bluuebunny/crossref_metadata_2025 huggingface dataset:
To breathe or not to breathe: the haematopoietic stem/progenitor cells dilemma
Authors: Piccoli C , Agriesti F , Scrima R , Falzetti F , Di Ianni M , Capitanio N
Published: May 2013

Adult haematopoietic stem/progenitor cells (HSPCs) constitute the lifespan reserve for the generation of all the cellular lineages in the blood. Although massive progress in identifying the cluster of master genes controlling self‐renewal and multipotency has been achieved in the past decade, some aspects of the physiology of HSPCs still need to be clarified. In particular, there is growing interest in the metabolic profile of HSPCs in view of their emerging role as determinants of cell fate. Indeed, stem cells and progenitors have distinct metabolic profiles, and the transition from stem to progenitor cell corresponds to a critical metabolic change, from glycolysis to oxidative phosphorylation. In this review, we summarize evidence, reported in the literature and provided by our group, highlighting the peculiar ability of HSPCs to adapt their mitochondrial oxidative/bioenergetic metabolism to survive in the hypoxic microenvironment of the endoblastic niche and to exploit redox signalling in controlling the balance between quiescence versus active cycling and differentiation. Especial prominence is given to the interplay between hypoxia inducible factor‐1, globins and NADPH oxidases in managing the mitochondrial dioxygen‐related metabolism and biogenesis in HSPCs under different ambient conditions. A mechanistic model is proposed whereby ‘mitochondrial differentiation’ is a prerequisite in uncommitted stem cells, paving the way for growth/differentiation factor‐dependent processes. Advancing the understanding of stem cell metabolism will, hopefully, help to (i) improve efforts to maintain, expand and manipulate HSPCs ex vivo and realize their potential therapeutic benefits in regenerative medicine; (ii) reprogramme somatic cells to generate stem cells; and (iii) eliminate, selectively, malignant stem cells.

Linked Articles

This article is part of a themed section on Emerging Therapeutic Aspects in Oncology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue‐8
The Roots of Stereotype Threat: When Automatic Associations Disrupt Girls' Math Performance
Authors: Galdi Silvia , Cadinu Mara , Tomasetto Carlo
Published: May 2013

Although stereotype awareness is a prerequisite for stereotype threat effects (Steele & Aronson, 1995), research showed girls' deficit under stereotype threat before the emergence of math–gender stereotype awareness, and in the absence of stereotype endorsement. In a study including 240 six‐year‐old children, this paradox was addressed by testing whether automatic associations trigger stereotype threat in young girls. Whereas no indicators were found that children endorsed the math–gender stereotype, girls, but not boys, showed automatic associations consistent with the stereotype. Moreover, results showed that girls' automatic associations varied as a function of a manipulation regarding the stereotype content. Importantly, girls' math performance decreased in a stereotype‐consistent, relative to a stereotype‐inconsistent, condition and automatic associations mediated the relation between stereotype threat and performance.
Influence of simulated bone–implant contact and implant diameter on secondary stability: a resonance frequency in vitro study
Authors: Veltri Mario , González‐Martín Oscar , Belser Urs C.
Published: May 2013

Objectives

This study tested the hypothesis of no differences in resonance frequency for standardized amounts of simulated bone–implant contact around implants with different diameters. In addition, it was evaluated if resonance frequency is able to detect a difference between stable and rotation mobile (“spinning”) implants.

Material and Methods

Implants with diameters of 3.3, 4.1 and 4.8 mm were placed in a purposely designed metal mould where liquid polyurethane resin was then poured to obtain a simulated bone‐implant specimen. By regulating the mould, it was possible to create the following simulated bone–implant contact groups: 3.3 mm (198.6 mm2); 4.1 mm (198.8 mm2); 4.8 mm (200.2 mm2); 4.8 mm (231.7 mm2); 4.8 mm (294.7 mm2). Each group included 10 specimens. After resin setting, resonance frequency was measured. On the last group, measurements were repeated after establishing implant rotational mobility. One‐way ANOVA tests with post hoc comparisons, a Pearson's correlation coefficient and a t‐test for repeated measurements were used to evaluate statistically significant differences.

Results

Implants with different diameters but with the same amount of simulated osseointegration revealed no differences in resonance frequency. On the contrary, an increase of simulated bone–implant contact resulted in significantly higher resonance frequency. A clear direct linear correlation resulted between resonance frequency and simulated bone–implant contact. Furthermore, a significant difference resulted between resonance frequency measured before and after creation of rotational mobility.

Conclusions

Within the conditions of this study, the secondary stability was correlated with the simulated bone–implant contact. In addition, resonance frequency was able to discern between stable and rotation mobile implants.
Diminished Aortic Excursion in Chronic Thromboembolic Pulmonary Hypertension
Authors: Kimura Bruce J. , Parise Charles M. , Monet Strachan G. , Auger William , Madani Michael M. , Daniels Lori B. , Blanchard Daniel G.
Published: May 2013

Background

Although studies have found diminished aortic root motion in left ventricular systolic dysfunction, few data exist on aortic root excursion in isolated right ventricular dysfunction due to chronic thromboembolic pulmonary hypertension (CTEPH).

Objective

We conducted this study to evaluate aortic root excursion in CTEPH.

