bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D is Not a Protective Factor in ALS
Authors: Blasco Hélène , Madji Hounoum Blandine , Dufour‐Rainfray Diane , Patin Franck , Maillot François , Beltran Stéphane , Gordon Paul H. , Andres Christian R. , Corcia Philippe
Published: June 2015

Aims

Vitamin D deficiency has been associated with poorer prognosis in ALS. Better understanding of the role of vitamin D in ALS is needed to determine whether trials of systematic supplementation are justified. Our aim was to report vitamin D levels during the course of ALS and to evaluate its relationship with clinical parameters at diagnosis and with disease progression.

Methods

We prospectively collected vitamin D serum concentrations from 125 consecutive ALS patients. Cox proportional hazard models analyzed the relationship between vitamin D concentrations, clinical parameters, and survival.

Results

The mean vitamin D concentration was below our laboratory's lower limit of normal (P < 0.0001) and did not change during the course of the disease. The concentrations were higher in patients with bulbar onset (P = 0.003) and were negatively associated with body mass index (BMI) (P = 0.0095). Models with ALSFRS‐R (ALS Functional Rating Scale‐Revised) and BMI as a covariates showed that vitamin D concentrations predicted worse prognosis.

Conclusion

The distribution of vitamin D concentrations in our cohort was consistent with previous reports. Surprisingly, we noted a negative effect of higher vitamin D levels on prognosis in ALS. More detailed research is warranted to determine whether manipulation of vitamin D could be beneficial to patients.
The impact of septoplasty on health‐related quality of life in paediatric patients
Authors: Anderson K. , Ritchie K. , Chorney J.M. , Bezuhly M. , Hong P.
Published: June 2015

Objectives

To assess the impact that septoplasty had on health‐related quality of life (HRQoL) in paediatric patients and to determine whether there were patient characteristics that predicted better outcomes.

Design

Retrospective cohort study.

Setting

Academic paediatric otolaryngology practice.

Participants

All paediatric patients who underwent septoplasty during the study period.

Main outcome measures

The current HRQoL was assessed using the Paediatric Quality of Life Inventory (PedsQL). The Glasgow Children's Benefit Inventory (GCBI) was used to evaluate the perceived change in HRQoL following septoplasty.

Results

A total of 29 patients (16 boys, mean age 13 years) and their caregivers responded (response rate of 72.5%). There was a statistically significant improvement in HRQoL following septoplasty, as demonstrated by the positive mean GCBI subscores and the total GCBI score (35.1, sd = 28.4). The total mean PedsQL score for child self‐report was 95.2 (sd = 6.9) and for parent‐proxy report was 91.8 (sd = 8.6), which indicated good current HRQoL. The enhancement in HRQoL post‐septoplasty was moderately correlated with self‐reported degree of nasal obstruction pre‐septoplasty (r = 0.621 for total GCBI). Also, there were differences in GCBI scores between the groups of children who wanted to have the surgery versus those who did not want to have the surgery.

Conclusions

There was a significant positive change in HRQoL following paediatric septoplasty in our study population. Children who reported more severe nasal obstruction and those who wanted to have the surgery were more likely to experience enhancement of HRQoL following their surgery.
Bone mineral density measurements in otosclerosis using dual‐energy X‐ray absorptiometry
Authors: Tonuk S.B. , Koybasi S. , Bicer Y.O. , Alkan Temel S.
Published: June 2015

Objectives

This study aims to evaluate patients with otosclerosis with respect to bone mineral density (BMD) at different regions of interest (ROI), using dual‐energy X‐ray absorptiometry (DXA).

Design

Cross‐sectional controlled study.

Setting

Tertiary referral hospital.

Participants

The patients with a definite diagnosis of otosclerosis confirmed intra‐operatively were defined as the study group (n = 30). The control group consisted of volunteer, healthy subjects with normal hearing (n = 43).

Main outcome measures

Following an audiometric evaluation, a venous blood sample was obtained and a single BMD measurement using DXA was applied to each participant.

Results

The mean BMD, T and Z scores were higher in the otosclerosis group than in the control group in all the regions considered, but not significantly; only the L2‐L3 lateral BMD and its T and Z scores were significant (P = 0.036, P = 0.029 and P = 0.036, respectively).

Conclusion

This study shows that the BMD does not decrease in the presence of otosclerosis despite its genetic and metabolic relevance with osteoporosis. Concerning the L2‐L3 lateral BMD measurements, the BMD increased in otosclerosis.
Impact of the United Kingdom national bowel cancer awareness campaigns 2012 on colorectal cancer services and patient survival
Authors: Khong T. L. , Naik K. , Sivakumar R. , Shah S.
Published: June 2015

Aim

The UK national bowel cancer awareness campaigns in 2012 were intended to improve survival of patients with colorectal cancer (CRC) by raising public awareness and prompting symptomatic individuals to seek medical attention early. The aim of the present study was to compare the number of CRCs diagnosed, tumour stage at diagnosis, survival and number of investigations performed during the campaigns compared with a similar time period in 2011.

Method

A retrospective study was carried out of 1439 consecutive referrals through the 2‐week wait pathway (2WW) to our colorectal unit during the February and September 2012 campaigns. Patient demographics, number of referrals, investigations performed and newly diagnosed cases of CRC with their respective staging were determined and compared with a group in 2011. Two‐year survival was evaluated by Kaplan–Meier statistics.

