bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Frailty a Prodromal Stage of Vascular Dementia? Results From the Three‐City Study
Authors: Avila‐Funes José Alberto , Carcaillon Laure , Helmer Catherine , Carrière Isabelle , Ritchie Karen , Rouaud Olivier , Tzourio Christophe , Dartigues Jean‐François , Amieva Hélène
Published: September 2012

Objectives

To investigate the relationship between frailty and incident vascular dementia (VaD).

Design

Seven‐year longitudinal study.

Setting

Three‐City Study, a French prospective study designed to evaluate the risk of dementia and cognitive decline attributable to vascular risk factors.

Participants

Five thousand four hundred eighty community‐dwelling persons aged 65 to 95.

Measurements

An expert committee established a clinical diagnosis of VaD. Frailty was defined as having at least three of the following criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. Participants with prior stroke or prevalent dementia at baseline were excluded from analyses. Multivariate models were used to evaluate the relationship between frailty and incident VaD.

Results

At baseline, 6.5% of participants were classified as frail. After 7 years of follow‐up, 54 persons were diagnosed with VaD, seven of whom where frail. In the proportional hazards models, frailty was marginally associated with greater risk of all types of dementia and was not associated with incident Alzheimer's disease, but frailty status was independently associated with incident VaD.

Conclusion

Frailty is a major risk factor for incident VaD, so its identification could contribute to better estimates of the risk of VaD in elderly adults.
Reliable and Repeatable Centric Relation Adjustment of the Maxillary Occlusal Device
Authors: Fleigel Jeffrey D , Sutton Alan J
Published: September 2012

This technique article describes a quantifiable, repeatable, and reliable method for occlusal device adjustment in centric relation using a leaf gauge. In addition, specific suggestions for occlusal device design are provided to enhance patient comfort with the prosthesis in place.
The Impairment of Endocardial Radial Strain Is Related to Aortic Stenosis Severity in Patients with Aortic Stenosis and Preserved LV Ejection Fraction Using Two‐Dimensional Speckle Tracking Echocardiography
Authors: Ohara Yoshikazu , Fukuoka Yohko , Tabuchi Isao , Sahara Shinji , Hosogi Shingo , Nishimoto Mika , Yamamoto Katsuhito
Published: September 2012

Background: Myocardial function is heterogeneous in different myocardial layers. Recently, two‐dimensional speckle tracking echocardiography has been used to define myocardial deformation parameters of the left ventricular (LV) segment. This study aimed to investigate strain in subendocardial and subepicardial layers in patients with aortic stenosis (AS) and preserved LV ejection fraction (LVEF) using speckle tracking echocardiography. Methods: Parasternal short‐axis and apical long‐axis views of the left ventricle were acquired at the mid‐papillary level in 35 control subjects and 32 patients with AS and preserved LVEF. Radial, circumferential, and longitudinal strain in subendocardial and subepicardial layers at the posterior and anteroseptal segments were calculated. Results: There was no significant difference in circumferential strain in subendocardial and subepicardial layers between the control subjects and the patients with AS. Similarly, there was no significant difference in epicardial radial strain at the posterior and anteroseptal segments between the control subjects and the patients with AS. Longitudinal strain at both the posterior and anteroseptal segments was significantly decreased in the AS group compared with that in the control group. AS patients had significantly decreased values of endocardial radial strain compared with those in controls (anteroseptal: 18.2 ± 11.2 vs. 34.5 ± 14.8, P < 0.005; posterior: 25.2 ± 14.8 vs. 32.6 ± 12.6, P < 0.05). In the AS group, endocardial radial strain in the posterior and anteroseptal segments was significantly correlated with the aortic valve area (posterior: r = 0.41, P < 0.05; anteroseptal: r = 0.33, P < 0.05). Conclusion: Patients with AS and preserved LVEF have impaired longitudinal strain and endocardial radial strain, although circumferential strain and epicardial radial strain are preserved. Despite preserved LVEF, endocardial radial strain was associated with AS severity.
The Syndrome of Degenerative Calcific Aortic Stenosis: Prevalence of Multiple Pathophysiologic Disorders in Association with Valvular Stenosis and Their Implications
Authors: Ramamurthi Alamelu , Pandian Natesa G. , Gangadharamurthy Dakshin , Urbano‐Moral Jose A. , Kuvin Jeffrey T. , Patel Ayan R. , Weintraub Andrew R.
Published: September 2012