Methods

We studied 20 consecutive patients with CTEPH, normal left ventricular ejection fraction and pulmonary capillary wedge pressures, and 10 normal control subjects. Anterior excursion of the aortic root was measured using M‐mode echocardiography as the difference between the maximal and minimal anterior distance of the posterior wall of the aortic root at the level of the aortic valve.

Results

Mean aortic excursion for CTEPH patients was approximately half that of normal controls (0.66 ± 0.25 cm vs. 1.16 ± 0.15 cm, P < 0.0001). There was a significant inverse linear correlation between mean pulmonary artery pressure and aortic excursion in the CTEPH group (r = 0.66, P = 0.001).

Conclusion

Aortic excursion is diminished in the right ventricular pressure overload of CTEPH. This impaired motion of the aortic root may influence systolic expansion of the left atrium, and may contribute to the impaired left atrial diastolic filling patterns often seen in patients with CTEPH.
Transesophageal Echocardiographic Diagnosis of Bronchopulmonary Vein Fistula Complicating Mitral Valve Replacement
Authors: Hsaad Ayman Haj , Bleich Steven , Nanda Navin C. , Athanasuleas Constantine L. , Kemaloğlu Öz Tuğba
Published: May 2013

A bronchopulmonary vein fistula (BVF) establishes a communication between a pulmonary vein and the alveolar space presumably secondary to alveolar rupture from increase in alveolar pressure. This rare fistula allows air to move continuously from the lungs to a pulmonary vein and into the left side of the heart causing systemic air embolization which is often fatal. We describe an adult patient undergoing a second mitral valve replacement surgery in whom intra‐operative transesophageal echocardiography proved crucial in diagnosing BVF by showing persistent and increased streaming of air bubbles into the left heart from the left superior pulmonary vein during each positive pressure ventilation cycle with consequent inability to de‐air the heart. This allowed initiation of appropriate management. The patient eventually had a fatal outcome from multiple organ infarcts.
Isolated Ruptured Inter‐Atrial Septal Cystic Echinococcosis during Pregnancy
Authors: Ercan Suleyman , Gokaslan Gokhan , Davutoglu Vedat , Inanc Ibrahim Halil , Bosnak Vuslat , Deniz Hayati
Published: May 2013

Herein, we present a case of asymptomatic isolated cardiac cystic echinococcosis localized entirely to the inter‐atrial septum in a pregnant woman. The patient underwent successful surgery. Cardiac cystic echinococcosis is rarely seen in pregnancy. A high index of suspicion is necessary for the diagnosis of a cardiac cyst hydatid. The treatment of cardiac cyst hydatid is surgical and should not be delayed during pregnancy. Early surgery might prevent septic embolization and cardiac life‐threatening complications and save the lives of both mother and baby as in the present case.
Haem catabolism: a novel modulator of inflammation in Gilbert's syndrome
Authors: Wallner Marlies , Bulmer Andrew C. , Mölzer Christine , Müllner Elisabeth , Marculescu Rodrig , Doberer Daniel , Wolzt Michael , Wagner Oswald F. , Wagner Karl‐Heinz
Published: May 2013

Background

Moderately elevated unconjugated bilirubin concentrations protect against inflammatory diseases and are present in individuals with Gilbert's syndrome. This study examined the relationship between circulating haem oxygenase catabolites, unconjugated bilirubin, carboxy haemoglobin, iron and inflammatory parameters.

Materials and methods

Seventy‐six matched individuals were allocated to Gilbert's syndrome (GS) or control group (unconjugated bilirubin ≥ or  < 17·1 μM). Iron, carboxy haemoglobin and high‐sensitivity C‐reactive protein were analysed using routine diagnostic tests. Unconjugated bilirubin and haem were analysed using high‐performance liquid chromatography. The cytokines IL‐1β, TNF‐α and IL‐6 were assessed using high‐sensitivity enzyme‐linked immunosorbent assays.

Results

Gilbert's syndrome subjects had significantly greater levels of unconjugated bilirubin (P < 0·05), carboxy haemoglobin (P < 0·05), iron (P < 0·05), IL‐1β (P < 0·05), a significantly lower body mass index (P < 0·05) and IL‐6 concentrations (P < 0·05) vs. controls. Regression analysis revealed that unconjugated bilirubin mainly explained IL‐1β results (16%), and body mass index+IL‐6 predicted 26% of the variance in C‐reactive protein concentrations.

Conclusions

A positive relationship between unconjugated bilirubin and free plasma haem, iron and carboxy haemoglobin indicated a positive feedback loop of haem oxygenase induction possibly mediated by unconjugated bilirubin. Furthermore, reduced body mass index in Gilbert's syndrome individuals was linked to reduced inflammation status, which could be influenced by circulating haem oxygenase catabolites and contribute to reduced risk of noncommunicable diseases in this population.
Improved spatial learning is associated with increased hippocampal but not prefrontal long‐term potentiation in mGluR4 knockout mice
Authors: Iscru E. , Goddyn H. , Ahmed T. , Callaerts‐Vegh Z. , D'Hooge R. , Balschun D.
Published: May 2013