Results

Referrals through the 2WW increased by 55–60% and endoscopic and the number of radiological investigations performed increased by over 70% during the awareness campaigns. Although new diagnoses of CRC nearly doubled, the increase in the patients referred meant the diagnostic yield remained low at 6%. The bowel cancer awareness campaigns did not alter the tumour stage at presentation, as over 50% of patients were diagnosed with Stage 3 and 4 CRC and there was no significant difference in 2‐year survival.

Conclusion

The UK bowel cancer awareness campaigns appear to have improved public awareness of CRC and encouraged symptomatic individuals to seek urgent medical attention. The increase in 2WW referrals has not translated into better survival for symptomatic patients, partly due to the proportion presenting with advanced disease.
New indices of arterial stiffness measured from longitudinal motion of common carotid artery in relation to reference methods, a pilot study
Authors: Yli‐Ollila Heikki , Laitinen Tomi , Weckström Matti , Laitinen Tiina M.
Published: June 2015

Background

Longitudinal wall motion of carotid artery is a useful but challenging parameter to measure. In this study, we tested our previously published motion tracking algorithm and validated our method against applanation tonometry measurements.

Methods and Results

We measured the two‐dimensional carotid artery wall motion from 19 healthy subjects and, as a reference, performed applanation tonometry measurements in parallel with the ultrasound study. The results show that peak velocities (R = −0·484; P<0·05) and accelerations (R = −0·524; P<0·05) of the longitudinal motion between intima and adventitia layers exhibit a greater correlation with the arterial stiffness parameters, for example the augmentation index than the corresponding amplitude of the longitudinal motion (R = −0·132; P>0·05). The amplitudes of the longitudinal motion, between intima and adventitia, are related more to the physical size of the subject, as they correlated significantly with the height (R = 0·597; P<0·01) and weight (R = 0·562; P<0·05) of the subject as well as the cross‐sectional dimension of the measured artery (R = 0·611; P<0·01). Furthermore, two new indices have been introduced, Polydeg and RAlength, with which to study the shape of the longitudinal motion curve; both parameters displayed significant correlation with arterial stiffness, for example augmentation index (R = 0·468; P<0·05 and R = 0·609; P<0·01, respectively).

Conclusions

The new longitudinal motion parameters presented here displayed clear potential to be used as novel stiffness indices.
Haemodynamic responses during resistance exercise with blood flow restriction in hypertensive subjects
Authors: Pinto Roberta R. , Polito Marcos D.
Published: June 2015

Purpose

This study aimed to compare haemodynamic responses during resistance exercise with blood flow restriction (BFR) in hypertensive women.

Methods

Twelve hypertensive women undertook three random experimental sessions in the leg‐press exercise: (i) Three sets, eight repetitions, 20% of one‐repetition maximum (1 RM), with BFR; (ii) Three sets, 15 repetitions, 65% of 1 RM, without BFR; and (iii) three sets, 15 repetitions, 20% of 1 RM, without BFR. The BFR was performed using two sphygmomanometers adjusted to fit both thighs. Systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) were measured on a beat‐to‐beat continuous basis.

Results

When compared to the 20% without BFR, the session with BFR presented increased values in all sets for the variables SBP, DBP, CO and SVR, and in the 2nd and 3rd sets for HR. The session with BFR also presented increased values compared to the 65% of 1 RM in the 2nd and 3rd sets for the variables SBP, DBP and HR and in all sets for the variables CO and SVR.

Conclusion

Low‐intensity resistance exercise with BFR can initiate higher haemodynamic and cardiovascular values than traditional high‐intensity resistance exercises in hypertensive women.
Physical fitness levels of adolescents in the Ile de France region: comparisons with European standards and relevance for future cardiovascular risk
Authors: Vanhelst Jérémy , Fardy Paul S. , Chapelot Didier , Czaplicki Grégory , Ulmer Zekya
Published: June 2015

The aim was to assess physical fitness in French schoolchildren in the region of Ile de France and to compare the results with European countries. The relationship between physical fitness and future health profile was of particular interest. Participants were 1851 French youth in the Ile de France region. Cardiorespiratory fitness, muscular endurance, speed, flexibility and speed agility were tested. Independent t‐tests were used to compare differences between different variables. Spearman's rho correlation coefficients assessed the relationship between body mass index, socio‐economic status and physical fitness. Boys were physically fitter than girls with the most significant difference being in agility. Subjects of normal weight have significantly better results than overweight or obese adolescents (+10·9% to 56·1%) (P<0·05). Subjects with high socio‐economic status had better physical fitness than those with low socio‐economic status (+0·5% to 9·4%) (P<0·05). Results also showed that the percentage of adolescents at increased future cardiovascular risk was 15·3% and 10·2% for boys and girls, respectively. Physical fitness in French schoolchildren living in the region of Ile de France is relatively low and unfavourable, especially in girls, when compared with existing European test results. In contrast, the adolescent boys are generally fitter and also above the average of the European data. Introducing a health promotion curriculum in the schools of Ile de France is suggested to improve health and physical fitness.
Effects of blood‐flow‐restricted resistance training on muscle function in a 74‐year‐old male with sporadic inclusion body myositis: a case report
Authors: Jørgensen A. N. , Aagaard P. , Nielsen J. L. , Frandsen U. , Diederichsen L. P.
Published: June 2015