Background: We hypothesized that degenerative calcific aortic stenosis (DCAS) is a syndrome influenced by factors beyond aortic valve stenosis (AS). The aim of this study was to assess how frequently DCAS is complicated by increased vascular load, systolic and/or diastolic left ventricular (LV) dysfunction, and comorbid disorders. Methods: In 215 consecutive patients > 60 years of age with severe and moderate AS, we analyzed systemic arterial compliance, global hemodynamic load, LV ejection fraction (EF), the presence of diastolic dysfunction, and other valvular or systemic disorders. Results: A total of 164 patients had severe AS and 51 had moderate AS. In patients with severe AS, the prevalence of increased vascular load was 42%; LV systolic and diastolic dysfunction was present in 27% and 42%; other valve diseases in 23%; and comorbid disorders in 82%. In the moderate AS group, abnormal vascular load was found in 52%; LV systolic and diastolic dysfunction was prevalent in 26% and 31%; other valve diseases in 17%; and comorbid disorders in 78% patients. More than half the patients in both groups had symptoms. In both severe and moderate AS groups, the prevalence of increased vascular load and systolic dysfunction was higher in the symptomatic group. Conclusion: Considerable number of patients with DCAS have abnormal vascular load, abnormal LV function, and significant coexisting disorders. These could influence the total pathophysiologic burden on the heart and symptom expression. Thus, DCAS should not be considered just as valvular stenosis, but a syndrome of DCAS because of the diagnostic, prognostic, and therapeutic implications of various factors associated with it.
Does Two‐Dimensional Image Reconstruction from Three‐Dimensional Full Volume Echocardiography Improve the Assessment of Left Ventricular Morphology and Function?
Authors: Amzulescu Mihaela Silvia , Slavich Massimo , Florian Anca , Goetschalckx Kaatje , Voigt Jens‐Uwe
Published: September 2012

Aims: (i) To investigate geometric differences between apical views of the left ventricle (LV) derived from standard 2D echocardiography (std2D) and triplane (TP) views, as well as the “ideally” reconstructed 2D (rec2D) views derived from 3D full volume (3DFV) acquisitions, and their influence on the assessment of LV morphology and function. (ii) To determine the feasibility and accuracy of the automatic reconstruction of 2D apical views from 3DFV datasets. Methods and results: In 59 patients with structurally normal, dilated, and hypertrophic hearts, rec2D was reconstructed manually and automatically and compared to std2D, TP, and 3DFV regarding the image plane orientation (true vs. ideal probe position, plane intersection angles), LV dimensions, volumes, and EF. The ideal probe position deviated from the true one by 6.9 ± 4.1 mm and 9.5 ± 4.5 mm, for manually and automatically rec2D, respectively, regardless of LV geometry. The mean difference±SD between manual and automatic reconstruction was −2.5 ± 4.4 mm. LV long axis was measured minimally, but significantly longer in rec2D than std2D and TP. LV volumes and EF did not differ between methods. The intersection angle of the two‐chamber view and the three‐chamber view with the four‐chamber view for manual and automatic reconstruction was 53°±7° and 129°±7° and 60° and 130°, respectively. Conclusion: Ideal reconstruction of nonforeshortened 2D images from 3DFV does not lead to a relevant improvement in image geometry or the assessment of LV morphology and function. The automatic reconstruction algorithm deviates only slightly from manual results.
Association of coronary artery calcium score and vascular dysfunction in long‐term hemodialysis patients
Authors: Zeb Irfan , Ahmadi Naser , Molnar Miklos Z. , Li Dong , Shantouf Ronney , Hatamizadeh Parta , Choi Taeyoung , Kalantar‐Zadeh Kamyar , Budoff Matthew J.
Published: September 2012

Long‐term hemodialysis patients are prone to an exceptionally high burden of cardiovascular disease and mortality. The novel temperature‐based technology of digital thermal monitoring (DTM) of vascular reactivity appears associated with the severity of coronary artery disease in asymptomatic population. We hypothesized that in hemodialysis patients, the DTM and coronary artery calcium (CAC) score have a gradient association that follows that of subjects without kidney disease. We examined the cross‐sectional DTM‐CAC associations in a group of long‐term hemodialysis patients, and their 1:1 matched normal counterpart. Area under the curve for temperature (TMP‐AUC), the surrogate of the DTM index of vascular function, was assessed after a 5‐minute arm‐cuff reactive hyperemia test. Coronary calcium score was measured via electron beam computed tomography or multidetector computed tomography scan. We studied 105 randomly recruited hemodialysis patients (age: 58 ± 13 years, 47% men) and 105 age‐ and gender‐matched controls. In hemodialysis patients vs. controls, TMP‐AUC was significantly worse (114 ± 72 vs. 143 ± 80, P = 0.001) and CAC score was higher (525 ± 425 vs. 240 ± 332, P < 0.001). Hemodialysis patients were 14 times more likely to have CAC score >1000 as compared with controls. After adjustment for known confounders, the relative risk for case vs. control for each standard deviation decrease in TMP‐AUC was 1.46 (95% confidence interval: 1.12–1.93, P = 0.007). Vascular reactivity measured via the novel DTM technology is incrementally worse across CAC scores in hemodialysis patients, in whom both measures are even worse than their age‐ and gender‐matched controls. The DTM technology may offer a convenient and radiation‐free approach to risk‐stratify hemodialysis patients.
Behavior Matching in Multimodal Communication Is Synchronized
Authors: Louwerse Max M. , Dale Rick , Bard Ellen G. , Jeuniaux Patrick
Published: September 2012

A variety of theoretical frameworks predict the resemblance of behaviors between two people engaged in communication, in the form of coordination, mimicry, or alignment. However, little is known about the time course of the behavior matching, even though there is evidence that dyads synchronize oscillatory motions (e.g., postural sway). This study examined the temporal structure of nonoscillatory actions—language, facial, and gestural behaviors—produced during a route communication task. The focus was the temporal relationship between matching behaviors in the interlocutors (e.g., facial behavior in one interlocutor vs. the same facial behavior in the other interlocutor). Cross‐recurrence analysis revealed that within each category tested (language, facial, gestural), interlocutors synchronized matching behaviors, at temporal lags short enough to provide imitation of one interlocutor by the other, from one conversational turn to the next. Both social and cognitive variables predicted the degree of temporal organization. These findings suggest that the temporal structure of matching behaviors provides low‐level and low‐cost resources for human interaction.
From food databases to dietary assessment: A beginning to an end approach for quality nutrition data
Authors: CHAMPAGNE Catherine M. , WROTEN Kathryn C.
Published: September 2012

Aim:  This paper reviews the historical basis of modern assessment of nutrient composition—from food composition tables and the transition to nutrient databases.