Although much information about metabotropic glutamate receptors (mGluRs) and their role in normal and pathologic brain function has been accumulated during the last decades, the role of group III mGluRs is still scarcely documented. Here, we examined mGluR4 knockout mice for types of behavior and synaptic plasticity that depend on either the hippocampus or the prefrontal cortex (PFC). We found improved spatial short‐ and long‐term memory in the radial arm maze, which was accompanied by enhanced long‐term potentiation (LTP) in hippocampal CA1 region. In contrast, LTP in the PFC was unchanged when compared with wild‐type controls. Changes in paired‐pulse facilitation that became overt in the presence of the GABAA antagonist picrotoxin indicated a function of mGluR4 in maintaining the excitation/inhibition balance, which is of crucial importance for information processing in the brain and the deterioration of these processes in neuropsychological disorders such as autism, epilepsy and schizophrenia.
Detection of new mutations and molecular pathology of mild and moderate haemophilia A patients from southern Brazil
Authors: Rosset C. , Vieira I. A. , Sinigaglia M. , Gorziza R. P. , Salzano F. M. , Bandinelli E.
Published: May 2013

A total of 76 unrelated male patients with mild (n = 55) or moderate (n = 21) haemophilia A living in the southern Brazilian state of Rio Grande do Sul were studied by direct sequencing of all F8 26 exons, the 5′ UTR and 3′ UTR, intron–exon junctions and the promoter region. When no mutation was found, a multiplex ligation‐dependent probe amplification analysis was performed. We identified the disease‐causing mutations in 69 patients, who showed 33 different mutations: 27 missense, one small deletion, two small duplications and three splice site mutations. Seven missense and two splice site mutations were not previously reported in HAMSTeRS and were not identified in any current literature search. Nine recurrent mutations were found, one of them never described before (p.Tyr1786Phe). Haplotype analysis indicated that this mutation had originated in the Brazilian population as a single event in a common ancestor. The possible influence of these mutations in the determination of the disease was carefully considered, including bioinformatic tools. These data add to the general knowledge of the disease and can also be useful for HA diagnosis and detection of carriers in the southern Brazilian population.
Self‐management and skills acquisition in boys with haemophilia
Authors: Khair Kate , Meerabeau Liz , Gibson Faith
Published: May 2013

Background

There is an increasing prevalence of children/young people with long‐term conditions (LTC) in the UK due to improvements in health‐care management and delivery. These children are often involved, from an early age, in their own care and management; yet, there are little data to support how or when they develop the necessary skills and knowledge to become competent at this care.

Objective

This study aimed to understand self‐management of haemophilia, from a child's perspective, in the 21st century in the UK where intensive prophylactic therapy is given from early childhood.

Design

A qualitative study using grounded theory to evaluate life‐experiences of children and young people with haemophilia.

Setting and participants

Thirty boys aged 4–16 with severe haemophilia treated at a single paediatric haemophilia care centre were interviewed at home or in a focus group.

Intervention/variables

Multimethod qualitative research including age‐appropriate research tools (draw and write, photo‐elicitation and interviews) to facilitate data collection from children.

Results

Boys develop self‐management skills over time. They learn from health‐care professionals, their parents and other family members with haemophilia.

Discussion

Self‐management skills (bleed recognition, self‐infusion, self and medicines management, pain and risk management and conceptualizing preventative therapy) are developed through experiential learning and individualized education, and not through formalized expert patient programmes.

Conclusion

The boys in this study have benefited from early prophylactic factor replacement therapy. They develop skills in haemophilia and self‐management at a relatively young age and are experts in their own haemophilia care.
How technology is empowering patients? A literature review
Authors: Calvillo Jorge , Román Isabel , Roa Laura M.
Published: May 2013

Background

The term ‘Patient Empowerment’ (PE) is a growing concept – so in popularity as in application – covering situations where citizens are encouraged to take an active role in the management of their own health. This concept is serving as engine power for increasing the quality of health systems, but a question is still unanswered, ‘how PE will be effectively achieved?’ Beyond psychological implications, empowerment of patients in daily practice relies on technology and the way it is used. Unfortunately, the heterogeneity of approaches and technologies makes difficult to have a global vision of how PE is being performed.

Objective

To clarify how technology is being applied for enhancing patient empowerment as well as to identify current (and future) trends and milestones in this issue.

Search strategy

Searches for relevant English language articles using Medline, Scopus, ACM Digital Library, Springer Link, EBSCO host and ScienceDirect databases from the year 2000 until October 2012 were conducted. Among others, a selection criterion was to review articles including terms ‘patient’ and ‘empowerment’ in title, abstract or as keywords.