Sporadic inclusion body myositis (sIBM) is a systemic disease that is characterized by substantial skeletal muscle weakness and muscle inflammation, leading to impaired physical function. The objective was to investigate the effect of low‐load resistance exercise with concurrent partial blood flow restriction to the working muscles (blood‐flow‐restricted (BFR) training) in a patient with sIBM. The training consisted of 12 weeks of lower extremity BFR training with low training loads (~25‐RM). The patient was tested for mechanical muscle function and functional capacity before and after 6 and 12 weeks of training. Maximal horizontal gait speed increased by 19%, which was accompanied by 38–92% improvements in mechanical muscle function (maximal isometric strength, rate of force development and muscle power). In conclusion, BFR training was well tolerated by the patient with sIBM and led to substantial improvements in mechanical muscle function and gait speed.
Loaded treadmill walking and cycle ergometry to assess work capacity: a retrospective comparison in 424 firefighters
Authors: Carlén Anna , Åström Aneq Meriam , Nylander Eva , Gustafsson Mikael
Published: June 2015

The fitness of firefighters is regularly evaluated using exercise tests. We aimed to compare, with respect to age and body composition, two test modalities for the assessment work capacity. A total of 424 Swedish firefighters with cycle ergometer (CE) and treadmill (TM) tests available from Jan 2004 to Dec 2010 were included. We compared results from CE (6 min at 200 W, 250 W or incremental ramp exercise) with TM (6 min at 8° inclination, 4·5 km h−1 or faster, wearing 24‐kg protective equipment). Oxygen requirements were estimated by prediction equations. It was more common to pass the TM test and fail the supposedly equivalent CE test (20%), than vice versa (0·5%), P<0·001. Low age and tall stature were significant predictors of passing both CE and TM tests (P<0·05), while low body mass predicted accomplishment of TM test only (P = 0·006). Firefighters who passed the TM but failed the supposedly equivalent CE test within 12 months had significantly lower body mass, lower BMI, lower BSA and shorter stature than did those who passed both tests. Calculated oxygen uptake was higher in TM tests compared with corresponding CE tests (P<0·001). Body constitution affected approval differently depending on the test modality. A higher approval rate in TM testing suggests lower cardiorespiratory requirements compared with CE testing, even though estimated oxygen uptake was higher during TM testing. The relevance of our findings in relation to the occupational demands needs reconsidering.
Right and left heart dysfunction predict mortality in pulmonary hypertension
Authors: Henein Michael Y. , Grönlund Christer , Tossavainen Erik , Söderberg Stefan , Gonzalez Manuel , Lindqvist Per
Published: June 2015

In pulmonary hypertension (PH), the right heart dysfunction is a strong predictor of adverse clinical outcome, while the role of the left heart is not fully determined. The aim of this study was to identify predictors of mortality in precapillary PH including measures of both right and left heart function. We studied 34 patients (mean age 64 ± 13, range 31–82 years, 24 females) with precapillary PH, all of whom underwent detailed Doppler echocardiographic examination of the right and left heart function using conventional and speckle‐tracking echocardiography. Patients were followed up for up to 8 years (mean 4·2 ± 1·9 years). At follow‐up, 16 patients survived. Left ventricular (LV) filling time (P = 0·007), pulmonary artery acceleration time (P = 0·009), right atrial pressure (RAP) (P<0·001) and tricuspid regurgitation (TR) severity (P = 0·007) were worse in the deceased group. RV global longitudinal strain (GLS) (P = 0·001), RAP (P≤0·001), LV filling time (P<0·001) and TR severity (P<0·001) were the most accurate predictors, having the largest AUC (>0·65) and carried the highest risk for mortality (P<0·001 for all). The strongest predictors of mortality in precapillary PH indirectly reflect both left and right heart dysfunction including atrial structure and function disturbances. While an interaction pattern is observed, it needs to be confirmed in a larger cohort.
Anti‐proliferative effects of γ‐tocotrienol are associated with suppression of c‐Myc expression in mammary tumour cells
Authors: Parajuli P. , Tiwari R. V. , Sylvester P. W.
Published: June 2015

Objectives

Aberrant c‐Myc activity plays a central role in cancer transformation. γ‐tocotrienol is a member of the vitamin E family that displays potent anti‐cancer activity. Here, studies were conducted to determine the role of c‐Myc in mediating anti‐proliferative effects of γ‐tocotrienol in mammary cancer cells.

Materials and methods

Treatment effects on mouse +SA and human MCF‐7 mammary cancer cell proliferation were determined by MTT assay and Ki‐67 staining. Protein expression was determined by western blot analysis. Immunofluorescence staining and qRT‐PCR were used to characterize cellular c‐Myc and MYC levels respectively.

Results

Anti‐proliferative effects of γ‐tocotrienol were associated with reduction in total c‐Myc and phosphorylated‐c‐Myc‐serine 62, and increase in phosphorylated‐c‐Myc‐threonine 58 levels. γ‐tocotrienol also reduced PI3K/Akt/mTOR and Ras/MEK/Erk mitogenic signalling, cyclin D1 and cyclin‐dependent kinase 4 levels, and increased p27 levels. However, γ‐tocotrienol had no effect on MYC mRNA levels. γ‐tocotrienol also increased levels of FBW7 (E3 ligase that initiates ubiquitination of c‐Myc), but had no effect on serine/threonine phosphatase PP2A or isomerase Pin 1 levels. Combined treatment with GSK3α/β inhibitor LiCl or proteasome inhibitor MG132 blocked γ‐tocotrienol‐induced reductions in c‐Myc.

Conclusions

These findings indicate that anti‐proliferative effects of γ‐tocotrienol are associated with reduction in c‐Myc that results from increase in GSK‐3α/β‐dependent ubiquitination and degradation, rather than from reduction in c‐Myc synthesis in +SA and MCF‐7 mammary cancer cells.
Serum zinc concentration in cystic fibrosis patients with CFTRI1234V mutation associated with pancreatic sufficiency
Authors: AbdulWahab Atqah , Abushahin Ahmed , Allangawi Mona , Chandra Prem , Abdel Rahman Mohamed Osman , Soliman Ashraf
Published: June 2015

Objective

To determine serum zinc (Zn) level among cystic fibrosis (CF) patients with homozygous CFTR I1234V mutation associated with pancreatic sufficiency (PS).