Method:  A narrative review was formed beginning with the first, very crude printed food composition tables, to electronic food databases and continuing to how dietary assessment is currently impacted by state‐of‐the‐art techniques and what that means for food composition.

Results:  A plethora of studies, especially international studies, have utilised information from food composition via nutrient databases and software designed to extract food composition data into relevant files for dietary assessment. The United States Department of Agriculture's nutrient data bank is widely used, even internationally, and concerns about its appropriateness in other locales needs to be addressed. A number of countries have developed food composition databases unique to the foods of their population. International studies realised a number of problems related to inconsistencies between countries. Essentially, high‐quality food composition data requires up‐to‐date information on food supply, supplement use and potential food contaminants. Food composition tables form the basis for data published on nutrient intakes of individuals via food diaries, food recalls and surveys and, in addition, nutrient claims for some food products; thus, accuracy and reliability are paramount. New tools in dietary assessment, such as food photography, make nutrient assessment more widely available, requiring even more attention paid to the accuracy of food composition databases.

Conclusions:  The globalisation of food sources and the need for continuity regarding dietary data present challenges needing reconciliation. International concepts for food composition tables have evolved to address these problems.
Advancing practice: Using nutrition information and technology to improve health—the nutrition informatics global challenge
Authors: AYRES Elaine J. , HOGGLE Lindsey B.
Published: September 2012

Aims:  The unique combination of technology, information and nutrition has been utilised in health care for decades. As technology and effective use of health data evolve, the field of ‘nutrition informatics’ is positioned to advance best practices of nutrition care delivered by registered dietitians and dietetic technicians registered. The present paper reviews the opportunities.

Methods:  A narrative review was constructed with reference to the literature.

Results:  Evolution of the use of digital health care in the USA is on an aggressive timeline because of regulations, which provide financial incentives to eligible professionals and hospitals who can prove ‘meaningful use’ of certified health‐care technology. While adoption and use of electronic health records has occurred at the international level for decades, only recently have American adoption rates increased. Health‐care providers are adjusting to rapid cultural changes, which support the interoperability of health data. The dietetics profession must move in tandem with this transition to digital care. This requires implementation and development of nutrition standards, vocabularies and quality measures, which support exchange of pertinent nutrition data critical to patient care and wellbeing. All dietetic professionals need to appreciate the paradigm shift in health care.

Conclusions:  Dietitians who are involved with informatics will help with this transition through their work with systems implementations, understanding competencies necessary for successful integration of digital nutrition and using electronic nutrition data for research.
Microbial community structure and dynamics in anaerobic fluidized‐bed and granular sludge‐bed reactors: influence of operational temperature and reactor configuration
Authors: Bialek Katarzyna , Kumar Amit , Mahony Thérèse , Lens Piet N. L. , O' Flaherty Vincent
Published: September 2012

Methanogenic community structure and dynamics were investigated in two different, replicated anaerobic wastewater treatment reactor configurations [inverted fluidized bed (IFB) and expanded granular sludge bed (EGSB)] treating synthetic dairy wastewater, during operating temperature transitions from 37°C to 25°C, and from 25°C to 15°C, over a 430‐day trial. Non‐metric multidimensional scaling (NMS) and moving‐window analyses, based on quantitative real‐time PCR data, along with denaturing gradient gel electrophoresis (DGGE) profiling, demonstrated that the methanogenic communities developed in a different manner in these reactor configurations. A comparable level of performance was recorded for both systems at 37°C and 25°C, but a more dynamic and diverse microbial community in the IFB reactors supported better stability and adaptative capacity towards low temperature operation. The emergence and maintenance of particular bacterial genotypes (phylum Firmicutes and Bacteroidetes) was associated with efficient protein hydrolysis in the IFB, while protein hydrolysis was inefficient in the EGSB. A significant community shift from a Methanobacteriales and Methanosaetaceae towards a Methanomicrobiales‐predominated community was demonstrated during operation at 15°C in both reactor configurations.
The RCMP's “Mr. Big” sting operation: A case study in police independence, accountability and oversight
Authors: Puddister Kate , Riddell Troy
Published: September 2012