Main results and conclusions

Results state that practical approaches to empower patients vary in scope, aim and technology. Health literacy of patients, remote access to health services, and self‐care mechanisms are the most valued ways to accomplish PE. Current technology already allows establishing the first steps in the road ahead, but a change of attitude by all stakeholders (i.e. professionals, patients, policy makers, etc.) is required.
Effects of Postdensification Annealing on Microwave Dielectric Properties of Ba([Mg1−xCox]1/3Nb2/3)O3 Ceramics
Authors: Sun Tu Lai , Li Lei , Mao Min Min , Chen Xiang Ming
Published: May 2013

Effects of postdensification annealing on microwave dielectric properties of Ba([Mg1−xCox]1/3Nb2/3)O3 ceramics have been investigated. The 1:2 ordered complex perovskite structure is obtained in the entire composition range of the as‐sintered samples, and the ordering degree decreases with increasing x. With increasing x, the dielectric constant (εr) increases, the temperature coefficient of resonant frequency (τf) shifts toward negative and can be tuned to near‐zero for x = 0.6, while the Q × f value decreases. With postdensification annealing at 1400°C in air for 24 h, the ordering degree increases, and Q × f value can be significantly improved without obvious change in εr, while the composition for obtaining near‐zero τf shifts to x = 0.8. Annealing at 1375°C and 1425°C in air for 24 h does not improve microwave dielectric properties more than annealing at 1400°C. A good combination of microwave dielectric properties of Ba([Mg1−xCox]1/3Nb2/3)O3 ceramics after postdensification annealing at 1400°C in air for 24 h has been obtained for x = 0.8: εr = 31.7, Q × f = 76,900 GHz, τf = 3.3 ppm/°C.
Collaboration between hospital physicians and nurses: An integrated literature review
Authors: Tang C.J. , Chan S.W. , Zhou W.T. , Liaw S.Y.
Published: May 2013

Background

Ineffective physician–nurse collaboration has been shown to cause work dissatisfaction among physicians and nurses and compromised the quality of patient care.

Aim

The review sought to explore: (1) attitudes of physicians and nurses toward physician–nurse collaboration; (2) factors affecting physician–nurse collaboration; and (3) strategies to improve physician–nurse collaboration.

Methods

A literature search was conducted in the following databases: CINAHL, PubMed, Wiley Online Library and Scopus from year 2002 to 2012, to include papers that reported studies on physician–nurse collaboration in the hospital setting.

Findings

Seventeen papers were included in this review. Three of the reviewed articles were qualitative studies and the other 14 were quantitative studies. Three key themes emerged from this review: (1) attitudes towards physician–nurse collaboration, where physicians viewed physician–nurse collaboration as less important than nurses but rated the quality of collaboration higher than nurses; (2) factors affecting physician–nurse collaboration, including communication, respect and trust, unequal power, understanding professional roles, and task prioritizing; and (3) improvement strategies for physician–nurse collaboration, involving inter‐professional education and interdisciplinary ward rounds.

Conclusion

This review has highlighted important aspects of physician–nurse collaboration that could be addressed by future research studies. These include: developing a comprehensive instrument to assess collaboration in greater depth; conducting rigorous intervention studies to evaluate the effectiveness of improvement strategies for physician–nurse collaboration; and examining the role of senior physicians and nurses in facilitating collaboration among junior physicians and nurses. Other implications include inter‐professional education to empower nurses in making clinical decisions and putting in place policies to resolve workplace issues.
The End of Ethics: A Thomistic Investigation
Authors: Reese Philip Neri
Published: May 2013

Capitalizing on the diversity of ways in which the phrase “the end of ethics” can be interpreted, this article explores how, from a Thomistic perspective, the virtue of prudence might be considered the “end” of ethics. After bringing to light certain problematic aspects of the relationship between ethics and prudence, it is argued that Aquinas’ understanding of the intellectual virtues allows for a clear line to be drawn between the two. In this way, it is possible to say where ethics “ends” and prudence begins. This answer, however, seems to raise a further difficulty which, upon resolution, reveals a sense in which prudence is also the “end” of ethics when “end” is taken to mean its goal.
Lagochilus lorestanicus sp. nov. (Lamiaceae) from Iran
Authors: Dehshiri M. M. , Mozaffarian V.
Published: May 2013

Lagochilus lorestanicus Dehshiri & Mozaffarian, a new species endemic to Iran, is described and illustrated. The new species is probably most closely related to L. cuneatus Benth. The diagnostic morphological characteristics, as well as a full description, ecological characteristics, and distribution data are given. Lagochilus lorestanicus is evaluated as ‘Vulnerable’ (VU) according to IUCN red list criteria.
Identification of the traditional methods of newborn mothers regarding jaundice in Turkey
Authors: Aydin Diler , Karaca Ciftci Esra , Karatas Hulya
Published: May 2013

Aims and objectives

To detect traditional methods applied for the treatment of newborn jaundice by mothers in Turkey.

Background

Traditional methods are generally used in our society. Instead of using medical services, people often use already‐known traditional methods to treat the disease. In such cases, the prognosis of the disease generally becomes worse, the treatment period longer and healthcare costs higher, and more medicine is used.

Design

A cross‐sectional descriptive study.

Methods

The participants of this study were 229 mothers with newborn babies aged 0–28 days in one university hospital and one public children's hospital in Sanliurfa. The study was conducted between March and May 2012. In this research, the Beliefs and Traditional Methods of Mothers for Jaundice Questionnaire, which was formed by searching the relevant literature, is used as a data collection tool. The data are evaluated by percentage distributions.

Results

Mothers apply conventional practices in cases of health problems such as jaundice, and application of these methods is important to mothers. Moreover, mothers reported applying hazardous conventional methods in cases of neonatal jaundice, such as cutting the area between the baby's eyebrows with a blade, cutting the back of the ear and the body and burning the body, which are not applied in different cultures.

Conclusions

Education regarding the effects of conventional methods being applied in families should be provided, and the results of this study should serve to guide further studies in assessing the effects of such education.

