetes was induced in nude athymic mice by streptozotocin injections. At 9 weeks after hyperglycemia, 105 PB-MNCs from diabetic patients, pretreated by EFNB2, were intravenously injected in diabetic mice with hindlimb ischemia. Two weeks later, the postischemic neovascularization was evaluated. The mechanisms involved were investigated by flow cytometry analysis and in vitro cell biological assays. Paw skin blood flow, angiographic score, and capillary density were significantly increased in ischemic leg of diabetic mice receiving EFNB2-activated diabetic PB-MNCs versus those receiving nontreated diabetic PB-MNCs. EFNB2 bound to PB-MNCs and increased the adhesion and transmigration of PB-MNCs. Finally, EFNB2-activated PB-MNCs raised the number of circulating vascular progenitor cells in diabetic nude mice and increased the ability of endogenous bone marrow MNCs to differentiate into cells with endothelial phenotype and enhanced their proangiogenic potential. Therefore, EFNB2 treatment of PB-MNCs abrogates the diabetes-induced stem/progenitor cell dysfunction and opens a new avenue for the clinical development of an innovative and accessible strategy in diabetic patients with critical ischemic diseases.
Meat Consumption and Its Association With C-Reactive Protein and Incident Type 2 Diabetes
Authors: van Woudenbergh Geertruida J. , Kuijsten Anneleen , Tigcheler Basia , Sijbrands Eric J.G. , van Rooij Frank J.A. , Hofman Albert , Witteman Jacqueline C.M. , Feskens Edith J.M.
Published: May 2012

OBJECTIVE

To investigate whether intake of different types of meat is associated with circulating C-reactive protein (CRP) and risk of type 2 diabetes in a prospective cohort study.

RESEARCH DESIGN AND METHODS

Our analysis included 4,366 Dutch participants who did not have diabetes at baseline. During a median follow-up period of 12.4 years, 456 diabetes cases were confirmed. Intake of red meat, processed meat, and poultry was derived from a food frequency questionnaire, and their association with serum high-sensitivity CRP was examined cross-sectionally using linear regression models. Their association with risk of type 2 diabetes was examined using multivariate Cox proportional hazards model, including age, sex, family history of diabetes, and lifestyle and dietary factors.

RESULTS

An increment of 50 g of processed meat was associated with increased CRP concentration (βprocessed meat = 0.12; P = 0.01), whereas intake of red meat and poultry was not. When comparing the highest to the lowest category of meat intake with respect to diabetes incidence, the adjusted relative risks were as follows: for red meat (1.42 [95% CI 1.06–1.91]), for processed meat (1.87 [1.26–2.78]), and for poultry (0.95 [0.74–1.22]). Additional analysis showed that the associations were not affected appreciably after inclusion of CRP into the model. After adjustment for BMI, however, the association for red meat attenuated to 1.18 (0.88–1.59).

CONCLUSIONS

Intake of processed meat is associated with higher risk of type 2 diabetes. It appears unlikely that CRP mediates this association.
Racial Differences in Association of Elevated Interleukin-18 Levels With Type 2 Diabetes
Authors: Negi Smita I. , Pankow James S. , Fernstrom Karl , Hoogeveen Ron C. , Zhu Na , Couper David , Schmidt Maria I. , Duncan Bruce B. , Ballantyne Christie M.
Published: May 2012

OBJECTIVE

Elevated plasma interleukin-18 (IL-18) has been linked to onset of diabetes mellitus (DM) and its complications. However, so far this association has been shown only in predominantly white populations. We examined IL-18 levels and their association with incident DM in a racially heterogeneous population.

RESEARCH DESIGN AND METHODS

In a nested case-cohort design representing a 9-year follow-up of 9,740 middle-aged, initially healthy, nondiabetic white and African American participants of the Atherosclerosis Risk in Communities Study, we selected and measured analytes on race-stratified (50% white, 50% African American) random samples of both cases of incident diabetes (n = 548) and eligible members of the full cohort (n = 536).