This paper analyses the RCMP's “Mr. Big” undercover investigation technique, which involves the use of undercover officers posing as high‐ranking members of a criminal organization. These officers befriend a target (the suspect) and promise the suspect that their leader (Mr. Big) can help the target in several ways; in exchange, the officers demand that the suspect truthfully reveal past criminal activity to establish credibility and protect the organization against surprises. There appears to be little interest on the part of state actors, other than the courts, in reducing police independence and providing more accountability and oversight for Mr. Big and other undercover operations. Yet, as parts of Canada's criminal justice system, such operations deserve scrutiny because of their cost and potential for wrongful convictions. This article calls for oversight of the police by several actors, including legislators providing guidelines for police investigations, closer judicial scrutiny and executive oversight of police operations, and improved police training.
Distribution and diversity of bacterial secretion systems across metagenomic datasets
Authors: Barret Matthieu , Egan Frank , O'Gara Fergal
Published: September 2012

Bacteria can manipulate their surrounding environment through the secretion of proteins into other living organisms and into the extracellular milieu. In Gram stain negative bacteria this process is mediated by different types of secretion systems from type I through type VI secretion system (T1SS–T6SS). In this study the prevalence of these secretion systems in 312 publicly available microbiomes derived from a wide range of ecosystems was investigated by a gene‐centric approach. Our analysis demonstrates that some secretion systems are over‐represented in some specific samples. In addition, some T3SS and T6SS phylogenetic clusters were specifically enriched in particular ecological niches, which could indicate specific bacterial adaptation to these environments.
Periodontitis with hypercementosis: report of a case and discussion of possible aetiologic factors
Authors: Zhou J , Zhao YF , Xia CY , Jiang L
Published: September 2012

Background:  Hypercementosis may be idiopathic or secondary to either local factors or systemic disorders. However, periodontitis as an aetiologic factor in the formation of hypercementosis has never been documented in the literature.

Methods:  We report a case of periodontitis with hypercementosis, affecting the right mandibular second premolar and first molar teeth.

Results:  Our patient’s maxillary was edentulous and the mandibular teeth #47, #43, #42, #41, #31, #32, #33, #36, #37 were missing. The right mandibular second premolar and first molar had first‐degree mobility and second‐degree mobility respectively. Periodontal pocket depth in the right mandibular second premolar and first molar were 5 mm and 8 mm at buccal pockets, 6 mm and 9 mm at distal pockets, respectively. The radiograph revealed that the roots of both teeth were grossly thickened and blunted. The right mandibular first molar was extracted and sent for histopathological examination. The definitive diagnoses were periodontitis and hypercementosis.

Conclusions:  The concomitant occurrence of periodontitis and hypercementosis in our patient suggests that periodontitis is a predisposing factor for hypercementosis development. This condition may be associated with various local stimuli and possible compensative phenomenon.
The impact of automation on workload and dispensing errors in a hospital pharmacy
Authors: James K Lynette , Barlow Dave , Bithell Anne , Hiom Sarah , Lord Sue , Pollard Mike , Roberts Dave , Way Cheryl , Whittlesea Cate
Published: September 2012

Objectives

To determine the effect of installing an original-pack automated dispensing system (ADS) on dispensary workload and prevented dispensing incidents in a hospital pharmacy.

Methods

Data on dispensary workload and prevented dispensing incidents, defined as dispensing errors detected and reported before medication had left the pharmacy, were collected over 6 weeks at a National Health Service hospital in Wales before and after the installation of an ADS. Workload was measured by non-participant observation using the event recording technique. Prevented dispensing incidents were self-reported by pharmacy staff on standardised forms. Median workloads (measured as items dispensed/person/hour) were compared using Mann–Whitney U tests and rate of prevented dispensing incidents were compared using Chi-square test. Spearman's rank correlation was used to examine the association between workload and prevented dispensing incidents. A P value of ≤0.05 was considered statistically significant.

Key findings

Median dispensary workload was significantly lower pre-automation (9.20 items/person/h) compared to post-automation (13.17 items/person/h, P < 0.001). Rate of prevented dispensing incidents was significantly lower post-automation (0.28%) than pre-automation (0.64%, P < 0.0001) but there was no difference (P = 0.277) between the types of dispensing incidents. A positive association existed between workload and prevented dispensing incidents both pre- (ρ = 0.13, P = 0.015) and post-automation (ρ = 0.23, P < 0.001). Dispensing incidents were found to occur during prolonged periods of moderate workload or after a busy period.

Conclusion

Study findings suggest that automation improves dispensing efficiency and reduces the rate of prevented dispensing incidents. It is proposed that prevented dispensing incidents frequently occurred during periods of high workload due to involuntary automaticity. Prevented dispensing incidents occurring after a busy period were attributed to staff experiencing fatigue after-effects.
Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial
Authors: Jepsen Karin , Jepsen Søren , Zucchelli Giovanni , Stefanini Martina , de Sanctis Massimo , Baldini Nicola , Greven Björn , Heinz Bernd , Wennström Jan , Cassel Björn , Vignoletti Fabio , Sanz Mariano
Published: September 2012

Aim

To evaluate the clinical outcomes of the use of a xenogeneic collagen matrix (CM) in combination with the coronally advanced flap (CAF) in the treatment of localized recession defects.

Material & Methods

In a multicentre single‐blinded, randomized, controlled, split‐mouth trial, 90 recessions (Miller I, II) in 45 patients received either CAF + CM or CAF alone.