Methods

A cross‐sectional study was conducted including both pediatric and adult CF patients. Data on age, weight, height, body mass index (BMI), BMI Z‐score, FEV1, and chronic Pseudomonas aeruginosa infection were collected. Serum Zn, albumin, and total proteins were measured and analyzed.

Results

Forty‐five CF patients with homozygous CFTR I1234V mutation belonging to a large Arab kindred tribe and eight CF patients with other mutations associated with pancreatic insufficiency (PI). Patient's age ranged from 2 to 49 years with a mean age of 15.1 ± 9.1 years and mean plasma Zn of 0.78 ± 0.15 mcg/mL. Seven (13.2%) patients with CFTR I1234V and PS had low Zn levels (<0.6 mcg/mL). Mean age among Zn deficient group was significantly older. The mean FEV1 in the deficient group was found to be insignificant low. Persistent P. aeruginosa colonization was more prevalent in Zn deficient group. BMI Z‐scosre of CF patients were positively correlated with Zn levels. Forty‐five healthy subjects belonging to the same Arab tribe were selected in order to assess their Zn levels and their mean plasma Zn of 0.84 ± 0.11 mcg/mL (range 0.65–1.1 mcg/mL) with mean age 20.4 ± 10.1 years (range 6–40 years).

Conclusion

These findings suggest that Zn deficiency can occur in CF patients with PS. The association of Zn levels and the frequency of P. aeruginosa isolated in CF patients need further investigation.
Structural Change
Authors: Storm Servaas
Published: June 2015

Development economics appears to have come full circle, as interest in and concern for industrialization have made a comeback, echoing major concerns of the early development economists. However, when it comes to the practice of industrialization strategy and industrial policy, the default recommendation is still the market and static comparative advantage — the main task of governments, in the new view, is to impose institutional reforms and improve governance so as to allow markets to perform more efficiently. History is thus about to repeat itself, but this time as farce, because no country has managed to climb the industrial ladder just by ‘getting prices and institutions right’. We have to re‐learn the old lessons of how to industrialize, learning from past mistakes and taking into account new challenges posed by today's global realities.
Surveillance colonoscopy for colitis‐associated dysplasia and cancer in ulcerative colitis patients
Authors: Hata Keisuke , Kishikawa Junko , Anzai Hiroyuki , Shinagawa Takahide , Kazama Shinsuke , Ishii Hiroaki , Nozawa Hiroaki , Kawai Kazushige , Kiyomatsu Tomomichi , Tanaka Junichiro , Tanaka Toshiaki , Nishikawa Takeshi , Otani Kensuke , Yasuda Koji , Yamaguchi Hironori , Ishihara Soichiro , Sunami Eiji , Kitayama Joji , Watanabe Toshiaki
Published: June 2015

Long‐standing ulcerative colitis patients are known to be at high risk for the development of colorectal cancer. Therefore, surveillance colonoscopy has been recommended for these patients. Because colitis‐associated colorectal cancer may be difficult to identify even by colonoscopy, a random biopsy method has been recommended. However, the procedure of carrying out a random biopsy is tedious and its effectiveness has also not yet been demonstrated. Instead, targeted biopsy with chromoendoscopy has gained popularity in European and Asian countries. Chromoendoscopy is generally considered to be an effective tool for ulcerative colitis surveillance and is recommended in the guidelines of the British Society of Gastroenterology and the European Crohn's and Colitis Organisation. Although image‐enhanced endoscopy, such as narrow‐band imaging and autofluorescence imaging, has been investigated as a potential ulcerative colitis surveillance tool, it is not routinely applied for ulcerative colitis surveillance in its present form. The appropriate intervals of surveillance colonoscopy have yet to be determined. Although the Japanese and American guidelines recommend annual or biannual colonoscopy, the British Society of Gastroenterology and the European Crohn's and Colitis Organisation stratified their guidelines according to the risks of colorectal cancer. A randomized controlled trial comparing random and targeted biopsy methods has been conducted in Japan and although the final analysis is still ongoing, the results of this study should address this issue. In the present review, we focus on the current detection methods and characterization of dysplasia/cancer and discuss the appropriate intervals of colonoscopy according to the stratified risks.
Predicting extremely preterm children's school performance by transient abnormal neurology?
Authors: Aarnoudse‐Moens Cornelieke S H
Published: June 2015

This commentary is on the original article by Harmon et al. on pages 865–871 of this issue.
Brain reward‐system activation in response to anticipation and consumption of palatable food is altered by glucagon‐like peptide‐1 receptor activation in humans
Authors: van Bloemendaal L. , Veltman D. J. , ten Kulve J. S. , Groot P. F. C. , Ruhé H. G. , Barkhof F. , Sloan J. H. , Diamant M. , Ijzerman R. G.
Published: June 2015

Aim

To test the hypothesis that food intake reduction after glucagon‐like peptide‐1 (GLP‐1) receptor activation is mediated through brain areas regulating anticipatory and consummatory food reward.

Methods

As part of a larger study, we determined the effects of GLP‐1 receptor activation on brain responses to anticipation and receipt of chocolate milk versus a tasteless solution, using functional MRI (fMRI). Obese subjects with type 2 diabetes, and obese and lean subjects with normoglycaemia (n = 48) underwent three fMRI sessions at separate visits with intravenous infusion of the GLP‐1 receptor agonist exenatide, exenatide with prior GLP‐1 receptor blockade by exendin‐9‐39 or placebo, during somatostatin pituitary‐pancreatic clamps.