RESULTS

Baseline IL-18 levels were significantly higher in white participants compared with African American participants (P < 0.001). Although white participants in the fourth (versus first) quartile of IL-18 levels had a significant hazard ratio (HR) for developing DM (HR: 2.1, 95% CI: 1.3–3.4), after adjustment for age, sex, and study center, no difference was seen among African Americans (HR: 1.0, 95% CI: 0.6–1.7). Unlike those in African Americans, IL-18 levels in whites had a significant correlation with age (P < 0.01); anthropometric characteristics such as waist circumference (P < 0.001), height (P = 0.04), waist-to-hip ratio (P < 0.001), and BMI (P < 0.01); and total (P < 0.001) and high-molecular-weight (P < 0.001) adiponectin.

CONCLUSIONS

There are racial differences in levels of IL-18 and the association of IL-18 with risk factors and incident type 2 DM. In addition, there seems to be a complex interplay of inflammation and adiposity in the development of DM.
Association of Adiposity Trajectories With Insulin Sensitivity and Glycemic Deterioration
Authors: Liu Rong , Brickman Wendy J. , Christoffel Katherine K. , Liu Xin , Wang Guoying , Arguelles Lester , Zhang Shanchun , Zimmerman Donald , Wang Binyan , Xu Xiping , Li Zhiping , Xing Houxun , Wang Xiaobin
Published: May 2012

OBJECTIVE

To evaluate associations between adiposity trajectories over time and insulin sensitivity and glucose deterioration in a Chinese twin cohort.

RESEARCH DESIGN AND METHODS

This study focused on 341 males and 292 females aged 20–50 years at baseline who had physical clinical examinations and oral glucose tolerance test at two time points with an average of 6 years apart. BMI, waist circumference, percent body fat (PBF), and percent trunk fat (PTF) trajectories were classified into five track groups based on age- and sex-specific tertiles at each visit. We calculated the odds of the insulin sensitivity index(0,120) [ISI(0,120)] or glycemic deterioration at follow-up among five defined trajectories (tertilebaseline → tertilefollow-up) using generalized estimate equation models. Additionally, we applied structural equation models to examine genetic and environmental influences on adiposity, adiposity change over time (ACO), ISI(0,120), and the interrelationships among them.

RESULTS

Participants with stable adiposity (BMI, waist circumference, PBF, and PTF) in the highest tertile or shifting to the highest tertile tended to have the lowest ISI(0,120) at follow-up or experience glycemic deterioration. Genetic factors exerted the major influence on adiposity, but environmental factors unique to each twin contributed more strongly to ISI and ACO. Correlations between adiposity/ACO and insulin sensitivity were mainly due to environmental influences.

CONCLUSIONS

When adiposity stays or becomes high, insulin sensitivity falls and risk of glycemic deterioration rises. Additionally, we found that genetic factors exerted the major influence on adiposity, while environmental factors played the principal role for ACO and insulin sensitivity.
Role of Muscle Mass and Muscle Quality in the Association Between Diabetes and Gait Speed
Authors: Volpato Stefano , Bianchi Lara , Lauretani Fulvio , Lauretani Fabrizio , Bandinelli Stefania , Guralnik Jack M. , Zuliani Giovanni , Ferrucci Luigi
Published: May 2012

OBJECTIVE

Older people with type 2 diabetes are at high risk of mobility disability. We investigated the association of diabetes with lower-limb muscle mass and muscle quality to verify whether diabetes-related muscle impairments mediate the association between diabetes and low walking speed.

RESEARCH DESIGN AND METHODS

We performed a cross-sectional analysis of 835 participants (65 years old and older) enrolled in the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) population-based study. Total, muscular, and fat cross-sectional areas of the calf and relative muscle density were measured using peripheral quantitative computerized tomography. Indicators of muscle performance included knee-extension torque, ankle plantar flexion and dorsiflexion strength, lower-extremity muscle power, and ankle muscle quality (ratio of ankle strength to the muscle area [kilograms per centimeters squared]). Gait performance was assessed by 4- and 400-m walking speed. Diabetes was ascertained by standard American Diabetes Association criteria.

RESULTS

Prevalence of diabetes was 11.4%. After adjustment for age and sex, participants with diabetes had lower muscle density, knee and ankle strength, and muscle power and worse muscle quality (all P < 0.05). Diabetic participants were also slower on both 4-m (β: −0.115 ± 0.024 m/s, P < 0.001) and 400-m (β:−0.053 ± 0.023 m/s, P < 0.05) walking tests. In multivariable linear regression models, lower-limb muscle characteristics accounted for 24.3 and 15.1% of walking speed difference comparing diabetic and nondiabetic subjects in the 4- and 400-m walks, respectively.