Results

At 6 months, root coverage (primary outcome) was 75.29% for test and 72.66% for control defects (p = 0.169), with 36% of test and 31% of control defects exhibiting complete coverage. The increase in mean width of keratinized tissue (KT) was higher in test (from 1.97 to 2.90 mm) than in control defects (from 2.00 to 2.57 mm) (p = 0.036). Likewise, test sites had more gain in gingival thickness (GT) (0.59 mm) than control sites (0.34 mm) (p = 0.003). Larger (≥3 mm) recessions (n = 35 patients) treated with CM showed higher root coverage (72.03% versus 66.16%, p = 0.043), as well as more gain in KT and GT.

Conclusions

CAF + CM was not superior with regard to root coverage, but enhanced gingival thickness and width of keratinized tissue when compared with CAF alone. For the coverage of larger defects, CAF + CM was more effective.
Altered response to hydrogen sulphide during experimental colitis in rats
Authors: Steidle J. , Würner L. , Diener M.
Published: September 2012

Hydrogen sulphide (H2S) is produced in the intestine by sulphate‐reducing bacteria and during metabolism of L‐cysteine within the mucosa. This gasotransmitter induces anion secretion by stimulating enteric neurons and by a direct effect on epithelial cells. As H2S is discussed to exert both pro‐ and anti‐inflammatory actions, we aimed to investigate the role of H2S during experimental colitis by comparing the effects of blockade of H2S‐forming endogenous enzymes with the effect of a S‐reduced diet to diminish microbial production of H2S. Rectal application of trinitrobenzenesulfonic acid (TNBS) was used to induce chronic colitis. The level of inflammation was assessed macroscopically and histologically. In Ussing chamber experiments, colonic specimens from TNBS‐treated animals exhibited a higher tissue conductance, that is, a higher epithelial permeability, and a slightly reduced basal short‐circuit current (a measure of net ion transport) in relation to non‐inflamed control tissue. Analgetic treatment with flupirtine, a central antinociceptive analgetic, did not interfere with the induction of the inflammatory response so that all animals were treated with flupirtine to reduce pain and distress during the development of colitis. The secretory response evoked by an exogenous H2S donor, NaHS, was significantly decreased after induction of colitis, whereas the response to Ca2+‐ or cAMP‐dependent secretagogues was unaltered. This downregulation was not observed in the colitis group fed on a S‐reduced diet. The decreased NaHS response indicates a desensitization of the tissue by inflammation, which might be explained by an upregulation of colonic H2S production as described in some models of inflammation.
Comparison of three markers for the determination of bacterial protein in terminal ileal digesta in the growing pig
Authors: Miner‐Williams W. , Moughan P. J. , Fuller M. F.
Published: September 2012

The aim of the study was to compare three methods commonly used to determine the concentrations of bacterial protein in digesta collected from the terminal ileum of growing pigs that had been fed a casein‐based diet. The amounts of bacterial protein in terminal ileal digesta were determined using three different markers: 2.6‐diaminopimelic acid (DAPA) and the d‐amino acids, d‐aspartic acid (d‐Asp) and d‐glutamic acid (d‐Glu). The effectiveness of each marker was compared against a control based on physical fractionation by centrifugation. The total bacterial protein concentrations derived from the markers d‐Asp and d‐Glu were significantly different (p = 0.05) to those calculated from DAPA and the control, but there was no difference between DAPA and the control. The percentage of bacterial nitrogen ranged from 40% to 52% dependent on the marker used. Bacterial protein expressed as a percentage of the total protein, ranged from 48% to 62%, a substantial proportion of which (12–28%) was derived from lysed bacterial cells. Statistical correlations between the estimation methods were low. Such poor correlation between the markers may be the result of random errors such as variance in the epimerization of the two d‐amino acids during protein hydrolysis. DAPA was accepted as a reliable marker for determining microbial protein in ileal digesta.
Expression of peptidylarginine deiminase‐2 and ‐4, citrullinated proteins and anti‐citrullinated protein antibodies in human gingiva
Authors: Harvey G. P. , Fitzsimmons T. R. , Dhamarpatni A. A. S. S. K. , Marchant C. , Haynes D. R. , Bartold P. M.
Published: September 2012

Background and Objective

The presence of citrullinated proteins, and peptidylarginine deiminase types ‐2 (PAD‐2) and ‐4 (PAD‐4) in periodontal tissues, determine the presence of anti‐cyclic citrullinated protein antibodies (anti‐CCP) in gingival crevicular fluid (GCF) and compare the expression of these proteins between inflamed and non‐inflamed sites.

Material and Methods

Tissue sections were stained using antibodies against citrullinated proteins, PAD‐2 and PAD‐4. RT‐PCR was performed to investigate PAD‐2 and PAD‐4 mRNA in inflamed and non‐inflamed gingival tissues. Anti‐CCP antibodies in gingival crevicular fluid were detected by ELISA.

Results

Citrullinated proteins, PAD‐2 and PAD‐4 were detected in gingiva. There was a correlation between inflammation and expression of these proteins. mRNAs for PAD‐2 and PAD‐4 were detected in both inflamed and non‐inflamed gingival tissues. Antibodies to CCP were found mostly in the GCF of individuals with periodontitis.