Results

Body mass index negatively correlated with brain responses to receipt of chocolate milk and positively correlated with anticipation of receipt of chocolate milk in brain areas regulating reward, appetite and motivation. Exenatide increased brain responses to receipt of chocolate milk and decreased anticipation of receipt of chocolate milk compared with placebo, paralleled by reductions in food intake. Exendin‐9‐39 largely prevented these effects.

Conclusions

Our findings show that GLP‐1 receptor activation decreases anticipatory food reward, which may reduce cravings for food and increases consummatory food reward, which may prevent overeating.
Sitagliptin improves glycaemic excursion after a meal or after an oral glucose load in Japanese subjects with impaired glucose tolerance
Authors: Kaku K. , Kadowaki T. , Terauchi Y. , Okamoto T. , Sato A. , Okuyama K. , Arjona Ferreira J. C. , Goldstein B. J.
Published: June 2015

Aims

To evaluate the efficacy and tolerability of sitagliptin in subjects with impaired glucose tolerance (IGT).

Methods

In a double‐blind, parallel‐group study, 242 Japanese subjects with IGT, determined by a 75‐g oral glucose tolerance test (OGTT) at week −1, were randomized (1 : 1 : 1) to placebo (n = 83), sitagliptin 25 mg (n = 82) or 50 mg (n = 77) once daily for 8 weeks. Glycaemic variables were assessed using another OGTT at week 7 and meal tolerance tests (MTTs) at weeks 0 and 8. Primary and secondary endpoints were percent change from baseline in glucose total area under the curve 0–2 h (AUC0–2 h) during the MTT and OGTT, respectively.

Results

Least squares mean percent change from baseline in glucose AUC0–2 h during the MTT were −2.4, −9.5 and −11.5%, and during the OGTT were −3.7, −21.4 and −20.1% with placebo, sitagliptin 25 mg once daily, and 50 mg once daily, respectively (p < 0.001 for either sitagliptin dose vs placebo in both tests). Sitagliptin treatment enhanced early insulin response during the OGTT and decreased total insulin response, assessed as the total AUC0–2 h during the MTT. Sitagliptin treatment also suppressed glucagon response during the MTT. The incidence of adverse events, including hypoglycaemia, was low and generally similar in all treatment groups.

Conclusions

Treatment with sitagliptin significantly reduced glucose excursions during both an MTT and an OGTT; this effect was associated with an increase in early insulin secretion after oral glucose loading as well as a blunted glucagon response during an MTT. Sitagliptin was generally well tolerated in subjects with IGT.
Importance of End‐Diastolic Rather than End‐Systolic Right Atrial Size in Chronic Pulmonary Hypertension
Authors: Lopez‐Candales Angel , Palm Denada S. , Lopez Francisco R. , Perez Reynerio , Candales Maria D.
Published: June 2015

Background

Right atrial (RA) enlargement has been associated with worse clinical outcomes in chronic pulmonary hypertension (cPH) patients. Even though current guidelines only recommend measurement of RA dimensions at the end of ventricular systole in these patients, there is paucity of information regarding the potential utility of RA dimensions obtained at the end of ventricular diastole.

Methods

In this retrospective study, standard echocardiographic data were collected from 80 studies. The population studied was divided into Group I that consisted of 35 patients (52 ± 10 years) without PH while Group II included 45 patients (56 ± 14 years; P = 0.2) with cPH. RA measurements were obtained not only at the end of ventricular systole, but also at the end of ventricular diastole to determine which RA measurement was more indicative of abnormal right ventricular afterload.

Results

Even though all RA measurements were abnormal, RA area (>8.4 cm2) measured at the end of ventricular diastole was the most useful RA variable to identify cPH patients with elevated pulmonary pressures (P < 0.0001) and with an abnormal pulmonary vascular resistance (P = 0.001).

Conclusions

Based on these results, it appears that isolated RA measurements made at the end of ventricular systole are insufficient to fully explain the hemodynamic load of cPH. Additional studies are now required to determine whether sequential monitoring of the composite change in RA dimensions that occur throughout the cardiac cycle over time correlates better with response to vasodilator therapy and overall clinical outcomes.
Should the Celiac Artery Be Used as an Anatomical Marker for the Descending Thoracic Aorta During Transesophageal Echocardiography?
Authors: Zhou Li , Jariwala Nikhil , Frazin Leon
Published: June 2015

Background

Transesophageal echocardiography (TEE) is a pivotal tool for diagnosis of aortic diseases. However, there are no suitable anatomical markers to describe location of disease in the descending thoracic aorta. In the past, we have used distance from the dental incisors to report location of disease, but this has no anatomical relevance. Our recent data comparing TEE and computed tomography (CT) have shown that the celiac artery is an accurate anatomical marker where disease is described as distance relative to the celiac artery. This study was designed to determine whether utilization of the celiac artery as an anatomical marker with TEE is practically feasible.

Methods

A clinical trial was performed at the University of Illinois at Chicago and the Jesse Brown VA Medical Center. A total of 160 patients referred for TEE were consecutively enrolled over a period of 18 months.

Results

The celiac artery was visualized in 97% of the patients.