Relevance to clinical practice

This approach can support beneficial practices involving individual care and prevent the negative health effects of hazardous practices.
Dysmenorrhoea and self‐care behaviours among hospital nurses: a questionnaire survey
Authors: Chiu Min‐Hui , Wang Hsiu‐Hung , Hsu Su‐Chen , Liu I‐Ping
Published: May 2013

Aims and objectives

To investigate self‐care behaviours and its predictors for dysmenorrhoea among hospital nurses.

Background

Dysmenorrhoea is an important issue in hospital nurses for its influence on job performance and quality of patient care. Given the difficulties in reorganising work schedule for taking menstrual leave in Taiwan, it is necessary to improve the comfort level of nurses during menstruation.

Design

A cross‐sectional correlation study using a structured questionnaire.

Methods

A convenience sampling method was used to select two hospitals in Southern Taiwan, and participants were recruited by random sampling method. Questionnaire used in the study contained personal information, Dysmenorrheic Knowledge Scale, Menstrual Attitude Scale and Dysmenorrheic Self‐Care Behavior Scale (DSCBS). Two hundred and ninety‐seven participants had experienced dysmenorrhoea in the last six months, with the prevalence rate of 70·7%.

Results

Results showed the average age of the participants was 30·3 years, and 252 participants (82·4%) self‐perceived they were bothered by dysmenorrhoea. The score of DSCBS was 29·9 (±5·3). The results of stepwise multiple regression analysis revealed the predictors of DSCBS included whether the participants (1) were married, (2) had irregular menstruation, (3) had received health education on dysmenorrhoea, (4) visited doctor for dysmenorrhoea, (5) knew they may take menstrual leave and (6) were identified with menstruation as a natural event. The r2 was 18·4%.

Conclusions

Hospital nurses' self‐care behaviour for dysmenorrhoea is suggested to be improved through enhanced peer support and caring.

Relevance to clinical practice

The prevalence rate of dysmenorrhoea among hospital nurses is high. Most of them take analgesics to reduce pain to return to work. We recommend hospitals to provide women‐friendly workplace and empowerment activities to improve the self‐care ability and comfort level of nurses during menstruation.
So, What Am I Supposed to Do? A Multilevel Examination of Role Clarity
Authors: Kauppila Olli‐Pekka
Published: May 2013

Although prior research generally holds that role clarity is affected by both individual characteristics and organizational contexts, current conceptual or empirical models do not reflect the multilevel nature of these antecedents. A more complete understanding of how role clarity emanates from different organizational levels is necessary to help prevent poor job performance and other harmful consequences of ambiguous role expectations. To address this, I begin this research by investigating the effects of internal work locus of control, general self‐efficacy, and leader–member exchange on role clarity. With respect to the cross‐level effects, I focus on the roles of a manager's control style and the organization's strategy‐making pattern. Analyses of a multi‐industry, multilevel dataset collected from 724 employees and 124 managers in 25 organizations in Finland suggest that all of the individual‐level independent variables and a deliberate strategy‐making pattern improve role clarity. However, a deliberate strategy‐making pattern negatively moderates the relationship between general self‐efficacy and role clarity. Finally, even though an outcome‐based control system causes role ambiguity among employees in most functional areas, it may be an effective driver of role clarity among employees in sales jobs.
Current definitions for neonatal apnoea: Are they evidence based?
Authors: Elder Dawn E , Campbell Angela J , Galletly Duncan
Published: May 2013

Apnoea is defined as cessation of breathing with implicit pathophysiology. This review considers definitions of neonatal apnoea currently available and explores the evidence to support their use. For preterm and term infants, apnoea definitions appear arbitrary, are not supported by guidelines and vary from study to study. Although most alarms on infant breathing monitors are set to alert after a respiratory pause >20 s duration is detected, this time period is the equivalent of 17 missed breaths in a preterm infant. Apnoea is likely to be better defined by associated consequence than by pause duration alone in this age group; however, the degree of change in heart rate or oxygen saturation that defines a respiratory pause as pathological is yet to be defined. Further research is required to determine the characteristics that differentiate respiratory events of clinical consequence from normal respiratory variability in term and preterm infants.
Porphyromonas gingivalis,Treponema denticola and toll‐like receptor 2 are associated with hypertensive disorders in placental tissue: a case–control study
Authors: Chaparro A. , Blanlot C. , Ramírez V. , Sanz A. , Quintero A. , Inostroza C. , Bittner M. , Navarro M. , Illanes S. E.
Published: May 2013

Aim(s)

To explore the associations between the presence of periodontal pathogens and the expression of toll‐like receptors (TLR‐2 and TLR‐4) in the placental tissue of patients with hypertensive disorders compared to the placentas of healthy normotensive patients.

Material and Methods

A case–control study was performed. From a cohort composed of 126 pregnant women, 33 normotensive healthy pregnant women were randomly selected, and 25 cases of patients with hypertensive disorders of pregnancy, including gestational hypertension and pre‐eclampsia, were selected. Placental biopsy was obtained after aseptic placental collection at the time of delivery. All of the samples were processed and analysed for the detection of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Treponema denticola and Tannerella forsythia using the polymerase chain reaction (PCR) technique. Determination of the expressions of TLR‐2 and TLR‐4 was performed in samples of total purified protein isolated from placental tissues and analysed by ELISA. The data were assessed using descriptive statistics. The associations among variables were estimated through multiple logistic regression models and the Mann–Whitney test to evaluate the differences between the two groups.