CONCLUSIONS

In older persons, diabetes is associated with reduced muscle strength and worse muscle quality. These impairments are important contributors of walking limitations related to diabetes.
Incidence of intervertebral disk degeneration–related diseases and associated mortality rates in dogs
Authors: Bergknut Niklas , Egenvall Agneta , Hagman Ragnvi , Gustås Pia , Hazewinkel Herman A. W. , Meij Björn P. , Lagerstedt Anne-Sofie
Published: May 2012

Objective—To determine the incidence and distribution of intervertebral disk (IVD) degeneration–related diseases in a large population of dogs of various breeds, ages, and sexes and to determine mortality rates among dogs with these diseases.

Design—Epidemiological study.

Sample—Insurance data for dogs with veterinary health-care and life insurance coverage (n = 665,249 and 552,120, respectively).

Procedures—Insurance claim records of 1 company in Sweden were searched to identify dogs with IVD degeneration–related diseases; incidence and mortality rates were determined for affected dogs < 12 years old and < 10 years old, respectively. Only the first paid IVD degeneration–related claim for a dog was included in incidence rate calculations.

Results—The incidence rate of IVD degeneration–related diseases was 27.8 (95% confidence interval [CI], 27.2 to 28.4) occurrences/10,000 dog-years at risk (DYAR), indicating that approximately 0.3% of dogs/y in this population were affected. Miniature Dachshund was the most highly represented breed, followed by Standard Dachshund and Doberman Pinscher (237.1 [95% CI, 212.9 to 261.4], 141.5 [95% CI, 135.5 to 147.4], and 88.6 [95% CI, 72.1 to 105.2] occurrences/10,000 DYAR, respectively). The incidence rate of IVD degeneration–related disease was greater in male than in female dogs and increased with age. Overall mortality rate attributed to IVD degeneration–related diseases was 9.4 (95% CI, 8.9 to 9.8) deaths/10,000 DYAR and was greater in males than in females.

Conclusions and Clinical Relevance—Differences in incidence rates among various breeds suggested a genetic involvement. Knowledge of the distribution of IVD degeneration–related diseases among dogs of various breeds and ages may facilitate early diagnosis and preemptive treatments in patients at risk for developing these diseases.
Rapid prototype modeling and customized titanium plate fabrication for correction of a persistent hard palate defect in a dog
Authors: Kuipers von Lande Richard G. , Worth Andrew J. , Peckitt Ninian S. , Cave Nick J. , Tang Liqiong
Published: May 2012

Case Description—An 8-month-old crossbred dog was evaluated because of an oronasal fistula following 2 previous attempts to surgically correct a secondary palate defect.

Clinical Findings—Three months after initial evaluation and successful closure of the soft palate section of the secondary palate defect via 2 surgeries, an oronasal fistula was present. The oronasal fistula was predominantly right sided, involving the rostral third of the hard palate and, at the widest aspect, spanning the transverse palate at the level of the maxillary canine teeth.

Treatment and Outcome—Following CT of the rostral aspect of the skull, rapid prototyping technology was used to create a stereolithographic model of the skull, allowing fabrication of a customized titanium plate for intranasal stenting. The titanium plate was inserted via a rostral nasal approach and secured rostrally with 1.5-mm screws and caudally with 2.4-mm screws from the nasal bridge. An oronasal fistula formed laterally at the edge of the plate, but bonding of a dental glass ionomer product resulted in successful resolution of the fistula.

Clinical Relevance—Results suggested that rapid prototyping and creation of customized implants may provide an option for the management of large or nonreconstructible oronasal defects in dogs.
Investigation of an outbreak of besnoitiosis in donkeys in northeastern Pennsylvania
Authors: Ness SallyAnne L. , Peters-Kennedy Jeanine , Schares Gereon , Dubey Jitender P. , Mittel Linda D. , Mohammed Hussni O. , Bowman Dwight D. , Felippe M. Julia B. , Wade Susan E. , Shultz Nicole , Divers Thomas J.
Published: May 2012

Objective—To describe the clinical, endoscopic, and serologic features of an outbreak of besnoitiosis in 2 donkey operations in northeastern Pennsylvania and to report the outcome of attempted treatment of 1 naturally infected individual.