Conclusions

The celiac artery is a reliable anatomical marker with TEE and should be routinely used to locate disease in the descending thoracic aorta.
Correlation between Pulmonary Artery Pressure Measured by Echocardiography and Right Heart Catheterization in Patients with Rheumatic Mitral Valve Stenosis (A Prospective Study)
Authors: Sohrabi Bahram , Kazemi Babak , Mehryar Alireza , Teimouri‐Dereshki Amir , Toufan Mehrnoush , Aslanabadi Naser
Published: June 2015

Introduction

Right heart catheterization (RHC) remains the gold standard for hemodynamic assessment of the right heart and pulmonary artery. However, this is an invasive tool, and noninvasive alternatives such as transthoracic echocardiography (TTE) are preferable. Nonetheless, the correlation between measurements by TTE and RHC are debated. In this study, we prospectively examined the correlation between systolic and mean pulmonary artery pressures (sPAP and mPAP) measured by RHC and TTE in patients with hemodynamically significant rheumatic mitral stenosis (MS).

Material and Methods

Three hundred patients with hemodynamically significant MS undergoing TTE who were scheduled to undergo RHC within 24 hours were analyzed. PAP measurements were taken for all patients by RHC (sPAPRHC, mPAPRHC). Maximum velocity of tricuspid regurgitation (TR) jet obtained by continuous‐wave Doppler with adding right atrial (RA) pressure was used for measuring sPAP by TTE (sPAPTRVmax). Mean PAP was measured using either pulmonary artery acceleration time (mPAPPAAT) method or by adding RA pressure to velocity–time integral of TR jet (mPAPTRVTI).

Results

A good correlation between sPAPRHC and sPAPTRVmax (r = 0.89, P < 0.001), between mPAPRHC and mPAPPAAT (r = 0.9, P < 0.001), and between mPAPRHC and mPAPTRVTI (r = 0.92, P < 0.001) was found. Sensitivity and specificity of sPAPTRVmax in detecting pulmonary hypertension (PH) were 92.8% and 86.6% and of mPAPPAAT were 94.1% and 73.3%, respectively.

Conclusion

The noninvasive assessment of sPAP and mPAP by TTE correlates well with invasive measurements and has an acceptable specificity and sensitivity in detecting PH in patients with hemodynamically significant MS.
Transient Apical Thickening Following Apical Ballooning Syndrome: A Case Series
Authors: Abudiab Muaz M. , Wilansky Susan , Lester Steven J. , Yousefzai Rayan , Tyler Rochelle , Tajik A. Jamil
Published: June 2015

The authors describe transient apical thickening mimicking apical hypertrophic cardiomyopathy following apical ballooning syndrome. These findings are observed on multimodality cardiac imaging and appear to constitute a novel entity. Possible pathophysiologic mechanisms are explored.
Screening of Congenital Heart Diseases by Three‐Dimensional Ultrasound Using Spatiotemporal Image Correlation: Influence of Professional Experience
Authors: Novaes Juliana Y. , Zamith Marina M. , Araujo Júnior Edward , de Sá Barreto Enoch Q. , Barros Fernanda S. B. , Moron Antonio F.
Published: June 2015

Objective

To evaluate the feasibility of the use of spatiotemporal image correlation (STIC) as a screening program for congenital heart disease and the influence of professional experience in those examinations.

Methods

This prospective cross‐sectional study included 64 pregnant women at gestational age between 20 and 34 weeks, and 12 physician participants who were divided into two groups: group 1—“STIC specialist”; and group 2—“STIC nonspecialist.” Volumes were analyzed to obtain the five axial views for optimal fetal heart screening: abdominal situs, four‐chamber view (4CV), outflow tract views (OTV), and three vessels and trachea view (3VT). The chi‐square test (χ2) was used to compare the group's results and kappa coefficient to evaluate inter‐ and intra‐observer reproducibility.

Results

Spatiotemporal image correlation volume acquisition was successful in 97.3% of cases in which it was attempted (group 1: 100%; group 2:95%). A total of 197 STIC volumes were used in this study. In 71%, it was possible to demonstrate 4CV and OTV (group 1:88.9%; group 2:58.6%). 4CV, OTV, and 3VT were visualized in 55.3% of the volume dataset (group 1:74.1% and group 2:42.2%). In 49% of volumes, all five views for optimal fetal heart screening were seen (group 1:67%; group 2: 36%). A good inter‐observer agreement was found in all cardiac views and a good intra‐observer agreement in most of views except in OTV.

Conclusion

We believe that STIC can be used as a tool to improve the cardiac screening examination of the fetus. Professional experience was the most important influence in the image quality of the STIC volume.
Three‐Dimensional Transesophageal Echocardiography in the Anatomical Assessment of Isolated Parachute Mitral Valve in an Adult Patient
Authors: López‐Pardo Francisco , Urbano‐Moral Jose Angel , González‐Calle Antonio , Laviana‐Martinez Fernando , Esteve‐Ruiz Iris , Lagos‐Degrande Oscar , López‐Haldon Jose E.
Published: June 2015

Parachute mitral valve (PMV) is a rare congenital anomaly of the mitral valve apparatus usually evidenced in infants and young children. Adult presentation is extremely rare and is generally mild in terms of mitral stenosis. A 73‐year‐old woman was admitted to the emergency department due to progressive dyspnea, with NYHA functional class IV symptoms on presentation. The echocardiographic examination identified a PMV with moderate mitral stenosis and a secondary smaller subvalvular mitral orifice. The report shows the usefulness of three‐dimensional transesophageal echocardiography in the detection and quantification of this rare anomaly.
Influence of different aetiologies on clinical course and outcome in patients with dilated cardiomyopathy
Authors: Pankuweit Sabine , Lüers Claus , Richter Anette , Ruppert Volker , Gelbrich Götz , Maisch Bernhard ,   the German Competence Network Heart Failure
Published: June 2015

Background

The clinical phenotype dilated cardiomyopathy is assumed to be the endstage of a multifactorial aetiopathogenetic pathophysiology which includes a not satisfactorily defined group of patients with inflammatory cardiomyopathy.