Conclusion

PAD‐2 and PAD‐4 (protein and mRNA) as well as citrullinated proteins are present in inflamed gingiva, and anti‐CCP antibodies can be detected in the GCF of some patients. Tissue expression of citrullinated proteins and PAD increased with the severity of inflammation. The presence of anti‐CCP antibodies in GCF was almost exclusive to a subset of patients with periodontitis. Increased expression of these proteins in inflamed gingiva lends support to the notion that periodontal inflammation contributes to the inflammatory burden in a similar way to rheumatoid arthritis.
Rapidly increasing incidence of eosinophilic esophagitis in a large cohort
Authors: van Rhijn B. D. , Verheij J. , Smout A. J. P. M. , Bredenoord A. J.
Published: September 2012

Background  Recent literature has shown increasing incidence and prevalence rates of eosinophilic esophagitis (EoE). However, data are mainly based on small studies and come from centers dedicated to EoE. Aim of this study was to estimate the incidence rates of EoE by using a large database.

Methods  We performed a cross‐sectional study of the pathology reports describing esophageal eosinophilia from 1996 through 2010, using the nationwide network and registry of histo‐ and cytopathology in The Netherlands (PALGA). All histopathology reports nationwide enter this database. We classified cases according to the diagnosis made by the pathologist. Annual incidence rates of EoE were estimated.

Key Results  Our search criteria yielded 8838 positive pathology reports. Eosinophilic esophagitis was diagnosed in 674 patients, of which 74% were men. In another 174 patients, no distinction was made between eosinophilia caused by gastro‐esophageal reflux disease or EoE. The incidence of EoE increased considerably over the years, being 0.01 in 1996, 0.01 in 2000, 0.14 in 2005, and 1.31 per 100 000 persons in 2010. Eosinophilic esophagitis was diagnosed in all age groups, but in 2010 the highest incidence was seen in 20–29 years old males, in whom it was estimated to be 3.23 per 100 000 persons. The incidence in children was 0.73 per 100 000 in 2010. No seasonal variation in diagnosis of EoE was observed.

Conclusions & Inferences  In this large study, we found robust data on increasing incidence rates of pediatric and adult EoE in the past 15 years. This rapidly increasing incidence has not reached a plateau yet.
Expression signature in peripheral blood cells for molecular diagnosis of head and neck squamous cell carcinoma
Authors: Braakhuis BJM , Graveland AP , Dijk F , Ylstra B , van Wieringen WN , Leemans CR , Brakenhoff RH
Published: September 2012

Patients with head and neck squamous cell carcinoma (HNSCC) have a poor prognosis due to the development of locoregional recurrences, distant metastases, and second primary tumors. There is an urgent need for biomarkers that enable detection and monitoring of the disease to provide adequate therapeutic strategies. In this study, we have investigated markers in peripheral blood cells (PBC) of 28 HNSCC patients who underwent surgery by means of expression profiling. Our hypothesis is that nucleated blood cells circulate continuously, also pass the tumor, and change their expression profile in response to tumor cell factors. For comparison, we enrolled a control group of 11 patients who underwent surgery in the head and neck region for non‐HNSCC reasons. A set of 2949 genes was found to be statistically different between the groups (P < 0.05, false discovery rate‐corrected) and the most prominently different pathways were EIF2, EIF4, and mTOR signaling. These preliminary results are promising and warrant further studies on the definitive role of PBC gene expression as a biomarker for HNSCC detection and monitoring.
Desensitization to antibiotics in children
Authors: Cernadas Josefina R.
Published: September 2012

To cite this article: Cernadas JR. Educational case series: Desensitization to antibiotics in children. Pediatr Allergy Immunol 2012.

Drug hypersensitivity reactions can occur to almost all drugs and antibiotics are among the most common cause for this kind of reactions. Drug hypersensitivity may affect any organ or system, and manifestations range widely in clinical severity from mild pruritus to anaphylaxis. In most cases, the suspected drug is avoided in the future. In case of infection, there is usually a safe antibiotic alternative. Nonetheless, in some cases, no alternative treatment exists for optimal therapy. Under these circumstances, desensitization may be performed. Drug desensitization is defined as the induction of a temporary state of tolerance to a drug which can only be maintained by continuous administration of the medication responsible for the hypersensitivity reaction. Desensitization is mainly performed in IgE‐mediated reactions. Increasing doses of the implicated drug are administered over a short period of time, until the therapeutic dose is achieved and tolerated. Very few studies confined to children are found in literature. Most of them are case reports. In general, the proposed desensitization schemes are similar to those used in adults differing only in the final dose administered. The purpose of this study is to review desensitization to antibiotics in children presenting and discussing three clinical practical cases of desensitization in this age group.
Bat Rabies Surveillance in Europe
Authors: Schatz J. , Fooks A. R. , McElhinney L. , Horton D. , Echevarria J. , Vázquez‐Moron S. , Kooi E. A. , Rasmussen T. B. , Müller T. , Freuling C. M.
Published: September 2012