Design—Observational study.

Animals—29 donkeys (Equus asinus) in northeastern Pennsylvania.

Procedures—Donkeys were examined for lesions suggestive of besnoitiosis in an outbreak investigation. Information was collected regarding the history and signalment of animals on each premises. Rhinolaryngoscopy was performed to identify nasopharyngeal and laryngeal lesions. Serum samples were collected for immunofluorescent antibody testing and immunoblotting for Besnoitia spp. Skin biopsy samples were obtained from 8 animals with lesions suggestive of besnoitiosis for histologic examination. Quantitative real-time PCR assay for Besnoitia spp was performed on tissue samples from 5 animals.

Results—Besnoitiosis was confirmed in 6 of the 8 suspected cases. The most common lesion site was the nares, followed by the skin and sclera. Donkeys with clinical signs of disease had higher serum antibody titers and tested positive for a greater number of immunoblot bands than did donkeys without clinical signs of disease. All animals evaluated by PCR assay tested positive. Putative risk factors for disease included age and sex. Ponazuril was not effective at treating besnoitiosis in a naturally infected donkey.

Conclusions and Clinical Relevance—Knowledge of clinical and serologic features of besnoitiosis in donkeys will assist clinicians in the diagnosis and prevention of this disease in donkey populations. Besnoitiosis may be an emerging disease of donkeys in the United States.
Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993–2005)
Authors: Textor Jamie A. , Puchalski Sarah M. , Affolter Verena K. , MacDonald Melinda H. , Galuppo Larry D. , Wisner Erik R.
Published: May 2012

Objective—To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH).

Design—Retrospective case series.

Animals—16 horses with EH.

Procedures—Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed.

Results—CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement occurred in all horses, but was incompletely defined prior to CT in 7 of 16 horses. The sphenopalatine sinus was affected in 6 of 16 horses as detected on CT; 4 of 6 of these were bilaterally affected. Medical and surgical treatments were performed. Six of 10 horses had a successful outcome, with recurrence in 4 of 10. Five of 6 patients in which treatment addressed all lesion sites identified by CT had a successful outcome. Bilateral disease did not confer a poor prognosis when all affected sites were treated. Sphenopalatine sinus involvement may have been associated with recurrence.

Conclusions and Clinical Relevance—CT provided anatomic information that may facilitate effective treatment of horses with EH, particularly in patients with bilateral disease and paranasal sinus involvement. Computed tomography is recommended for patients in which the lesion cannot be viewed endoscopically, when sinus involvement or multifocal disease are suspected, or when the lesion has been unresponsive to treatment.
Frequency of use and proficiency in performance of surgical skills expected of entry-level veterinarians by general practitioners
Authors: Hill Lawrence N. , Smeak Daniel D. , Lord Linda K.
Published: May 2012

Objective—To identify a list of core surgical skills and determine the frequency of use and proficiency in performance of these skills expected of entry-level veterinarians by general practitioners.

Design—Mail-based survey.

Sample—750 general practitioners randomly chosen from the AVMA membership database.

Procedures—Survey respondents rated the proficiency and frequency of use expected of entry-level veterinarians in regard to 26 surgical skills. Demographic information (gender; graduation year; practice type, geographic location, and setting; number of veterinarians in practice; number of surgical procedures performed per week; and number of new graduates mentored in the past 5 years) of respondents was obtained.

Results—387 (52%) general practitioners responded to the survey. Greater than 60% of respondents expected new graduates to have high proficiency and require minimal supervision for 21 of 26 skills. Greater than 60% of respondents assigned 6 of the skills a low expected frequency of use rating. Orthopedic skills, creation of square knots by use of a 1-handed tie technique, and use of electrosurgical and laser instruments received some of the lowest ratings.

Conclusions and Clinical Relevance—Core surgical skills were identified. Results indicated a broad consensus among general practitioners independent of demographic characteristics. Results may aid veterinary colleges in identification of the surgical skills that are most important to include in surgical curricula and for which new graduates should attain proficiency according to general practitioners.