Methods

Within the German Competence Network Heart Failure patients with heart failure due to dilated cardiomyopathy of viral/inflammatory (DCMi/v) and nonviral/noninflammatory (DCM) aetiology were enrolled. After 1 year 237 patients (180 male/57 female) were re‐examined including complete clinical work‐up. The association of different clinical courses with the time from initial diagnosis of heart failure (newly: ≤ 1 year; late: > 1 year) was investigated.

Results

After 1‐year‐follow‐up New York Heart Association (NYHA) class (by −0·48 in newly diagnosed DCM and −0·82 in newly diagnosed DCMi/v in addition to −0·24 in late diagnosed DCM and −0·17 in late diagnosed DCMi/v) as well as left ventricular ejection fraction (+14% in newly diagnosed DCM and DCMi/v and +6% in later diagnosed DCM and DCMi/v) were significantly improved in all patients. In patients with early diagnosed dilated cardiomyopathy a strong improvement of NYHA class could be demonstrated.

Conclusions

This study demonstrates for the first time a significant interaction between duration of disease, NYHA class and left ventricular ejection fraction in patients with DCM. Our results clearly demonstrate that in patients with DCM an early diagnosis within 1 year after occurrence of clinical signs is associated with a strong improvement in the clinical course, whereas late diagnosis results in a loss of change in clinical course and outcome.
SALARIES OR PIECE RATES: ON THE ENDOGENOUS MATCHING OF HARVEST WORKERS AND CROPS
Authors: Kandilov Ivan , Vukina Tomislav
Published: June 2015

The objective of this paper is to determine whether the choice of payment schemes (hourly vs. piece rates) is systematically related to the workers' risk aversion and ability. We derive the equilibrium relationship between agents' risk aversion and ability and the power of incentives (payment scheme) in a market where many heterogeneous principals and agents are endogenously matched. The equilibrium matching between principals and agents depends on the traits and is critical in determining the contract choice. Using confidential data from the National Agricultural Workers Survey (NAWS), we find evidence of matching between agricultural workers and the riskiness of their jobs (crops they harvest) based on workers' risk aversion and no matching based on ability. When controlling for matching, we find strong evidence that high risk‐averse workers choose hourly rates and low risk‐averse workers choose piece rates. We also found that high ability types choose piece rates and low ability types choose hourly rates but the evidence is weaker. (JEL J33, D82, Q12)
The scaling of parasite biomass with host biomass in lake ecosystems: are parasites limited by host resources?
Authors: Lagrue Clément , Poulin Robert
Published: June 2015

The standing crop biomass of different populations or trophic levels reflects patterns of energy flow through an ecosystem. The contribution of parasites to total biomass is often considered negligible; recent evidence suggests otherwise, although it comes from a narrow range of natural systems. Quantifying how local parasite biomass, whether that of a single species or an assemblage of species sharing the same host, varies across localities with host population biomass, is critical to determine what constrains parasite populations. We use an extensive dataset on all free‐living and parasitic metazoan species from multiple sites in New Zealand lakes to measure parasite biomass and test how it covaries with host biomass. In all lakes, trematodes had the highest combined biomass among parasite taxa, ranging from about 0.01 to 0.25 g m−2, surpassing the biomass of minor free‐living taxa. Unlike findings from other studies, the life stage contributing the most to total trematode biomass was the metacercarial stage in the second intermediate host, and not sporocysts or rediae within snail first intermediate hosts, possibly due to low prevalence and small snail sizes. For populations of single parasite species, we found no relationship between host and parasite biomass for either juvenile or adult nematodes. In contrast, all life stages of trematodes had local biomasses that correlated positively with those of their hosts. For assemblages of parasite species sharing the same host, we found strong relationships between local host population biomass and the total biomass of parasites supported. In these host–parasite biomass relationships, the scaling factor (slope in log‐log space) suggests that parasites may not be making full use of available host resources. Host populations appear capable of supporting a little more parasite biomass, and may be open to expansion of existing parasites or invasion by new ones.
Who flies first? – habitat‐specific phenological shifts of butterflies and orthopterans in the light of climate change: a case study from the south‐eastMediterranean
Authors: ZOGRAFOU KONSTANTINA , ADAMIDIS GEORGE C. , GRILL ANDREA , KATI VASSILIKI , WILSON ROBERT J. , HALLEY JOHN M.
Published: June 2015

1. Insects undergo phenological change at different rates, showing no consistent trend between habitats, time periods, species or groups. Understanding how and why this variability occurs is crucial.

2. Phenological patterns of butterflies andOrthoptera were analysed using a novel approach ofstandardised major axis (SMA) analysis. It was investigated whether: (i) phenology (the mean date and duration of flight) of butterflies andOrthoptera changed from one survey (1998 and 1999 respectively) to another (2011), (ii) the rate at which phenology changed differed between taxa and (iii) phenological change was significantly different across habitat types (agriculture fields, grasslands, and forests). Using the 2011 dataset, we investigated relationships between habitat‐specific variables and species phenology.