Rabies is the oldest known zoonotic disease and was also the first recognized bat associated infection in humans. To date, four different lyssavirus species are the causative agents of rabies in European bats: the European Bat Lyssaviruses type 1 and 2 (EBLV‐1, EBLV‐2), the recently discovered putative new lyssavirus species Bokeloh Bat Lyssavirus (BBLV) and the West Caucasian Bat Virus (WCBV). Unlike in the new world, bat rabies cases in Europe are comparatively less frequent, possibly as a result of varying intensity of surveillance. Thus, the objective was to provide an assessment of the bat rabies surveillance data in Europe, taking both reported data to the WHO Rabies Bulletin Europe and published results into account. In Europe, 959 bat rabies cases were reported to the RBE in the time period 1977–2010 with the vast majority characterized as EBLV‐1, frequently isolated in the Netherlands, North Germany, Denmark, Poland and also in parts of France and Spain. Most EBLV‐2 isolates originated from the United Kingdom (UK) and the Netherlands, and EBLV‐2 was also detected in Germany, Finland and Switzerland. Thus far, only one isolate of BBLV was found in Germany. Published passive bat rabies surveillance comprised testing of 28 of the 52 different European bat species for rabies. EBLV‐1 was isolated exclusively from Serotine bats (Eptesicus serotinus and Eptesicus isabellinus), while EBLV‐2 was detected in 14 Daubenton′s bats (Myotis daubentonii) and 5 Pond bats (Myotis dasycneme). A virus from a single Natterer’s bat (Myotis nattereri) was characterized as BBLV. During active surveillance, only oral swabs from 2 Daubenton′s bats (EBLV‐2) and from several Eptesicus bats (EBLV‐1) yielded virus positive RNA. Virus neutralizing antibodies against lyssaviruses were detected in various European bat species from different countries, and its value and implications are discussed.
PyCox: computing with (finite) Coxeter groups and Iwahori–Hecke algebras
Authors: Geck Meinolf
Published: September 2012

We introduce the computer algebra package PyCox, written entirely in the Python language. It implements a set of algorithms, in a spirit similar to the older CHEVIE system, for working with Coxeter groups and Hecke algebras. This includes a new variation of the traditional algorithm for computing Kazhdan–Lusztig cells andW-graphs, which works efficiently for all finite groups of rank ≤8 (exceptE8). We also discuss the computation of Lusztig’s leading coefficients of character values and distinguished involutions (which works forE8as well). Our experiments suggest a re-definition of Lusztig’s ‘special’ representations which, conjecturally, should also apply to the unequal parameter case. Supplementary materials are available with this article.
Adult‐like action potential properties and abundant GABAergic synaptic responses in amygdala neurons from newborn marmosets
Authors: Yamada Daisuke , Miyajima Moeko , Ishibashi Hidetoshi , Wada Keiji , Seki Kazuhiko , Sekiguchi Masayuki
Published: September 2012

Key points

The amygdala plays an important role in the processing of emotional events, but little is known about the postnatal development of electrophysiological properties of amygdala neurons.

We performed slice patch‐clamp recordings from basolateral amygdala (BLA) pyramidal neurons in the developing and adult common marmoset (Callithrix jacchus).

The marmoset is a non‐human primate that has been increasingly used as an animal model of human disease, but no previous studies have used brain slice patch‐clamp techniques in marmosets.

We found that BLA pyramidal neurons from newborn marmosets possess relatively mature action potentials and receive vigorous GABAergic synaptic inputs, and that marmoset BLA neurons acquire adult‐like electrophysiological properties within the first 4 weeks of life.

Our study provides novel information on several features of postnatal development of BLA pyramidal neurons in marmosets.

Abstract The amygdala plays an important role in the processing of emotional events. This information processing is altered by development, but little is known about the development of electrophysiological properties of neurons in the amygdala. We studied the postnatal development of electrophysiological properties of neurons in the basolateral amygdala (BLA) of the common marmoset (Callithrix jacchus). Whole‐cell patch‐clamp recordings were obtained from BLA pyramidal neurons in brain slices prepared from developing and adult marmosets, and electrophysiological properties known to change during development in rats were analysed. Two passive electrical properties of the neuronal membrane – the input resistance (Rin) and the membrane time constant (τ) – significantly decreased with postnatal development. In contrast, the action potential only showed a slight decrease in duration during the first month of life, whereas the amplitude did not change after birth. Passive electrical properties and action potentials in neurons of 4‐week‐old marmosets were similar to those in neurons of 4‐year‐old marmosets. The development of the action potential duration was not correlated with the development ofRinor τ, whereas the development ofRinand τ was correlated with each other. Abundant spontaneous and noradrenaline‐induced GABAergic currents were present immediately after birth and did not change during postnatal development. These results suggest that newborn infant marmoset BLA pyramidal neurons possess relatively mature action potentials and receive vigorous GABAergic synaptic inputs, and that they acquire adult‐like electrophysiological properties by the fourth week of life.
Lifelong physical activity preserves functional sympatholysis and purinergic signalling in the ageing human leg
Authors: Mortensen S. P. , Nyberg M. , Winding K. , Saltin B.
Published: September 2012

Key points

Ageing is associated with a reduced exercise hyperaemia and impaired ability to override sympathetic vasoconstrictor activity (functional sympatholysis).

We find that sedentary elderly have a lower vasodilator response to ACh and ATP in the leg compared to young, but also that this age‐related reduction is partially (ACh) or completely (ATP) offset in lifelong physically active elderly subjects.