Results

A significant increase was observed in the expression of TLR‐2 in the placentas of patients with hypertensive disorders (p = 0.04). Additionally, the multiple logistic regression models demonstrated an association between the presence of T. denticola and P. gingivalis in placental tissues and hypertensive disorders (OR: 9.39, p = 0.001, CI 95% 2.39–36.88 and OR: 7.59, p = 0.019, CI 95% 1.39–41.51, respectively).

Conclusions

In the present study, pregnant women with periodontal disease presented an association in the placental tissue between the presence of T. denticola and P. gingivalis and hypertensive disorders. Additionally, increased expression of TLR‐2 was observed. However, further studies are required to determine the specific roles of periodontal pathogens and TLRs in the placental tissue of patients with pregnancy‐related hypertensive disorders.
Iron plays a key role in the cytodifferentiation of human periodontal ligament cells
Authors: Hou J. , Yamada S. , Kajikawa T. , Ozaki N. , Awata T. , Yamaba S. , Fujihara C. , Murakami S.
Published: May 2013

Background and Objective

The periodontal ligament (PDL) is vital to maintaining the homeostasis of the tooth and periodontal tissue. The influence of iron levels on the cytodifferentiation of PDL cells has not been studied, despite evidence that iron overload or deficiency can have adverse effects on alveolar bone density. The purpose of this study was to examine the effects of altered iron levels on cytodifferentiation in human PDL cells.

Material and Methods

Human PDL cells were incubated with culture media supplemented with 10–50 μm ammonium ferric citrate or 5 μm deferoxamine (an iron chelator) during differentiation. Intracellular iron status was assessed by measuring changes in the expression of ferritin RNA and protein. PDL cell differentiation and function were evaluated by measuring osteoblast differentiation gene markers and the capacity of cultures to form mineralized nodules.

Results

Iron accumulation resulted in upregulation of light and heavy chain ferritin proteins. Concurrently, osteoblast differentiation gene markers and mineralized nodule formation were suppressed. Iron deficiency resulted in downregulation of light and heavy chain ferritin proteins, suppression of alkaline phosphatase activity and formation of mineralized nodules during PDL cell differentiation.

Conclusion

We conclude that iron is critical for normal cell differentiation of human PDL cells.
Fluid inclusions in microstructures of shocked quartz from the Keurusselkä impact site, Central Finland
Authors: Poutiainen Matti , Heikkilä Pasi
Published: May 2013

Granitoid rock samples from the assumed center of the Keurusselkä impact site were subjected to a systematic study of fluid‐inclusion compositions and densities in various microstructures of the shocked quartz. The results are consistent with the following impact‐induced model of formation. After cessation of all major regional tectonic activity and advanced erosional uplift of the Fennoscandian shield, a meteorite impact (approximately 1.1 Ga) caused the formation of planar fractures (PFs) and planar deformation features (PDFs) and the migration of shock‐liberated metamorphic fluid (CO2 ± H2O) to the glass in the PDFs. Postimpact annealing of the PDFs led to the formation of CO2 (±H2O) fluid‐inclusion decorated PDFs. The scarce fluid‐inclusion implosion textures (IPs) suggest a shock pressure of 7.6–10 GPa. The postimpact pressure release and associated heating initiated hydrothermal activity that caused re‐opening of some PFs and their partial filling by moderate‐salinity/high temperature (>200 °C) H2O (+ chlorite + quartz) and moderate‐density CO2. The youngest postimpact endogenic sub‐ and nonplanar microfractures (MFs) are characterized by low‐density CO2 and low‐salinity/low‐temperature (<200 °C) H2O.
Multilocus phylogeny and Bayesian estimates of species boundaries reveal hidden evolutionary relationships and cryptic diversity in Southeast Asian monitor lizards
Authors: Welton L. J. , Siler C. D. , Oaks J. R. , Diesmos A. C. , Brown R. M.
Published: May 2013

Recent conceptual, technological and methodological advances in phylogenetics have enabled increasingly robust statistical species delimitation in studies of biodiversity. As the variety of evidence purporting species diversity has increased, so too have the kinds of tools and inferential power of methods for delimiting species. Here, we showcase an organismal system for a data‐rich, comparative molecular approach to evaluating strategies of species delimitation among monitor lizards of the genus Varanus. The water monitors (Varanus salvator Complex), a widespread group distributed throughout Southeast Asia and southern India, have been the subject of numerous taxonomic treatments, which have drawn recent attention due to the possibility of undocumented species diversity. To date, studies of this group have relied on purportedly diagnostic morphological characters, with no attention given to the genetic underpinnings of species diversity. Using a 5‐gene data set, we estimated phylogeny and used multilocus genetic networks, analysis of population structure and a Bayesian coalescent approach to infer species boundaries. Our results contradict previous systematic hypotheses, reveal surprising relationships between island and mainland lineages and uncover novel, cryptic evolutionary lineages (i.e. new putative species). Our study contributes to a growing body of literature suggesting that, used in concert with other sources of data (e.g. morphology, ecology, biogeography), multilocus genetic data can be highly informative to systematists and biodiversity specialists when attempting to estimate species diversity and identify conservation priorities. We recommend holding in abeyance taxonomic decisions until multiple, converging lines of evidence are available to best inform taxonomists, evolutionary biologists and conservationists.
Anaplastic oligodendroglioma arising from the brain stem and featuring 1p/19q co‐deletion
Authors: Hewer Ekkehard , Beck Jürgen , Vassella Erik , Vajtai Istvan
Published: May 2013