3. For both groups, late‐emerging species had an advanced onset on the second survey while the duration showed no consistent trend for butterflies and did not change forOrthoptera. Although the rate at which phenology changed was consistent between the two groups, at the habitat level, a longer duration of flight period emerged for butterflies in agriculture fields whileOrthoptera showed no differentiation in flight duration between habitats. We found an earlier emergence of butterflies in grasslands compared to forests, attributed to habitat‐specific temperature, whereas spatial variation in humidity had a significantly lower effect on butterflies' phenology in grasslands compared to forests. A gradual delay of butterfly appearances as the canopy cover increased was also found.

4. The utility ofSMAanalysis was demonstrated in phenological studies and evidence was detected that both habitat type and habitat‐specific variables refine species' phenological responses.
Anti‐adherence and bactericidal activity of sphingolipids against Streptococcus mutans
Authors: Cukkemane Nivedita , Bikker Floris J. , Nazmi Kamran , Brand Henk S. , Sotres Javier , Lindh Liselott , Arnebrant Thomas , Veerman Enno C. I.
Published: June 2015

This study evaluated the anti‐biofilm activity of sphingosine, phytosphingosine (PHS), and sphinganine for: (i) anti‐adherence activity on hydroxyapatite (HA) surfaces; and (ii) bactericidal activity on different Streptococcus mutans phenotypes (i.e. planktonic cells and cells from a disrupted biofilm). For this, HA discs treated with sphingolipids were incubated with S. mutans and the number of adherent cells was evaluated by both culture and confocal microscopy. Sphinganine strongly inhibited bacterial adherence by 1000‐fold compared with an untreated surface. Phytosphingosine and sphingosine inhibited bacterial adherence by eight‐ and five‐fold, respectively, compared with an untreated surface. On saliva‐coated HA, sphinganine and PHS inhibited bacterial adherence by 10‐fold. Bactericidal activity of sphingolipids was evaluated by culture. For biofilms, the strongest bactericidal activity was exhibited by sphingosine compared with PHS and sphinganine. At a concentration of 12.5 μg ml−1, PHS and sphingosine were profoundly effective against planktonic and disrupted biofilms; and sphinganine reduced the number of cells in planktonic form by 100‐fold and those derived from a disrupted biofilm by 1000‐fold. Atomic force microscopy studies suggested that mechanical stability does not appear to be a factor relevant for anti‐fouling activity. The results suggest that sphingolipids may be used to control oral biofilms, especially those loaded with S. mutans.
Do stressful conditions make adaptation difficult? Guppies in the oil‐polluted environments of southern Trinidad
Authors: Rolshausen Gregor , Phillip Dawn A. T. , Beckles Denise M. , Akbari Ali , Ghoshal Subhasis , Hamilton Patrick B. , Tyler Charles R. , Scarlett Alan G. , Ramnarine Indar , Bentzen Paul , Hendry Andrew P.
Published: June 2015

The ability of populations to rapidly adapt to new environments will determine their future in an increasingly human‐modified world. Although meta‐analyses do frequently uncover signatures of local adaptation, they also reveal many exceptions. We suggest that particular constraints on local adaptation might arise when organisms are exposed to novel stressors, such as anthropogenic pollution. To inform this possibility, we studied the extent to which guppies (Poecilia reticulata) show local adaptation to oil pollution in southern Trinidad. Neutral genetic markers revealed that paired populations in oil‐polluted versus not‐polluted habitats diverged independently in two different watersheds. Morphometrics revealed some divergence (particularly in head shape) between these environments, some of which was parallel between rivers. Reciprocal transplant experiments in nature, however, found little evidence of local adaptation based on survival and growth. Moreover, subsequent laboratory experiments showed that the two populations from oil‐polluted sites showed only weak local adaptation even when compared to guppies from oil‐free northern Trinidad. We conclude that guppies show little local adaptation to oil pollution, which might result from the challenges associated with adaptation to particularly stressful environments. It might also reflect genetic drift owing to small population sizes and/or high gene flow between environments.
Treatment of chronic septic osteoarthritis of the antebrachiocarpal joint with a synovial‐cutaneous fistula utilising arthroscopic lavage combined with ultrasonic assisted wound therapy and vacuum assisted closure with a novel wound lavage system
Authors: Rettig M. J. , Lischer C. J.
Published: June 2015

This case report describes the successful management of a chronic multidrug resistant infection of the antebrachiocarpal joint with a synovial‐cutaneous fistula 7 weeks after initial trauma in a 14‐year‐old Icelandic stallion. Resolution of the multiresistantEnterobacter cloacae(extended‐spectrum β‐lactamase) infection from the joint and complete closure of the fistula was achieved by arthroscopic lavage under general anaesthesia repeated on 3 occasions, surgical debridement, ultrasound assisted wound therapy and vacuum assisted closure. Lavage of the wound with the vacuum assisted closure in place was facilitated via the novel VeraFlo instillation system consisting of specially designed therapeutic regulated accurate care pad tubing. The combination of these therapies resulted in resolution of the septic arthritis and fistula. Six weeks after admission the horse was discharged from the hospital with a completely healed wound and was not lame at a walk.
Where does it hurt? Problems with interpretation of regional and intra‐synovial diagnostic analgesia
Authors: Pilsworth R. , Dyson S.
Published: June 2015

Detailed clinical evaluation and diagnostic analgesia are crucial for accurate lameness diagnosis. This review discusses the ways in which local analgesic techniques can cause confusion and highlights how important it is to recognise that the majority of methods are less specific than was formerly thought. Interpretation of responses must be done together with the results of clinical examination and careful assessment of diagnostic images. With the knowledge of false negative and false positive results of local analgesic techniques and the recognition that there may be more than one focus of pain contributing to lameness, it is still possible to reach accurate diagnoses, provided that a logical, thoughtful approach is utilised.