An increase in sympathetic vasoconstrictor activity induced by tyramine reduces exercise hyperaemia in sedentary elderly, but not active elderly and young subjects.

Interstitial ATP levels during exercise and P2Y2 receptor content are more related to the physical activity level than age.

Physical activity can prevent the age‐related impairment in functional sympatholysis and maintain a sufficient O2 delivery during moderate intensity exercise despite a loss of endothelial function.

Abstract  Ageing is associated with an impaired ability to modulate sympathetic vasoconstrictor activity (functional sympatholysis) and a reduced exercise hyperaemia. The purpose of this study was to investigate whether a physically active lifestyle can offset the impaired functional sympatholysis and exercise hyperaemia in the leg and whether ATP signalling is altered by ageing and physical activity. Leg haemodynamics, interstitial [ATP] and P2Y2 receptor content was determined in eight young (23 ± 1 years), eight lifelong sedentary elderly (66 ± 2 years) and eight lifelong active elderly (62 ± 2 years) men at rest and during one‐legged knee extensions (12 W and 45% maximal workload (WLmax)) and arterial infusion of ACh and ATP with and without tyramine. The vasodilatory response to ACh was lowest in the sedentary elderly, higher in active elderly (P < 0.05) and highest in the young men (P < 0.05), whereas ATP‐induced vasodilatation was lower in the sedentary elderly (P < 0.05). During exercise (12 W), leg blood flow, vascular conductance and was lower and leg lactate release higher in the sedentary elderly compared to the young (P < 0.05), whereas there was no difference between the active elderly and young. Interstitial [ATP] during exercise and P2Y2 receptor content were higher in the active elderly compared to the sedentary elderly (P < 0.05). Tyramine infusion lowered resting vascular conductance in all groups, but only in the sedentary elderly during exercise (P < 0.05). Tyramine did not alter the vasodilator response to ATP infusion in any of the three groups. Plasma [noradrenaline] increased more during tyramine infusion in both elderly groups compared to young (P < 0.05). A lifelong physically active lifestyle can maintain an intact functional sympatholysis during exercise and vasodilator response to ATP despite a reduction in endothelial nitric oxide function. A physically active lifestyle increases interstitial ATP levels and skeletal muscle P2Y2 receptor content.
Acute vagal stimulation attenuates cardiac metabolic response to β‐adrenergic stress
Authors: Vimercati Claudio , Qanud Khaled , Ilsar Itamar , Mitacchione Gianfranco , Sarnari Roberto , Mania Daniella , Faulk Ryan , Stanley William C. , Sabbah Hani N. , Recchia Fabio A.
Published: September 2012

Key points

Whereas the effects of catecholamines on myocardial metabolism are well characterized, the potential role of the parasympathetic system is generally considered minor or absent.

We tested the hypothesis that acute stimulation of the right vagus nerve alters the balance between cardiac free fatty acid and carbohydrate oxidation and opposes the metabolic effects of beta‐adrenergic stimulation.

Using a clinical‐type selective stimulator of the vagal efferent fibers in dogs, we found that vagal stimulation did not significantly affect baseline cardiac performance, haemodynamics and myocardial metabolism.

During dobutamine stress, vagal stimulation attenuated the increase in left ventricular mechanical performance, cardiac oxygen consumption and myocardial glucose oxidation, while free fatty acid oxidation was affected only at low catecholamine dose.

Our results elucidate a previously unexplored parasympathetic function, indicating that selective vagal efferent stimulation antagonizes the effects of beta‐adrenergic activation on myocardial metabolism.

Abstract  The effects of vagal stimulation (VS) on cardiac energy substrate metabolism are unknown. We tested the hypothesis that acute VS alters the balance between free fatty acid (FFA) and carbohydrate oxidation and opposes the metabolic effects of β‐adrenergic stimulation. A clinical‐type selective stimulator of the vagal efferent fibres was connected to the intact right vagus in chronically instrumented dogs. VS was set to reduce heart rate by 30 beats min−1, and the confounding effects of bradycardia were then eliminated by pacing the heart at 165 beats min−1. [3H]Oleate and [14C]glucose were infused to measure FFA and glucose oxidation. The heart was subjected to β‐adrenergic stress by infusing dobutamine at 5, 10 and 15 μg kg−1 min−1 before and during VS. VS did not significantly affect baseline cardiac performance, haemodynamics or myocardial metabolism. However, at peak dobutamine stress, VS attenuated the increase in left ventricular pressure–diameter area from 235.9 ± 72.8 to 167.3 ± 55.8%, and in cardiac oxygen consumption from 173.9 ± 23.3 to 127.89 ± 6.2% (both P < 0.05), and thus mechanical efficiency was not enhanced. The increase in glucose oxidation fell from 289.3 ± 55.5 to 131.1 ± 20.9%(P < 0.05), while FFA oxidation was not increased by β‐adrenergic stress and fell below baseline during VS only at the lowest dose of dobutamine. The functional and in part the metabolic changes were reversed by 0.1 mg kg−1 atropine i.v. Our data show that acute right VS does not affect baseline cardiac metabolism, but attenuates myocardial oxygen consumption and glucose oxidation in response to adrenergic stress, thus functioning as a cardio‐selective antagonist to β‐adrenergic activation.