With respect to localization, oligodendrogliomas are characterized by a marked preponderance of the cerebral hemispheres. Outside these typical sites, any tumor histopathologically reminiscent of oligodendroglioma a priori is likely to represent one of its morphological mimics, including clear cell ependymoma, neurocytoma, pilocytic astrocytoma or glioneuronal tumors. This is particularly relevant as several of the latter are in principle curable by surgery. Among extrahemispherical sites, bona fide oligodendroglioma – as characterized by loss of heterozygosity (LOH) of chromosome arms 1p and 19q – so far has not been documented to occur in the brain stem. Here, we report the case of a 55‐year‐old female patient with an anaplastic oligodendroglioma (WHO grade III) of the brain stem and cerebellum diagnosed by stereotactic biopsy and featuring combined LOH of 1p and 19q. A morphological peculiarity was a population of interspersed tumor giant cells, a phenomenon that has been referred to as polymorphous oligodendroglioma. Our findings confirm the notion that – although very infrequently – true oligodendrogliomas do occur in the infratentorial compartment.
Tricuspid Insufficiency after Laser Lead Extraction
Authors: RODRIGUEZ YASSER , MESA JULIAN , ARGUELLES ERIC , CARRILLO ROGER G.
Published: May 2013

Background

The use of laser lead extraction (LLE) to remove pacemaker and implantable cardiac defibrillator leads has become more prevalent in the past decade. Though the procedure is associated with a low rate of complications, LLE still poses some risks to patients. Some reports have suggested an increase in tricuspid insufficiency (TI) associated with LLE. We present a series of patients who underwent both LLE and complete evaluation for TI with echocardiographic techniques.

Methods

From August 2008 to January 2010, 173 prospective, consecutive patients underwent LLE in a single center. All patients had transesophageal echocardiograms (TEE) during the extraction. Fifty‐three patients had tricuspid valve function evaluated a day before the procedure with a transthoracic echocardiogram (TTE), during the procedure with a TEE and 2 days postoperatively with a TTE.

Results

All 173 patients experienced no change in tricuspid valve function during the procedure with TEE. Of the 53 patients who underwent a complete TI evaluation, 38 were males (72%) and 15 females (38%), with a mean age of 69.45 ± 14.08. Mean ejection fraction was 35.82 ± 14.72. Three (6%) patients experienced TI after the procedure (two mild and one severe, all with tricuspid valve endocarditis); 16 (30%) patients were found to have TI before LLE that returned to normal valve function during or after the procedure. Thirty‐four (64%) patients did not experience any significant change of the tricuspid valve performance after LLE.

Conclusion

LLE was not associated with increased TI.
Evaluation of Acute Cardiac and Chest Wall Damage after Shocks with a Subcutaneous Implantable Cardioverter Defibrillator in Swine
Authors: KILLINGSWORTH CHERYL R. , MELNICK SHARON B. , LITOVSKY SILVIO H. , IDEKER RAYMOND E. , WALCOTT GREGORY P.
Published: May 2013

Background

A subcutaneous implantable cardioverter defibrillator (S‐ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices.

Methods

During sinus rhythm, anesthetized pigs (38 ± 6 kg) received an S‐ICD (n = 4) and five 80‐Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35‐J shocks. An inactive S‐ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24 hours. Troponin I and creatine kinase muscle isoenzyme (CK‐MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semiquantitative scoring.

Results

Troponin I was significantly elevated at 4 hours and 24 hours (22.6 ± 16.3 ng/mL and 3.1 ± 1.3 ng/mL; baseline 0.07 ± 0.09 ng/mL) in control pigs but not in S‐ICD pigs (0.12 ± 0.11 ng/mL and 0.13 ± 0.13 ng/mL; baseline 0.06 ± 0.03 ng/mL). CK‐MM was significantly elevated in S‐ICD pigs after shocks (6,544 ± 1,496 U/L and 9,705 ± 6,240 U/L; baseline 704 ± 398 U/L) but not in controls. Electrocardiogram changes occurred postshock in controls but not in S‐ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S‐ICD compared to controls.

Conclusion

Although CK‐MM suggested more skeletal muscle injury in S‐ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80‐J S‐ICD shocks than 35‐J transvenous shocks.
Multipole Analysis of Heart Rate Variability as a Predictor of Imminent Ventricular Arrhythmias in ICD Patients
Authors: ROZEN GUY , KOBO ROI , BEINART ROY , FELDMAN SHLOMO , SAPUNAR MICHAL , LURIA DAVID , ELDAR MICHAEL , LEVITAN JACOB , GLIKSON MICHAEL
Published: May 2013

Background

Contemporary implantable cardiac defibrillators (ICD) enable storage of multiple, preepisode R‐R recordings in patients who suffered from ventricular tachyarrhythmia (VTA). Timely prediction of VTA, using heart rate variability (HRV) analysis techniques, may facilitate the implementation of preventive and therapeutic strategies.

Aim

To evaluate the novel multipole method of the HRV analysis in prediction of imminent VTAs in ICD patients.

Methods

We screened patients from the Biotronik HAWAI Registry (Heart Rate Analysis with Automated ICDs). A total of 28 patients from the HAWAI registries (phase I and II), having medical records, who had experienced documented, verified VTA during the 2‐year follow‐up, were included in our analysis. HRV during preepisode recordings of 4,500 R‐R intervals were analyzed using the Dyx parameter and compared to HRV of similar length recordings from the same patients that were not followed by arrhythmia.

Results

Our study population consisted mainly of men 25 of 28 (89%), average age of 64.8 ± 9.4 years, 92% with coronary artery disease. HRV during 64 preevent recordings (2.3 events per patient on average) was analyzed and compared with 60 control recordings. The multipole method of HRV analysis showed 50% sensitivity and 91.6% specificity for prediction of ventricular tachycardia/ventricular fibrillation in the study population, with 84.5% positive predictive value. No statistically significant correlation was found between various clinical parameters and the sensitivity of imminent VTA predetection in our patients.

Conclusion

The multipole method of HRV analysis emerges as a highly specific, possible predictor of imminent VTA, providing an early warning allowing to prepare for an arrhythmic episode.
Axillary Vein Puncture Without Contrast Venography for Pacemaker and Defibrillator Leads Implantation
Authors: ANTONELLI DANTE , FELDMAN ALEXANDER , FREEDBERG NAHUM A. , TURGEMAN YOAV
Published: May 2013

Background

Axillary vein puncture has been demonstrated to be an effective method for pacemaker and defibrillator leads implantation, without the complications encountered with the standard intrathoracic approach.

Objective

Different techniques have been adopted for the cannulation of the axillary vein. We report our experience using the outer edge of the first rib below the inferior border of the clavicle as fluoroscopic landmark.

Method

A subcutaneous pocket is created 1‐cm medially and parallel to the delto‐pectoral groove and 2 cm below the clavicle. An 18‐gauge needle from the upper border of the pocket is directed perpendicularly to the outer edge of the first rib just below the inferior border of the clavicle. If the vein is not entered, the needle is withdrawn and the puncture is repeated with slight variations of needle direction for a maximum of four to five times, then contrast‐guided vein puncture is performed. Upon successful vein puncture, a guidewire is inserted and positioned in the superior vena cava. The remainder of the implantation is carried out in a routine manner.

Results

The axillary vein was successfully cannulated without venography in 172 of 182 consecutive patients (94.5%); the vein could not be found in 10 patients (5.5%): in these patients the vein was successfully cannulated after venography performance. No pneumothorax, hemothorax, or brachial plexus injury occurred.

Conclusions

Our approach of axillary venipunture using fluoroscopic landmark, without contrast venography, is simple, safe, and effective.
Single Center Experience of Fluoroless AVNRT Ablation Guided by Electroanatomic Reconstruction in Children and Adolescents
Authors: SCAGLIONE MARCO , EBRILLE ELISA , CAPONI DOMENICO , BLANDINO ALESSANDRO , DI DONNA PAOLO , SIBOLDI ALESSANDRA , BERTERO GIOVANNI , ANSELMINO MATTEO , RAIMONDO CRISTINA , SARDI DAVIDE , GABBARINI FULVIO , MARASINI MAURIZIO , GAITA FIORENZO
Published: May 2013

Background

Anatomical considerations and risks related to x‐ray exposure make atrioventricular nodal reentrant tachycardia (AVNRT) ablation in pediatric patients a concerning procedure. We aimed to evaluate the feasibility, safety, and efficacy of performing fluoroless slow‐pathway cryoablation guided by the electroanatomic (EA) mapping in children and adolescents.

Methods

Twenty‐one consecutive patients (mean age 13.5 ± 2.4 years) symptomatic for AVNRT were prospectively enrolled to right atrium EA mapping and electrophysiological study prior to cryoablation. Cryoablation was guided by slow‐pathway potential and performed using a 4‐mm‐tip catheter.

Results

Sustained slow‐fast AVNRT was inducible in all the patients with a dual AV nodal physiology in 95%. Acute success was achieved in 100% of the patients with a median of two cryo‐applications. Fluoroless ablation was feasible in 19 patients, while in two subjects 50 seconds and 45 seconds of x‐ray were needed due to difficult progression of the catheters along the venous system. After a mean follow‐up of 25 months, AVNRT recurred in five patients. All the recurrences were successfully treated with a second procedure. In three patients, a fluoroless cryoablation with a 6‐mm‐tip catheter was successfully performed, while in the remaining two patients, a single pulse of 60 seconds of radiofrequency energy was applied under fluoroscopic monitoring. No complications occurred.

Conclusions

Combination of EA mapping systems and cryoablation may allow to perform fluoroless slow‐pathway ablation for AVNRT in children and adolescents in the majority of patients. Fluoroless slow‐pathway cryoablation showed a high efficacy and safety comparable to conventional fluoroscopy guided procedures.